Demographic Predictors of Dropping Out of Treatment (DOT) in Substance Use Disorder Treatment.

BACKGROUND: Researchers have not studied or used novel methods for identifying potential disparities for sexual minorities, those with criminal pasts, and veterans in (DOT). METHODS: We used Bayesian logistic regression to identify factors associated with DOT, tested interaction effects, and used machine learning to classify qualitative responses. FINDINGS: With 2,772 clients from two inpatient clinics in the Southwest United States, we found sexual minorities and females had 52% and 61%, increases and African Americans had 54% decreases in the odds of DOT. Additionally, those with a criminal past and 34.5 and older were less likely to DOT by 5% relative to clients with no prior involvement in the criminal justice system. CONCLUSIONS: This study illustrated the disparities for women and sexual minorities in DOT as well as demonstrated novel methodological approaches to addressing previously unanswered questions.

Invariance of a recovery capital scale across gender, ethnicity, and sexual orientation in a substance use disorder treatment program.

BACKGROUND: Behavioral health care providers aim to see their clients achieve lifelong recovery from substance use disorders (SUDs). To do so, they must accurately assess incoming resources and barriers to recovery to identify areas of need for their clients. A recovery capital scale (RCS) is one way to identify these resources and barriers. However, there is limited evidence that RCSs are invariant across different demographics. OBJECTIVES: To evaluate whether a short 10-item RCS (SRCS-10) is invariant across gender (male versus female), ethnicity (white versus African American, Hispanic, and other racial identities) and sexual orientation (heterosexual versus non-heterosexual). METHODS: The SRCS-10 is a shortened version of White's original unpublished 35-item RCS scale that was matched on items similar to the Brief Assessment of Recovery Capital (BARC-10). We used confirmatory factor analysis (CFA) to confirm unidimensionality and then conducted measurement invariance tests. RESULTS: This study included 2751 females (67%) and 1341 males (33%) totaling 4092 clients from six large residential treatment centers. Using both exploratory factor analysis (EFA) and CFA the SRCS-10 has a large first to second eigenvalue ratio and had a CFI and TLI close to and above .9 with an SRMR of below .05 and an omega of .85. Additionally, we saw limited changes in key indicators such as the CFI and RMSEA across gender, race, and sexual orientation. CONCLUSIONS: These findings provide evidence that the SRCS-10 is a valid and reliable assessment across gender, race, and sexual orientation.

Effects of Intensive Family Preservation Services in Rural Tennessee on Parental Hopefulness with Families Affected by Substance Use.

This article describes how Building Strong Families in Rural Tennessee (BS-FinRT) increased hopefulness and helped to promote the policy goal of developing a recovery focus among families with vulnerabilities. These outcomes were achieved by implementing collaborative strategies for addressing issues of child safety, substance use, and family stability. Early analyses of the program's outcomes indicated an unexpected positive influence on parent and child hopefulness. Further analyses found that changes in hope between baseline and discharge correlated positively with changes over the same time period in problem severity, general functioning, and mental health symptomology.