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The Journal of Behavioral Health Services & Research

Erschienen in:

01.01.2006 | Regular Article

Availability of Services for Women in Outpatient Substance Abuse Treatment: 1995–2000

verfasst von: Cynthia I. Campbell, PhD, MPH, Jeffrey A. Alexander, PhD

Erschienen in: The Journal of Behavioral Health Services & Research | Ausgabe 1/2006

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Abstract

Women entering substance abuse treatment have more severe substance abuse problems and more medical and psychiatric comorbidities than men. Research shows that specialized women’s services are associated with better retention and outcomes but relatively little is known about their availability nationwide. This study examined the adoption and implementation of reproductive and female-sensitive social services in a national sample of outpatient substance abuse treatment (OSAT) organizations in 1995 (N = 617) and 2000 (N = 571) by several organizational factors. Overall, reproductive and social services for women have not been widely adopted, although some services did increase over the study period, particularly social services. There was no evidence of large-scale decreases in service availability over the study period, although child care did decline. Nonprofit and public ownership (relative to for-profit) were associated with greater service provision. Managed care units had greater service adoption compared to nonmanaged care units, and this increased over time. Public units and hospital-affiliated units had greater service implementation than other units. However, OSAT units did not always implement the services they adopted, suggesting access to some services may be restricted.

New units were selected to be representative of new units in general, because research staff were concerned that they were underrepresented in the panel units. The relatively high percentage of private for-profit units in the new sample compensates for the low representation of private for-profits in the panel sample, making the sample more representative. The new units tended to be somewhat smaller and younger, which was not surprising because Wave 5 sampled for younger units to compensate for the preponderance of older units in the panel sample. Because new units in Wave 5 may represent units less likely to adopt and implement female-sensitive treatment services (private for-profit, small, young), the effect of these differences was explored by including a variable indicating whether or not a unit was new or a panel unit in a series of multivariate models predicting women’s services. This variable was not significant for any of the models, suggesting that it is an unlikely source of bias in this study.

The information lost by correcting for multiple comparisons is important and the authors prefer to highlight areas that deserve further exploration than potentially lose important information, while maintaining caution about drawing conclusions. The number of comparisons is high for these analyses, such that a correction would render very little significant and the null hypotheses would fail to be rejected for relationships that may truly exist not by chance and are worth exploring. According to Rothman, “the theoretical basis for advocating a routine adjustment for multiple comparisons. . .undermines the basic premises of empirical research, which holds that nature follows regular laws that may be studied through observations. A policy of not making adjustments for multiple comparisons is preferable because it will lead to fewer errors of interpretation when the data under evaluation are not random numbers but actual observations on nature.”

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Titel: Availability of Services for Women in Outpatient Substance Abuse Treatment: 1995–2000
verfasst von: Cynthia I. Campbell, PhD, MPH
Jeffrey A. Alexander, PhD
Publikationsdatum: 01.01.2006
Verlag: Springer US
Erschienen in: The Journal of Behavioral Health Services & Research / Ausgabe 1/2006
Print ISSN: 1094-3412
Elektronische ISSN: 2168-6793
DOI: https://doi.org/10.1007/s11414-005-9002-2

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