Friedmann Peter D, Wilson Donna, Knudsen Hannah K, Ducharme Lori J, Welsh Wayne N, Frisman Linda, Knight Kevin, Lin Hsiu-Ju, James Amy, Albizu-Garcia Carmen E, Pankow Jennifer, Hall Elizabeth A, Urbine Terry F, Abdel-Salam Sami, Duvall Jamieson L, Vocci Frank J
Providence Veteran Affairs Medical Center and Brown University, Providence, RI, USA; Rhode Island Hospital, Providence, RI, USA.
Rhode Island Hospital, Providence, RI, USA.
J Subst Abuse Treat. 2015 Mar;50:50-8. doi: 10.1016/j.jsat.2014.10.001. Epub 2014 Oct 14.
Medication-assisted treatment (MAT) is effective for alcohol and opioid use disorders but it is stigmatized and underutilized in criminal justice settings.
This study cluster-randomized 20 community corrections sites to determine whether an experimental implementation strategy of training and an organizational linkage intervention improved staff perceptions of MAT and referral intentions more than training alone. The 3-hour training was designed to address deficits in knowledge, perceptions and referral information, and the organizational linkage intervention brought together community corrections and addiction treatment agencies in an interagency strategic planning and implementation process over 12 months.
Although training alone was associated with increases in familiarity with pharmacotherapy and knowledge of where to refer clients, the experimental intervention produced significantly greater improvements in functional attitudes (e.g. that MAT is helpful to clients) and referral intentions. Corrections staff demonstrated greater improvements in functional perceptions and intent to refer opioid dependent clients for MAT than did treatment staff.
Knowledge, perceptions and information training plus interorganizational strategic planning intervention is an effective means to change attitudes and intent to refer clients for medication assisted treatment in community corrections settings, especially among corrections staff.
药物辅助治疗(MAT)对酒精和阿片类药物使用障碍有效,但在刑事司法环境中受到污名化且未得到充分利用。
本研究对20个社区矫正场所进行整群随机分组,以确定培训的实验性实施策略和组织联系干预措施是否比单独培训更能改善工作人员对MAT的认知和转诊意愿。为期3小时的培训旨在弥补知识、认知和转诊信息方面的不足,组织联系干预措施在12个月的跨机构战略规划和实施过程中将社区矫正机构和成瘾治疗机构联合起来。
尽管单独培训与对药物治疗的熟悉程度提高以及知晓何处转诊客户的知识增加有关,但实验性干预措施在功能态度(例如MAT对客户有帮助)和转诊意愿方面产生了显著更大的改善。与治疗工作人员相比,惩教人员在对阿片类药物依赖客户进行MAT转诊的功能认知和意愿方面有更大的改善。
知识、认知和信息培训加上组织间战略规划干预是改变社区矫正环境中工作人员对客户进行药物辅助治疗的态度和转诊意愿的有效手段,尤其是在惩教人员中。