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

描述（由申请人提供）：本修订后的K01申请的主要目标是进一步发展药物滥用治疗方面富有成效的独立研究事业。修订后的应用程序的主要变化包括增加一个生态理论框架，补充教学和经验定性培训，以及改进征聘和分析战略。额外的培训将增强Carrie Oser博士在组织层面模型方面的经验，以涵盖多层次的视角，并将她的研究重点扩大到农村地区。拟议的培训目标将提供以下方面的额外指导：(1)农村社区的文化差异，(2)定性研究方法，(3)针对多层次建模（例如，HLM， SEM）的高级统计培训，以及(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。这一修订研究计划的总体目标是更好地理解辅导员的背景和组织对农村公共治疗机构治疗结果的贡献。具体目标是：(1)描述农村客户与城市客户相比的特征；(2)比较农村心理咨询师与城市心理咨询师的特点和治疗方法；(3)利用基于pda的数据收集方法，确定农村县国家资助的治疗设施与城市相比的组织特征；(4)从生态学角度建立两级层次线性模型，预测农村和城市的治疗效果；(5)运用生态学的理论框架，分别考察客户层面因素、咨询师情境因素和组织因素对农村和城市治疗结果的比例贡献。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。关注农村公共治疗机构的治疗结果是Oser博士在私人资助的治疗机构中采用创新药理治疗的研究生工作的合理过渡。这个拟议的项目将允许从K01培训活动中获得的实质性知识和分析技能的实际应用，并最终在未来研究者发起的NIDA资助申请的发展中达到高潮。

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.