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通过社区互助减少伤害,促进康复:描述参与混合同伴康复社区组织的人员特征。

Reducing harm and promoting recovery through community-based mutual aid: Characterizing those who engage in a hybrid peer recovery community organization.

机构信息

Substance Use Disorders Institute, University of the Sciences, Philadelphia, PA, United States of America.

Center for Young Adult Addiction and Recovery, Kennesaw State University, Kennesaw, GA, United States of America.

出版信息

Addict Behav. 2019 Nov;98:106037. doi: 10.1016/j.addbeh.2019.106037. Epub 2019 Jun 26.

Abstract

BACKGROUND

Peer-based support services are often used within harm reduction organizations, and more recently within recovery community organizations (RCO). Identifying the characteristics of individuals who engage with these novel RCOs is needed. Additionally, conducting collaborative research with communities of people who use drugs (PWUD) or are in recovery is an effective and rewarding approach that allows individuals to take ownership and play a critical role in the study.

METHODS

This exploratory study employs a community-based participatory research (CBPR) framework in partnership with a peer-led hybrid recovery community organization, Rebel Recovery, in Florida. Peer staff participated in all phases of the study, helping to inform the study protocol, data collection, analysis, interpretation, and results write-up. A cross-sectional survey instrument was used to collect consumer intake data. Pearson Chi-square tests and multivariate binomial logistic regressions were used to examine relationships between consumer characteristics and service utilization.

RESULTS

Consumers (n = 396) of Rebel Recovery peer support services had a mean age of 35.60 years (SD = 9.74). Many were experiencing homelessness (35.4%), unemployed (69.7%), high school graduates or GED holders (68.2%) and had a last year income of less than $10,000 (58.3%). The majority were users of heroin primarily (70.7%), with intravenous use being the preferred route of administration (63.9%). Exploratory analysis found that gender, marital status, and involvement in the child welfare system were significantly related to primary substance of use. Past 30-day engagement in recovery meetings had several statistically significant predictors including primary substance of use, age, housing status, annual income level, past-30-day arrests, tobacco use, and alcohol harm perception. Process findings from the CBPR methods used reconfirm the value of including peers in research involving PWUD and individuals in recovery.

CONCLUSIONS

Results suggest that peer-based support services at a hybrid recovery community organization can successfully engage populations that are often underserved (i.e., experiencing homelessness, involved in drug court, intravenous users, etc.). Significant relationships identified in the exploratory analysis suggest that additional education concerning overdose and the potential benefits of recovery meetings may be useful for specific consumers. Additionally, several recommendations and benefits of engaging in community-based participatory research with peer-led organizations are made for future research.

摘要

背景

同伴支持服务通常在减少伤害组织中使用,最近也在康复社区组织(RCO)中使用。需要确定参与这些新型 RCO 的个人的特征。此外,与使用毒品的人(PWUD)或正在康复的社区进行合作研究是一种有效的、有益的方法,它允许个人拥有所有权,并在研究中发挥关键作用。

方法

本探索性研究采用社区参与式研究(CBPR)框架,与佛罗里达州的一个由同伴领导的混合康复社区组织 Rebel Recovery 合作。同伴工作人员参与了研究的所有阶段,帮助制定研究方案、收集数据、分析、解释和结果报告。使用横断面调查工具收集消费者入组数据。使用 Pearson Chi-square 检验和多变量二项逻辑回归检验消费者特征与服务利用之间的关系。

结果

Rebel Recovery 同伴支持服务的消费者(n=396)的平均年龄为 35.60 岁(SD=9.74)。许多人无家可归(35.4%)、失业(69.7%)、高中毕业或 GED 持有者(68.2%),去年收入低于 10000 美元(58.3%)。大多数人主要使用海洛因(70.7%),首选静脉注射途径(63.9%)。探索性分析发现,性别、婚姻状况和参与儿童福利系统与主要物质的使用显著相关。过去 30 天内参加康复会议的情况有几个具有统计学意义的预测因素,包括主要物质的使用、年龄、住房状况、年收入水平、过去 30 天内的逮捕情况、吸烟和酒精危害感知。使用 CBPR 方法得出的过程结果再次证实了让同伴参与涉及 PWUD 和康复人员的研究的价值。

结论

结果表明,混合康复社区组织的同伴支持服务可以成功地接触到那些通常服务不足的人群(即无家可归、参与毒品法庭、静脉注射使用者等)。探索性分析中确定的显著关系表明,针对特定消费者,提供有关过量用药和康复会议潜在好处的额外教育可能会有所帮助。此外,还为未来的研究提出了一些与同伴领导的组织进行社区参与式研究的建议和好处。

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