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Service Utilization Among Hispanic Substance-Abusing Adolescents

Service Utilization Among Hispanic Substance-Abusing Adolescents. Maite P. Mena, Psy.D. Frank R. Dillon, Ph.D. Yannine Estrada, B.A. Ellen Vaughan, M.A. Daniel A. Santisteban, Ph.D.

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Service Utilization Among Hispanic Substance-Abusing Adolescents

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  1. Service Utilization Among Hispanic Substance-Abusing Adolescents Maite P. Mena, Psy.D. Frank R. Dillon, Ph.D. Yannine Estrada, B.A. Ellen Vaughan, M.A. Daniel A. Santisteban, Ph.D.

  2. In 2002, approximately 1.4 million youths between the ages of 12-17 required treatment for a drug use problem. Only 10% received treatment (SAMHSA, 2002). • We know little about what predicts service utilization, particularly among Hispanics.

  3. Ethnicity-specific programs were found to be better than mainstream programs in: • Client return rates • 2) Length of treatment Latino clients were 11 times more likely to return to Latino specific programs than to mainstream programs. Takeuchi, Sue & Yeh (1998)

  4. The following variables have been the focus of research and have been found to be related to service utilization by adults and child/adolescents: Adolescent Psychopathology Socio-demographic Variables Family and Parental Predictors Ethnicity-related Factors

  5. METHOD • Participants in the study: • 110 Hispanic adolescents (mean age 15.6, range 14-17) and their parents • Adolescents met criteria for Substance Abuse or Dependency Disorder • Adolescents admitted to the Juvenile Addictions Receiving Facility • 60% of participants were male

  6. Profile of adolescent substance abuse during the last 12 months: • 32% had used alcoholic beverages at least 20 or more times (20% 40 or more times). • 75% had used marijuana at least 20 or more times (60% 40 or more times). • 20% had used cocaine at least 20 or more times (14% 40 or more times).

  7. Mother’s reported ethnicities were 60% Cuban, 12% Honduran, 9% Puerto Rican, 8% Dominican, 8% Nicaraguan, 7% Colombian and 16% other Hispanic. • 81% of Mother’s reported an educational level of High School or less. • 61% of the families reported an annual household income of $25,000 or less. • 66% of the adolescents were born in the U.S. and 34% were born in a Hispanic country.

  8. ASSESSMENT • Adolescents and parents were assessed at the JARF. • Data on utilization of services are based on a telephone interview conducted with parents 6 weeks post-discharge. • Response rate for the telephone interview was 96%.

  9. Measures used: • Substance Use- Personal Experiences Inventory (A) • Parenting Practices- Parenting Practices Quest. (A & P) • Stress- Hispanic Stress Inventory (A & P) • Attachment- IPPA (A) • Psychiatric Comorbidity- DPS 4 (A & P) • Acculturation- Bicultural Involvement Scale (A & P) • Demographics

  10. Analytic Plan • Analyses were conducted in two steps: • Univariate logistical regression models were run for the full sample, the outpatient sample and the residential sample. • 2. Hierarchical logistic regression models were run for those variables that were found significant in the univariate analysis.

  11. Figure 1. Utilizer & Non-Utilizer Differences on Parent Discipline Style (Full Sample n = 86) Parent Discipline Style

  12. Figure 2. Utilizer & Non-Utilizer Differences on Adolescent Externalizing Disorders (Full Sample) Adolescent Externalizing Disorders

  13. Hierarchical logistic regression- Full Sample Total number of adolescent externalizing disorders (χ2 = 4.18, df = 1, p< .05). Parenting Practices- Discipline Style (χ2 = 8.73, df = 2, p<.05). The hypothesized model (adolescent externalizing disorders, discipline style, and parenting stress) correctly predicts 63% of the cases.

  14. Outpatient Sample Parenting Practices-Discipline Style (χ2 = 7.99, df = 1, p<.01;) Parental Years in the U.S. (χ2 = 6.83, df = 2, p<.05) The hypothesized model correctly predicts 81.3% of the cases.

  15. Residential Sample A single variable was found significant, HSI Parenting Stress (χ2 = 4.03, df = 1, p<.05), in the univariate analyses. The hypothesized model correctly predicts 63.2%.

  16. Clinical Implications The results of this research highlight the fact that those families who are most in need of treatment do not receive treatment. Referral and receiving facilities should address, through specialized engagement strategies, the clinical and familial characteristics that could hinder adolescents and families from following through with recommended services.

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