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，本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 (AA)、太平洋岛民 (PI) 和多种族个体（太太）。 AA、PI 和 MR 是研究最多和最不为人所知的少数群体，特别是在物质问题和治疗需求方面。由于缺乏关于酒精和 9 类药物使用的发生率和流行率以及物质相关疾病的模式和严重程度以及每个群体的治疗需求的人口数据，因此几乎不可能制定基于证据的计划和政策解决这些增长最快且服务不足的人群与物质相关的负担。利用美国最大的药物使用和疾病国家研究（国家药物使用和健康调查，NSDUH）和美国最大的精神科电子病历数据存储库（MindLinc），拟议的团队将检查每个国家的药物滥用和治疗差距团体。研究目的包括 (a) 检查首次使用酒精和九种主要药物类别的发病率和决定因素，包括发病趋势、开始使用的风险期以及最近开始使用的相关性； (b) 确定多物质使用和物质障碍的模式、顺序和相关性； (c) 调查药物滥用治疗使用的普遍性、模式和相关性，包括接受服务的地点、接受治疗的主要滥用药物以及认为未得到满足的治疗使用需求和障碍； (d) 阐明共病疾病的综合模式及其时间关联； (e) 确定精神科治疗的途径，包括治疗进入设置、治疗进入的主要疾病（物质与非物质疾病）、治疗模式和治疗反应。对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（AA、PI、MR 与白人），并在每个群体内为每个特定人群提供深入的知识库。研究结果将确定开始酗酒或吸毒的高风险期和高危亚组，以促进有针对性的初级预防计划。他们还将指定显示多物质使用、药物障碍和其他精神障碍几率较高的亚组，以便他们可以有针对性地进行针对性干预，以减少严重后果。该领域将更好地了解 AA、PI 和 MR 治疗使用中未满足的需求和障碍。鉴于《患者保护和平价医疗法案》，及时需要这样一个全面的知识库来指导循证研究、干预和政策制定，以减少与药物使用相关的负担和成本。这些群体最大的国家数据文件将得到纵向收集的治疗数据的补充，以更全面地了解这些研究不足的群体的药物滥用治疗需求。该项目是研究 AA、PI 和 MR 之间实质性问题的分布、相关性、过程、后果和治疗差距的初步且具有成本效益的步骤。