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康复社区中心:新参与者的特征以及参与的预测因素和效果的纵向调查。

Recovery community centers: Characteristics of new attendees and longitudinal investigation of the predictors and effects of participation.

作者信息

Kelly John F, Fallah-Sohy Nilofar, Cristello Julie, Stout Robert L, Jason Leonard A, Hoeppner Bettina B

机构信息

Recovery Research Institute, Massachusetts General Hospital and Harvard Medical School, 151 Merrimac Street, Boston, MA 02114, United States of America.

Florida International University, United States of America.

出版信息

J Subst Abuse Treat. 2021 May;124:108287. doi: 10.1016/j.jsat.2021.108287. Epub 2021 Jan 13.

Abstract

OBJECTIVE

Recovery community centers (RCCs) have expanded across the U.S., serving as social "recovery hubs" that increase recovery capital (e.g., employment, housing) by providing resources that clinical care does not provide. While research supports RCCs' general utility, little is known about new participants' characteristics, predictors of engagement, services used, and benefits derived. Greater knowledge would inform the field about RCCs' clinical and public health potential.

METHOD

Prospective, single-group study of individuals (N = 275) starting at RCCs (k = 7) in the northeastern U.S. and reassessed 3 months later regarding the services these individuals used and the benefits they derived (e.g., reduced substance problems, enhanced quality of life [QOL]). Regression and longitudinal models tested theorized relationships.

RESULTS

Participants were mostly young to middle-aged, racially diverse, single, unemployed, men and women, with low education and income, suffering from opioid or alcohol use disorder, with a history of psychiatric problems, low QOL, and prior treatment/mutual-help participation. Attendance varied greatly, but on average, was 1-2 times/week, with greater RCC engagement predicted by Hispanic ethnicity, shorter travel time, prior treatment, lower initial social support, and relatively greater baseline QOL (QOL was low overall). Commonly used and highly valued services included social support infrastructures (e.g., recovery coaching/meetings), and technological and employment assistance. In longitudinal analyses (n = 138), the study observed improvements in duration of abstinence, substance problems, psychological well-being, and QOL, but not in recovery assets.

CONCLUSION

Findings generally are consistent with prior observations that RCCs engage and provide benefits for individuals facing the greatest challenges in terms of clinical pathology and low QOL and resources.

摘要

目的

康复社区中心(RCCs)已在美国各地扩展,作为社会“康复枢纽”,通过提供临床护理所不提供的资源来增加康复资本(如就业、住房)。虽然研究支持RCCs的一般效用,但对于新参与者的特征、参与的预测因素、使用的服务以及获得的益处知之甚少。更多的了解将使该领域了解RCCs的临床和公共卫生潜力。

方法

对美国东北部7个RCCs的275名个体进行前瞻性单组研究,并在3个月后重新评估这些个体使用的服务及其获得的益处(如减少物质问题、提高生活质量[QOL])。回归和纵向模型检验了理论关系。

结果

参与者大多为中青年,种族多样,单身,失业,男女皆有,教育程度和收入较低,患有阿片类药物或酒精使用障碍,有精神问题病史,生活质量低,且曾接受过治疗/互助参与。出勤率差异很大,但平均每周1 - 2次,西班牙裔、较短的出行时间、先前的治疗、较低的初始社会支持以及相对较高的基线生活质量(总体生活质量较低)可预测更高的RCC参与度。常用且高度重视的服务包括社会支持基础设施(如康复指导/会议)以及技术和就业援助。在纵向分析(n = 138)中,研究观察到禁欲时长、物质问题、心理健康和生活质量有所改善,但康复资产方面没有改善。

结论

研究结果总体上与先前的观察结果一致,即RCCs为在临床病理、低生活质量和资源方面面临最大挑战的个体提供服务并带来益处。

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