Substance Use Disorders & Service Use Among Rural Youth

物质使用障碍

• 批准号: 7048251
• 负责人: CRAIG ANNE HEFLINGER
• 金额: $ 21.77万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-06-01 至 2008-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7048251
• 关键词: Medicare /Medicaid; clinical research; community; health; interview; model; rural area; substance abuse related disorder

DESCRIPTION (provided by applicant): In response to PA-04-061 and PA-01-097, this revised proposal describes a health services research project to examine patterns of service use by adolescents with substance abuse problems living in rural areas using the R21 Exploratory/Developmental Grant mechanism (PA-02-171). The specific aims of this project are: 1) To generate new knowledge on rural adolescents' use of behavioral health services for substance use disorders by: a) Describing differences in predisposing, enabling and need characteristics between rural and non-rural youth entering publicly funded substance use treatment, with a focus on levels of substance use, mental health issues and physical health characteristics, and b) Testing hypotheses about differences between rural and urban populations in access and service use patterns and clinical outcomes; and 2) To refine established theoretical models of service use and outcomes for future health services research with this population. The project will use previously collected interview and administrative data. Secondary analysis is an efficient method for gaining insight into the experiences of youth struggling with substance abuse problems in rural settings. Descriptive and hypothesis-testing analyses are proposed around two areas: 1) what are the types of substances used, patterns of substance use, and consequences of substance use among rural youth entering publicly-funded substance abuse treatment? How do these differ from urban youth? 2) What are types of substance abuse services used, patterns of service use, and consequences (outcomes) of treatment for rural youth? How do these differ from urban youth? Descriptive analyses will focus unadjusted differences. The multivariate hypothesis-testing analyses will consider differences in service use and clinical outcomes between rural and urban youth, using multi-level modeling to assess the influence of community and service system variables. Relevance: As highlighted at the NIDA-sponsored Drug Abuse Research in Rural Communities: Current Knowledge and Future Directions meeting (12/2004) of experts in substance abuse and rural studies, improving understanding of substance abuse and its treatments in rural areas is a national imperative, and comparative studies are needed. This project provides a unique opportunity to address these critical issues by studying differences in rural and urban substance abuse patterns, barriers to treatment, service utilization and outcomes for youth. Given that Medicaid is the largest health insurance program in the country for adolescents and that at least one out of every five substance services are funded by Medicaid, examining these questions for Medicaid-enrolled youth strengthens the policy relevance of the findings.

描述（由申请人提供）： 作为对PA-04-061和PA-01-097的回应，本修订提案描述了一个卫生服务研究项目，旨在使用R21探索/发展补助金机制（PA-02-171）检查生活在农村地区有药物滥用问题的青少年使用服务的模式。 该项目的具体目标是：1）通过以下方式，产生关于农村青少年利用行为健康服务治疗药物使用障碍的新知识：（a）描述接受公共资助的药物使用治疗的农村和非农村青年在倾向性、促成性和需求特征方面的差异，重点是药物使用水平、心理健康问题和身体健康特征，和B）检验关于农村和城市人口在获得和服务使用模式以及临床结果方面的差异的假设;和2）完善已建立的服务使用和结果的理论模型，以用于该人群未来的卫生服务研究。 该项目将使用以前收集的访谈和行政数据。 次级分析是深入了解农村青年与药物滥用问题作斗争的经历的一种有效方法。 描述性和假设检验分析提出了两个方面：1）什么是使用的物质类型，物质使用的模式，以及物质使用的后果，在农村青年进入公共资助的药物滥用治疗？这与城市青年有何不同？2)使用的药物滥用服务类型、服务使用模式以及农村青年治疗的后果（结果）是什么？这与城市青年有何不同？描述性分析将关注未校正的差异。 多变量假设检验分析将考虑农村和城市青年之间的服务使用和临床结果的差异，使用多层次模型来评估社区和服务系统变量的影响。相关性：正如由荷兰国际开发署主办的药物滥用和农村研究专家会议“农村社区药物滥用研究：当前知识和未来方向”（2004年12月）所强调的那样，提高对农村地区药物滥用及其治疗的认识是国家的当务之急，需要进行比较研究。该项目提供了一个独特的机会，通过研究农村和城市药物滥用模式的差异、治疗障碍、服务利用和对青年的影响来解决这些关键问题。鉴于医疗补助是该国最大的青少年健康保险计划，并且每五项物质服务中至少有一项是由医疗补助资助的，因此对参加医疗补助的青少年进行这些问题的研究加强了研究结果的政策相关性。