[R01] Improving alcohol treatment outcomes for women across the lifespan
Ente: National Institute on Alcohol Abuse and Alcoholism
Scadenza: 2031-08-31
Importo max: $758,464
Paese: US
Descrizione
Project Summary/Abstract
There has been an alarming escalation of alcohol-related consequences and deaths among women in the US over the past few decades. Alcohol use behaviors and consequences for women vary by age group and have changed over time. The most pronounced increases in high-risk alcohol use and alcohol use disorder (AUD) have been among women in middle adulthood (aged 30-49). AUD treatment is effective, yet rates are extremely low in the US. Women face common AUD treatment barriers (e.g., stigma, provider availability), and unique barriers (e.g., lack of women-focused treatment and childcare). Together, state and insurance plan characteristics may influence AUD treatment use, progression in treatment, and outcomes. Organized by the cascade of care framework and the socio-ecological model, we use rigorous quasi-experimental methods (e.g., target trial emulation), household survey data (National Survey of Drug Use and Health (NSDUH)) to capture high-risk alcohol use and AUD treatment need, and medical claims data (Medicaid and MarketScan commercial insurance claims) to capture clinically diagnosed AUD, movement through the cascade of care, and outcomes by developmental age cohort (18-29, 30-49, 50-64). Study analyses include data from 2021-2025 and are stratified by Medicaid and commercial insurance populations to ensure that results are directly applicable to each distinct population. Specific Aims are: AIM 1: Estimate the prevalence of high-risk alcohol use, alcohol use disorder, and alcohol-attributable conditions and injuries for women by age cohort, and test for differences over time. AIM 2: 2a. Among women with AUD, determine the proportion of women receiving AUD treatment (NSUDH); and 2b. describe movement along the cascade of care from AUD treatment initiation to engagement and retention, by age cohort, and determine if there is variation by state characteristics, women-focused treatment availability, and primary care provider availability (claims). AIM 3: Using Medicaid and commercial insurance claims data, among women initiating AUD treatment, leverage target trial emulation to determine if there is an association of treatment engagement and retention with clinical outcomes (i.e., alcohol-attributable conditions and injuries, self-harm/suicidality) and health care use (i.e., alcohol-related ED visits, alcohol-related hospitalizations) by age cohort, and determine if there is variation by state characteristics, women-focused treatment availability, primary care provider availability, and individual characteristics. By identifying gaps in the AUD treatment cascade, this proposal will accelerate targeted improvements in AUD treatment for women across the lifespan, within both Medicaid and commercial insurance populations, with the ultimate goal of saving lives.
Istituzione: BOSTON UNIVERSITY MEDICAL CAMPUS
PI: Rachel Sayko Adams, Maureen T Stewart
Progetto: 1R01AA033066-01
Settori: National Institute on Alcohol Abuse and Alcoholism
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