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一站式康复服务:美国康复社区中心的参与者特征和受益调查。

One-Stop Shopping for Recovery: An Investigation of Participant Characteristics and Benefits Derived From U.S. Recovery Community Centers.

机构信息

From the, Recovery Research Institute, (JFK, NF-S, LAH, BBH), Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.

DePaul University, (RLS), Chicago, Illinois.

出版信息

Alcohol Clin Exp Res. 2020 Mar;44(3):711-721. doi: 10.1111/acer.14281. Epub 2020 Feb 3.

Abstract

BACKGROUND

Recovery community centers (RCCs) are the "new kid on the block" in providing addiction recovery services, adding a third tier to the 2 existing tiers of formal treatment and mutual-help organizations (MHOs). RCCs are intended to be recovery hubs facilitating "one-stop shopping" in the accrual of recovery capital (e.g., recovery coaching; employment/educational linkages). Despite their growth, little is known about who uses RCCs, what they use, and how use relates to improvements in functioning and quality of life. Greater knowledge would inform the field about RCC's potential clinical and public health utility.

METHODS

Online survey conducted with participants (N = 336) attending RCCs (k = 31) in the northeastern United States. Substance use history, services used, and derived benefits (e.g., quality of life) were assessed. Systematic regression modeling tested a priori theorized relationships among variables.

RESULTS

RCC members (n = 336) were on average 41.1 ± 12.4 years of age, 50% female, predominantly White (78.6%), with high school or lower education (48.8%), and limited income (45.2% <$10,000 past-year household income). Most had either a primary opioid (32.7%) or alcohol (26.8%) problem. Just under half (48.5%) reported a lifetime psychiatric diagnosis. Participants had been attending RCCs for 2.6 ± 3.4 years, with many attending <1 year (35.4%). Most commonly used aspects were the socially oriented mutual-help/peer groups and volunteering, but technological assistance and employment assistance were also common. Conceptual model testing found RCCs associated with increased recovery capital, but not social support; both of these theorized proximal outcomes, however, were related to improvements in psychological distress, self-esteem, and quality of life.

CONCLUSIONS

RCCs are utilized by an array of individuals with few resources and primary opioid or alcohol histories. Whereas strong social supportive elements were common and highly rated, RCCs appear to play a more unique role not provided either by formal treatment or by MHOs in facilitating the acquisition of recovery capital and thereby enhancing functioning and quality of life.

摘要

背景

康复社区中心(RCC)是提供成瘾康复服务的“新贵”,为现有的正式治疗和互助组织(MHO)两个层次增加了第三个层次。RCC 旨在成为促进“一站式购物”的康复中心,以获得康复资本(例如,康复指导;就业/教育联系)。尽管它们在不断发展,但人们对谁使用 RCC、他们使用什么以及使用方式如何与功能和生活质量的改善相关知之甚少。更多的知识将为该领域提供关于 RCC 潜在临床和公共卫生效用的信息。

方法

对参加美国东北部 31 个康复社区中心(k=31)的参与者(N=336)进行在线调查。评估了药物使用史、使用的服务以及获得的利益(例如,生活质量)。系统回归模型测试了变量之间预先设想的关系。

结果

RCC 成员(n=336)的平均年龄为 41.1±12.4 岁,50%为女性,主要为白人(78.6%),高中或以下学历(48.8%),收入有限(45.2%过去一年家庭收入<10,000 美元)。大多数人有主要的阿片类药物(32.7%)或酒精(26.8%)问题。将近一半(48.5%)报告有终生精神科诊断。参与者参加 RCC 的时间平均为 2.6±3.4 年,其中许多人参加不到 1 年(35.4%)。最常使用的方面是社交导向的互助/同伴群体和志愿服务,但技术援助和就业援助也很常见。概念模型测试发现,RCC 与增加的康复资本有关,但与社会支持无关;然而,这两个理论上的近端结果都与心理困扰、自尊和生活质量的改善有关。

结论

RCC 被各种资源较少、主要有阿片类药物或酒精史的人使用。虽然强烈的社会支持元素很常见且评价很高,但 RCC 似乎在促进康复资本的获取方面发挥着更为独特的作用,而这既不是正式治疗也不是 MHO 所能提供的,从而增强了功能和生活质量。

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