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Outcomes Measures for Sexual Minority Patients in an Opioid Treatment Program   C. John-Hull, S. Kritz, M. Chu, C. Madray,...
ABSTRACT Studies of sexual minorities have overwhelmingly been cross-sectional and descriptive.  Some of the findings are:...
ACKNOWLEDGEMENTS <ul><li>PATIENTS AND STAFF OF THE ADDICTION RESEARCH AND TREATMENT CORPORATION, A COMMUNITY-BASED SUBSTAN...
ACKNOWLEDGEMENTS <ul><li>There are no financial interests or disclosures to report for any of the authors involved in this...
BACKGROUND <ul><li>Studies of sexual minority substance abusers have been largely cross-sectional and descriptive </li></u...
STUDY DESIGN <ul><li>Prospective, longitudinal study </li></ul><ul><li>Pre-post implementation evaluation  </li></ul><ul><...
STUDY POPULATION <ul><li>Sexual minorities, which can include… </li></ul><ul><li>Lesbians </li></ul><ul><li>Gays </li></ul...
PRELIMINARY ACTIVITIES <ul><li>Needs assessment surveys of stakeholders:   </li></ul><ul><li>Sexual minority patients </li...
HYPOTHESES <ul><li>Participation by sexual minorities in specialized groups will result in: </li></ul><ul><li>Decreased su...
CURRICULUM <ul><li>Medical </li></ul><ul><li>Hormone therapy for transgender patients  </li></ul><ul><li>Referral for cosm...
CURRICULUM <ul><li>Clinical (Psychological):  </li></ul><ul><li>Process of “coming out” </li></ul><ul><li>Behavior modific...
CURRICULUM <ul><li>Clinical (Psychological):  </li></ul><ul><li>Definition of “self” as a sexual minority </li></ul><ul><l...
CURRICULUM <ul><li>Substance Abuse:  </li></ul><ul><li>Drugs of abuse by LGBTI patients </li></ul><ul><li>Relapse preventi...
MEASURES <ul><li>Substance Abuse </li></ul><ul><li>Serial toxicology screens and Composite International Diagnostic Interv...
DOMAINS, MEASURES  & DATA SOURCES  Domain Measure Data Source Substance Abuse Toxicology screens Patient chart Breathalyze...
DATA ANALYSIS <ul><li>Quantitative analysis of each study measure </li></ul><ul><li>Categorical variables: chi-square test...
CURRENT STATUS <ul><li>Scientific Review Group (SRG) review: Not scored; SRG recommended inclusion of control group </li><...
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Outcomes Measures for Sexual Minority Patients in an Opioid Treatment Program

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  • PROTOCOL TEAM MEMBERSHIP TO DATE
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  • Transcript of "Outcomes Measures for Sexual Minority Patients in an Opioid Treatment Program"

    1. 1. Outcomes Measures for Sexual Minority Patients in an Opioid Treatment Program C. John-Hull, S. Kritz, M. Chu, C. Madray, G. Dominguez, C. Bowers, R. Sumpter, J. Mitchell, L.S. Brown Addiction Research and Treatment Corp, Brooklyn, NY 11201 Submitted as R-21 application in response to NIDA PA-06-218: Health Research with Diverse Populations
    2. 2. ABSTRACT Studies of sexual minorities have overwhelmingly been cross-sectional and descriptive. Some of the findings are: (1) increased risk for mental health and substance abuse problems; (2) different substances of abuse; (3) engagement in riskier sexual practices; and, (4) unique healthcare access issues as compared to heterosexuals. The Addiction Research and Treatment Corporation is the largest non-hospital based Opioid Treatment Program in New York State, serving more than 3,000 patients annually. We provide a wide range of healthcare and social services to patients throughout Brooklyn and Manhattan. On the basis of anonymous surveys, there is clearly an interest in having programs geared towards this population. In response to a NIDA R-01 Program Announcement (PA-06-218), we propose to do a pre and post-intervention study that evaluates sexual minority patients participating in specialized groups in the following outcomes measures: (1) substance abuse; and, (2) quality of life. These particular outcomes were chosen because they will provide sufficient data for statistical analysis of significance, which is lacking in studies of this population.
    3. 3. ACKNOWLEDGEMENTS <ul><li>PATIENTS AND STAFF OF THE ADDICTION RESEARCH AND TREATMENT CORPORATION, A COMMUNITY-BASED SUBSTANCE ABUSE SERVICE AGENCY </li></ul>
    4. 4. ACKNOWLEDGEMENTS <ul><li>There are no financial interests or disclosures to report for any of the authors involved in this project </li></ul>
    5. 5. BACKGROUND <ul><li>Studies of sexual minority substance abusers have been largely cross-sectional and descriptive </li></ul><ul><li>Longitudinal studies have been virtually non-existent </li></ul><ul><li>ARTC provides substance abuse treatment to a predominantly (90%) racial/ethnic minority population that includes sexual minorities </li></ul>
    6. 6. STUDY DESIGN <ul><li>Prospective, longitudinal study </li></ul><ul><li>Pre-post implementation evaluation </li></ul><ul><li>2-year timeline </li></ul>
    7. 7. STUDY POPULATION <ul><li>Sexual minorities, which can include… </li></ul><ul><li>Lesbians </li></ul><ul><li>Gays </li></ul><ul><li>Bisexuals </li></ul><ul><li>Transgender </li></ul><ul><li>Intersex </li></ul><ul><li>ARTC’s patient population is 48% Hispanic and 42% </li></ul><ul><li>African American </li></ul>
    8. 8. PRELIMINARY ACTIVITIES <ul><li>Needs assessment surveys of stakeholders: </li></ul><ul><li>Sexual minority patients </li></ul><ul><li>Treatment staff (medical, counseling, social service and case management staff) </li></ul><ul><li>The surveys indicated clear interest by patients and staff in having programs for sexual minorities, and willingness by both to participate in a research project </li></ul>
    9. 9. HYPOTHESES <ul><li>Participation by sexual minorities in specialized groups will result in: </li></ul><ul><li>Decreased substance abuse </li></ul><ul><li>Improved Quality of Life </li></ul>
    10. 10. CURRICULUM <ul><li>Medical </li></ul><ul><li>Hormone therapy for transgender patients </li></ul><ul><li>Referral for cosmetic and sex reassignment surgery </li></ul><ul><li>LGBTI-specific healthcare services, including HIV-related services </li></ul>
    11. 11. CURRICULUM <ul><li>Clinical (Psychological): </li></ul><ul><li>Process of “coming out” </li></ul><ul><li>Behavior modification interventions to promote healthy lifestyle skills (i.e. HIV prevention and intervention to promote safer sex/harm reduction) </li></ul>
    12. 12. CURRICULUM <ul><li>Clinical (Psychological): </li></ul><ul><li>Definition of “self” as a sexual minority </li></ul><ul><li>Building self acceptance and self-esteem; dealing with societal discrimination and stigma; issues surrounding LGBTI Pride Week </li></ul>
    13. 13. CURRICULUM <ul><li>Substance Abuse: </li></ul><ul><li>Drugs of abuse by LGBTI patients </li></ul><ul><li>Relapse prevention; identifying triggers </li></ul><ul><li>Legal: </li></ul><ul><li>Transgender legal rights issues (i.e. legal name change) </li></ul><ul><li>Parenting; legal issues concerning child custody and child abuse </li></ul><ul><li>Housing issues and homelessness </li></ul>
    14. 14. MEASURES <ul><li>Substance Abuse </li></ul><ul><li>Serial toxicology screens and Composite International Diagnostic Interview (CIDI) assessments </li></ul><ul><li>Quality of Life </li></ul><ul><li>Serial World Health Organization Quality of Life (WHOQOL) – BREF assessments </li></ul>
    15. 15. DOMAINS, MEASURES & DATA SOURCES Domain Measure Data Source Substance Abuse Toxicology screens Patient chart Breathalyzer Patient chart CIDI Patent interview Quality of Life WHOQOL-BREF Patient interview
    16. 16. DATA ANALYSIS <ul><li>Quantitative analysis of each study measure </li></ul><ul><li>Categorical variables: chi-square tests for statistical significance </li></ul>
    17. 17. CURRENT STATUS <ul><li>Scientific Review Group (SRG) review: Not scored; SRG recommended inclusion of control group </li></ul><ul><li>ARTC analysis of SRG review: Logistics of control group deemed not appropriate; too few subjects in each arm </li></ul><ul><li>Next Steps: Submit to CSAT under Targeted Capacity Expansion grant program in early 2008 </li></ul>
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