Historique
Article de Périodique
Barriers to retention in substance use treatment: Validation of a new, theory-based scale (2021)
Auteur(s) :
ZEMORE, S. E. ;
WARE, O. D. ;
GILBERT, P. A. ;
PINEDO, M.
Année
2021
Page(s) :
art. 108422
Langue(s) :
Anglais
Domaine :
Alcool / Alcohol ; Drogues illicites / Illicit drugs
Thésaurus mots-clés
TRAITEMENT
;
MOTIVATION
;
OBSERVANCE DU TRAITEMENT
;
ATTITUDE
;
ECHELLE D'EVALUATION
;
THEORIE
;
ETUDE CLINIQUE
;
FACTEUR PREDICTIF
Thésaurus géographique
ETATS-UNIS
Résumé :
Purpose: Few studies and no theory-based scales have addressed specific barriers to substance use disorder (SUD) treatment retention. The current study, building on the Theory of Planned Behavior (TPB), sought to (a) identify those barriers that are most strongly associated with treatment retention, and most common, and (b) develop and validate a new scale of retention barriers, focusing on TPB attitude and perceived control components.
Methods: The study administered surveys to 200 participants initiating SUD treatment at a public, outpatient program in Northern California; the analytic sample (N = 156) included only those not strongly coerced into treatment. Surveys included TPB-based measures of treatment barriers; other motivational readiness measures; treatment coercion and social desirability measures; and clinical severity variables and demographics. Discharge status was collected from program records.
Results: Item and scale analyses identified three dimensions of attitudinal barriers (i.e., Low Perceived Treatment Need/Value, Social Concerns, and Concerns about Missing Substances) and two dimensions of perceived control barriers (i.e., Personal Limitations and Basic Logistic Barriers). Results informed creation of a 19-item Barriers to Retention Scale (BRS) with 5 subscales and very good internal reliability (alpha = 0.88). While all subscale scores were correlated with treatment completion, only Concerns about Missing Substances and total BRS scores predicted treatment completion in multivariate analyses.
Conclusions: The present study identified core dimensions of treatment retention barriers and developed a new scale predictive of treatment completion and potentially useful as a screener and in future research. Results suggest that interventions to improve retention should focus strongly on concerns about the negative impacts of abstaining from alcohol and drugs on craving and quality of life.
Highlights:
• Surveyed outpatients at intake to substance use disorder treatment.
• Developed a 19-item scale of specific treatment retention barriers based on the Theory of Planned Behavior.
• Identified 3 dimensions of attitudinal barriers and 2 dimensions of perceived control barriers.
• Found that Concerns about Missing Substances was the only robust predictor of treatment completion.
• Interventions to improve retention should focus on concerns about the negative impacts of abstaining from alcohol and drugs.
Methods: The study administered surveys to 200 participants initiating SUD treatment at a public, outpatient program in Northern California; the analytic sample (N = 156) included only those not strongly coerced into treatment. Surveys included TPB-based measures of treatment barriers; other motivational readiness measures; treatment coercion and social desirability measures; and clinical severity variables and demographics. Discharge status was collected from program records.
Results: Item and scale analyses identified three dimensions of attitudinal barriers (i.e., Low Perceived Treatment Need/Value, Social Concerns, and Concerns about Missing Substances) and two dimensions of perceived control barriers (i.e., Personal Limitations and Basic Logistic Barriers). Results informed creation of a 19-item Barriers to Retention Scale (BRS) with 5 subscales and very good internal reliability (alpha = 0.88). While all subscale scores were correlated with treatment completion, only Concerns about Missing Substances and total BRS scores predicted treatment completion in multivariate analyses.
Conclusions: The present study identified core dimensions of treatment retention barriers and developed a new scale predictive of treatment completion and potentially useful as a screener and in future research. Results suggest that interventions to improve retention should focus strongly on concerns about the negative impacts of abstaining from alcohol and drugs on craving and quality of life.
Highlights:
• Surveyed outpatients at intake to substance use disorder treatment.
• Developed a 19-item scale of specific treatment retention barriers based on the Theory of Planned Behavior.
• Identified 3 dimensions of attitudinal barriers and 2 dimensions of perceived control barriers.
• Found that Concerns about Missing Substances was the only robust predictor of treatment completion.
• Interventions to improve retention should focus on concerns about the negative impacts of abstaining from alcohol and drugs.
Affiliation :
Alcohol Research Group, Emeryville, CA, USA