Barriers to Alcohol, Drug and PTSD Treatment for Returning National Guard

返回国民警卫队的酒精、毒品和创伤后应激障碍治疗障碍

基本信息

批准号：
8891307
负责人：
Genevieve Marie Ames
金额：
$ 15.51万
依托单位：
PACIFIC INSTITUTE FOR RES AND EVALUATION
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-09-10 至 2017-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8891307
关键词：
Afghanistan Alcohol consumption Alcohol or Other Drugs use Alcohols Arizona Belief Case Study Communities Confidentiality Conflict (Psychology)Data Collection Detection Diagnosis Disease Drug Use Disorder Early identification Early treatment Employment Environment Exercise Face Family Fright Future Goals Government Guidelines Hawaii Healed Health Professional Home environment Human Resources Individual Insurance Coverage Interview Iraq Leadership Life Light Mental Health Military Personnel Modality Outcome Patients Persons Pharmaceutical Preparations Policies Population Post-Traumatic Stress Disorders Prevalence Procedures Process Professional counselor Provider Psychological Factors Qualitative Research Relative Risks Research Risk Sampling Screening procedure Services Social Environment Soldier Structure Substance Use Disorder Substance abuse problem Symptoms Training Veterans Work Workplace arm brief screening combat effective therapy experience healing help-seeking behavior inclusion criteria informant innovation meetings member peer programs psychologic response social social stigma

项目摘要

DESCRIPTION (provided by applicant): The goal of the proposed 3.5-year program of qualitative research is to identify, explain and thereafter provide guidelines for eliminating individual, socio-cultural, and structural barriers to treatment for alcohol and drug use disorders and Post-Traumatic Stress Disorder among U.S. National Guard service members returning from deployment in Afghanistan and Iraq. Psychological barriers veterans face to seeking treatment include stigma. Socio-cultural barriers may include culturally-prescribed beliefs about help-seeking and the influence of social settings such as the family, community and the civilian workplace. Additionally, treatment access policies, deployment exit procedures, employment policies and other structural factors may also systematically deter soldiers from seeking help, despite substantial efforts by the armed forces and the VA to encourage personnel to seek treatment. The objectives by which we will meet this goal are as follows: Specific Aim 1: To identify and provide contextual understandings of individual-level barriers (e.g., stigma, fear of jeopardizing future government and civilian employment) that inhibit National Guard members from seeking treatment for PTSD or alcohol or drug use disorders after they return home from deployment. Specific Aim 2: To identify and describe barriers for treatment-seeking in the cultural and social environment (e.g., workplace, community and family settings) for post-deployment National Guard personnel as they return to civilian life. Specific Aim 3: To identify and provide understandings of the structural barriers (e.g., military and civilian employer screening procedures, lack of military confidentiality, insurance coverage, promotion policies and procedures, etc.) that impede treatment seeking in this population. We propose to conduct semi-structured qualitative interviews with a stratified random sample of 120 members of the Hawaii and Arizona National Guards who indicate symptoms of PTSD or substance use disorders in a screener administered to 1000 personnel with combat exposure during deployment. Interviews will occur at least six months after their return from Afghanistan and Iraq. We will also interview 20 key informants (e.g., family support providers, chaplains, counselors, and officers) who have practical experience regarding treatment-related issues. A dynamic critical incident approach that elicits narratives illustrating the treatment seeking process, including individual, socio-cultural, and structural impediments, will provide evidence for each of the three specific aims.

描述（由申请人提供）：拟议的 3.5 年定性研究计划的目标是识别、解释并随后提供指南，以消除酒精和药物滥用障碍及后遗症治疗的个人、社会文化和结构性障碍。从阿富汗和伊拉克部署返回的美国国民警卫队军人中出现创伤性应激障碍。退伍军人在寻求治疗时面临的心理障碍包括耻辱。社会文化障碍可能包括关于寻求帮助的文化规定信念以及家庭、社区和民用工作场所等社会环境的影响。此外，尽管武装部队和退伍军人管理局为鼓励人员寻求治疗做出了巨大努力，但治疗获取政策、部署退出程序、就业政策和其他结构性因素也可能系统性地阻止士兵寻求帮助。我们实现这一目标的目标如下：具体目标 1：识别并提供对阻碍国民警卫队成员寻求治疗的个人层面障碍（例如，耻辱、对危及未来政府和平民就业的恐惧）的背景理解部署回家后是否患有创伤后应激障碍 (PTSD) 或酒精或药物滥用障碍。具体目标 2：确定并描述部署后国民警卫队人员返回平民生活时在文化和社会环境（例如工作场所、社区和家庭环境）中寻求治疗的障碍。具体目标 3：查明并了解阻碍该人群寻求治疗的结构性障碍（例如军事和民事雇主筛选程序、缺乏军事机密、保险范围、晋升政策和程序等）。我们建议对 120 名夏威夷和亚利桑那州国民警卫队成员的分层随机样本进行半结构化定性访谈，这些人员在部署期间对 1000 名经历过战斗的人员进行的筛查中显示出 PTSD 或药物使用障碍的症状。采访将在他们从阿富汗和伊拉克返回后至少六个月进行。我们还将采访 20 位在治疗相关问题方面拥有实际经验的关键知情人（例如家庭支持提供者、牧师、辅导员和官员）。一种动态的关键事件方法，引出说明寻求治疗过程的叙述，包括个人、社会文化和结构性障碍，将为三个具体目标中的每一个提供证据。