Access to substance abuse treatment in the Cape Town metropole ...

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In addition, a 2-item “Utility barrier scale” examines the extent to which treatmentservices are perceived to be effective and useful. This study obtained Cronbachalpha coefficients of .81 and .78 for the culture/gender scale and the utility scale,respectively.o Competing prioritiesThe ATQ includes two questions about whether the need to take care of othersand/or the need to pay for food and shelter limits access to treatment.o Barriers related to psychological functioningThe ATQ includes self-esteem, depression and anxiety scales. These scales havegood reliability, with Cronbach alpha coefficients of .93, .85, and .92 beingobtained for the self-esteem, depression and anxiety scales during the mainphase of the study.o Stigma-related barriersThe 10-item Stigma Consciousness Scale measures expectations of being judgedon the basis of one’s substance abuse (Ross et al., 2005), with higher scoresreflecting greater degrees of internalized stigma. Cronbach alpha coefficients of.90 and .84 were obtained for the pilot and implementation phases, respectively.The 16-item Stigma towards Substance Abusers Scale measures communitybasedstigma towards substance users, with higher scores reflecting moreperceived stigma. A Cronbach alpha coefficient of.84 was obtained in this study.o Barriers associated with neighbourhood environmentThe Neighbourhood Environment Scale (NES, Crum et al., 1996) measuresneighbourhood disadvantage. This scale has good internal reliability, with thisstudy obtaining a Cronbach alpha coefficient of .82. The ATQ also includesquestions that examine perceived levels of crime, poverty, alcohol and drug use inparticipants’ neighbourhoods.o Barriers related to social support• RAND MOS-SSS (Sherbourne & Stewart, 1991)33
The 19-item MOS-SSS measures functional dimensions of perceived socialsupport. The MOS-SSS consists of 4 subscales: the emotional and informationalsupport subscale measures the extent to which others are perceived to expressunderstanding and offer advice and information, the tangible support subscaleassesses the extent to which others are perceived to provide material aid, thepositive social interaction subscale measures the extent to which others areperceived to be available to do fun things with, and the affectionate supportsubscale measures the extent to which others are perceived to express feelings ofaffection for the respondent. The MOS-SSS has good internal reliability, withCronbach alpha coefficients of.97 being obtained for the composite score. Morespecifically, the pilot and main study obtained subscale alpha coefficients thatranged between .80 and .96.• TCU Social Support ScaleThe 9-item TCU Social Support scale measures the extent to which others act asexternal supports for treatment and abstinence from substance use, specifically.Higher composite scores indicate greater levels of support for treatment andabstinence. This study obtained a Cronbach alpha coefficient of .77.o Barriers related to social capitalThe ATQ included two indicators of social capital: interpersonal trust and socialcohesion. The 17-item Neighbourhood Trust Scale measures the extent to whichparticipants trust others, with higher scores reflecting greater social trust. Thisscale has good internal reliability, with the main study obtaining an alphacoefficients of.86. The 5-item Social Cohesion Scale (Sampson et al., 1997) is aneighborhood-level measure of social cohesion, with higher scores reflectinggreater levels of cohesion. A Cronbach alpha coefficient of .83 was obtained forthe main study.3.3.4. Data analysisAll quantitative data were analysed using the Statistical Package for the SocialSciences (SPSS, Norusis, 1999). To examine significant differences between34
Page 1 and 2: Access to substance abuse treatment
Page 3 and 4: CONTENTSINTRODUCTION ..............
Page 5 and 6: 5.4. SUMMARY.......................
Page 7 and 8: al., 2004; Reddy et al., 2003; Shis
Page 9 and 10: 1.3. IS ACCESS TO SUBSTANCE ABUSE T
Page 11 and 12: 1.4.2. Racial disparities in the ne
Page 13 and 14: illegally and are unregulated by th
Page 15 and 16: CONCEPTUAL MODELThis study’s conc
Page 17 and 18: presenting problems and ability to
Page 19 and 20: need for services is the most immed
Page 21 and 22: This study focuses specifically on
Page 23 and 24: METHOD3.1. STUDY AIMS & OBJECTIVESA
Page 25 and 26: the researcher to explore possible
Page 27 and 28: esidential areas from each of the s
Page 29 and 30: 3.3.2.4. Data collection: controlsF
Page 31 and 32: o Problem recognition, Desire for h
Page 33: Table 1.Domains and measures compri
Page 37 and 38: information on the accessibility of
Page 39 and 40: RESULTS: PHASE ONE4.1. VARIABLES AS
Page 41 and 42: efficacy to stop using drugs for mo
Page 43 and 44: (Table 6). Effect sizes were large
Page 45 and 46: were 2.4 times more likely to not a
Page 47 and 48: esteem scales (Table 9). Stigma als
Page 49 and 50: Table 10.Logistic regression coeffi
Page 51 and 52: 4.2.2. Model 2: Predisposing variab
Page 53 and 54: poverty scale, and the variable “
Page 55 and 56: of the model increased significantl
Page 57 and 58: controls had greater self-efficacy
Page 59 and 60: and R1000 per month than their fema
Page 61 and 62: subjects earning less than R500 per
Page 63 and 64: and race (Table 16). This indicates
Page 65 and 66: were 3 times more likely to earn le
Page 67 and 68: (which are higher for Black/African
Page 69 and 70: substance use or remain abstinent d
Page 71 and 72: monetary needs rise, subjects repor
Page 73 and 74: with improved awareness of services
Page 75 and 76: 4.4.4.4. Predictors of “community
Page 77 and 78: • In historically disadvantaged c
Page 79 and 80: RESULTS: PHASE TWODuring qualitativ
Page 81 and 82: 5.1.1.3. Government’s responses t
Page 83 and 84: “Part of the government's agenda
Page 85 and 86:
putting extra strain and pressure o
Page 87 and 88:
The impact of availability and affo
Page 89 and 90:
availability of affordable services
Page 91 and 92:
completed a hospital-based detoxifi
Page 93 and 94:
“I have thirty beds that are unus
Page 95 and 96:
“I don't see it amongst the bona
Page 97 and 98:
going to be a good day. So, yes it
Page 99 and 100:
in the fourth week they relapse, it
Page 101 and 102:
esponses to treatment, in part, are
Page 103 and 104:
• Awareness of appropriate treatm
Page 105 and 106:
This perception is prevalent in Col
Page 107 and 108:
substance abuse problem - without a
Page 109 and 110:
o These community influences are lo
Page 111 and 112:
6.2.1. Awareness of substance abuse
Page 113 and 114:
informational support can improve a
Page 115 and 116:
salient for low-income groups who h
Page 117 and 118:
diminishing self-efficacy and motiv
Page 119 and 120:
self-efficacy and negative percepti
Page 121 and 122:
6.3. TREATMENT SYSTEM FACTORS ASSOC
Page 123 and 124:
This study found that limited resou
Page 125 and 126:
6.4. RECOMMENDATIONSBased on study
Page 127 and 128:
• As findings suggest that female
Page 129 and 130:
• While the affordability of trea
Page 131 and 132:
To address these barriers, we argue
Page 133 and 134:
o To ensure objectivity, this needs
Page 135 and 136:
egistration process should gather i
Page 137 and 138:
REFERENCESAday, L.A., & Awe, W.C. (
Page 139 and 140:
First, MB; Spitzer, RL; Gibbon, M;
Page 141 and 142:
Myers, B., & Parry, C.D.H. (2005).
Page 143 and 144:
Ross, M.W., Williams, M.L., Timpson
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