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Twelve‐Step attendance trajectories over 7 years among adolescents entering substance use treatment in an integrated health plan
Author(s) -
Chi Felicia W.,
Campbell Cynthia I.,
Sterling Stacy,
Weisner Constance
Publication year - 2012
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/j.1360-0443.2011.03758.x
Subject(s) - attendance , medicine , odds , observational study , longitudinal study , logistic regression , odds ratio , demography , generalized estimating equation , psychology , pathology , sociology , economics , economic growth , statistics , mathematics
Aims This study examines 12‐Step attendance trajectories over 7 years, factors associated with the trajectories, and relationships between the trajectories and long‐term substance use outcomes among adolescents entering out‐patient substance use treatment in a private, non‐profit integrated managed‐care health plan. Design Longitudinal observational study. Setting Four Kaiser Permanente Northern California substance use treatment programs. Participants A total of 391 adolescents entering treatment between 2000 and 2002 who completed at least one follow‐up interview in year 1, and at least one during years 3–7, after treatment entry. Measurements Alcohol and drug use, 12‐Step meeting attendance and activity involvement and post‐treatment medical service utilization. Findings Semiparametric group‐based modeling identified three distinct 12‐Step attendance trajectory groups over 7 years: low/no attendance (60%), early but not continued (26%) and continued (14%). There were lower proportions of males and of adolescents with prior substance use treatment experience in the low/no attendance group ( P = 0.019 and P = 0.003, respectively). In addition, those in the low/no attendance group had lower perception on circumstances, motivation and readiness for treatment at baseline ( P = 0.023). Multivariate logistic generalized estimating equation analyses found that those in the continued group were more likely to be abstinent from both alcohol and drugs during follow‐ups than those in the low/no attendance group [odds ratio (OR) = 2.40, P = 0.003 and OR = 1.96, P = 0.026, respectively]. However, no differences in long‐term outcomes were found between those in the other two groups. Conclusion Robust connection with 12‐Step groups appears to be associated with better long‐term outcomes among adolescents with substance use disorders.