Spence Richard, Wallisch Lynn, Smith Shanna
Addiction Research Institute, University of Texas at Austin, Austin, Texas 78703, USA.
Alcohol Clin Exp Res. 2007 Jun;31(6):1002-11. doi: 10.1111/j.1530-0277.2007.00362.x. Epub 2007 May 4.
Only a small proportion of persons with alcohol or drug problems seek help in the form of treatment for these problems. To examine service disparities among Hispanics living in urban and rural border areas, an improved understanding of factors associated with service seeking is needed for this population.
In-person interviews were conducted with a sample of 1,200 colonia residents and urban residents living along the Texas border with Mexico. For the present study, the dataset was limited to Hispanic respondents (85% of the sample) and those who reported any indicator of need for treatment (38% of the sample). There were 380 respondents who met these criteria. Treatment seeking was measured by any past attempt, successful or unsuccessful, to obtain treatment or by their present stated desire for treatment. Factors influencing treatment seeking were compared across 3 sites.
Path analyses indicated that, after taking demographics into account, severity of need (the total number of drug-related and alcohol-related problems experienced by an individual) was a strong influence on treatment seeking, but income-related variables were more influential than severity of need in 1 site. Generation of immigration was positively related to treatment seeking in 2 sites, and in colonias, high religiosity was related to treatment seeking. In 2 sites, need severity was related to neighborhood variables. In colonias, need severity was related to low income and low religiosity.
This framework for understanding treatment seeking in border communities suggests that pathways to treatment seeking vary by locality in ways that may reflect variations in local environments and service systems. Design of outreach efforts should be tailored to the unique social and service system challenges of each local community. Although service seeking is low overall, findings are suggestive of an inequitable service access structure in 1 site where need is not the predominant factor for treatment seeking.
只有一小部分有酒精或药物问题的人会寻求针对这些问题的治疗帮助。为了研究生活在城乡边境地区的西班牙裔人群之间的服务差异，需要更好地了解与该人群寻求服务相关的因素。
对1200名居住在与墨西哥接壤的得克萨斯边境沿线的聚居区居民和城市居民进行了面对面访谈。在本研究中，数据集仅限于西班牙裔受访者（占样本的85%）以及那些报告有任何治疗需求指标的人（占样本的38%）。共有380名受访者符合这些标准。寻求治疗的衡量标准是过去任何获得治疗的尝试，无论成功与否，或者他们目前表示有治疗的愿望。对三个地点影响寻求治疗的因素进行了比较。
路径分析表明，在考虑人口统计学因素后，需求严重程度（个人经历的与药物和酒精相关问题的总数）对寻求治疗有很大影响，但在一个地点，与收入相关的变量比需求严重程度更具影响力。移民代际在两个地点与寻求治疗呈正相关，在聚居区，高宗教信仰与寻求治疗有关。在两个地点，需求严重程度与邻里变量有关。在聚居区，需求严重程度与低收入和低宗教信仰有关。
这个用于理解边境社区寻求治疗情况的框架表明，寻求治疗的途径因地点而异，这可能反映了当地环境和服务系统的差异。外展工作的设计应根据每个当地社区独特的社会和服务系统挑战进行调整。尽管总体上寻求服务的比例较低，但研究结果表明在一个地点存在不公平的服务获取结构，在该地点需求不是寻求治疗的主要因素。
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