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

描述（由申请人提供）：本修订K 01应用程序的主要目标是进一步发展在药物滥用治疗的生产独立的研究生涯。修订后的应用程序的主要变化包括增加了生态理论框架，补充教学和经验定性培训，以及改进的招聘和分析策略。额外的培训将增强Carrie Oser博士在组织一级模式方面的经验，以涵盖多层次的视角，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，（4）伦理研究的开展。Carrie Oser博士将由Carl Leukefeld博士赞助，他在农村药物滥用研究方面有经验。这项修订后的研究计划的总体目标是更好地了解辅导员上下文和组织的贡献，农村治疗结果在公共治疗设施。具体目标是：（1）描述农村客户的特征，与城市客户相比;（2）检查农村咨询师的特征和治疗实践，与城市设施中雇用的咨询师相比;（3）确定国家资助的治疗设施在农村县的组织特征，与城市相比，利用PDA为基础的数据收集方法;（4）从生态学视角构建两水平线性模型，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因素、咨询师背景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客户结果。农村公共治疗设施内的治疗结果的重点是一个合乎逻辑的过渡，从博士奥瑟的研究生工作，在私人资助的治疗组织内采用创新的药物治疗。这个拟议的项目将允许从K 01培训活动中获得的实质性知识和分析技能的实际应用，并最终导致未来调查员发起的NIDA赠款申请的发展。

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.