The Washington circle engagement performance measures' association with adolescent treatment outcomes
The Washington circle engagement performance measures' association with adolescent treatment outcomes
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DOI：
10.1016/j.drugalcdep.2012.01.011
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发表时间：
2012-08-01
影响因子：
4.2
通讯作者：
Godley, Mark D.
中科院分区：
文献类型：
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作者：
Garnick, Deborah W.;Lee, Margaret T.;Godley, Mark D.
背景：对于青少年而言，物质使用障碍（SUD）的治疗结果（例如，戒断、问题行为）往往无法足够快地得到测量以影响治疗轨迹。尽管过程指标（例如，治疗参与度）可以发挥重要作用，但证明它们与结果之间的关联至关重要。本研究探讨了门诊治疗参与度在多大程度上与结果相关，以及人口统计学/临床特征是否调节了这些关系。
方法：这是一项对青少年（N = 1491）的前瞻性研究，这些青少年在参与一项全国循证实践实施计划的28个治疗点之一接受物质使用障碍的门诊治疗。使用了入院时和6个月随访时的个人需求全球评估访谈信息以及接触数据。采用调整后的分层逻辑模型来估计参与度对6个月结果的影响。
结果：61%的青少年参与了门诊治疗。参与治疗的青少年报告任何物质使用（优势比0.60，95%置信区间0.41，0.87）、饮酒（优势比0.63，95%置信区间0.45，0.87）、重度饮酒（优势比0.53，95%置信区间0.33，0.86）和使用大麻（优势比0.64，95%置信区间0.45，0.93）的可能性显著降低。参与度与戒断结果之间的这种关联并不局限于任何特定群体。然而，治疗参与度与青少年在随访时自我报告的非法活动或行为控制困难无关。
结论：在个体层面，华盛顿圈参与度指标是门诊治疗青少年一些积极结果的预测因子。更好地让青少年参与治疗的努力可以提高护理质量。（c）2012爱思唯尔爱尔兰有限公司。保留所有权利。
Background: For adolescents, substance use disorder (SUD) treatment outcomes (e.g., abstinence, problematic behaviors) often cannot be measured soon enough to influence treatment trajectory. Although process measures (e.g., treatment engagement) can play an important role, it is essential to demonstrate their association with outcomes. This study explored the extent to which engagement in outpatient treatment was associated with outcomes and whether demographic/clinical characteristics moderated these relationships.Methods: This is a prospective study of adolescents (N = 1491) who received outpatient treatment for SUDs at one of 28 treatment sites taking part in a national evidence-based practice implementation initiative. Information from the Global Appraisal of Individual Needs interviews at intake and six-month follow-up, as well as encounter data, were used. Adjusted hierarchical logistic models were used to estimate effects of engagement on six-month outcomes.Results: Sixty-one percent of adolescents engaged in outpatient treatment. Adolescents engaging in treatment had significantly lower likelihoods of reporting any substance use (OR 0.60, 95% CI 0.41, 0.87), alcohol use (OR 0.63,95% CI 0.45, 0.87), heavy alcohol use (OR 0.53, 95% CI 0.33, 0.86), and marijuana use (OR 0.64, 95% CI 0.45, 0.93). This association of engagement with abstinence outcomes was not limited to any particular group. Treatment engagement, however, was not associated with adolescents' self-report of illegal activity or trouble controlling behavior at follow-up.Conclusion: At the individual level, the Washington Circle engagement measure was a predictor of some positive outcomes for adolescents in outpatient treatment. Efforts to better engage adolescents in treatment could improve quality of care. (c) 2012 Elsevier Ireland Ltd. All rights reserved.