BARRIERS TO TREATMENT FOR COCAINE-DEPENDENT WOMEN

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The overall goal of the proposed research is a more comprehensive understanding of barriers and incentives to treatment among crime- involved cocaine-dependent women- a particularly different group for drug treatment programs to access and help. The specific aims of the project are to (1) develop and test measures that integrate street and treatment research findings, can forms robust multidimensional scales for hypothesis testing, and are of potential use to drug treatment programs in assessing the needs of women who are enmeshed in crime/cocaine lifestyles; (2) documentation, through testing of hypothesis and a structural model, of the interplay between women;s cocaine and crime involvement, their willingness to enter treatment, their concurrent life problems beyond drug use and crime, and supports and pressures from their social networks; (3) recommendation of policy alternatives, treatment initiatives, and support services that will increase treatment entry, retention, and success for crime-involved cocaine-dependent women; and (4) further exploration of two factors about which particularly little empirical information exists for crime-involved cocaine-dependent women: (a) attitudes toward treatment among women who have never been in treatment, and (b) the impact of ethnic/class-cultural differences on treatment entry. The methodology entails a 4-year 2 sample study to be conducted in the Miami, Florida area. Sample 1 is 900 crime-involved cocaine-dependent women ages 20-34, to be interviewed using a highly three treatment subsamples, women with both prior and no prior treatment experience, both treatment seekers and treatment resisters among women contacted on the street, and both voluntary and involuntary entrants to residential treatment. Sample 2 is 30 recovering women with a history of cocaine dependency and criminal involvement, to be interviewed as "key informants" with a longer, open-ended instrument oriented toward explanatory insight and ethnographic detail; half of these informants will be counselors in local drug treatment programs, and half will be more recent treatment graduates. Intensive multivariate analysis of the Sample 1 data, aided by insights from Sample 2, will emphasize index construction and hypothesis testing to achieve the study's specific aims.