Online Program

Findings from moving on to recovery and empowerment (MORE): A community-based intensive outpatient substance abuse treatment program for ethnically diverse, urban women

Monday, November 4, 2013

Aileen Ochoa, BA, Institute on Urban Health Research, Northeastern University, Boston, MA
Ling Shi, PhD, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA
Hortensia Amaro, PhD, University of Southern California, Los Angeles, CA
Rita Nieves, RN, MPH, LCSW, Addictions Prevention, Treatment and Recovery Support Services Bureau, Boston Public Health Commission, Boston, MA
To address gaps in the literature, quasi-experimental study findings from a gender- and culturally-informed Intensive Substance Abuse Outpatient Treatment (IOT) program for low-income, urban women are presented. We compared outcomes for those who received treatment exposure goal (TEG) defined as >84 hours (>5.25 hours/week) vs. lower. Treatment followed an integrated substance abuse (SA), mental health (MH) and trauma model not previously implemented in IOT. Data were obtained from 401 women (consecutive admissions) via in-person independent structured interviews at program entry and 6 months post-baseline to assess changes in SA, MH, and other outcomes. Sample is 36% Latina, 29% Black and 67% younger than 40. Six-month follow-up rate was 80.5%. Those lost to follow-up compared to follow-up completers had significantly lower perceived stress; and higher drug addiction severity and substance use coping strategy. The analytic sample (N=293) were those eligible for and with complete follow-up data. Mixed effects models were employed to account for repeated measures within the same subject. Participants showed significant pre-post improvements in SA, MH, selected coping strategies, criminal activity, and employment status (all p<.05). Multivariate analyses controlling for confounders and within-subject correlations showed that those who received > 84 treatment hours (N=90, 30.7%) had greater improvements in days of MH problems (p=.02), trauma symptomatology (p<.01), perceived stress (p<.01), and general psychological distress (p=.04). No other differences by TEG group were found. We will discuss findings in the context of the documented need to improve treatment retention and outcomes among disenfranchised women; study limitations and implications for practice.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Diversity and culture
Social and behavioral sciences

Learning Objectives:
Describe three features of the MORE treatment approach and elements. Discuss outcome differences by treatment exposure group. Identify implications of findings for IOT with poor, ethnically diverse urban women in need of substance abuse treatment.

Keyword(s): Substance Abuse Treatment, Community-Based Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the research coordinator for several federally funded grants focusing on treatment of drug addiction, and co-occurring mental health disorders with Latina and African-American women in community-based settings. On the data being presented I was the research coordinator throughout the course of the study. I’m also participating in the writing of several manuscripts regarding these data.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.