The 130th Annual Meeting of APHA

5052.0: Wednesday, November 13, 2002 - Board 1

Abstract #50605

Estimating the association of child care with the length of stay of female clients in a nationally representative sample of non-methadone substance abuse treatment facilities

Thomas M. Brady, PhD1, Lev S. Sverdlov, MD, PhD2, Sameena Salvucci, PhD2, Maxime Bokossa, PhD2, Hannah Keyune2, and Emmanuel Sikali, MS2. (1) Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Parklawn Bldg, 5600 Fishers Lane, Suite 16-105, Rockville, MD 20857, (301) 443-9049,, (2) Synectics for Management Decisions, Inc., 1901 North Moore Street, Suite 900, Arlington, VA, VA 22209

The purpose of this paper is to illustrate the relationship of retention with attending treatment facilities that provide on-site child care for female clients. Our outcome measure, retention, is defined as the length of time clients remain in treatment. Our paper used the Alcohol and Drug Services Survey (ADSS), a nationwide survey of substance abuse treatment clients. The sample included 1,176 female clients treated in non-hospital residential (n=143), non-methadone outpatient (n=818) and multi-modality facilities (n=215). The average length of stay was the dependent variable in a Cox regression that controlled for possibly confounding factors, including treatment modality. In the regression analysis, attending facilities with child care appeared to have a marginal protective effect on dropping out of treatment. Controlling for source of payment, modality, race, age, education, and referral from the criminal justice system, female clients attending facilities providing child care remained in treatment longer than female clients attending facilities without child care (RR=0.76, 95% C.I. (.58,1.00), Wald statistic=4.13, p=0.04). The analyses suggest that attending substance abuse treatment facilities with child care enhances the length of stay for female clients. The lack of child care may be a significant barrier to the successful engagement of adult female clients into treatment. In our presentation, we discuss some of the possible threats to validity of this analysis. In order to be reliable, these findings need to be replicated in studies using other national data sets. More research is needed on the role of child care and its effect on retention among women.

Learning Objectives:

  • At the conclusion of this presentation, participants should be able to

    Presenting author's disclosure statement:
    I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

    Child care

    The 130th Annual Meeting of APHA