The Development and Validation of an Index to Measure Vicarious Trauma Exposure Among Substance Use Providers

衡量药物使用提供者替代性创伤暴露指数的开发和验证

• 批准号: 10353869
• 负责人: Elisabeth Anne Stelson
• 金额: $ 5.25万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-15 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10353869
• 关键词: Address; Alcoholism; Anxiety; Behavior; COVID-19 pandemic; Caring; Case Manager; Client; Data; Data Set; Development; Documentation; Drug abuse; Epidemic; Epidemiology; Exposure to; Factor Analysis; Focus Groups; Funding; Goals; Group Interviews; Hand; Health; Health Personnel; Intention; Intervention; Interview; Linear Models; Literature; Massachusetts; Measures; Mental Depression; Mental Health; Modeling; Occupational; Occupational Health; Occupations; Outcome; Overdose; Participant; Personal Satisfaction; Persons; Policy Maker; Prevalence; Principal Component Analysis; Professional Organizations; Professional counselor; Provider; Publishing; Reading; Recovery; Research; Research Personnel; Respondent; Review Literature; Sampling; Services; Social Work; Source; Specialist; Structure; Symptoms; Technology Transfer; Testing; Training; Transcript; Trauma; Trauma Research; United States; United States Substance Abuse and Mental Health Services Administration; Validation; Validity and Reliability; Work; addiction; associated symptom; care delivery; cognitive interview; combat; experience; falls; high risk; improved; indexing; informant; innovation; instrument; member; opioid epidemic; peer; physical conditioning; post-traumatic stress; prevent; professional atmosphere; psychological distress; recruit; response; safety net; satisfaction; substance use; trauma exposure; trauma symptom; traumatic event; traumatic stress; treatment services

PROJECT ABSTRACT An often-overlooked consequence of the opioid epidemic in the United States is its health impact on substance use providers (SUPs), such as addiction therapists, peer recovery specialists, and case managers. The opioid epidemic has strained addiction treatment services, and the US will likely fall 250,000 SUPs short of the number needed to address the opioid epidemic by 2025. Workforce turnover contributes substantially to this shortage, driven in part by SUP exposure to vicarious trauma. Vicarious trauma refers to the “second hand” trauma transmitted when interacting with people who experienced trauma “firsthand.” Among social service professionals, vicarious trauma is associated with the development of depression, anxiety, and post-traumatic stress. The SUP workforce is likely particularly vulnerable to vicarious trauma since over 50% are recovering from addiction themselves. No instrument currently exists to measure exposure to vicarious trauma, and existing scales only measure biproducts of the exposure, such as symptoms. It is therefore difficult to assess prevalence of vicarious trauma exposure among SUPs and other “helping professionals” and the sources of this exposure. As a result, it is challenging to identify where to intervene to protect this workforce. The goal of this study is to develop the Vicarious Occupational Trauma Exposure (VOTE) Index and assess its validity and reliability in a representative national sample of SUPs. Previously-collected focus group and interview data and empirical literature on social service working conditions will be analyzed to identify vicarious trauma exposure sources. This will inform VOTE Index development, which will be modified using cognitive interview of SUPs (N=10). The refined index will be disseminated in a national sample of SUPs using quota sampling. Participants (N=600) will be recruited through partnerships with the National Association of Alcoholism and Drug Abuse Counselors and Addiction Technology Transfer Centers. A subsample will be randomly resampled to establish test-retest reliability. Respondents will be divided into training and testing datasets. Bootstrapped nonlinear principal component analysis will be used to analyze the structure of items and observations and reduce items to uncorrelated principal components. Confirmatory factor analysis will be used to assess model fit and reliability. A linear model will be fit to assess convergent and discriminant validity. The contribution of this proposed research is the development and validation of the first instrument to measure vicarious trauma exposure and differentiate it from “downstream” effects, such as symptoms and health outcomes. The VOTE Index will advance occupational epidemiologic understanding of the relationship between vicarious trauma exposure and poor worker health, workforce turnover, and client care. This index will also help researchers, practitioners, and policy-makers identify where to intervene to protect the workforce, thereby improving capacity to provide critical addiction treatment services to address the US opioid epidemic.

项目摘要 美国阿片类药物流行的一个经常被忽视的后果是其对物质的健康影响 使用提供者 (SUP)，例如成瘾治疗师、同伴康复专家和个案经​​理。阿片类药物 疫情导致成瘾治疗服务紧张，美国可能会缺口25万个SUP 到 2025 年解决阿片类药物流行问题所需的数量。劳动力流动对此做出了重大贡献 短缺，部分原因是 SUP 暴露于替代性创伤。替代性创伤指的是“二手” 与“亲身经历”创伤的人互动时，创伤会传播。社会服务当中 专业人士认为，替代性创伤与抑郁、焦虑和创伤后的发展有关 压力。 SUP 员工可能特别容易受到替代性创伤，因为超过 50% 的人正在康复中 来自成瘾本身。目前没有仪器可以测量替代性创伤的暴露程度，并且 现有的量表仅测量暴露的副产品，例如症状。因此很难评估 SUP 和其他“帮助专业人员”中替代性创伤暴露的普遍性及其来源 此次曝光。因此，确定在哪里进行干预以保护这些劳动力是一项挑战。 本研究的目标是制定替代职业创伤暴露 (VOTE) 指数和 在具有代表性的国家 SUP 样本中评估其有效性和可靠性。先前收集的焦点小组 将分析有关社会服务工作条件的访谈数据和实证文献，以确定 替代性创伤暴露源。这将为 VOTE 指数的开发提供信息，该指数将使用 SUP 的认知访谈（N=10）。细化后的指数将在全国 SUP 样本中发布，使用 配额抽样。参与者（N = 600）将通过与全国协会的合作伙伴关系招募 酗酒和药物滥用咨询师和成瘾技术转让中心。子样本将是 随机重新抽样以建立重测可靠性。受访者将分为培训和测试 数据集。 Bootstrap非线性主成分分析将用于分析项目的结构 和观察结果，并将项目减少到不相关的主成分。验证性因素分析将 用于评估模型的拟合度和可靠性。线性模型将适合评估收敛有效性和判别有效性。 这项拟议研究的贡献是开发和验证了第一个仪器 测量替代性创伤暴露并将其与“下游”效应区分开来，例如症状和 健康结果。投票指数将促进职业流行病学对这种关系的理解 替代性创伤暴露与工人健康状况不佳、劳动力流动率和客户服务之间的关系。该指数将 还帮助研究人员、从业者和政策制定者确定在哪里进行干预以保护劳动力， 从而提高提供关键成瘾治疗服务的能力，以应对美国阿片类药物的流行。