阿片类药物使用障碍治疗药物在监狱环境中的传播：对监狱工作人员观点的聚合混合方法研究。

IF 3.7 2区医学 Q1 SUBSTANCE ABUSE

Addiction Science & Clinical Practice Pub Date : 2024-02-12 DOI:10.1186/s13722-024-00440-2

Pryce S Michener, Elizabeth A Evans, Warren J Ferguson, Peter D Friedmann

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引用次数: 0

摘要

背景：监狱中阿片类药物使用障碍（MOUD）的实施情况因设施和州而异。组织氛围，包括员工对变革的态度和接受教育的情况，会影响对监狱中阿片类药物使用障碍等创新的看法。我们采用混合方法设计，旨在了解组织氛围与监狱工作人员对 MOUD 的看法之间的关联：马萨诸塞州 6 所监狱中实施 MOUD 项目的工作人员（n = 111）完成了调查，其中包括 "实施变革的组织准备情况"（ORIC）调查。随机效应逻辑回归模型评估了组织氛围与感知 MOUD 的有效性、可接受性和知识等几种结果之间的关联，同时控制了协变量。监狱工作人员（N = 61）参加了定性访谈和焦点小组，重点关注组织氛围和知识传播，我们使用归纳和演绎方法对其进行了分析：结果表明，ORIC 中的组织变革准备程度与对 MOUD 的积极看法相关，教育资源促进了 MOUD 的实施。更高的 ORIC 与美沙酮对监狱人群的高度可接受性的更高认知度（Odds ratio [OR] 2.3，95% Confidence Interval [CI]1.2-4.4）和对美沙酮的高度了解（OR 2.3，95% CI 1.1-4.9）相关，对丁丙诺啡的影响程度类似。监狱工作人员接受美沙酮和丁丙诺啡方面的高水平培训也与对这两种药物的高认知度有关（美沙酮：OR 7.2，95% CI 1.1 至 4.9，丁丙诺啡：OR 2.3，95% CI 1.1 至 4.9）：OR 7.2，95% CI 2.2 至 23.2；丁丙诺啡：OR 3.4，95% CI 1.2 至 9.5）。定性结果表明了组织氛围的重要性，并阐明了改善员工对 MOUD 感知的教育策略：研究结果强调了组织氛围对成功实施监狱MOUD项目的重要性，并支持将特定药物教育资源作为监狱环境中成功实施MOUD的促进因素。研究结果强调了可改善监狱工作人员对MOUD看法的实施策略。

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Diffusion of medications for opioid use disorder treatment in jail settings: a convergent mixed methods study of jail staff perspectives.

Background: Implementation of medications for opioid use disorder (MOUD) in jails varies by facility and across states. Organizational climate, including staff attitudes toward change and exposure to education, can influence perceptions of innovations like MOUD in jails. Using a mixed methods design, we aimed to understand the association between organizational climate and jail staff perceptions of MOUD.

Methods: Jail staff (n = 111) who operate MOUD programs in 6 Massachusetts jails completed surveys that included the Organizational Readiness for Implementing Change (ORIC) survey. Random effects logistic regression models assessed associations between organizational climate and several outcomes of perceived MOUD efficacy, acceptability, and knowledge, while controlling for covariates. Jail staff (N = 61) participated in qualitative interviews and focus groups focused on organizational climate and knowledge diffusion, which we analyzed using inductive and deductive methods.

Results: The results indicate that organizational change readiness on the ORIC was associated with positive perceptions of MOUD, and educational resources facilitated MOUD implementation. Greater ORIC was associated with higher perception of methadone as highly acceptable for jail populations (Odds ratio [OR] 2.3, 95% Confidence Interval [CI] 1.2 to 4.4), and high knowledge of methadone (OR 2.3, 95% CI 1.1 to 4.9), with similar magnitude of effects for buprenorphine. High levels of training for jail staff on methadone and buprenorphine were also associated with higher knowledge of these medications (Methadone: OR 7.2, 95% CI 2.2 to 23.2; Buprenorphine: OR 3.4, 95% CI 1.2 to 9.5). Qualitative results point towards the importance of organizational climate and elucidate educational strategies to improve staff perceptions of MOUD.

Conclusion: Results underscore the importance of organizational climate for successful implementation of jail MOUD programs and provide support for medication-specific educational resources as a facilitator of successful MOUD implementation in jail settings. Findings highlight implementation strategies that may improve jail staff perceptions of MOUD.

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来源期刊

Addiction Science & Clinical Practice Psychology-Clinical Psychology

CiteScore

3.90

自引率

10.80%

发文量

审稿时长

28 weeks

期刊介绍： Addiction Science & Clinical Practice provides a forum for clinically relevant research and perspectives that contribute to improving the quality of care for people with unhealthy alcohol, tobacco, or other drug use and addictive behaviours across a spectrum of clinical settings. Addiction Science & Clinical Practice accepts articles of clinical relevance related to the prevention and treatment of unhealthy alcohol, tobacco, and other drug use across the spectrum of clinical settings. Topics of interest address issues related to the following: the spectrum of unhealthy use of alcohol, tobacco, and other drugs among the range of affected persons (e.g., not limited by age, race/ethnicity, gender, or sexual orientation); the array of clinical prevention and treatment practices (from health messages, to identification and early intervention, to more extensive interventions including counseling and pharmacotherapy and other management strategies); and identification and management of medical, psychiatric, social, and other health consequences of substance use. Addiction Science & Clinical Practice is particularly interested in articles that address how to improve the quality of care for people with unhealthy substance use and related conditions as described in the (US) Institute of Medicine report, Improving the Quality of Healthcare for Mental Health and Substance Use Conditions (Washington, DC: National Academies Press, 2006). Such articles address the quality of care and of health services. Although the journal also welcomes submissions that address these conditions in addiction speciality-treatment settings, the journal is particularly interested in including articles that address unhealthy use outside these settings, including experience with novel models of care and outcomes, and outcomes of research-practice collaborations. Although Addiction Science & Clinical Practice is generally not an outlet for basic science research, we will accept basic science research manuscripts that have clearly described potential clinical relevance and are accessible to audiences outside a narrow laboratory research field.