Levine Emily A, Sugarman Dawn E, Rockas Mary, McHugh R Kathryn, Jordan Chloe, Greenfield Shelly F
McLean Hospital.
Department of Psychiatry, Harvard Medical School.
Curr Addict Rep. 2023 Dec;10:638-648. doi: 10.1007/s40429-023-00515-1. Epub 2023 Sep 12.
The purpose of this review is to examine recent literature (2012-2022) on alcohol treatment access and engagement in women in the U.S. and propose future directions for research and clinical practice.
A targeted literature review resulted in 27 studies encompassing screening and brief intervention (SBIRT), treatment utilization, treatment engagement, and barriers to treatment. Recent literature demonstrates overall low rates of screening and brief interventions and treatment utilization in the population with women less likely to be screened and utilize alcohol treatment. The magnitude of these gender differences varies with race/ethnicity. Extensive barriers to care include provider knowledge, structural barriers, and attitudinal barriers and these vary with service setting, gender, and race/ethnicity.
There is an increasing prevalence of alcohol use and Alcohol Use Disorder (AUD) in women with low rates of screening, brief treatment, treatment, and engagement which have resulted from extensive barriers to care. Possible areas of further inquiry include the impact of race/ethnicity on gender differences, improving provider and system level policies to promote SBIRT and treatment engagement and utilization, further developing digital interventions, and implementation research to investigate factors associated with optimizing effectiveness of gender-responsive and culturally tailored interventions that address the unique needs of women.
本综述旨在审视2012年至2022年期间美国女性酒精治疗可及性与参与度方面的最新文献,并提出未来研究及临床实践的方向。
一项有针对性的文献综述纳入了27项研究,涵盖筛查与简短干预(SBIRT)、治疗利用情况、治疗参与度以及治疗障碍。最新文献表明,总体而言,筛查、简短干预及治疗利用的比例较低,女性接受酒精治疗筛查及利用治疗的可能性更小。这些性别差异的程度因种族/族裔而异。广泛的护理障碍包括提供者知识、结构障碍和态度障碍,这些障碍因服务环境、性别和种族/族裔而异。
女性酒精使用及酒精使用障碍(AUD)的患病率不断上升,而筛查、简短治疗、治疗及参与的比例较低,这是由广泛的护理障碍导致的。可能进一步探究的领域包括种族/族裔对性别差异的影响、改善提供者及系统层面的政策以促进SBIRT及治疗参与和利用、进一步开发数字干预措施,以及开展实施研究以调查与优化满足女性独特需求的性别针对性和文化适应性干预措施有效性相关的因素。