基于定制化物质使用治疗项目的潜在类别分析：对治疗性与性别少数群体面临的综合征条件的启示。
A latent class analysis of tailored substance use treatment programs: Implications for treating syndemic conditions facing sexual and gender minority populations.
机构信息
Department of Psychology, Syracuse University, Syracuse, NY, USA.
Department of Psychology, Syracuse University, Syracuse, NY, USA; Department of Counseling and Educational Psychology, New Mexico State University, Las Cruces, NM, USA.
出版信息
Drug Alcohol Depend. 2022 Sep 1;238:109550. doi: 10.1016/j.drugalcdep.2022.109550. Epub 2022 Jun 30.
BACKGROUND
Syndemics (i.e., multiple, co-occurring, and synergistic conditions) contribute to elevated substance use among sexual and gender minority (SGM) people relative to heterosexual, cisgender people. Research suggests that syndemic-informed and SGM-tailored treatments are effective in substance use treatment among SGM people. However, few studies have examined 1) the proportion of substance use treatment facilities offering syndemic-informed, SGM-tailored treatment programming; and 2) the availability and accessibility of syndemic-informed, SGM-tailored treatment programs across the U.S.
METHODS
We used the 2020 National Survey of Substance Abuse Treatment Services (N-SSATS) dataset to perform a latent class analysis examining whether substance use treatment facilities' tailored treatment programs cluster together to form distinct classes indicating whether facilities offer syndemic-informed and SGM-tailored programming. We then used multinomial logistic regression to examine associations between class membership and facility availability and accessibility.
RESULTS
Analyses revealed four classes of substance use treatment facilities' tailored programs. Facilities with syndemic-informed and SGM-tailored treatment programs compared to facilities with no tailored programs were more likely to be in the Northeast compared to the Midwest and South; to offer payment assistance versus not offer payment assistance; and to be private, for-profit facilities versus public or non-profit facilities.
CONCLUSIONS
This study's findings identify the need for more facilities with syndemic-informed and SGM-tailored treatment, particularly in the Midwestern and Southern U.S. regions. Facilities offering syndemic-informed and SGM-tailored treatment might present accessibility barriers for low-income SGM people, as they were more likely to be private, for-profit facilities; however, they were more likely to offer payment assistance.
背景
综合征（即多种、同时发生且协同作用的情况）导致性少数群体（SGM）的物质使用相对异性恋、顺性别者增加。研究表明，综合征知情和 SGM 定制的治疗方法在 SGM 人群的物质使用治疗中是有效的。然而，很少有研究调查 1）提供综合征知情、SGM 定制的治疗计划的物质使用治疗设施的比例；以及 2）美国各地综合征知情、SGM 定制的治疗计划的可用性和可及性。
方法
我们使用 2020 年国家物质滥用治疗服务调查（N-SSATS）数据集进行潜在类别分析，以检查物质使用治疗设施的定制治疗方案是否聚类形成不同的类别，表明设施是否提供综合征知情和 SGM 定制的方案。然后，我们使用多项逻辑回归来检查类别的成员资格与设施的可用性和可及性之间的关联。
结果
分析显示，物质使用治疗设施的定制方案分为四个类别。与没有定制方案的设施相比，提供综合征知情和 SGM 定制治疗方案的设施更有可能位于东北部，而不是中西部和南部；提供支付援助，而不是不提供支付援助；以及是私营、营利性设施，而不是公共或非营利性设施。
结论
本研究的结果表明需要更多提供综合征知情和 SGM 定制的治疗设施，特别是在美国中西部和南部地区。提供综合征知情和 SGM 定制治疗的设施可能会对低收入 SGM 人群的可及性造成障碍，因为它们更有可能是私营、营利性设施；但是，他们更有可能提供支付援助。
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