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

4.2.2. Model 2: Predisposing variables and need variablesThe addition of a block of predisposing variables in Model 2, while controlling forthe effects of need for treatment variables, significantly increased the predictivevalue of the model; P 2 (5; N = 989) = 196.16, D < .001. When compared to theintercept-only model, Model 2 was better able to predict access to treatment (ΔP 2(12; N = 989) = 646.65, D < .001). Although Model 2 predicted a greaterproportion of the estimated variance (64%) in access to treatment than Model 1(Nagelkerke R 2 = .643), the general fit of the model to the data remained poor(Hosmer–Lemeshow χ 2 (8; N= 989) = 60.57, p < .001).For this model, findings from the hierarchical logistic regression show that “selfperceivedproblem recognition” and “others suggesting the need for help”continue to be associated with almost a tripling of the odds of accessingtreatment (Table 10). Similarly, increases in readiness to change drug use, druguse severity, age at which first used drugs, problem recognition and desire forhelp remained associated with an increased likelihood of accessing treatment,although these associations are weak.For predisposing variables, living in own home, community views about accessto treatment, beliefs about treatment effectiveness, treatment concerns, andneighbourhood poverty all had significant partial effects on access to treatment.“Living in one’s own home” strongly predicted access to treatment when theinfluence of other predisposing and need variables were controlled for, with theinverted odds ratio indicating that subjects living in their own home were 3.3times more likely to not access treatment compared to subjects living elsewhere.Inverting the odds ratio for community views about access to treatment revealsthat a one-unit increase in the 5-point scale resulted in a 6.3 times increase in theodds of not accessing treatment. This shows that as community perceptionsabout the inaccessibility of treatment increase, the chances of individualsaccessing treatment decrease. In contrast, although significant, the effects oftreatment effectiveness beliefs and treatment concerns were much smaller, with50