271463 A sex-worker diversion program: Factors predicting success in treatment for co-occurring disorders in high-risk, hard to reach population

Tuesday, October 30, 2012 : 3:30 PM - 3:45 PM

Mackenzie Cutchall, Student , School of Public Health - Epidemiology Department, University of North Texas - Health Science Center, Fort Worth, TX
Raquel Y. Qualls-Hampton, PhD, MS , Department of Obstetrics & Gynecology, Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX
Monique Shuler, MS , School of Public Health, Department of Epidemiology, University of North Texas Health Science Center, Fort Worth, TX
Martha Felini, DC, PhD , Department of Ob/Gyn, College of Osteopathic Medicine, University of North Texas Health Science Center, School of Public Health, Fort Worth, TX
Erin Kader , School of Public Health - Epidemiology, University of North Texas Health Science Center, Fort Worth, TX
     
Background: The Dallas Police Department initiated a unique, pre-booking diversion program, the Prostitute Diversion Initiative (PDI), in which assessment and preliminary services occur on the streets. Evaluating PDI's effectiveness is complex, as treatment success for co-occurring disorders is multifaceted. Currently, PDI women receive the same inpatient treatment as non-PDI women. This study will reveal differences between PDI and non-PDI women and determine if these factors are predictive of success in inpatient treatment.

Method: Demographic and treatment information were abstracted from treatment center charts. Inpatient treatment completion, age, race, education level and co-occurring disorders (e.g., having at least one psychiatric and one substance use disorder) were compared between diversion groups. Exploratory analysis will examine length of stay (LOS) and criminal justice history using logistic modeling to explain treatment patterns related to success.

Results: Initial analysis indicated PDI women experienced lower completion rates than non-PDI women (45% and 80%, respectively). PDI women tended to be African American (69%), older, (76% 35+), and attained lower education (100% ≤ high school) compared to their Non-PDI counterparts (white (54%), younger (55%, age 35+), and higher education (12%, some college)). Modeling will uncover patterns of success between groups controlling for LOS and criminal justice history.

Conclusion: Success of national diversion programs is contingent upon the success of inpatient treatment. Diverted women are assumed to be similar to women seeking treatment through non-diversion opportunities. A more intensive treatment plan may be needed, and diversion programs must be informed of the heterogeneity of this hard-to-reach, high risk population.

Learning Areas:
Epidemiology
Implementation of health education strategies, interventions and programs
Social and behavioral sciences

Learning Objectives:
1. Determine demographic factors associated with treatment completion rates among women admitted to treatment for co-occurring disorders through a prostitute diversion initiative. 2. Compare treatment completion rates in diversion initiative women to those receiving treatment without going through the diversion initiative. 3. Examine the association of the diversion initiative on inpatient treatment completion rates by demographic factors. 4. Use modeling to estimate the effect of length of stay and criminal justice history on treatment completion rates controlling for demographic factors.

Keywords: Psychiatric Epidemiology, Substance Abuse Treatment

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I work as a student research assistant on a project assessing the effectiveness of treatment for co-occurring substance abuse and mental disorders in women. Specifically, I have compared treatment completion rates in women from a prostitute diversion initiative with those of women seeking treatment through other opportunities. I am interested in the developing a treatment strategy fitted to their specific needs.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4304.0: Psychiatric Epidemiology