INROADS-A: Intersecting Research on Addiction and Disability Services - Alcohol

INROADS-A：成瘾和残疾服务的交叉研究 - 酒精

• 批准号: 10777298
• 负责人: Rachel Sayko Adams
• 金额: $ 72.07万
• 依托单位: BRANDEIS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-20 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10777298
• 关键词: Acceleration; Acute; Address; Adult; Affect; Alcohol abuse; Alcohol consumption; Alcohol dependence; Alcohols; Americans with Disabilities Act; Brain Injuries; Caring; Cognition; Communities; Data; Data Set; Data Sources; Diagnosis; Disabled Persons; Discrimination; Disparity; Drug usage; Foundations; Future; Health; Health Services Accessibility; Healthcare; Hearing; Household; Impairment; Independent Living; Institute of Medicine (U.S.); Insurance; Intellectual functioning disability; Knowledge; Literature; Measures; Medicaid; Medical; Mental Health; Methodology; Methods; Morbidity - disease rate; Outcome; Pain; Patient Self-Report; Pattern; Personal Satisfaction; Persons; Pharmaceutical Preparations; Policies; Policy Maker; Population; Quasi-experiment; Recording of previous events; Research; Research Personnel; Risk; Risk Factors; Sampling; Self Care; Social isolation; Socioeconomic Status; Spinal cord injury; Stigmatization; Surveys; Transportation; Trauma; Traumatic Brain Injury; Treatment outcome; Update; Vision; Visual impairment; Woman; Work; access disparities; addiction; alcohol abstinence; alcohol abuse therapy; alcohol availability; alcohol consequences; alcohol risk; alcohol screening; alcohol services; alcohol use disorder; barrier to care; blind; comorbidity; cost; deaf; disability; experience; hard of hearing; health care disparity; health care quality; health care settings; health data; health definition; health disparity; health disparity populations; health inequalities; high risk; high risk drinking; improved; interest; intersectionality; low socioeconomic status; men; opioid use disorder; physical conditioning; severe mental illness; social health determinants; social stigma; theories; treatment comparison; treatment services; women with disabilities

Abstract People with disabilities (PWD) are an overlooked health disparity population who routinely experience stigma, discrimination, ableism, and lower socioeconomic status. Barriers to health care are generally high for PWD, and despite over three decades of the Americans with Disabilities Act, many health care settings including addiction treatment are not fully accessible for PWD. Recent studies have found that PWD abstain from alcohol more frequently than people without disabilities (PWoD); however, among current drinkers, PWD have elevated rates of at-risk alcohol use. Furthermore, PWD have greater risk for addiction, given higher rates of mental and physical health comorbidities, social isolation, trauma history and adverse social determinants of health. Despite this constellation of risk factors, very little is known about risk for alcohol use disorder (AUD) or alcohol-related morbidity or consequences among PWD, or whether disparities exist for PWD in accessing or engaging in AUD treatment compared to PWoD. We will use rigorous quasi-experimental methods to compare PWD to PWoD, using household survey data (National Survey on Drug Use and Health) and complementary medical claims datasets (Medicaid in 13 states; commercial insurance in MarketScan) to examine alcohol use, AUD indicators, morbidity and consequences, AUD treatment services, quality measures and outcomes by disability status. Disability status is defined by functional limitations in survey data and by diagnoses of disabling conditions in claims. Because disability is not homogeneous, analyses will consider any disability and types of disability. Analyses will be replicated to investigate outcomes for women with disabilities, an understudied and further stigmatized population. Our approach is organized by the cascade of care framework, and informed by intersectionality, critical disability theory, and the Institute of Medicine definition of health care disparities that separates needs-related differences from true disparities. The proposed specific aims are to: 1) identify differences in alcohol use, alcohol-related morbidity, and AUD diagnoses, by disability status; 2) among people with AUD, investigate disparities by disability status in alcohol-related morbidity, consequences, and access to AUD treatment; and 3) among people receiving AUD treatment, assess disparities by disability status in receiving quality-aligned AUD treatment and experiencing acute alcohol-related outcomes. Our multifaceted approach to data source selection and focus on disparities between PWD and PWoD will allow a more comprehensive picture of how the disability community is affected by alcohol problems. Findings are expected to provide policy makers, researchers, and clinicians with critical information to address disparities in access to, engagement in, and outcomes of AUD treatment for PWD, helping to reduce alcohol-related morbidity and improve the health of this commonly overlooked health disparity population.

抽象的 残疾人（PWD）是一个被忽视的健康差异人群，经常经历 污名，歧视，能力主义和较低的社会经济地位。医疗保健的障碍通常很高 PWD，尽管《美国残疾人法案》有超过三十年的卫生保健环境 PWD无法完全使用成瘾治疗。最近的研究发现PWD弃权 比没有残疾人（PWOD）更频繁地从酒精中获得。但是，在目前的饮酒者中，PWD 高危酒精的速度升高。此外，PWD具有更大的成瘾风险 较高的精神和身体健康合并症，社会隔离，创伤历史和不利社会率 健康的决定因素。尽管存在这一风险因素，但对饮酒的风险知之甚少 疾病（AUD）或与酒精有关的发病率或PWD之间的后果，或者是否存在差异 与PWOD相比，PWD可以访问或从事AUD处理。我们将使用严格的准实验 使用家庭调查数据（全国药物使用和健康调查）将PWD与PWOD进行比较的方法 以及补充医学索赔数据集（在13个州的医疗补助；市场范围的商业保险） 检查酒精使用，音调指标，发病率和后果，AUD治疗服务，质量措施 和残疾状况的结果。残疾状态是由调查数据中的功能限制定义的 诊断索赔中禁用条件。由于残疾不是同质的，因此分析将考虑任何 残疾和残疾类型。分析将被复制以调查患有 残疾人，被研究不足，进一步污名化的人群。 我们的方法是由一系列的护理框架组织的，并由交叉口告知，关键 残疾理论和医学研究所的定义医疗保健差异，将需求与需求相关的差异 与真实差异的差异。拟议的具体目的是：1）确定酒精使用差异， 通过残疾状况，与酒精有关的发病率和AUD诊断； 2）在有AUD的人中，调查 与酒精相关的发病率，后果和获得AUD治疗的差异；和 3）在接受AUD治疗的人中，通过残疾状态评估差异 AUD治疗并经历急性酒精相关的结果。我们多方面的数据源方法 选择和关注PWD和PWOD之间的差异将允许更全面地了解 残疾人社区如何受到酒精问题的影响。发现结果将提供政策 制造商，研究人员和临床医生提供关键信息，以解决访问，参与，参与的差异 PWD的AUD治疗结果，有助于降低与酒精有关的发病率并改善健康状况 在这个通常被忽视的健康差异人群中。