Research Centers & Affiliations

IUHR - Evaluation of a Residential Substance Abuse Treatment Program for Latina Women and Their Children

Evaluation of a Residential Substance Abuse Treatment Program for Latina Women and Their Children

Authors:
Hortensia D. Amaro, Ph.D.,Northeastern University
Rita Nieves, RN, MPH, Boston Public Health Commission
Sergut Wolde Yohannes, MPH, EdM, New England Research Institutes

Funding Resource:

Substance Abuse and Mental Health Services Administration (SAMHSA) of the U.S. Department of Health and Human Services.

Body of Abstract

Purpose:
The Entre Familia program, cited at the Boston Public Health Commission, was first funded in 1995 by the Substance Abuse and Mental Health Services Administration as a model substance abuse treatment program for Latina/Hispanic women and their children. It provided a comprehensive, gender- and culturally specific family focused 12-month residential treatment for substance abuse. The purpose of the program evaluation was to measure and demonstrate the effectiveness of this program in treating substance abusing Latina/Hispanic women and to document challenges and approaches in implementation. In this abstract, we report only on the outcomes of the treatment program.

Methods:
This study employed a one-group pre-post test design with repeated measures over time. Data from clients were obtained via structured in-person interviews conducted by a bilingual/bicultural trained research interviewer at admission, discharge, and 6- and 12-month post discharge. Additional data were collected from a quarterly service instrument and a discharge form that were completed by program staff. The major study outcomes of interest were treatment effects on

  1. drug use
  2. physical and mental health status
  3. involvement in the criminal justice system
  4. employment
  5. participation in school/vocational training
  6. reliance on public assistance.

Results:
During the first 5 years of the program, of the 125 women admitted to the program, 82 (66%) women completed the 6-month follow-up interview and 72 (58%) completed the 12-month follow-up interview. No statistically significant differences in baseline background characteristics were found between women who enrolled in the study and those who completed the 6-month interview and those who completed 12-month interview. Analysis of pre-post measures on the major outcomes were conducted on all clients with completed measures at 6 and 12 months post discharge by using McNemar Chi-square analysis and paired t-tests. At 6 months post discharge, we found statistically significant reduction in: 1) drug use (p <0.001), 2) physical health problems (p=0.012), 3) reliance on public assistance (p<0.001), and 4) criminal justice involvement (p=0.008); and a statistically increase in employment (p<0.001). At 12 months post discharge reductions in these areas except criminal justice involvement remained significant. In addition, there was a significant increase in school enrollment at 12 months post discharge (p=0.004). At 6 and 12 months post discharge, no statistically significant change in mental health status as measured by McNemar Chi-square test. By using Chi-square analyses, we found women with better outcomes at 12 months post discharge usually had less experienced depression and psychological trauma, was older, and stayed in treatment longer than 180 days. The influence of baseline client characteristics and program factors on client treatment retention was assessed by using Chi-Square analysis and t-tests, and none of these factors were found statistically significantly associated with program retention.

Conclusions:
The evaluation on the first 5 years of the Entre Familia program demonstrated decreases in drug and alcohol use and improvements in health and social functioning. The program has achieved statistically significant improvements in most targeted outcomes, which demonstrates the effectiveness of this gender, culture and language-specific program in treating substance abusing Latina/Hispanic women. However, caution in interpreting the results should be noted due to loss at follow-up assessments and possible associated biases.


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