Kao Dennis, Torres Luis R, Guerrero Erick G, Mauldin Rebecca L, Bordnick Patrick S
Graduate College of Social Work, University of Houston, Houston, TX, United States; Center for Drug and Social Policy Research, University of Houston, Houston, TX, United States.
Graduate College of Social Work, University of Houston, Houston, TX, United States; Center for Drug and Social Policy Research, University of Houston, Houston, TX, United States.
Int J Drug Policy. 2014 May;25(3):598-607. doi: 10.1016/j.drugpo.2013.12.012. Epub 2013 Dec 21.
This study explores the spatial accessibility of outpatient drug treatment facilities and the potential relationship with drug use-related outcomes among Mexican American heroin users.
Secondary data on 219 current and former heroin-injecting Mexican American men aged 45 and older were drawn from a research study in Houston, Texas. We used geographic information systems (GIS) to derive two spatial accessibility measures: distance from one's place of residence to the closest drug treatment facility (in minutes); and the number of facilities within a 10-minute driving distance from one's place of residence. Exploratory logistic regression analyses examined the association between the spatial accessibility of drug treatment facilities and several drug use-related outcomes: internal locus of control (LOC); perceived chances and worries of injecting in the next six months; treatment utilization; and location of last heroin purchase.
Participants with greater spatial access to treatment programs were more likely to report a higher chance of injecting in the near future. However, while current heroin users were more worried about injecting in the next six months, greater spatial access to treatment programs seemed to have a buffering effect. Finally, those who lived closer to a treatment programs were more likely to have last purchased heroin inside the neighborhood versus outside the neighborhood. Spatial accessibility was not associated with internal LOC or treatment utilization.
The findings showed that the presence of outpatient treatment facilities-particularly services in Spanish-may influence perceived risk of future heroin use and purchasing behaviors among Mexican American men. Implications for future spatially-informed drug use research and the planning of culturally and linguistically responsive drug treatment programs are discussed.
本研究探讨了门诊药物治疗设施的空间可达性以及与墨西哥裔美国海洛因使用者药物使用相关结果之间的潜在关系。
从德克萨斯州休斯顿的一项研究中获取了219名年龄在45岁及以上的现用和曾用海洛因注射的墨西哥裔美国男性的二手数据。我们使用地理信息系统（GIS）得出两种空间可达性指标：从居住地到最近药物治疗设施的距离（以分钟计）；以及从居住地出发10分钟车程内的设施数量。探索性逻辑回归分析检验了药物治疗设施的空间可达性与几种药物使用相关结果之间的关联：内控点（LOC）；未来六个月内注射的感知可能性和担忧；治疗利用情况；以及上次购买海洛因的地点。
在空间上更容易获得治疗项目的参与者更有可能报告在不久的将来注射的可能性更高。然而，虽然现用海洛因使用者更担心在接下来的六个月内注射，但在空间上更容易获得治疗项目似乎具有缓冲作用。最后，那些居住在离治疗项目更近的人比起在社区外，更有可能上次在社区内购买海洛因。空间可达性与内控点或治疗利用情况无关。
研究结果表明，门诊治疗设施的存在——特别是西班牙语服务——可能会影响墨西哥裔美国男性对未来海洛因使用的感知风险和购买行为。讨论了对未来空间导向型药物使用研究以及文化和语言适应性药物治疗项目规划的启示。
