背景:筛选,简短的干预,美国预防服务工作组建议采用转诊治疗(SBIRT)模式,以提高对不健康饮酒的认识和干预。人们对SBIRT的实施如何因人口统计学特征而有所不同知之甚少。
方法:我们分析了来自2015-2019年全国药物使用和健康调查的数据,这些数据来自过去一年内使用门诊诊所并至少饮用一种酒精饮料的18岁以上的受访者。受访者被分为三个相互排斥的群体之一:“没有暴饮暴食或饮酒障碍(AUD),没有AUD的暴饮暴食,\"或\"AUD。“结果变量是筛查的可能性,简短干预(BI),转诊治疗(RT),AUD治疗回归结果的人口统计学预测因素包括性别,年龄,种族和民族,性取向,保险状况,和军事介入的历史。与SBIRT准则一致,整个样本都包括在筛选模型中;BI模型中包括无AUD或有AUD的暴饮暴食者;RT模型中包括有AUD的筛选者,并将接受AUD治疗的患者纳入AUD治疗模型.
结果:分析包括120,804名受访者。女性比男性更有可能接受筛查,但不太可能接受BI或RT。当提到治疗时,女性比男性更有可能接受它。年龄≥50岁的人最不可能接受酒精筛查,但最有可能收到BI,而18-25岁的人最不可能接受BI或AUD治疗。与白人相比,种族和少数民族接受筛查的可能性较小;亚洲人接受RT的可能性较小,与白人相比,黑人接受治疗的可能性较小。认定为同性恋的人,拉拉,或双性恋者接受SBIRT或AUD治疗的可能性与被鉴定为异性恋者相同或更可能。没有保险的人比有保险的人更不可能接受筛查。与未在军队服役的人相比,有军事介入史的人更有可能接受筛查并接受BI和RT。
结论:SBIRT实施中存在人口统计学差异。解决这些差异的根源并最大程度地减少护理中的减员,可以改善不健康饮酒者的预后。
BACKGROUND: The screening, brief intervention, and referral to treatment (SBIRT) model is recommended by the U.S. Preventive Services Task Force to improve recognition of and intervention for unhealthy alcohol use. How SBIRT implementation differs by demographic characteristics is poorly understood.
METHODS: We analyzed data from the 2015-2019 National Survey on Drug Use and Health from respondents ≥18 years old who used an outpatient clinic and had at least one alcoholic drink within the past year. Respondents were grouped into one of three mutually exclusive groups: \"no binge drinking or alcohol use disorder (AUD),\" \"binge drinking without AUD,\" or \"AUD.\" Outcome variables were likelihood of screening, brief intervention (BI), referral to treatment (RT), and AUD treatment. The demographic predictors on which outcomes were regressed included gender, age, race and ethnicity, sexual orientation, insurance status, and history of military involvement. Consistent with SBIRT guidelines, the entire sample was included in the screening model; screened persons with either binge drinking without AUD or with AUD were included in the BI model; screened persons with AUD were included in the RT model, and persons referred to treatment with AUD were included in the AUD treatment model.
RESULTS: Analyses included 120,804 respondents. Women were more likely than men to be screened, but less likely to receive BI or RT. When referred to treatment, women were more likely than men to receive it. Persons aged ≥50 were least likely to be screened about alcohol, but most likely to receive BI, while persons aged 18-25 were least likely to receive BI or AUD treatment. Racial and ethnic minorities were less likely than White persons to be screened; Asians were less likely to receive RT, and Black persons were less likely to receive treatment than White persons. Persons identifying as gay, lesbian, or bisexual were equally as likely or more likely to receive SBIRT or AUD treatment as those identifying as heterosexual. Persons without insurance were less likely to be screened than those with insurance. Persons with a history of military involvement were more likely to be screened and receive BI and RT than persons who had not served in the military.
CONCLUSIONS: Demographic disparities in SBIRT implementation exist. Addressing the sources of these disparities and minimizing attrition from care could improve outcomes for persons with unhealthy alcohol use.