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Wells M, Kelly PJ, Mullaney L, Lee ML, Stirling R, Etter S, Larance B. Predictors of alcohol and other drug treatment completion among young people accessing residential and community-based treatment: A retrospective analysis of routinely collected service data. Addiction 2024; 119:1813-1825. [PMID: 38946548 DOI: 10.1111/add.16602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 05/24/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND AND AIMS Young people accessing alcohol and other drug (AOD) treatment experience high rates of treatment disengagement, contributing to poorer outcomes. To improve outcomes, it is important to identify factors associated with treatment retention. This study measured the relationships between client characteristics, treatment characteristics, clinical severity measures and completion of treatment among young people. DESIGN, SETTING AND PARTICIPANTS This study was a retrospective analysis of routinely collected data set in residential- and community-based AOD services in New South Wales, Australia. Routinely collected data from the Network of Alcohol and Other Drug Agencies' (NADA) database were used. Included individuals were aged 10-24 years and accessed treatment between 2012 and 2023 (n = 17 474). MEASUREMENTS Variables included client-related characteristics, service characteristics and baseline measures of clinical severity [Kessler-10 (K10), EUROHIS-QoL, severity of dependence scale (SDS)]. Multivariable binary logistic regression models assessed the relationships between these characteristics and treatment completion. FINDINGS Rates of treatment completion were highest among adolescents in community-based treatment (57%) and lowest among young adults in residential treatment (35%). Polysubstance use was negatively associated with treatment completion among adolescents [adjusted odds ratio (adjOR) = 0.71, P < 0.001] and adults (adjOR = 0.70, P < 0.001) in community-based treatment, and adolescents in residential treatment (adjOR = 0.62, P = 0.006), as was housing insecurity (adolescents in community treatment, adjOR = 0.61, P = 0.001; adults in community treatment, adjOR = 0.77, P = 0.002; adolescents in residential treatment, adjOR = 0.42, P = 0.005). Attending youth-specific services was associated with higher treatment completion rates among adults in community-based (adjOR = 1.81, P < 0.001) and residential treatment (adjOR = 1.72, P < 0.001). Varying correlates of treatment completion were identified throughout treatment groups, reflecting the differences in population and/or needs across contexts. CONCLUSIONS In New South Wales, Australia, fewer than half of young people accessing alcohol and other drug treatment between 2012 and 2023 completed treatment, and completion rates were lower among those facing barriers such as polysubstance use and housing insecurity.
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Affiliation(s)
- Megan Wells
- School of Psychology, University of Wollongong, Wollongong, Australia
| | - Peter J Kelly
- School of Psychology, University of Wollongong, Wollongong, Australia
| | | | - Mei Lin Lee
- School of Psychology, University of Wollongong, Wollongong, Australia
- Network of Alcohol and Other Drug Agencies, Sydney, Australia
| | - Robert Stirling
- Network of Alcohol and Other Drug Agencies, Sydney, Australia
- Social Policy Research Centre, University of New South Wales, Sydney, Australia
| | - Sarah Etter
- Network of Alcohol and Other Drug Agencies, Sydney, Australia
| | - Briony Larance
- School of Psychology, University of Wollongong, Wollongong, Australia
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
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Black E, Bruno R, Mammen K, Mills L, Siefried KJ, Deacon RM, Shakeshaft A, Dunlop AJ, Ezard N, Montebello M, Childs S, Reid D, Holmes J, Lintzeris N. Substance use, socio-demographic characteristics, and self-rated health of people seeking alcohol and other drug treatment in New South Wales: baseline findings from a cohort study. Med J Aust 2023; 219:218-226. [PMID: 37449648 DOI: 10.5694/mja2.52039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/11/2023] [Accepted: 05/15/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE To investigate the demographic characteristics, substance use, and self-rated health of people entering treatment in New South Wales public health services for alcohol, amphetamine-type stimulants, cannabis, cocaine, or opioids use, by principal drug of concern. DESIGN Baseline findings of a cohort study; analysis of data in patient electronic medical records and NSW minimum data set for drug and alcohol treatment services. SETTING, PARTICIPANTS People completing initial Australian Treatment Outcomes Profile (ATOP) assessments on entry to publicly funded alcohol and other drug treatment services in six NSW local health districts/networks, 1 July 2016 - 30 June 2019. MAIN OUTCOME MEASURES Socio-demographic characteristics, and substance use and self-rated health (psychological, physical, quality of life) during preceding 28 days, by principal drug of concern. RESULTS Of 14 087 people included in our analysis, the principal drug of concern was alcohol for 6051 people (43%), opioids for 3158 (22%), amphetamine-type stimulants for 2534 (18%), cannabis for 2098 (15%), and cocaine for 246 (2%). Most people commencing treatment were male (9373, 66.5%), aged 20-39 years (7846, 50.4%), and were born in Australia (10 934, 86.7%). Polysubstance use was frequently reported, particularly by people for whom opioids or amphetamine-type stimulants were the principal drugs of concern. Large proportions used tobacco daily (53-82%, by principal drug of concern group) and reported poor psychological health (47-59%), poor physical health (32-44%), or poor quality of life (43-52%). CONCLUSIONS The prevalence of social disadvantage and poor health is high among people seeking assistance with alcohol, amphetamine-type stimulants, cannabis, cocaine, or opioids use problems. Given the differences in these characteristics by principal drug of concern, health services should collect comprehensive patient information during assessment to facilitate more holistic, tailored, and person-centred care.
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Affiliation(s)
- Emma Black
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, NSW
- Central Clinical School, the University of Sydney, Sydney, NSW
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW
- The University of Tasmania, Hobart, TAS
| | - Kristie Mammen
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, NSW
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
| | - Llewellyn Mills
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, NSW
- Central Clinical School, the University of Sydney, Sydney, NSW
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
| | - Krista J Siefried
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
- National Centre for Clinical Research on Emerging Drugs, University of New South Wales, Sydney, NSW
- Alcohol and Drug Service, St Vincent's Hospital Sydney, Sydney, NSW
| | - Rachel M Deacon
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, NSW
- Central Clinical School, the University of Sydney, Sydney, NSW
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
| | - Anthony Shakeshaft
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW
- The Poche Centre for Indigenous Health, the University of Queensland, Brisbane, QLD
| | - Adrian J Dunlop
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
- Drug and Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, NSW
- The University of Newcastle, Newcastle, NSW
- Hunter Medical Research Institute, Newcastle, NSW
| | - Nadine Ezard
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
- National Centre for Clinical Research on Emerging Drugs, University of New South Wales, Sydney, NSW
- Alcohol and Drug Service, St Vincent's Hospital Sydney, Sydney, NSW
| | - Mark Montebello
- Central Clinical School, the University of Sydney, Sydney, NSW
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
- Drug and Alcohol Services, North Sydney Local Health District, Sydney, NSW
| | - Steven Childs
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
- Drug and Alcohol Services, Central Coast Local Health District, Gosford, NSW
| | - David Reid
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
- Drug and Alcohol Services, Illawarra Shoalhaven Local Health District, Wollongong, NSW
| | - Jennifer Holmes
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, NSW
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
| | - Nicholas Lintzeris
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, NSW
- Central Clinical School, the University of Sydney, Sydney, NSW
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
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Carlyle M, Walter ZC, Theroux B, Leung J, Hides L. Reliability of online self-report versions of the Australian Treatment Outcome Profile (ATOP) and Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) among people in residential treatment for substance use problems. Addict Behav 2023; 144:107756. [PMID: 37257357 DOI: 10.1016/j.addbeh.2023.107756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 04/12/2023] [Accepted: 05/18/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND Online self-report measures are resource-efficient and widely used for monitoring substance use, yet few studies have assessed their reliability. This study assessed the reliability of online self-report versions of the Australian Treatment Outcomes Profile (ATOP) and Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) among people seeking treatment for substance use problems. PROCEDURES One-hundred and five clients entering residential treatment for substance use problems (Mage = 33.34, 65% male) were recruited from two facilities in Queensland, Australia. Using a repeated-measures design, we compared online self-report with the original interview versions of the ASSIST, which measured (i) lifetime substance use and (ii) past 3-month substance-use and related harms, and the ATOP, which measured (i) past month frequency of substance use and (ii) the typical quantity used per day. Assessments were administered 1-7 days apart. FINDINGS The ATOP demonstrated moderate-excellent inter-rater reliability for the past month use (yes/no) for all substance types, but had poor reliability for alcohol and cannabis. ATOP reliability was high-excellent for the total number of days used in the past month for all substances. The ASSIST demonstrated moderate-excellent inter-rater reliability for substance-use and related harms for all substances except tobacco, however was poor for lifetime use for most substances due to greater reporting in the interview assessment. CONCLUSIONS Reliable responding was observed for the frequency of substance use in the past month on the ATOP, and past 3-month substance-use and related harms on the ASSIST. These findings support use of online-self report measures a resource-efficient method to monitor substance use. Underreporting of lifetime use was found in self-report online version of the ASSIST, highlighting the need for improved instruction or interviewer/clinician assistance for lifetime use.
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Affiliation(s)
- Molly Carlyle
- Lives Lived Well Research Group, School of Psychology, The University of Queensland, Australia; National Centre for Youth Substance Use Research (NCYSUR), The University of Queensland, Australia
| | - Zoe C Walter
- Lives Lived Well Research Group, School of Psychology, The University of Queensland, Australia; National Centre for Youth Substance Use Research (NCYSUR), The University of Queensland, Australia
| | - Bronwyn Theroux
- Lives Lived Well Research Group, School of Psychology, The University of Queensland, Australia
| | - Janni Leung
- Lives Lived Well Research Group, School of Psychology, The University of Queensland, Australia; National Centre for Youth Substance Use Research (NCYSUR), The University of Queensland, Australia
| | - Leanne Hides
- Lives Lived Well Research Group, School of Psychology, The University of Queensland, Australia; National Centre for Youth Substance Use Research (NCYSUR), The University of Queensland, Australia.
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de Kuijper GM, Den Besten-van Ravenswaaij JJC, Hoekstra PJ, de Bildt A. Preferred outcome measures in treatments for challenging behaviour in individuals with intellectual disabilities: Results of an inclusive Delphi method. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:374-384. [PMID: 36526402 DOI: 10.1111/jar.13067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 09/26/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Interventions for challenging behaviours in individuals with intellectual disabilities benefit from outcome monitoring that takes clients' preferences into account. We determined clients' and representatives' preferred outcome domains and measures to secure their involvement in treatment decisions for challenging behaviours. METHOD We used an inclusive Delphi method. A focus group of individuals with mild intellectual disabilities and representatives of those with moderate and severe intellectual disabilities prepared the first round by assisting us in collecting possible outcomes. Panels of individuals with intellectual disabilities and representatives were composed to achieve consensus on instruments for preferred outcome domains. RESULTS Preferred outcome domains were behaviour, side-effects of psychotropic drugs, quality of life, daily functioning, caregiver burden and family quality of life. Corresponding outcome measures included self-report, interview and proxy-scales, including spoken versions. CONCLUSION Including the preferred domains on outcomes of interventions for challenging behaviours is recommended. Research on corresponding outcome measures is necessary.
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Affiliation(s)
- Gerda M de Kuijper
- Mental Healthcare Drenthe (GGZ Drenthe), Centre for intellectual Disability and Mental Health, Assen, The Netherlands.,Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Child and Adolescent Psychiatry, Accare Child Study Center, Groningen, The Netherlands
| | - Annelies de Bildt
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Child and Adolescent Psychiatry, Accare Child Study Center, Groningen, The Netherlands
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5
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Black E, Mammen K, Deacon RM, Ezard N, Mills L, Dunlop AJ, Montebello M, Reid D, Childs S, Bruno R, Shakeshaft A, Siefried KJ, Farrell M, Holmes J, Lintzeris N. Health and social characteristics of clients reporting amphetamine type substance use at entry to public alcohol and other drug services in New South Wales, Australia, 2016-2019. Drug Alcohol Rev 2023; 42:389-400. [PMID: 36524444 PMCID: PMC10107800 DOI: 10.1111/dar.13588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 11/09/2022] [Accepted: 11/11/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Amphetamine type substances (ATS) are commonly used by Australian alcohol and other drug service entrants. We describe demographic characteristics, patterns of ATS and other substance use, health and social conditions among clients entering New South Wales (NSW) public alcohol and other drug services. METHODS Retrospective cohort of 13,864 records across six health districts (2016-2019) for clients seeking substance use treatment. These districts service approximately 44% of the NSW population aged 15 years and over. Multivariate analysis was conducted on a subsample for whom full data were available (N = 9981). Data included NSW Minimum Data Set for drug and alcohol treatment services and Australian Treatment Outcomes Profile items. RESULTS Over the preceding 4 weeks, 77% (n = 10,610) of clients (N = 13,864) reported no recent ATS use, 15% (n = 2109) reported 'low frequency' (1-12 days) and 8% (n = 1145) 'high frequency' (13-28 days) use. ATS use was most common among people attending for ATS or opioids as primary drug of concern. A multinomial regression (N = 9981) identified that clients reporting recent arrest (aOR 1.74, 95% CI 1.36, 2.24), higher cannabis use frequency (aOR 1.01, 95% CI 1.00, 1.02), lower opioid use frequency (aOR 0.98, 95% CI 0.97, 0.99) and poorer quality of life (aOR 0.91, 95% CI 0.86, 0.97) were more likely to report 'high frequency' rather than 'low frequency' ATS use. DISCUSSION AND CONCLUSIONS People who use ATS experience health and social issues that may require targeted responses. These should be integrated across all services, not only for clients with ATS as principal drug of concern.
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Affiliation(s)
- Emma Black
- Drug and Alcohol Services, South Eastern Sydney Local Health DistrictSydneyAustralia
- Specialty of Addiction MedicineThe University of SydneySydneyAustralia
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
| | - Kristie Mammen
- Drug and Alcohol Services, South Eastern Sydney Local Health DistrictSydneyAustralia
| | - Rachel M. Deacon
- Drug and Alcohol Services, South Eastern Sydney Local Health DistrictSydneyAustralia
- Specialty of Addiction MedicineThe University of SydneySydneyAustralia
| | - Nadine Ezard
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
- Alcohol and Drug Service, St Vincent's HospitalSydneyAustralia
- National Centre for Clinical Research on Emerging DrugsSydneyAustralia
- NSW Drug and Alcohol Clinical Research and Improvement Network, NSW Ministry of HealthSydneyAustralia
| | - Llewellyn Mills
- Drug and Alcohol Services, South Eastern Sydney Local Health DistrictSydneyAustralia
- Specialty of Addiction MedicineThe University of SydneySydneyAustralia
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
| | - Adrian J. Dunlop
- NSW Drug and Alcohol Clinical Research and Improvement Network, NSW Ministry of HealthSydneyAustralia
- Drug and Alcohol Clinical Services, Hunter New England Local Health DistrictNewcastleAustralia
- School of Medicine and Public HealthCollege of Health & Wellbeing, University of NewcastleNewcastleAustralia
- HMRI Healthcare Transformation Research ProgramNewcastleAustralia
| | - Mark Montebello
- Specialty of Addiction MedicineThe University of SydneySydneyAustralia
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
- NSW Drug and Alcohol Clinical Research and Improvement Network, NSW Ministry of HealthSydneyAustralia
- Drug and Alcohol Services, North Sydney Local Health DistrictSydneyAustralia
| | - David Reid
- NSW Drug and Alcohol Clinical Research and Improvement Network, NSW Ministry of HealthSydneyAustralia
- Drug and Alcohol Services, Illawarra and Shoalhaven Local Health DistrictWollongongAustralia
| | - Steven Childs
- NSW Drug and Alcohol Clinical Research and Improvement Network, NSW Ministry of HealthSydneyAustralia
- Drug and Alcohol Services, Central Coast Local Health DistrictGosfordAustralia
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
- School of Psychological SciencesUniversity of TasmaniaHobartAustralia
| | | | - Krista J. Siefried
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
- Alcohol and Drug Service, St Vincent's HospitalSydneyAustralia
- National Centre for Clinical Research on Emerging DrugsSydneyAustralia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
| | - Jennifer Holmes
- Centre for Alcohol and other Drugs, NSW Ministry of HealthSydneyAustralia
| | - Nicholas Lintzeris
- Drug and Alcohol Services, South Eastern Sydney Local Health DistrictSydneyAustralia
- Specialty of Addiction MedicineThe University of SydneySydneyAustralia
- Drug and Alcohol Services, Illawarra and Shoalhaven Local Health DistrictWollongongAustralia
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6
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Caruana T, Mao L, Gray RM, Bryant J. Engagement and outcomes of marginalised young people in an early intervention youth alcohol and other drug program: The Street Universities model. PLoS One 2023; 18:e0286025. [PMID: 37200391 DOI: 10.1371/journal.pone.0286025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 05/06/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND Early intervention alcohol and drug (AOD) programs for disadvantaged young people have the potential to substantially decrease the need for future intervention, however there is little research about how young people use these programs or the substance use and other outcomes of such programs. This paper uses data from an Australian AOD early intervention program, The Street Universities, to: describe young people's participation; examine changes in substance use and wellbeing over 90 days; and assess which young people are most positively impacted. METHODS Data come from a prospective study of new attendees, measuring retention in and attendance patterns in an 'engagement' program focussed on arts and lifestyle activities (n = 95), and a routine service dataset collected from seven years of therapeutic intervention (n = 3,893), measuring substance dependence (SDS), psychological distress (K10) and quality of life (EQoL). RESULTS Analysis reveals that young people were retained in the program at high proportion (63% at six months) and more than half of these returned at a frequency of weekly or more often. Young people participating in the therapeutic component of the program reported significant improvements in all key wellbeing indicators with SDS, K10 and EQoL scores significantly improving (at p < .001). These improvements occurred rapidly, within the first 30 days, and were maintained over the 90 day study period. Moreover, young people with the highest SDS and K10 scores and lowest quality of life at baseline experienced the most positive changes. CONCLUSION Aligning engagement program with therapeutic intervention can provide comprehensive support to disadvantaged young people, producing substantial improvements in AOD use, distress and wellbeing.
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Affiliation(s)
- Theresa Caruana
- Centre for Social Research in Health, University of New South Wales, Sydney, NSW, Australia
| | - Limin Mao
- Centre for Social Research in Health, University of New South Wales, Sydney, NSW, Australia
| | - Rebecca M Gray
- Centre for Social Research in Health, University of New South Wales, Sydney, NSW, Australia
| | - Joanne Bryant
- Centre for Social Research in Health, University of New South Wales, Sydney, NSW, Australia
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Gliske K, Welsh JW, Braughton JE, Waller LA, Ngo QM. Telehealth Services for Substance Use Disorders During the COVID-19 Pandemic: Longitudinal Assessment of Intensive Outpatient Programming and Data Collection Practices. JMIR Ment Health 2022; 9:e36263. [PMID: 35285807 PMCID: PMC8923149 DOI: 10.2196/36263] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/04/2022] [Accepted: 02/04/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The onset of the COVID-19 pandemic necessitated the rapid transition of many types of substance use disorder (SUD) treatments to telehealth formats, despite limited information about what makes treatment effective in this novel format. OBJECTIVE This study aims to examine the feasibility and effectiveness of virtual intensive outpatient programming (IOP) treatment for SUD in the context of a global pandemic, while considering the unique challenges posed to data collection during an unprecedented public health crisis. METHODS The study is based on a longitudinal study with a baseline sample of 3642 patients who enrolled in intensive outpatient addiction treatment (in-person, hybrid, or virtual care) from January 2020 to March 2021 at a large substance use treatment center in the United States. The analytical sample consisted of patients who completed the 3-month postdischarge outcome survey as part of routine outcome monitoring (n=1060, 29.1% response rate). RESULTS No significant differences were detected by delivery format in continuous abstinence (χ22=0.4, P=.81), overall quality of life (F2,826=2.06, P=.13), financial well-being (F2,767=2.30, P=.10), psychological well-being (F2,918=0.72, P=.49), and confidence in one's ability to stay sober (F2,941=0.21, P=.81). Individuals in hybrid programming were more likely to report a higher level of general health than those in virtual IOP (F2,917=4.19, P=.01). CONCLUSIONS Virtual outpatient care for the treatment of SUD is a feasible alternative to in-person-only programming, leading to similar self-reported outcomes at 3 months postdischarge. Given the many obstacles presented throughout data collection during a pandemic, further research is needed to better understand under what conditions telehealth is an acceptable alternative to in-person care.
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Affiliation(s)
- Kate Gliske
- Butler Center for Research, Hazelden Betty Ford Foundation, Center City, MN, United States
| | - Justine W Welsh
- Department of Psychiatry and Behavioral Services, Emory University School of Medicine, Emory University, Atlanta, GA, United States
| | - Jacqueline E Braughton
- Butler Center for Research, Hazelden Betty Ford Foundation, Center City, MN, United States
| | - Lance A Waller
- Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Quyen M Ngo
- Butler Center for Research, Hazelden Betty Ford Foundation, Center City, MN, United States
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Kelly PJ, Coyte J, Robinson LD, Deane FP, Russell S, Clapham K, Dale E, Longbottom M, Solley R, Baker AL. Evaluating an Aboriginal community controlled residential alcohol and other drug services: Use of benchmarking to examine within treatment changes in wellbeing. Drug Alcohol Rev 2022; 41:953-962. [PMID: 35106858 DOI: 10.1111/dar.13432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 12/08/2021] [Accepted: 12/12/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Aboriginal Community Controlled Organisations (ACCO) have an important role in the Australian health-care sector. However, there has been a lack of research evaluating ACCOs in the treatment of alcohol and other drug (AOD) use. Using a benchmarking approach, the present study examined within treatment changes on measures of wellbeing for people attending a residential AOD ACCO. METHODS The study focused on The Glen, an AOD residential treatment service that is managed by the Ngaimpe Aboriginal Corporation (n = 775). The Glen is a male-only service and provides treatment to both Indigenous and non-Indigenous men. The evaluation focused on measures of wellbeing (i.e. symptom distress and quality of life) collected at intake, 30 and 60 days during the person's stay. Comparative benchmarking was conducted with a cohort of men who were attending non-ACCO residential AOD treatment services (n = 4457). RESULTS The Glen participants demonstrated statistically significant improvements on measures of wellbeing. The Glen participants were more likely to complete treatment than participants attending non-ACCO services. Likewise, Indigenous people attending The Glen were more likely to complete treatment (compared to Indigenous people attending non-ACCO services). Rates of reliable and clinically significant change suggested that changes in quality of life were largely equivalent between The Glen and non-ACCO services, while participants attending The Glen tended to demonstrate larger reductions in symptom distress compared to the non-ACCO services. DISCUSSION AND CONCLUSION The study provides further support for the important role that ACCOs play in supporting Indigenous people in their recovery.
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Affiliation(s)
- Peter J Kelly
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Joe Coyte
- The Glen, Central Coast Alcohol and Drug Rehabilitation Centre, Ngaimpe Aboriginal Corporation, Chittaway Point, Australia
| | - Laura D Robinson
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Frank P Deane
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Sophie Russell
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Kathleen Clapham
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Elizabeth Dale
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia.,Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Marlene Longbottom
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Ryan Solley
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Amanda L Baker
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
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