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基于同伴康复教练为育龄妇女实施的社区戒毒减少项目中的种族差异保留情况。

Racial Differences in Retention in a Community-based Addiction Reduction Program Implemented by Peer Recovery Coaches for Women of Reproductive Age.

机构信息

Indiana University School of Medicine, Indianapolis, IN, USA.

Regenstrief Institute, Inc., Indianapolis, IN, USA.

出版信息

Inquiry. 2023 Jan-Dec;60:469580231218644. doi: 10.1177/00469580231218644.

Abstract

To identify program characteristics that influence the retention of women of reproductive age in the ommunity-based ddiction duction program (CARE), mixed-method analyses of CARE survey data and CARE Peer Recovery Coach (PRC) narrative entries of participant encounters were performed. About 251 women were enrolled in this prospective community-based implementation science intervention. We compared survey responses by race for treatment status, treatment motivation scales, and retention in the program at intake, 2-, 6-, 9-, and 12-month follow ups using Chi-square/-tests. Qualitative analysis of PRC narrative entries was conducted following thematic analysis and crystallization immersion analytic methods. White compared with Black women in CARE were significantly more likely to be in treatment at intake ( < .001) and more motivated to engage in recovery treatment ( < .001). However, Black women were retained longer in CARE at 2- ( < .006), 6- ( < .011), and 9- ( < .004) months. PRC narrative entries were coded, and emergent themes mapped well to the 4 types of supports provided by PRC as outlined by the Substance Abuse and Mental Health Services Administration: emotional, instrumental, informational, and affiliational. Analysis of narrative entries by race revealed that Black women were given more detailed information, communications with PRC were more encouraging and proactive in identifying and meeting needs, and PRC took a more hands-on approach when assisting and linking to resources. The inclusion of PRC as integral members of SUD recovery programs may preferentially provide Black women with SUD the opportunity to build more trusting relationships with these peer coaches, thereby increasing their participation and retention.

摘要

为了确定影响社区成瘾康复计划(CARE)中育龄妇女保留率的项目特征,我们对 CARE 调查数据和 CARE 同伴康复教练(PRC)的参与者遭遇叙述条目进行了混合方法分析。大约有 251 名女性参与了这项前瞻性的社区实施科学干预研究。我们比较了按种族分类的治疗状况、治疗动机量表和在入组时、2 个月、6 个月、9 个月和 12 个月随访时的保留率,使用卡方检验。对 PRC 叙述条目的定性分析采用主题分析和结晶浸析分析方法。与 CARE 中的黑人女性相比,白人女性在入组时更有可能接受治疗( < .001),更有动机参与康复治疗( < .001)。然而,黑人女性在 CARE 中的保留时间更长,分别在 2 个月( < .006)、6 个月( < .011)和 9 个月( < .004)。对 PRC 叙述条目进行编码,并对出现的主题进行分析,与 PRC 提供的四种支持类型(情感支持、工具支持、信息支持和联系支持)很好地吻合。按种族分析叙述条目发现,黑人女性获得了更详细的信息,PRC 的沟通更具鼓励性和主动性,能够主动识别和满足需求,并且在协助和链接资源方面,PRC 采取了更直接的方法。将 PRC 作为 SUD 康复计划的不可或缺的成员纳入其中,可能会优先为 SUD 的黑人女性提供与这些同伴教练建立更信任关系的机会,从而提高她们的参与度和保留率。

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