Alcohol treatment & health disparity in American Indians

酒精治疗

• 批准号: 7127499
• 负责人: R. Dale WALKER
• 金额: $ 14.42万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-08-01 至 2009-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7127499
• 关键词: Native Americans; alcoholic beverage consumption; alcoholism /alcohol abuse; alcoholism /alcohol abuse therapy; clinical research; culture; gender difference; health care quality; health care service utilization; health disparity; health services research tag; human subject; interview; longitudinal human study; medically underserved population; substance abuse related behavior

DESCRIPTION (provided by applicant): This proposal is the third submission of application number R01 AA013806-01 which was originally submitted in response to Request for Application Number AA02.002 ("Research on Alcohol Health Disparities") and most recently reviewed February 13, 2003 by the National Institute on Alcohol Abuse and Alcoholism Health Services Research Review sub-committee (AA-2). The application has again been extensively revised in response to reviewer comments. Nonetheless, this health services research study continues to be motivated by health disparities such as the high rates of morbidity and mortality related to alcohol use among American Indians. Given these health disparities, it is worrisome that there have been few studies examining relationships between treatments and outcomes for natives with alcohol problems. In particular, there is little or no research on services for urban Native Americans with alcohol abuse or dependence. This lack of information is unfortunate since most American Indians now live in cities. The proposed project will examine processes of treatment and outcomes among clients of programs focusing on American Indians in Seattle, Washington and Portland, Oregon. The Seattle Indian Health Board and the Native American Rehabilitation Association in Portland, Oregon primarily serve urban American Indians, are closely connected with general medical services, offer ancillary care such as family therapy, provide numerous treatment modalities for individuals with alcohol problems, and support ongoing research projects. Both agencies serve members of several tribes and both have clients who spend part of the year in the city and part on reservations. Both agencies have adapted for Native people and incorporated into their treatment programs standardized therapies including Motivational Enhancement and Cognitive-Behavioral Treatment. The project will use an inception cohort design. Clients presenting for treatment of alcohol problems at the study programs will be informed about the project. After informed consent is obtained, subjects will be interviewed using instruments such as the Addiction Severity Index and the Project Match Form 90. Subjects will be interviewed again six months, 12, and 18 months after baseline. Outcomes of interest will include abstinence, number of drinking days, alcohol-related problems, psychiatric problems, general medical problems, and satisfaction with services. Interviews with clients and providers, observations of treatment sessions, and reviews of taped treatment encounters will be employed to elicit details of treatment services received. Hierarchical linear models and structural equations models will be used to relate treatments to outcomes. Predictors will include variables describing culturally specific treatments provided to the Native clients as well as measures of clinician cultural competence. Administrative data will be used to compare outcomes for American Indians versus general population clients. Information generated from the project will be useful in devising optimal treatment for indigenous people living in urban areas and in planning randomized clinical trials. The research team (headed by a Cherokee psychiatrist and including members of several tribes) will disseminate results in collaboration with the newly funded American Indian and Alaska Native National Resource Center on Substance Abuse Prevention and Treatment.

描述（由申请人提供）：本提案是申请号R01 AA013806-01的第三次提交，最初提交是为了响应申请号AA02.002（“酒精健康差异研究”）的请求，最近由国家酒精滥用和酒精中毒健康服务研究审查小组委员会（AA-2）于2003年2月13日审查。根据审稿人的意见，应用程序再次进行了广泛的修改。