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

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4.1. VARIABLES ASSOCIATED WITH ACCESS TO SUBSTANCE ABUSETREATMENT: BIVARIATE ANALYSES............................................................... 384.1.1. Predisposing variables associated with access to treatment . 384.1.2. Need for treatment variables associated with access totreatment ................................................................................................................ 414.1.3. Enabling and restricting variables associated with access..... 424.2. PREDICTORS OF ACCESS TO SUBSTANCE ABUSE TREATMENT464.2.1. Model 1: Need for treatment variables ........................................... 464.2.2. Model 2: Predisposing variables and need variables ............... 504.2.3. Model 3: Need for treatment, predisposing, and enablingvariables ................................................................................................................. 514.2.4. A more parsimonious model of access to treatment: Model 4 534.3. SOCIODEMOGRAPHIC DIFFERENCES ON PREDISPOSING, NEEDFOR TREATMENT AND ENABLING VARIABLE DOMAINS........................... 554.3.1. Gender differences on predictors of access among individualswho did not access treatment .......................................................................... 554.3.2. Factors that differentiate between male and female subjectsthat did not access treatment........................................................................... 584.3.3. Race differences on predictors of access among subjects whodid not access treatment ................................................................................... 604.3.4. Factors that differentiate between Black/African and Colouredsubjects that did not access treatment.......................................................... 644.4. VARIABLES ASSOCIATED WITH PREDICTORS OF ACCESS TOTREATMENT AMONG CONTROLS...................................................................... 664.4.1. Relationships between predisposing variables and predictorsof access to treatment among controls......................................................... 674.4.2. Relationships between need for treatment variables andpredictors of access among respondents who did not access treatment684.4.3. Relationships between enabling variables and predictors ofaccess among respondents who did not access treatment..................... 694.4.4. Predictors of awareness, competing needs, travelling time totreatment, and community views about treatment access....................... 714.5. SUMMARY OF FINDINGS........................................................................... 75RESULTS: PHASE TWO................................................................. 785.1. THEMES RELATED TO BROAD SYSTEM DYNAMICS ....................... 785.1.1. Provincial government’s responses to substance abuse ............. 785.1.2. Allocation of resources to the social welfare and healthsectors 825.2. THEMES RELATED TO TREATMENT SYSTEM DYNAMICS ............. 885.2.1. Organisation of the substance abuse treatment system .......... 885.2.2. Resource allocation within the treatment system....................... 915.3. THEMES RELATED TO COMMUNITY DYNAMICS ............................... 975.3.1. Community expectations about treatment.................................... 975.3.2. Community enabling/restricting resources ................................ 1003
5.4. SUMMARY.................................................................................................... 107DISCUSSION AND RECOMMENDATIONS.................................. 1096.1. IS ACCESS TO SUBSTANCE ABUSE TREATMENT EQUITABLE?1096.2. FACTORS THAT PREDICT ACCESS TO SERVICES......................... 1096.2.1. Awareness of substance abuse treatment.................................. 1106.2.2. Geographical accessibility .............................................................. 1136.2.3. Availability of affordable treatment............................................... 1156.2.4. Negative perceptions of treatment................................................ 1176.3. TREATMENT SYSTEM FACTORS ASSOCIATED WITH ACCESS TOSUBSTANCE ABUSE TREATMENT................................................................... 1206.3.1. Organisational barriers to accessing substance abusetreatment .............................................................................................................. 1206.3.2. Resource-related barriers within the treatment system.......... 1216.4. RECOMMENDATIONS............................................................................... 124Based on study findings, a number of recommendations for interventions thataddress barriers to accessing substance abuse treatment services withinHDCs can be made. Some of these recommendations are described below:1246.4.1. Recommendations for interventions that address awarenessrelatedbarriers ....................................................................................................... 1246.4.2. Recommendations for interventions that address geographicalaccessibility barriers............................................................................................. 1256.4.3. Recommendations for interventions that address affordabilitybarriers 1276.4.4. Recommendations for interventions that address negativeperceptions about treatment............................................................................... 1286.4.5. Recommendations for interventions within the treatment system:129In order to improve access to treatment for people from HDCs, interventionsare also required at the level of the treatment system. ...................................... 129REFERENCES............................................................................... 1364
Page 1 and 2: Access to substance abuse treatment
Page 3: CONTENTSINTRODUCTION ..............
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 and 34: Table 1.Domains and measures compri
Page 35 and 36: The 19-item MOS-SSS measures functi
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
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controls had greater self-efficacy
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and R1000 per month than their fema
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subjects earning less than R500 per
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and race (Table 16). This indicates
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were 3 times more likely to earn le
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(which are higher for Black/African
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substance use or remain abstinent d
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monetary needs rise, subjects repor
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with improved awareness of services
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4.4.4.4. Predictors of “community
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• In historically disadvantaged c
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RESULTS: PHASE TWODuring qualitativ
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5.1.1.3. Government’s responses t
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“Part of the government's agenda
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putting extra strain and pressure o
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The impact of availability and affo
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availability of affordable services
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completed a hospital-based detoxifi
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“I have thirty beds that are unus
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“I don't see it amongst the bona
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going to be a good day. So, yes it
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in the fourth week they relapse, it
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esponses to treatment, in part, are
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• Awareness of appropriate treatm
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This perception is prevalent in Col
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substance abuse problem - without a
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o These community influences are lo
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6.2.1. Awareness of substance abuse
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informational support can improve a
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salient for low-income groups who h
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diminishing self-efficacy and motiv
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self-efficacy and negative percepti
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6.3. TREATMENT SYSTEM FACTORS ASSOC
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This study found that limited resou
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6.4. RECOMMENDATIONSBased on study
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• As findings suggest that female
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• While the affordability of trea
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To address these barriers, we argue
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o To ensure objectivity, this needs
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egistration process should gather i
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REFERENCESAday, L.A., & Awe, W.C. (
Page 139 and 140:
First, MB; Spitzer, RL; Gibbon, M;
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Myers, B., & Parry, C.D.H. (2005).
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Ross, M.W., Williams, M.L., Timpson
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Access to substance abuse treatment in the Cape Town metropole ...

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