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Disparities in Infection-Related Services in Substance Abuse Treatment Programs for Underserved Populations L.S. Brown, MD, MPH; S. Kritz, MD; E. Bini, MD, MPH; J. Robinson, MEd, D. Alderson, MS; J. Rotrosen, MD and the NIDA Clinical Trials Network Infections Study (CTN-0012) Team Addiction Research & Treatment Corp, Brooklyn, NY; NYU School of Medicine and VA Hospital, NY, NY; Nathan Kline Institute, Orangeburg, NY; and NYS Psychiatric Institute, NY, NY
17 Nodes with 116 Community Treatment Agencies Reaching into 26 States! Drug Abuse Treatment Clinical Trials Network Philadelphia Portland Los Angeles Charleston Miami Cincinnati Denver CTN Study Sites Seattle Raleigh/ Durham Long Island Boston   San Francisco (CA/AZ Node) New York City Detroit Albuquerque Baltimore/Richmond New Haven
ACKNOWLEDGEMENTS ,[object Object],[object Object],[object Object],[object Object],[object Object]
RATIONALE: THIS REPORT ,[object Object],[object Object],[object Object]
OBJECTIVES: THIS REPORT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
STUDY POPULATION ,[object Object],[object Object],[object Object],[object Object],[object Object]
STUDY DESIGN ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
STATISTICAL ANALYSIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SUBSTANCE ABUSE TREATMENT PROGRAMS (N=269) OFFERING ADDICTION SERVICES FOR VARIOUS POPULATIONS 20.1 4 or More Special Population Groups 25.3 2-3 Special Population Groups 34.5 One Special Population Group 79.9 At Least One Special Population Group 20.1 No Women or Special Population 15.7 Hawaiian/Pacific Islander 18.6 Asian 19.4 American Indian/Alaskan Native 43.3 Latinos 37.5 African Americans 73.9 Women PERCENT  OF PROGRAMS WITH TAILORED SERVICES POPULATION
Percent of Treatment Programs Providing  HIV -Related Health Services With and Without Addiction Services Designed For:  *  p<0.05;  #  p<0.001 47% 60% 47% 58% 47% 60% 39% # 63% 38% # 67% 37% 53% Medical Monitoring 41% 53% 40% 56% 40% 56% 33% # 58% 30% # 64% 33% 45% Medical Treatment 54% 47% 54% 45% 53% 52% 50% 57% 48% 60% 51% 54% Biological Testing 61% 61% 61% 60% 61% 65% 57% 66% 55% * 72% 57% 62% Medical History & Physical Exam 70% 81% 71% 82% 70% 84% 66% * 82% 64% * 86% 64% 75% Counseling 89% 92% 88% 93% 88% 95% 88% 91% 88% 92% 85% 90% Risk Assessment 90% 95% 90% 98% 91% 95% 89% 94% 88% 95% 85% 92%   Education   n=232   n=37   n=225   n=44   n=223   n=46   n=163   n=106   n=171   n=91   n=79   n=190   Without   With   Without   With   Without   With   Without   With   Without   With   Without   With   TYPES OF HEALTH SERVICES HAWAIIANS/ PACIFIC ISLANDERS ASIANS AMERICAN INDIANS/  ALASKAN NATIVES LATINO AMERICANS AFRICAN AMERICANS WOMEN
Percent of Treatment Programs Providing  HCV -Related Health Services With and Without Addiction Services Designed For:  *  p<0.05;  #  p<0.001 37% 47% 36% 51% 35% * 57% 31% * 49% 29% # 56% 34% 39% Medical Monitoring 29% 44% 28% * 47% 28% * 48% 23% # 42% 21% # 51% 28% 32% Medical Treatment 37% 36% 37% 37% 35% 48% 33% 43% 30% # 49% 38% 37% Biological Testing 53% 58% 53% 58% 52% 63% 48% 59% 47% # 65% 49% 55% Medical History & Physical Exam 62% 69% 61% 74% 60% * 77% 58% 70% 56% # 76% 56% 66% Counseling 77% 78% 76% 84% 76% 86% 75% 81% 75% 82% 66% * 81% Risk Assessment 79% 83% 79% 86% 79% 89% 79% 81% 78% 84% 74% 82%   Education   n=232   n=37   n=225   n=44   n=223   n=46   n=163   n=106   n=171   n=91   n=79   n=190   Without   With   Without   With   Without   With   Without   With   Without   With   Without   With   TYPES OF HEALTH SERVICES HAWAIIANS/ PACIFIC ISLANDERS ASIANS AMERICAN INDIANS/  ALASKAN NATIVES LATINO AMERICANS AFRICAN AMERICANS WOMEN
Percent of Treatment Programs Providing  STI -Related Health Services With and Without Addiction Services Designed For:  *  p<0.05;  #  p<0.001 40% 56% 39% * 58% 39% 58% 33% # 55% 31% # 63% 36% 44% Medical Monitoring 34% 49% 32% * 55% 33% 53% 28% # 49% 24% # 57% 29% 38% Medical Treatment 43% 41% 40% 55% 42% 50% 39% 48% 35% # 56% 39% 44% Biological Testing 52% 51% 52% 55% 52% 56% 47% 59% 44% # 65% 48% 54% Medical History & Physical Exam 63% 72% 61% * 79% 61% 76% 57% * 73% 54% # 81% 60% 66% Counseling 77% 84% 77% 86% 77% 84% 74% 83% 73% * 86% 71% 79% Risk Assessment 81% 86% 81% 84% 81% 87% 76% * 87% 77% * 89% 76% 82%   Education   n=232   n=37   n=225   n=44   n=223   n=46   n=163   n=106   n=171   n=91   n=79   n=190   Without   With   Without   With   Without   With   Without   With   Without   With   Without   With   TYPES OF HEALTH SERVICES HAWAIIANS/ PACIFIC ISLANDERS ASIANS AMERICAN INDIANS/  ALASKAN NATIVES LATINO AMERICANS AFRICAN AMERICANS WOMEN
RESULTS:  Treatment Program Characteristics ,[object Object],[object Object],[object Object],[object Object],[object Object]
RESULTS:  Infection-Related Health Services ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
RESULTS:  Infection-Related Health Services (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object]
RESULTS:  Barriers to Providing Infection-Related Health Services ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
RESULTS:  Barriers to Providing Infection-Related Health Services (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object]
LIMITATIONS ,[object Object],[object Object],[object Object]
CONCLUSIONS ,[object Object],[object Object],[object Object],[object Object]
CONCLUSIONS ,[object Object],[object Object],[object Object],[object Object]

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Implementation of an Electronic Information System to Enhance Practice at an Opioid Treatment Program

  • 1. Disparities in Infection-Related Services in Substance Abuse Treatment Programs for Underserved Populations L.S. Brown, MD, MPH; S. Kritz, MD; E. Bini, MD, MPH; J. Robinson, MEd, D. Alderson, MS; J. Rotrosen, MD and the NIDA Clinical Trials Network Infections Study (CTN-0012) Team Addiction Research & Treatment Corp, Brooklyn, NY; NYU School of Medicine and VA Hospital, NY, NY; Nathan Kline Institute, Orangeburg, NY; and NYS Psychiatric Institute, NY, NY
  • 2. 17 Nodes with 116 Community Treatment Agencies Reaching into 26 States! Drug Abuse Treatment Clinical Trials Network Philadelphia Portland Los Angeles Charleston Miami Cincinnati Denver CTN Study Sites Seattle Raleigh/ Durham Long Island Boston San Francisco (CA/AZ Node) New York City Detroit Albuquerque Baltimore/Richmond New Haven
  • 3.
  • 4.
  • 5.
  • 6.
  • 7.
  • 8.
  • 9. SUBSTANCE ABUSE TREATMENT PROGRAMS (N=269) OFFERING ADDICTION SERVICES FOR VARIOUS POPULATIONS 20.1 4 or More Special Population Groups 25.3 2-3 Special Population Groups 34.5 One Special Population Group 79.9 At Least One Special Population Group 20.1 No Women or Special Population 15.7 Hawaiian/Pacific Islander 18.6 Asian 19.4 American Indian/Alaskan Native 43.3 Latinos 37.5 African Americans 73.9 Women PERCENT OF PROGRAMS WITH TAILORED SERVICES POPULATION
  • 10. Percent of Treatment Programs Providing HIV -Related Health Services With and Without Addiction Services Designed For: * p<0.05; # p<0.001 47% 60% 47% 58% 47% 60% 39% # 63% 38% # 67% 37% 53% Medical Monitoring 41% 53% 40% 56% 40% 56% 33% # 58% 30% # 64% 33% 45% Medical Treatment 54% 47% 54% 45% 53% 52% 50% 57% 48% 60% 51% 54% Biological Testing 61% 61% 61% 60% 61% 65% 57% 66% 55% * 72% 57% 62% Medical History & Physical Exam 70% 81% 71% 82% 70% 84% 66% * 82% 64% * 86% 64% 75% Counseling 89% 92% 88% 93% 88% 95% 88% 91% 88% 92% 85% 90% Risk Assessment 90% 95% 90% 98% 91% 95% 89% 94% 88% 95% 85% 92% Education n=232 n=37 n=225 n=44 n=223 n=46 n=163 n=106 n=171 n=91 n=79 n=190 Without With Without With Without With Without With Without With Without With TYPES OF HEALTH SERVICES HAWAIIANS/ PACIFIC ISLANDERS ASIANS AMERICAN INDIANS/ ALASKAN NATIVES LATINO AMERICANS AFRICAN AMERICANS WOMEN
  • 11. Percent of Treatment Programs Providing HCV -Related Health Services With and Without Addiction Services Designed For: * p<0.05; # p<0.001 37% 47% 36% 51% 35% * 57% 31% * 49% 29% # 56% 34% 39% Medical Monitoring 29% 44% 28% * 47% 28% * 48% 23% # 42% 21% # 51% 28% 32% Medical Treatment 37% 36% 37% 37% 35% 48% 33% 43% 30% # 49% 38% 37% Biological Testing 53% 58% 53% 58% 52% 63% 48% 59% 47% # 65% 49% 55% Medical History & Physical Exam 62% 69% 61% 74% 60% * 77% 58% 70% 56% # 76% 56% 66% Counseling 77% 78% 76% 84% 76% 86% 75% 81% 75% 82% 66% * 81% Risk Assessment 79% 83% 79% 86% 79% 89% 79% 81% 78% 84% 74% 82% Education n=232 n=37 n=225 n=44 n=223 n=46 n=163 n=106 n=171 n=91 n=79 n=190 Without With Without With Without With Without With Without With Without With TYPES OF HEALTH SERVICES HAWAIIANS/ PACIFIC ISLANDERS ASIANS AMERICAN INDIANS/ ALASKAN NATIVES LATINO AMERICANS AFRICAN AMERICANS WOMEN
  • 12. Percent of Treatment Programs Providing STI -Related Health Services With and Without Addiction Services Designed For: * p<0.05; # p<0.001 40% 56% 39% * 58% 39% 58% 33% # 55% 31% # 63% 36% 44% Medical Monitoring 34% 49% 32% * 55% 33% 53% 28% # 49% 24% # 57% 29% 38% Medical Treatment 43% 41% 40% 55% 42% 50% 39% 48% 35% # 56% 39% 44% Biological Testing 52% 51% 52% 55% 52% 56% 47% 59% 44% # 65% 48% 54% Medical History & Physical Exam 63% 72% 61% * 79% 61% 76% 57% * 73% 54% # 81% 60% 66% Counseling 77% 84% 77% 86% 77% 84% 74% 83% 73% * 86% 71% 79% Risk Assessment 81% 86% 81% 84% 81% 87% 76% * 87% 77% * 89% 76% 82% Education n=232 n=37 n=225 n=44 n=223 n=46 n=163 n=106 n=171 n=91 n=79 n=190 Without With Without With Without With Without With Without With Without With TYPES OF HEALTH SERVICES HAWAIIANS/ PACIFIC ISLANDERS ASIANS AMERICAN INDIANS/ ALASKAN NATIVES LATINO AMERICANS AFRICAN AMERICANS WOMEN
  • 13.
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Editor's Notes

  1. PROTOCOL TEAM MEMBERSHIP TO DATE