Substance Abuse & Treatment Gaps in Asians, Pacific Islanders & Multiple-race Ind

药物滥用

• 批准号: 8795113
• 负责人: Li-Tzy Wu
• 金额: $ 39.25万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-07-03 至 2016-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8795113
• 关键词: Accident and Emergency department; Accounting; Address; Admission activity; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Asian Americans; Asians; Budgets; Caring; Clinic; Clinical; Cocaine; Communities; Comorbidity; Complement; Computerized Medical Record; Data; Data Files; Databases; Development; Diagnostic; Disease; Drug Use Disorder; Drug usage; Evidence based program; Goals; Hallucinogens; Health; Healthcare; Heroin; Hospitalization; Immigration; Incidence; Individual; Inhalant dose form; Intervention; Knowledge; Length; Literature; Location; Marijuana; Measures; Medical; Mental disorders; Minority; Minority Groups; Modality; Modeling; Office Management; Opioid; Outpatients; Pacific Island Americans; Pathway interactions; Patients; Pattern; Perception; Pharmaceutical Preparations; Pharmacotherapy; Policies; Population; Poverty; Prevalence; Prevention program; Primary Prevention; Psychiatric therapeutic procedure; Psychotherapy; Public Health; Race; Reporting; Research; Resources; Respondent; Risk; Sampling; Services; Specific qualifier value; Stress; Subgroup; Substance Use Disorder; Substance-Related Disorders; Surveys; Tranquilizing Agents; Treatment outcome; Underserved Population; addiction; behavioral health; cost; cost effective; evidence base; health care quality; health disparity; improved; knowledge base; patient home care; patient oriented; population based; programs; screening; sedative; substance abuse treatment; treatment response; trend

DESCRIPTION (provided by applicant): Consistent with the goal of RFA-MD-12-003, this application proposes to address health disparities among the identified minority groups: Asian Americans (AAs), Pacific Islanders (PIs), and multiple-race individuals (MRs). AAs, PIs, and MRs are among the most understudied and the least known minority populations, especially for substance problems and treatment needs. The lack of population-based data on the incidence and prevalence of use of alcohol and 9 drug classes as well as the patterns and magnitude of substance-related disorders and treatment needs for each group make it almost impossible to develop evidence-based programs and policies to address substance-related burdens for these fastest-growing and underserved populations. Capitalizing on the largest national studies of substance use and disorders (National Survey on Drug Use and Health, NSDUH) and the largest psychiatric electronic medical record data repository (MindLinc) in the US, the proposed team will examine substance abuse and treatment gaps for each group. Study aims include to (a) examine the incidence and determinants of first use (onset) of alcohol and nine major drug classes, including incidence trends, risk periods for initiation, and correlates of recent initiatin; (b) determine the patterns, sequences, and correlates of polysubstance use and substance disorders; (c) investigate the prevalence, patterns, and correlates of substance abuse treatment use, including the location of services received, the primary abused substance for receiving treatment, and perceived unmet needs for and barriers to treatment use; (d) elucidate comprehensive patterns of comorbid disorders and their temporal associations; and (e) determine pathways to psychiatric treatment, including treatment entry settings, primary disorders for treatment entry (substance vs. non-substance disorders), modes of treatment, and treatment responses. Analyses for each aim will examine differences across racial groups to gauge the extent of health disparities (AAs, PIs, MRs vs. whites) and within each group to provide an in-depth knowledge base for each specific population. The findings will identify the heightened risk periods for initiating alcohol or drug use and at-risk subgroups to facilitate targeting primary prevention programs. They also will specify subgroups showing elevated odds of polysubstance use, drug disorders, and other mental disorders, so they can be targeted for focused interventions to reduce serious consequences. The field will understand better the unmet needs for and barriers to treatment use among AAs, PIs, and MRs. Given the Patient Protection and Affordable Care Act, such a comprehensive knowledge base is timely needed to guide evidence-based research, intervention, policymaking to reduce burdens and costs associated with substance use. The largest national data files for these groups will be complemented by longitudinally collected treatment data to provide a fuller picture of substance abuse treatment needs for these understudied groups. This project constitutes an initial and cost-effective step to study the distributions, correlates, courses, consequences, and treatment gaps of substance problems among AAs, PIs, and MRs.

描述（由申请人提供）：与RFA-MD-12-003的目标一致，该申请建议解决已确定的少数群体之间的健康差异：亚裔美国人（AAS），太平洋岛民（PIS）和多赛车人（MRS）。 AAS，PI和MRS是最熟悉，最鲜为人知的少数群体之一，尤其是针对物质问题和治疗需求。缺乏关于酒精和9种药物类别的发生率和流行率的基于人群的数据，以及与物质有关的疾病的模式和大小，每组的疾病和治疗需求几乎不可能制定基于证据的计划和政策来解决这些快速增长和不受欢迎的人群的与物质相关的负担。利用美国最大的药物使用和疾病研究（全国药物使用和健康调查，NSDUH）和美国最大的精神病医疗记录数据存储库（MindLinc），该团队将检查每组的药物滥用和治疗差距。研究目的包括（a）检查酒精和九个主要药物类别的首次使用（发病）的发病率和决定因素，包括发病率趋势，起始风险期以及最近的启动蛋白的相关性； （b）确定多物质使用和物质疾病的模式，序列和相关性； （c）调查使用药物治疗的患病率，模式和相关性，包括接受的服务位置，接受治疗的主要滥用物质以及对治疗使用的未满足需求和障碍； （d）阐明合并症及其时间关联的全面模式； （e）确定精神病治疗的途径，包括治疗入境设置，治疗入境的主要疾病（物质与非固定性疾病），治疗方式和治疗反应。每个目标的分析将检查种族群体之间的差异，以衡量健康差异的程度（AAS，PIS，MRS vs. Whites），并在每个群体中为每个特定人群提供深入的知识库。这些发现将确定启动酒精或药物使用以及处于危险的亚组的风险时期，以促进针对初级预防计划。他们还将指定亚组，显示使用多物质的使用率升高，药物疾病和其他精神障碍，因此可以将其作为针对重点干预措施的目标，以减少严重的后果。该领域将更好地了解AAS，PI和MR之间对治疗使用的未满足需求和障碍。鉴于《患者保护和负担得起的护理法》，这种全面的知识库及时需要指导基于证据的研究，干预，决策，以降低负担和与药物使用相关的成本。这些小组最大的国家数据文件将由纵向收集的治疗数据补充，以提供这些研究研究小组的药物滥用治疗需求的更全面。该项目构成了研究AAS，PI和MRS中物质问题的分布，相关性，课程，后果和治疗差异的初始且具有成本效益的步骤。