Does the implementation of evidence-based and culturally competent practices reduce disparities in addiction treatment outcomes?

Research is limited on the extent to which implementation of evidence-based and culturally responsive practices reduces outcome disparities in substance use disorder treatment. We examined the role of contingency management treatment (CMT), medication-assisted treatment (MAT), and culturally compete...

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Vydané v:Addictive behaviors Ročník 73; s. 119 - 123
Hlavní autori: Guerrero, Erick G., Garner, Bryan R., Cook, Benjamin, Kong, Yinfei
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: England Elsevier Ltd 01.10.2017
Elsevier Science Ltd
Predmet:
Addictions
Adult
Certification
Clinical outcomes
Competence
Completion
Contingency learning
Cultural competence
Cultural Competency
Cultural sensitivity
Culture
Demography
Dissemination
Drug abuse
Drugs
Evidence based research
Evidence-based medicine
Evidence-Based Practice - standards
Evidence-based practices
Female
Health care policy
Health disparities
Healthcare Disparities - ethnology
Hispanic Americans
Humans
Implementation
Independent variables
Latin American cultural groups
Los Angeles
Male
Medical treatment
Mental disorders
Mental health
Mental health services
Mexican Americans
Mexican Americans - statistics & numerical data
Minority & ethnic groups
Program implementation
Psychiatry
Racial and ethnic groups
Substance abuse
Substance abuse treatment
Substance use disorder
Substance-Related Disorders - ethnology
Substance-Related Disorders - rehabilitation
Successful treatment completion
Treatment outcomes
Treatment programs
Variables
White people
Cultural competence
Evidence-based practices
Racial and ethnic groups
Successful treatment completion
ISSN:0306-4603, 1873-6327, 1873-6327
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Shrnutí:Research is limited on the extent to which implementation of evidence-based and culturally responsive practices reduces outcome disparities in substance use disorder treatment. We examined the role of contingency management treatment (CMT), medication-assisted treatment (MAT), and culturally competent practices on Mexican Americans' rate of successful completion of treatment. We analyzed a concatenated dataset from 153 publicly funded substance use disorder treatment programs in Los Angeles County, California, in 2011 and 2013. These data were merged with data from 15,412 adult clients in both periods, of whom we selected only Mexican Americans (46.3%) and non-Latino Whites (53.7%). The outcome was successful treatment completion. The main independent variables were client demographics, drug use severity, mental health issues, and program license and professional accreditation. Less than half of the programs highly implemented CMT, MAT, and culturally competent practices. CMT and cultural competence were not associated with successful treatment completion. However, Mexican Americans in programs with high degree of implementation of MAT had higher odds of successfully completing treatment compared to non-Latino Whites and programs with low MAT (OR=1.389; 95% CI=1.018, 1.897). Findings highlight the role of MAT in reducing the disparity in treatment completion between Mexican Americans and non-Latino Whites. Implications for health policy and the dissemination of MAT are discussed. •Examined the role of contingency management (CMT), medication assisted treatment (MAT) and cultural competence in treatment completion.•Less than half of the programs had highly implemented CMT, MAT and culturally competent practices.•Mexican Americans in programs with high implementation of MAT had higher odds of completion compared to Whites and low implementation programs.
Bibliografia:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:0306-4603
1873-6327
1873-6327
DOI:10.1016/j.addbeh.2017.05.006