Does change in readiness influence retention among African American women and men in substance abuse treatment?

Abstract

African Americans are less likely than other racial groups to engage in and complete outpatient substance abuse treatment. The current study, conducted as a secondary analysis of a multisite randomized clinical trial, examined if readiness to change (RTC) over time influences retention and if gender moderates the relationship between changes in RTC and retention among 194 African American women and men. Participants completed the University of Rhode Island Change Assessment at baseline and at the end of the 16 week study. Findings revealed a significant relationship between RTC over time and retention. Specifically, the more RTC increased throughout the 16 week study, the longer participants remained in treatment. In addition, gender moderated the relationship between changes in RTC and retention, with a stronger association between changes in RTC and retention among men relative to women. One approach to improving substance abuse treatment retention rates is to focus on increasing RTC during treatment, especially among African American men.

A Qualitative Study on the Perspectives of Latinas Enrolled in a Diabetes Prevention Program: Is the Cost of Prevention Too High?

“… 9 Still other studies have credited successful adoption of preventive behaviors to readiness to change (RTC) behaviors. 10 - 12 Assessing RTC is important enough that healthcare providers are strongly advised to assess RTC before recommending behavior modification to their patients. 13 In the context of diabetes prevention, participants in the landmark Diabetes Prevention Program (DPP)—after which NDPP programs are modeled—were highly screened for RTC and for their ability to adopt and maintain healthy behaviors.…”

A systematic scoping review of research on Black participants in the National Drug Abuse Treatment Clinical Trials Network.

“…When examining retention in 24 trials including approximately 11,000 participants, the retention rate was under 75% for three retention indicators (baseline assessments, treatment exposure, and follow-up data) and consistently lower among Black compared to Hispanic and White participants, but the differences were not statistically significant. In CTN studies investigating retention in MET, retention was higher among Black women in MET versus TAU (Montgomery et al, 2011), and high readiness to change was associated with greater retention among Black people in MET (Montgomery, Burlew, & Korte, 2017).…”

Risk factors of substance use treatment gaps among a nationally representative sample of black American adults in relation to sexual minority status and health insurance coverage

“…Drug use was defined as using any of the following substances: marijuana, cocaine, heroin, hallucinogens, inhalants, methamphetamine, prescription pain relievers, tranquilizers, stimulants, or sedatives. For the purposes of this study, we included marijuana as an illicit drug for two reasons: ( 1 ) it is included as part of “illicit drug use” classification in the NSDUH, and ( 2 ) not all states have legalized or decriminalized recreational marijuana use at the time of this writing.…”

“…Substance use treatment gaps (i.e., needing substance use treatment services but not receiving them) exacerbate the deleterious effect of substance misuse on adults, particularly among Black Americans. Black adults enter substance use treatment at an older age, with lower socioeconomic statuses, and with a wider range of self-reported primary substance use relative to their White counterparts [ 1 ]. Not only do Black patients comprise the highest proportion of racial/ethnic groups to participate in alcohol use disorder treatment compared to other racial/ethnic groups, but they also experience significantly greater odds for initiating AUD treatment compared to their White counterparts [ 2 ].…”