Department of African American Studies, Virginia Commonwealth University, Richmond, Virginia, USA.
School of Nursing, Virginia Commonwealth University, Richmond, Virginia, USA.
J Prev Interv Community. 2023 Jul-Sep;51(3):268-286. doi: 10.1080/10852352.2021.1930820. Epub 2021 May 31.
This study aims to determine whether current tobacco and/or alcohol use is associated with setting preferences for seeking support for substance use (SU) and mental health (MH) services to African Americans ages 50 and older.
Data from 368 African American individuals (aged 50+) who participated in a community-based needs assessment survey were used. Preferences included community-based (e.g., health centers) and traditional settings (e.g., doctor's office). SU was measured as a categorical variable detailing past-month use of conventional cigarettes and alcohol graded by risk levels. Logistic regression models tested the associations between SU and setting preference before and after adjusting for the influence of self-reported MH diagnoses.
Prior to adjustment for the influence of MH outcomes, high-risk use of tobacco and alcohol in the past month was associated with a lower odds of preferring MH/SU support in traditional settings (OR = 0.23, 95% CI = 0.06-0.85) compared to participants engaged in no-/low- risk substance use. This association was no longer significant after accounting for the influence of mental health symptoms and covariates.
These results provide preliminary evidence that mental health outcomes mediate the association between substance use and setting preference for seeking MH/SU support in traditional settings.
This exploratory study encourages additional investigation of the association between substance use, setting preferences, and the likelihood of seeking treatment in community health centers using larger sample sizes. Additional opportunities to offer mental health/substance use support to African American older adults within clinical settings should be explored.
本研究旨在确定当前的烟草和/或酒精使用是否与 50 岁及以上非裔美国人寻求药物使用（SU）和心理健康（MH）服务支持的偏好有关。
使用了 368 名参与基于社区的需求评估调查的非裔美国个体（年龄在 50 岁及以上）的数据。偏好包括基于社区的（例如，健康中心）和传统设置（例如，医生办公室）。SU 被测量为一个分类变量，详细说明过去一个月内常规香烟和酒精的使用情况，并按风险水平分级。逻辑回归模型在调整自我报告的 MH 诊断结果的影响后，测试了 SU 与设置偏好之间的关联。
在调整 MH 结果的影响之前，过去一个月内高风险的烟草和酒精使用与传统环境中 MH/SU 支持偏好的几率降低相关（OR=0.23，95%CI=0.06-0.85），与无/低风险物质使用者相比。在考虑到心理健康症状和协变量的影响后，这种关联不再显著。
这些结果提供了初步证据，表明心理健康结果中介了物质使用与传统环境中寻求 MH/SU 支持的设置偏好之间的关联。
这项探索性研究鼓励使用更大的样本量，进一步调查物质使用、设置偏好以及在社区健康中心寻求治疗的可能性之间的关联。应探索在临床环境中为非裔美国老年人提供心理健康/物质使用支持的其他机会。
