The ecology of adolescent substance abuse service utilization.
The ecology of adolescent substance abuse service utilization.
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青少年药物滥用服务利用的生态学。
DOI：
10.1007/s10464-007-9138-8
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发表时间：
2007
影响因子：
3.1
通讯作者：
Saunders,RobertC
中科院分区：
文献类型：
--
作者：
Jones,DianaL;Heflinger,CraigAnne;Saunders,RobertC
本文提出了一个生态社区模型，用于解释参加田纳西州医疗补助计划(Tenncare)的青少年药物滥用(SA)服务利用模式的差异。在Bronfenbrenner的社会生态学研究和Aday和Andersen提出的卫生服务利用模型的理论框架下，我们应用社会指标方法来解释社区生态对SA识别和治疗参与度的影响。同时考察了县级比率和个人水平的治疗利用情况，并采用分层线性模型来考察个人在社区中的现象。本研究是对以往服务利用研究的扩展，认为对青少年服务利用的解释不仅必须包括个人、家庭和服务系统的特征，而且还必须包括社区因素。
This paper presents an ecological-community model toward the explanation of variation in patterns of substance abuse (SA) service utilization among adolescents who are enrolled in Tennesssee’s Medicaid program (TennCare). Guided by a theoretical framework that draws from the social ecology work of Bronfenbrenner and health services utilization models promoted by Aday and Andersen, we apply a social indicators approach toward explaining the impact of community ecology on identification of SA and treatment engagement. Both county-level rates and individual-level treatment utilization are examined and hierarchical linear modeling is incorporated to examine the individual-in-community phenomenon. This study is an expansion of previous service utilization research and suggests that explanations of youth’s service utilization must necessarily include not only individual, familial, and service system characteristics, but community factors, as well.