Multi-level Analyses of the NESARC to Explain Treatment Gaps

NESARC 的多层次分析解释治疗差距

• 批准号: 7046278
• 负责人: Mary Jo Larson
• 金额: $ 21.19万
• 依托单位: NEW ENGLAND RESEARCH INSTITUTES, INC.
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-30 至 2010-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7046278
• 关键词: alcoholism /alcohol abuse therapy; clinical research; drug abuse therapy; gender difference; geographic difference; health care cost /financing; health care policy; health care service organization; health care service utilization; health services research tag; human data; longitudinal human study; racial /ethnic difference; socioeconomics; statistics /biometry

DESCRIPTION (provided by applicant): The objective of this grant application is to investigate the factors that explain the heterogeneity in alcohol and drug disorders, treatment seeking, and recovery across geographic areas, racial/ethnic groups and gender groups. This project conducts secondary analyses of the NESARC and NLAES to study the dynamic interaction of factors at both the individual level and societal/health system level, specifically: state policies, public financing, health system organization, and state/area socio-economic characteristics. To understand the influence of these contextual level factors, the study will employ hierarchical multi-level analytical techniques, modeling the behavior of individuals as nested within social and geographic environments. The analytic approach is informed by theories of treatment seeking, the social determinants of health, and research on recovery in treated and untreated populations. The Specific Aims are to: AIM 1: describe the variation in treatment need, treatment utilization (formal and informal services), and treatment gap across the 50 states, and identify the contextual factors (policy, financing, health system organization, and socio-economic) that explain the observed variation, controlling for demographic and other differences across states. This aim will involve cross-sectional and trends analyses of 1990-91 NLAES and 2001-02 NESARC. AIM 2: analyze how characteristics of individuals (particularly race/ethnicity and gender) interact with state and area contextual factors (policy, financing, health system organization, and socio-economic) to determine the probability that individuals with alcohol and drug use problems will recognize the need for care, seek care, and receive care. This aim will be addressed with cross-sectional analyses of NLAES and the 2001-02 NESARC. AIM 3: assess the impact of the state-level treatment gap and other area contextual factors on the probability of individual remission from alcohol and drug disorders and problems, all other things equal. This aim will involve longitudinal analysis of prospective data gathered on the 2004-2005 NESARC controlling for cohort information from the 2001-2002 NESARC. The treatment gap is a pressing problem in substance abuse health services research today, and yet there are significant limitations in our understanding of the problem. The NLAES and NESARC surveys offer an unprecedented opportunity to understand these dynamics since the surveys are based on representative samples of the community-at-large rather than a treated population and the NESARC collects longitudinal data on its community sample.

描述（由申请人提供）： 该赠款应用的目的是调查解释酒精和药物障碍，治疗寻求治疗以及跨地理区域，种族/种族群体和性别群体的异质性的因素。该项目对NESARC和NLAE进行了次要分析，以研究个人级别和社会/卫生系统水平的因素的动态相互作用，特别是：国家政策，公共融资，卫生系统组织以及州/地区社会经济特征。为了了解这些上下文级别因素的影响，该研究将采用分层多层次分析技术，将个人的行为建模为嵌套在社会和地理环境中。分析方法是由寻求治疗的理论，健康的社会决定因素以及治疗和未经治疗人群的康复研究所告知的。 具体目的是：目标1：描述50个州的治疗需求，治疗利用（正式和非正式服务）以及治疗差距的差异，并确定上下文因素（政策，融资，卫生系统组织和社会经济），这些因素解释了观察到的差异，控制人口统计学和其他州的人口统计学和其他差异。该目标将涉及1990 - 91年NLAE和2001-02 NESARC的横断面和趋势分析。目标2：分析个人的特征（尤其是种族/种族和性别）如何与国家和地区的背景因素（政策，融资，卫生系统组织和社会经济）相互作用，以确定患有酒精和吸毒问题的人会认识到需要护理，寻求护理和接受护理的可能性。该目标将通过NLAE和2001-02 NESARC的横截面分析来解决。 AIM 3：评估州级治疗差距和其他领域上下文因素对酒精和药物疾病和问题的个人缓解可能性的影响，所有其他方面相等。这个目标将涉及对2004 - 2005年NESARC控制的前瞻性数据的纵向分析，该数据控制了2001 - 2002年NESARC的同类信息。 治疗差距是当今药物滥用卫生服务研究的一个紧迫问题，但是我们对问题的理解有很大的局限性。 NLAE和NESARC调查提供了一个前所未有的机会来了解这些动态，因为调查基于社区 - 大型人群的代表性样本，而不是经过治疗的人群，而NESARC在其社区样本上收集了纵向数据。