Sterk Claire E, Elifson Kirk W, DePadilla Lara
Emory University, Rollins School of Public, Department of Behavioral Sciences and Health Education, United States.
Emory University, Rollins School of Public, Department of Behavioral Sciences and Health Education, United States.
Int J Drug Policy. 2014 May;25(3):616-23. doi: 10.1016/j.drugpo.2013.12.007. Epub 2013 Dec 18.
Crack cocaine use and associated negative social and health consequences remain a significant public health problem. Research that expands beyond the individual by considering the environmental context as a determinant of cocaine use is growing. The main objectives of this paper are to examine the effects of perceived neighbourhood disorder as an independent correlate of the frequency of recent crack cocaine use and whether its impact is mediated by use-related practices and social context of use among an African American adult sample in Atlanta (GA).
Cross-sectional data were collected from 461 respondents who were recruited through active and passive community outreach from 70 disadvantaged urban neighbourhoods across Atlanta. Multivariable negative binomial regression was performed to assess the independent association of perceived neighbourhood disorder with crack cocaine use frequency and to explore potential mediation by use-related practices and social context of use.
Perceived neighbourhood disorder did not remain statistically significant after accounting for use-related practices and social context of use. Involvement in drug distribution and having traded sex were associated with increases in frequency of drug use, while using in safer places and using alone were associated with decreases in frequency of use.
The results show that perceived neighbourhood disorder is associated with frequency of crack cocaine use independently of socio-demographics. However, its significance was eliminated when controlling for use-related practices and the social context of use. Such practices and the social context of use may mediate the relationship between neighbourhood disorder and crack cocaine use. Future research is needed to more fully elucidate the links between individual and neighbourhood characteristics that are related to crack cocaine use and strategies to reduce use must consider the salience of use-related practices and the social context of use.
使用快克可卡因及其相关的负面社会和健康后果仍然是一个重大的公共卫生问题。通过将环境背景视为可卡因使用的一个决定因素来展开超越个体层面的研究正在不断增加。本文的主要目的是考察感知到的邻里失序作为近期快克可卡因使用频率的一个独立相关因素的影响，以及在佐治亚州亚特兰大的非裔美国成年人样本中，其影响是否通过与使用相关的行为及使用的社会背景来介导。
通过主动和被动社区外展从亚特兰大70个弱势城市社区招募了461名受访者，收集了横断面数据。进行多变量负二项回归以评估感知到的邻里失序与快克可卡因使用频率之间的独立关联，并探索与使用相关的行为及使用的社会背景的潜在中介作用。
在考虑了与使用相关的行为及使用的社会背景后，感知到的邻里失序在统计学上不再显著。参与毒品分销和进行性交易与毒品使用频率增加有关，而在更安全的地方使用和独自使用与使用频率降低有关。
结果表明，感知到的邻里失序与快克可卡因使用频率相关，独立于社会人口统计学因素。然而，在控制了与使用相关的行为及使用的社会背景后，其显著性消失了。此类行为及使用的社会背景可能介导邻里失序与快克可卡因使用之间的关系。需要未来的研究来更全面地阐明与快克可卡因使用相关的个体和邻里特征之间的联系，并且减少使用的策略必须考虑与使用相关的行为及使用的社会背景的重要性。
