Steinka-Fry Katarzyna T, Tanner-Smith Emily E, Dakof Gayle A, Henderson Craig
Vanderbilt University, United States.
Vanderbilt University, United States.
J Subst Abuse Treat. 2017 Apr;75:22-37. doi: 10.1016/j.jsat.2017.01.006. Epub 2017 Jan 23.
This systematic review and meta-analysis synthesized findings from studies examining culturally sensitive substance use treatment for racial/ethnic minority youth. An extensive literature search located eight eligible studies using experimental or quasi-experimental designs. The meta-analysis quantitatively synthesized findings comparing seven culturally sensitive treatment conditions to seven alternative conditions on samples composed of at least 90% racial/ethnic minority youth. The results from the meta-analysis indicated that culturally sensitive treatments were associated with significantly larger reductions in post-treatment substance use levels relative to their comparison conditions (g=0.37, 95% CI [0.12, 0.62], k=7, total number participants=723). The average time between pretest and posttest was 21weeks (SD=11.79). There was a statistically significant amount of heterogeneity across the seven studies (Q=26.5, p=0.00, τ=0.08, I=77.4%). Differential effects were not statistically significant when contrasts were active generic counterparts of treatment conditions (direct "bona fide" comparisons; g=-0.08, 95% CI [-0.51, 0.35]) and 'treatment as usual' conditions (g=0.39, 95% CI [-0.14, 0.91]). Strong conclusions from the review were hindered by the small number of available studies for synthesis, variability in comparison conditions across studies, and lack of diversity in the adolescent clients served in the studies. Nonetheless, this review suggests that culturally sensitive treatments offer promise as an effective way to address substance use among racial/ethnic minority youth.
本系统评价和荟萃分析综合了有关针对少数族裔青少年的文化敏感型物质使用治疗的研究结果。广泛的文献检索确定了八项采用实验性或准实验性设计的合格研究。荟萃分析对七项文化敏感型治疗条件与七项替代条件进行了定量综合分析,样本至少90%为少数族裔青少年。荟萃分析结果表明,与对照条件相比,文化敏感型治疗与治疗后物质使用水平的显著更大降低相关(g=0.37,95%置信区间[0.12, 0.62],k=7,参与者总数=723)。前测和后测之间的平均时间为21周(标准差=11.79)。七项研究之间存在统计学上显著的异质性(Q=26.5,p=0.00,τ=0.08,I=77.4%)。当对比为治疗条件的活性通用对应物(直接“真正”比较;g=-0.08,95%置信区间[-0.51, 0.35])和“常规治疗”条件(g=0.39,95%置信区间[-0.14, 0.91])时,差异效应无统计学显著性。可用于综合分析的研究数量较少、各研究对照条件的变异性以及所研究的青少年客户缺乏多样性,阻碍了本综述得出强有力的结论。尽管如此,本综述表明,文化敏感型治疗有望成为解决少数族裔青少年物质使用问题的有效方法。