Readiness to adopt a performance measurement system for substance abuse treatment: Findings from the Service Quality Measures initiative

Background. A performance measurement system ­ the Service Quality Measures (SQM) initiative ­ has been developed to monitor the quality of South Africa (SA)'s substance abuse treatment services. Identifying factors associated with readiness to adopt this system may inform strategies to facilitate its robust implementation.Objective. To examine factors associated with readiness to adopt a performance measurement system among SA substance abuse treatment providers.Methods. We surveyed 81 treatment providers from 13 treatment sites in the Western Cape, SA. The survey examined awareness, resources, organisational climate, leadership support and readiness to adopt the SQM system. Regression analysis was used to identify factors associated with readiness to adopt this system.Results. Readiness to adopt the SQM initiative was high (M=5.64, standard deviation 1.63). In bivariate analyses, caseload size (F=3.73 (degrees of freedom (df)=3.70), p=0.015), awareness (r=0.78, p<0.0001), leadership support (r=0.70, p<0.0001), resources (r=0.65, p<0.0001), openness to change (r=0.372, p=0.001), and external pressure to change were associated with readiness to adopt the SQM. In multivariate analyses, only awareness of the SQM initiative (B=0.34, standard error (SE) 0.08, t=4.4, p<0.0001) and leadership support (B=0.45, SE 0.11, t=4.0, p<0.0001) were significantly associated with readiness to adopt this system.Conclusion. While treatment providers report high levels of readiness to adopt the SQM system, findings show that the likelihood of adoption can be further increased through improved provider awareness and enhanced leadership support for this health innovation

Gender differences in barriers to alcohol and other drug treatment in Cape Town, South Africa

Objective: The study aimed to identify gender differences in barriers to alcohol and other drug (AOD) treatment use among disadvantaged communities in Cape Town; South Africa. The Behavioral Model of Health Services Utilization was used as an analytic framework. Method: A case-control design was used to compare 434 individuals with AOD problems from disadvantaged communities who had accessed treatment with 555 controls who had not accessed treatment on a range of variables. Logistic regression procedures were employed to examine the unique profile of variables associated with treatment utilization for male and female participants. Results: Few gender differences emerged in terms of the pattern of variables associated with AOD treatment use. Greater awareness of treatment options and fewer geographic access and affordability barriers were strongly associated with an increased likelihood of AOD treatment use for both men and women from disadvantaged communities. However; while similar types of barriers to treatment were reported by men and women; these barriers had a greater impact on treatment utilization for women compared to men. Conclusion: Compared to men; women from disadvantaged communities in South Africa do not have equal access to AOD treatment. Recommendations on how to reduce these barriers and ways to improve AOD treatment use among women from disadvantaged communities in South Africa are provided