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

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ut also predicts a large percentage of cases correctly, a strong argument can bemade for using this model rather than that of Model 3.Figure 2. ROC curves for Regression Models 1-4.1.0Sensitivity 0.8Source of the CurveModel 1Model 2Model 3Model 4Reference Line0.60.40.20.00.00.20.40.60.81.01 - Specificity4.3. SOCIODEMOGRAPHIC DIFFERENCES ON PREDISPOSING, NEEDFOR TREATMENT AND ENABLING VARIABLE DOMAINSTo refine possible interventions, we explored potential gender and racedifferences on predictors of access to treatment among control subjects (N =555). Chi-square tests of association or independent sample t tests wereconducted on all variables that were significantly associated with access in initialbivariate analyses by gender and race.4.3.1. Gender differences on predictors of access among individuals whodid not access treatment4.3.1.1. Predisposing factorsFor control subjects, the only gender differences found among predisposingpredictors of access to treatment, was on “housing arrangements”, particularly“living in own home” (see Table 11) and self-efficacy (Table 12), where male55
controls had greater self-efficacy to remain abstinent in risky situations for onemonth and for more than 1 month compared to their female counterparts. Theeffect sizes for these variables were, however weak.4.3.1.2. Need for treatment factorsAmongst the categorical need for treatment variables, significant associationswere found only between gender and “perceived AOD problem” and “perceivedneed for treatment”. For the former, the inverted odds ratio revealed that malecontrols had double the odds of perceiving an AOD problem compared to theirfemale counterparts. For the latter, the inverted odds ratio revealed that malecontrols had 1.7 times the odds of perceiving a need for treatment compared totheir female counterparts (Table 12). In contrast, gender differences were foundon all of the continuous need for treatment variables associated with access, withmale controls again showing greater need for treatment than their femalecounterparts (Table 13). Male respondents who did not access treatment hadsignificantly higher levels of drug severity (both perceived and evaluated),readiness and motivation to change drug use, problem recognition and desire forhelp, and had started using drugs at an earlier age than their female counterparts(Table 13). Apart from readiness and motivation to change, effect sizes for theother need variables were small, indicating weak associations with gender.4.3.1.3. Enabling/restricting factorsThe only categorical enabling variables significantly associated with gender werelegal income, competing needs for money, and competing needs to care forothers (Table 11). For legal income, each response category was transformedinto a dummy variable and more Chi-square tests conducted.56
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Access to substance abuse treatment
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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 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: of the model increased significantl
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
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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
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
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To address these barriers, we argue
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o To ensure objectivity, this needs
Page 135 and 136:
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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