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）： 为了回应 PA-04-061 和 PA-01-097，此修订后的提案描述了一项卫生服务研究项目，旨在利用 R21 探索性/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的服务使用模式。 该项目的具体目标是： 1) 通过以下方式生成关于农村青少年使用行为健康服务治疗药物滥用障碍的新知识：a) 描述农村和非农村青少年接受公共资助的药物滥用治疗的倾向、促成和需求特征方面的差异，重点关注药物使用水平、心理健康问题和身体健康特征，以及 b) 检验关于农村和城市人口在获取药物方面差异的假设 以及服务使用模式和临床结果； 2) 完善已建立的服务使用和结果的理论模型，以便针对该人群进行未来的卫生服务研究。 该项目将使用之前收集的访谈和行政数据。 二次分析是深入了解农村地区青少年与药物滥用问题作斗争的经历的有效方法。 围绕两个领域提出了描述性和假设检验分析：1）接受公共资助的药物滥用治疗的农村青年使用的药物类型、药物使用模式以及药物使用的后果是什么？他们与城市青年有何不同？ 2) 农村青少年所使用的药物滥用服务类型、服务使用模式以及治疗后果（结果）是什么？他们与城市青年有何不同？描述性分析将关注未调整的差异。 多变量假设检验分析将考虑农村和城市青年之间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 NIDA 主办的农村社区药物滥用研究：当前知识和未来方向会议（12/2004）上药物滥用和农村研究专家所强调的那样，提高对农村地区药物滥用及其治疗的了解是国家当务之急，并且需要进行比较研究。该项目通过研究农村和城市药物滥用模式的差异、治疗障碍、服务利用和青年结果，为解决这些关键问题提供了独特的机会。鉴于医疗补助是美国针对青少年最大的健康保险计划，并且至少五分之一的物质服务由医疗补助资助，因此针对参加医疗补助的青少年研究这些问题加强了研究结果的政策相关性。