Year: 2022
Type: preprint
Abstract: Background: Workforce diversity is a key strategy to improve treatment engagement among members of racial and ethnic minority groups. In this study, we seek to determine whether programs with higher workforce diversity show differences in wait time to treatment entry and retention in treatment for opioid use disorders among individuals self-identified as Black/African American or Latino/Hispanic. We account for the role of Medicaid expansion and program ownership type (i.e., public, non-profit, for-profit) among opioid treatment programs (OTP) located across the United States. Methods: We examined four waves of the National Drug Abuse Treatment System Survey (NDATSS), a nationally representative longitudinal dataset (2000- 2017), to assess the associations between OTPs’ program ownership type and workforce diversity on wait time and retention. We conducted comparative and predictive analysis in an analytic sample of programs pre- and post-Medicaid expansion (162 in 2000, 173 in 2005, 282 in 2014, and 300 in 2017). We considered the moderated effect of workforce diversity and program ownership type on wait time and retention. Results: We found significant differences in wait time to treatment entry and retention in treatment across waves. Average days waiting decreased in the last two waves of the NDATSS (2014 and 2017) (post Medicaid expansion per the Affordable Care Act), while retention rates varied across years. Key findings show that programs with both a higher percent of African American staff and a higher percent of African American clients were associated with longer wait times to enter treatment. Programs with both a higher percent of Latino staff and a higher percent of Latino clients were associated with lower retention in treatment. Program ownership type (public, non-profit and for-profit) played an important role in whether diversity was related to wait time and/or retention. Conclusions: Findings show decreases in wait time over the years with significant variation in retention during the same period. Workforce diversity was associated with higher wait time and lower retention when programs also had high percentages of African American and Latino clients. Findings have implications for OTPs in minority communities to enhance wait time to treatment entry and retention in treatment.
Source: Research Square
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4280527313