性别差异在酒精治疗服务的使用和未使用的原因在全国样本。
Gender Differences in Use of Alcohol Treatment Services and Reasons for Nonuse in a National Sample.
机构信息
Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, Iowa.
Alcohol Research Group, Public Health Institute, Emeryville, California.
出版信息
Alcohol Clin Exp Res. 2019 Apr;43(4):722-731. doi: 10.1111/acer.13965. Epub 2019 Feb 26.
BACKGROUND
The majority of adults with alcohol use disorders do not obtain help, and women are less likely to utilize alcohol services than men. We sought to quantify gender differences in alcohol services utilization, overall and by type, using national longitudinal data and to explore potential gender differences in perceived need for help and reasons for not seeking help.
METHODS
We analyzed data from the National Epidemiologic Survey on Alcohol and Related Conditions from White, African American, and Hispanic adults (n = 2,592) who met DSM-IV criteria for alcohol abuse or dependence at Wave 1 (2000 to 2001). We tested gender differences in Wave 2 (2004 to 2005) services utilization, perceived need for help, and treatment barriers using Rao-Scott chi-square tests and assessed predictors of outcomes in multivariable logistic regression, adjusting for problem severity, co-occurring disorders, and demographics.
RESULTS
Women had much lower odds than men of utilizing any alcohol service (adjusted odds ratio [aOR] 0.53; 95% confidence interval [95% CI]: 0.33, 0.86), specialty services (aOR 0.41; 95% CI 0.19, 0.87), and 12-step groups (aOR 0.39; 95% CI 0.21, 0.71). Perceived need for help among those who had not used any services was very low (5%), with no gender difference. Further, men and women reported equivalent numbers of treatment barriers and the same rank order for the most frequently endorsed barriers. However, women were twice as likely as men to think a problem would get better by itself-the most frequent reason for not seeking help (47% vs. 24%, p < 0.001), and men were more likely than women to report unsuccessful past help-seeking and not thinking anyone could help (19% vs. 3%, p < 0.001 and 17% vs. 5%, p = 0.001, respectively).
CONCLUSIONS
Consistent with previous studies, women were less likely to utilize alcohol services than men. Future interventions should address low problem recognition, and tailoring to gender-specific barriers may help close the disparity in services utilization.
背景
大多数患有酒精使用障碍的成年人都没有获得帮助，而且女性使用酒精服务的可能性低于男性。我们旨在使用全国性纵向数据来量化在使用酒精服务方面的性别差异，包括总体差异和类型差异，并探讨寻求帮助的可能性和不寻求帮助的原因方面潜在的性别差异。
方法
我们分析了符合 DSM-IV 酒精滥用或依赖标准的白人、非裔美国人和西班牙裔成年人（n=2592）在第 1 波（2000 年至 2001 年）的全国酒精相关情况流行病学调查中的数据。我们使用 Rao-Scott 卡方检验测试了第 2 波（2004 年至 2005 年）服务利用、感知到的帮助需求和治疗障碍方面的性别差异，并使用多变量逻辑回归评估了结果的预测因素，调整了问题严重程度、共病和人口统计学因素。
结果
与男性相比，女性利用任何酒精服务（调整后的优势比[aOR] 0.53；95%置信区间[95%CI]：0.33，0.86）、专科服务（aOR 0.41；95%CI 0.19，0.87）和 12 步团体（aOR 0.39；95%CI 0.21，0.71）的可能性要低得多。没有使用任何服务的人感知到的帮助需求非常低（5%），且不存在性别差异。此外，男性和女性报告的治疗障碍数量相当，最常被认可的障碍排名相同。然而，女性认为问题会自行好转的可能性是男性的两倍，这是不寻求帮助的最常见原因（47%比 24%，p<0.001），男性认为过去寻求帮助不成功和没有人能帮助的可能性比女性高（19%比 3%，p<0.001 和 17%比 5%，p=0.001）。
结论
与以往的研究一致，女性使用酒精服务的可能性低于男性。未来的干预措施应解决低问题识别问题，并针对性别特定的障碍进行调整，可能有助于缩小服务利用方面的差距。
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