Understanding Outcome Disparities in Alcohol Treatment

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DESCRIPTION (provided by applicant): Racial disparities in alcohol treatment outcomes are a national problem. There are a number of possible explanations for these disparities in outcomes, including differential access to treatment, different motivations to seek and complete treatment, as well as cultural and sociodemographic factors. Neighborhood and other environmental triggers may also play a role, as well as prior treatment experience. We propose a secondary data analyses of existing alcohol treatment data, utilizing a multilevel modeling approach. The proposed secondary analysis is of the Los Angeles County Alcohol and Drug Treatment Program Participant annual data sets for years 1998, 1999 and 2000, which contain minority focused as well as non-minority focused treatment outcomes in publicly funded clinics for low income clients. The analysis will evaluate the relative effectiveness of the treatments in terms of minority groups, geographic and neighborhood factors, as well as reveal the treatment program characteristics that contribute to positive outcomes. This information about the rating of relative success of each treatment program will be combined with a cost/benefit analysis of treatment programs. Our analytical approach incorporates system level data on neighborhoods and geographic factors, as well as client demographics, and treatment program characteristics, which may all be related to disparities in treatment outcomes. The county of Los Angeles is uniquely appropriate to address these questions regarding disparities in treatment access and outcome. With a total population of over 9.5 million, and with a multiracial mix of Caucasians, African-Americans and Latinos (31.1 %, 9.5% and 44.6% of the total county population, respectively). The specific aims of the proposed research are as follows: (1) to determine the relationship of client demographics, geographic location, and treatment program and racial disparities in treatment outcomes; (2) to determine if the patterns of disparities in treatment outcomes differ by gender and by race for African Americans, Latinos and Caucasians