Acevedo Andrea, Panas Lee, Garnick Deborah, Acevedo-Garcia Dolores, Miles Jennifer, Ritter Grant, Campbell Kevin
Department of Community Health, Tufts University, 574 Boston Avenue, Suite 208, Medford, MA, 02155, USA.
Institute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis University, 415 South Street MS035, Waltham, MA, 02453, USA.
J Behav Health Serv Res. 2018 Oct;45(4):533-549. doi: 10.1007/s11414-018-9586-y.
This study focused on (1) whether disparities in timely receipt of substance use services can be explained in part by the characteristics of the community in which the clients reside and (2) whether the effect of community characteristics on timely receipt of services was similar across racial/ethnic groups. The sample was composed of adults receiving publicly funded outpatient treatment in Washington State. Treatment data were linked to data from the US census. The outcome studied was "Initiation and Engagement" in treatment (IET), a measure noting timely receipt of services at the beginning of treatment. Community characteristics studied included community level economic disadvantage and concentration of American Indian, Latino, and Black residents in the community. Black and American Indian clients were less likely to initiate or engage in treatment compared to non-Latino white clients, and American Indian clients living in economically disadvantaged communities were at even greater risk of not initiating treatment. Community economic disadvantage and racial/ethnic makeup of the community were associated with treatment initiation, but not engagement, although they did not entirely explain the disparities found in IET.
（1）及时获得物质使用服务方面的差异是否能部分由客户居住社区的特征来解释；（2）社区特征对及时获得服务的影响在不同种族/族裔群体中是否相似。样本由华盛顿州接受公共资助门诊治疗的成年人组成。治疗数据与美国人口普查数据相链接。所研究的结果是治疗中的“启动与参与”（IET），这是一项衡量指标，用于记录治疗开始时及时获得服务的情况。所研究的社区特征包括社区层面的经济劣势以及社区中美国印第安人、拉丁裔和黑人居民的集中程度。与非拉丁裔白人客户相比，黑人和美国印第安客户开始治疗或参与治疗的可能性较小，并且生活在经济弱势社区的美国印第安客户不开始治疗的风险甚至更高。社区经济劣势和社区的种族/族裔构成与治疗启动相关，但与参与无关，尽管它们并未完全解释在IET中发现的差异。
