Alcohol Research Group, Emeryville, California.
Massachusetts General Hospital & Harvard Medical School, Boston, Massachusetts.
J Stud Alcohol Drugs. 2024 Jan;85(1):32-40. doi: 10.15288/jsad.23-00086. Epub 2023 Aug 30.
Mutual-help groups (MHGs) like Alcoholics Anonymous (AA) are effective for resolving alcohol use disorders (AUDs), but few studies have examined disparities in MHG participation, particularly recently. We used five waves of National Alcohol Survey data to investigate whether prevalence of AA attendance among those with a lifetime AUD differed by race/ethnicity, age, and sex, directly testing whether these associations varied with time.
Analyses pooled weighted data from 2000 to 2020, including only participants with a lifetime AUD and identifying as non-Hispanic White, Latinx/Hispanic, or non-Hispanic Black/African American ( = 8,876). Logistic regression models examined associations between lifetime AA attendance and survey year, race/ethnicity, age, and sex; models also tested for differences in demographic effects across survey year using interaction terms.
In bivariate models, AA attendance was significantly less prevalent among participants identifying as Latinx/Hispanic (vs. White); ages 18-29 (vs. 30-64); and female (vs. male). Survey year was unrelated to AA attendance, and all interactions involving survey year were nonsignificant. In the final multivariate model (which controlled for severity and other help-seeking), disparities persisted for those identifying as Latinx/Hispanic (vs. White; adjusted odds ratio [aOR] = 0.63) and ages 18-29 (vs. 30-64; aOR = 0.35); AA attendance was also less prevalent among Black/African American (vs. White) participants (aOR = 0.59), but sex became nonsignificant.
Results replicate and extend sparse findings regarding disparities in MHG attendance and suggest a stagnation in AA's growth and reach to underserved populations. Findings highlight the need to more effectively facilitate MHG attendance (and perhaps broader social network change) among racial/ethnic minorities and emerging adults.
互助小组（如匿名戒酒会）对于解决酒精使用障碍（AUD）非常有效，但很少有研究探讨互助小组参与方面的差异，尤其是最近的研究。我们使用了五次全国酒精调查数据，调查了一生中 AUD 的参与者中 AA 出勤率是否因种族/民族、年龄和性别而异，直接检验了这些关联是否随时间变化而变化。
我们对 2000 年至 2020 年的加权数据进行了分析，仅包括一生中 AUD 并自认为是非西班牙裔白人、拉丁裔/西班牙裔或非西班牙裔黑人和非洲裔美国人（=8876）的参与者。逻辑回归模型检验了一生中 AA 出勤率与调查年份、种族/民族、年龄和性别之间的关联；模型还使用交互项检验了人口统计学效应在调查年份之间的差异。
在双变量模型中，拉丁裔/西班牙裔（与白人相比）；年龄在 18-29 岁（与 30-64 岁）；以及女性（与男性相比），AA 出勤率明显较低。调查年份与 AA 出勤率无关，且所有涉及调查年份的交互项均无统计学意义。在最终的多变量模型中（控制了严重程度和其他寻求帮助的因素），与白人相比，拉丁裔/西班牙裔（调整后的优势比[OR] = 0.63）和 18-29 岁（与 30-64 岁相比；调整后的 OR = 0.35）的参与者中仍存在差异；黑人和非洲裔美国人（与白人相比）AA 出勤率也较低（调整后的 OR = 0.59），但性别变得无统计学意义。
结果复制并扩展了关于互助小组参与差异的稀疏发现，并表明 AA 在服务不足人群中的增长和影响力停滞不前。这些发现强调了需要更有效地促进少数族裔和年轻成年人参与互助小组（或许还有更广泛的社交网络变化）。
