Florida International University, Herbert Wertheim College of Medicine and Robert Stempel College of Public Health and Social Work, 11200 SW 8th St, AHC4, Miami, FL 33199, United States.
California State University, Fullerton College of Business and Economics, 800 N State College Blvd, Fullerton CA 92831, United States.
Eval Program Plann. 2023 Apr;97:102240. doi: 10.1016/j.evalprogplan.2023.102240. Epub 2023 Jan 16.
Policies and programs that aim to minimize wait time to enter opioid use disorder (OUD) treatment and maximize retention respond to potential differences in female and male clients' risk profiles. We conducted multigroup latent class analysis using significant individual risk factors. Our sample included 13,453 opioid treatment episodes from 135 unique substance use disorder treatment programs in Los Angeles County, California, in four waves: 2011 (66 programs, 1035 clients), 2013 (77 programs, 3671 clients), 2015 (75 programs, 4625 clients), and 2017 (69 programs, 4106 clients). Groups at risk of waiting longer included clients who were female, had mental health issues, received medication for OUD, had criminal justice involvement, received mandated referrals, had children in child protective services, and had caretaker responsibilities. All clients with children in protective services were likely to wait longer than those not in protective services, but women waited longer. Findings highlight that: (a) women and men in OUD treatment have significant health and social problems; (b) female and male clients have distinct risk profiles; and (c) targeted services responding to risk profiles may improve treatment access and engagement. Findings have implications for health policy and program evaluation and planning in the delivery of treatment services considering gendered risk factors.
旨在将进入阿片类药物使用障碍（OUD）治疗的等待时间最小化并最大限度地提高保留率的政策和计划，针对女性和男性客户的风险状况的潜在差异做出反应。我们使用重要的个体风险因素进行了多群组潜在类别分析。我们的样本包括加利福尼亚州洛杉矶县 135 个独特的物质使用障碍治疗计划中的 13453 个阿片类药物治疗发作，分四波进行：2011 年（66 个计划，1035 名患者），2013 年（77 个计划，3671 名患者），2015 年（75 个计划，4625 名患者）和 2017 年（69 个计划，4106 名患者）。等待时间较长的风险群体包括女性、有心理健康问题、接受 OUD 药物治疗、有刑事司法牵连、接受强制性转介、有儿童受保护服务和有照顾者责任的患者。所有有儿童受保护服务的患者都比没有受保护服务的患者更有可能等待更长时间，但女性等待的时间更长。研究结果表明：（a）OUD 治疗中的女性和男性患者都有严重的健康和社会问题；（b）女性和男性患者的风险状况明显不同；（c）针对风险状况提供的针对性服务可能会改善治疗的获得和参与。研究结果对考虑性别风险因素的治疗服务的健康政策、计划评估和规划具有重要意义。
