Interaction effects in the association between methadone maintenance therapy and experiences of racial discrimination in US healthcare settings
Interaction effects in the association between methadone maintenance therapy and experiences of racial discrimination in US healthcare settings
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DOI：
10.1371/journal.pone.0228755
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发表时间：
2020-02-06
期刊：
影响因子：
3.7
通讯作者：
Zaller, Nick
中科院分区：
文献类型：
--
作者：
Pro, George;Zaller, Nick
美沙酮维持治疗（MMT）结果的差异受到了有限的关注，但有重要的负面结果与MMT值得调查。种族歧视在医疗环境中很常见，并影响阿片类药物使用障碍（OUD）治疗和合并症。然而，种族/族裔本身并不能完全解释歧视的经历。MMT仍然受到高度污名化，可能会加剧种族/民族对医疗保健环境中歧视的影响。我们试图量化MMT和种族/民族之间的种族歧视的经验，在美国国家sample.MethodsWe使用的酒精和相关条件-III（2012-2013年）的国家流行病学调查之间的差异关联，以确定一个子集的人一生OUD谁曾经使用MMT（调查n = 766;加权人口n = 5,276,507）。我们使用多变量逻辑回归来模拟过去一年在医疗环境中的种族歧视经历。我们纳入了种族/民族和MMT状态之间的相互作用项，以确定种族/民族组内歧视的几率（MMT与无MMT [参考]）。我们使用的调查程序与权重占父研究的复杂的调查design. FindingsTwenty百分之我们的样本经历了种族歧视的医疗设置在过去的一年。歧视在曾经使用MMT的人（x（2）= 10.00，p = 0.001）和少数种族/民族（x（2）= 23.15，p
BackgroundDisparities in methadone maintenance therapy (MMT) outcomes have received limited attention, but there are important negative outcomes associated with MMT that warrant investigation. Racial discrimination is common in healthcare settings and affects opioid use disorder (OUD) treatment and comorbidities. However, race/ethnicity alone may not fully explain experiences of discrimination. MMT remains highly stigmatized and may compound the effect of race/ethnicity on discrimination in healthcare settings. We sought to quantify differential associations between MMT and experiences of racial discrimination between racial/ethnic groups in a U.S. national sample.MethodsWe used the National Epidemiologic Survey on Alcohol and Related Conditions-III (2012-2013) to identify a subset of individuals with a lifetime OUD who had ever used MMT (survey n = 766; weighted population n = 5,276,507). We used multivariable logistic regression to model past-year experience of racial discrimination in a healthcare setting. We included an interaction term between race/ethnicity and MMT status to identify the odds of discrimination (MMT vs. no MMT [referent]) within racial/ethnic groups. We used survey procedures with weights to account for the parent study's complex survey design.FindingsTwenty-two percent of our sample experienced racial discrimination in a healthcare setting in the past year. Discrimination was more common among those who had ever used MMT (x(2) = 10.00, p = 0.001) and racial/ethnic minorities (x(2) = 23.15, p