Rural Drug Abuse Treatment: Organizations, Counselors, and Client Outcomes

描述(由申请人提供)：此次修订的K01申请的主要目标是进一步发展在药物滥用治疗方面富有成效的独立研究事业。这一修订后的应用程序的主要变化包括增加了一个生态理论框架，补充了教学和体验式的定性培训，以及改进了招募和分析策略。额外的培训将加强Carrie Oser博士在组织一级模型方面的经验，以涵盖多层次的观点，并将她的研究重点扩大到农村地区。拟议的培训目标将在以下方面提供额外的指导：(1)农村社区的文化细微差别，(2)定性研究方法，(3)针对多层次建模的高级统计培训(例如，HLM、SEM)，以及(4)进行伦理研究。Carrie Oser博士将由在农村药物滥用研究方面有经验的Carl Leukefeld博士赞助。这项修订的研究计划的总体目标是更好地了解辅导员在公共治疗设施中对农村治疗结果的背景和组织贡献。具体目标是：(1)与城市客户相比，描述农村客户的特征；(2)与受雇于城市机构的农村辅导员相比，检验农村辅导员的特征和治疗做法；(3)利用基于PDA的数据收集方法，确定与城市相比，农村县国家资助的治疗机构的组织特征；(4)从生态学的角度建立两级分层线性模型，以预测农村治疗结果和城市治疗结果；(5)运用生态学理论框架，分别考察服务对象层面的因素、辅导员情境因素和组织因素对农村治疗结果和城市治疗结果的贡献比例。该项目将大大有助于了解农村和城市县的社区治疗和服务结果。把重点放在农村公共治疗机构的治疗结果上，是从奥瑟博士的研究生工作转向在私人资助的治疗机构中采用创新的药理治疗方法的合乎逻辑的过渡。这一拟议项目将使从K01培训活动中获得的实质性知识和分析技能得以实际应用，并最终形成未来由调查员发起的NIDA赠款申请。

DESCRIPTION (provided by applicant): The primary goal of this revised K01 application is to further develop a productive independent research career in substance abuse treatment. The major changes in this revised application include the addition of an ecological theoretical framework, supplementary didactic and experiential qualitative training, as well as improved recruitment and analytic strategies. Additional training will enhance Dr. Carrie Oser's experience in organizational-level models to encompass a multi-level perspective and broaden her research focus to rural areas. The proposed training goals will provide additional instruction in: (1) the cultural nuances of rural communities, (2) qualitative research methods, (3) advanced statistical training specific to multi-level modeling (e.g., HLM, SEM), and (4) the conduct of ethical research. Dr. Carrie Oser will be sponsored by Dr. Carl Leukefeld, who has experience in rural substance abuse research. The overall goal of this revised research plan is to better understand counselor contextual and organizational contributions to rural treatment outcomes in public treatment facilities. The specific aims are: (1) to describe the characteristics of rural clients, as compared to urban clients; (2) to examine the characteristics and treatment practices of rural counselors, as compared to those employed in urban facilities; (3) to identify the organizational characteristics of state-funded treatment facilities in rural counties, as compared to urban, utilizing a PDA-based data collection methodology; (4) to develop two-level hierarchical linear models from an ecological perspective to predict rural treatment outcomes and urban treatment outcomes; (5) to separately examine the proportional contributions of client-level factors, counselor contextual factors, and organizational factors to rural treatment outcomes and urban treatment outcomes using an ecological theoretical framework. This project will significantly contribute to understanding community treatment and client outcomes in rural and urban counties. The focus on treatment outcomes within rural public treatment facilities is a logical transition from Dr. Oser's graduate work on the adoption of innovative pharmacological treatments within privately funded treatment organizations. This proposed project will allow for a practical application of the substantive knowledge and analytical skills acquired from the K01 training activities and will ultimately culminate in the development of future investigator initiated NIDA grant applications.