DeCristofaro Diadora, Futter Allison, Williamson Alivia, Hoeppner Susanne S, Hoffman Lauren A, Riggs Marion J, Joseph Judeline, Ojeda Julia, Mericle Amy A, Rao Vinod, Rutherford Philip X, McCarthy Patty, Hoeppner Bettina B
Psychiatry Department, Massachusetts General Hospital, Boston, MA, United States.
Department of Neurology, Harvard Medical School, Boston, MA, United States.
Front Public Health. 2025 Jul 2;13:1532488. doi: 10.3389/fpubh.2025.1532488. eCollection 2025.
Racial and ethnic disparities exist in opioid-related overdose death rates and engagement with substance use disorder (SUD) treatment. Emerging peer recovery support services (PRSS) show promise in engaging and supporting marginalized populations. Recovery community centers (RCCs) are an important and growing source of community-based PRSS. Our goal was to examine if RCCs serving Black, Hispanic/Latino, or other racial/ethnic communities successfully engage marginalized populations in their community and if there are differences in the service models and functioning of RCCs serving different racial/ethnic communities.
We conducted exploratory secondary analyses of a nationwide survey of RCC directors ( = 122), in which directors described their RCC in terms of logistics, footprints, service model, linkages, services, and attitudes toward medication treatment. Analysis of variance and chi-square tests were used to compare RCCs serving different communities (i.e., Black, Hispanic/Latino, Other) on these variables, where "serving a Black/Hispanic/Latino community" was operationally defined as being in a ZIP code with more than double the national prevalence of Black (13.6%) and Hispanic/Latino (19.1%) individuals in the United States.
On average, the median [IQR] percentage of Black participants within RCCs serving Black communities was 45% [30-63%] (51% of residents in the RCCs' ZIP codes were Black); in RCCs serving Hispanic/Latino communities, 50% [28-60%] of RCC participants were Hispanic/Latino (57% of residents in the RCCs' ZIP codes were Hispanic/Latino). Across 70 variables describing the RCCs' service model and functioning, only two statistically significant differences emerged between RCCs serving Black, Hispanic/Latino, and other communities, using an alpha of 0.05. RCCs differed in offering 12-step mutual aid groups (lowest in RCCs serving Hispanic/Latino communities; = 0.03) and the existence of direct collaboration with clinical sites providing medications for opioid use disorder (MOUD, most common in RCCs serving Black communities; = 0.03).
The overall RCC model appears to be consistent across racial/ethnic settings in terms of footprints, model of care, services offered, connection to relevant systems and organizations, and attitudes toward medications. Given the commonly observed racial/ethnic disparities in SUD care, the robustness of the RCC model across communities is promising.
阿片类药物相关过量死亡率以及物质使用障碍(SUD)治疗的参与度方面存在种族和族裔差异。新兴的同伴康复支持服务(PRSS)在吸引和支持边缘化人群方面显示出前景。康复社区中心(RCC)是基于社区的PRSS的一个重要且不断增长的来源。我们的目标是研究服务于黑人、西班牙裔/拉丁裔或其他种族/族裔社区的RCC是否成功吸引了其社区中的边缘化人群,以及服务于不同种族/族裔社区的RCC在服务模式和功能上是否存在差异。
我们对一项针对RCC主任的全国性调查(n = 122)进行了探索性二次分析,在该调查中,主任们从后勤、规模、服务模式、联系、服务以及对药物治疗的态度等方面描述了他们的RCC。方差分析和卡方检验用于比较服务于不同社区(即黑人、西班牙裔/拉丁裔、其他)的RCC在这些变量上的差异,其中“服务于黑人/西班牙裔/拉丁裔社区”在操作上被定义为位于邮政编码区域内,黑人(13.6%)和西班牙裔/拉丁裔(19.1%)个体的全国患病率超过两倍的地区。
平均而言,服务于黑人社区的RCC中黑人参与者的中位数[四分位间距]百分比为45%[30 - 63%](RCC邮政编码区域内51%的居民为黑人);在服务于西班牙裔/拉丁裔社区的RCC中,50%[28 - 60%]的RCC参与者为西班牙裔/拉丁裔(RCC邮政编码区域内57%的居民为西班牙裔/拉丁裔)。在描述RCC服务模式和功能的70个变量中,使用0.05的显著性水平,服务于黑人、西班牙裔/拉丁裔和其他社区的RCC之间仅出现了两个具有统计学意义的差异。RCC在提供12步互助小组方面存在差异(在服务于西班牙裔/拉丁裔社区的RCC中比例最低;P = 0.03),以及在与提供阿片类药物使用障碍药物(MOUD)的临床场所直接合作的情况方面存在差异(在服务于黑人社区的RCC中最为常见;P = 0.03)。
总体而言,RCC模式在足迹、护理模式、提供的服务、与相关系统和组织的联系以及对药物的态度等方面在不同种族/族裔环境中似乎是一致的。鉴于在SUD护理中普遍观察到的种族/族裔差异,RCC模式在不同社区的稳健性是有前景的。