The overall objective of the proposed research is to provide a comprehensive understanding of barriers, adherence and incentives to treatment among crack-cocaine dependent African Americans Male Adolescent (AAMA)-a particularly difficult group for drug treatment programs to recruit, assess and treat.
The specific aims of the project are to (1) develop and test measures that integrate research findings that form vigorous multidimensional scales for hypothesis testing, and are of potential use to drug treatment programs in recruiting and assessing the needs of young black men who are enmeshed in crack-cocaine lifestyles; (2) documentation, through testing of hypotheses and a structural model, of the interplay between AAMA's crack-cocaine and street involvement, their willingness to enter treatment, their concurrent life problems beyond drug use and criminal activities, and supports and pressures from their socio-cultural networks, in a way that builds on and updates existing information on young black male street addicts; (3) explore through ethnographic investigation of two factors about which little empirical information exists for crack-cocaine dependent AAMA: (a) attitudes toward treatment and treatment providers among AAMA who have never been in treatment, and (b) the impact of ethnic/class-cultural difference on treatment entry and retention; (4) recommendation of policy alternatives, treatment initiatives, and supportive social services that will increase treatment entry, retention, adherence, and success for crack-cocaine dependent AAMA. The methodology entails a 4-year 3-sample study to be conducted in the Miami-Fort Lauderdale, Florida area. Sample 1 is 200 crack-cocaine dependent AAMA age 15-25, sample 2 is a subsample of sample 1 to be interviewed using a highly structured instrument designed for hypothesis testing and ethnographic techniques. This multi-ethnic sample will consist of young black men with both prior and no prior treatment experience, both treatment seekers and treatment resisters among men contacted on the street. Sample 3 is 25 recovering young men with histories of crack-cocaine dependency, to be interviewed as """"""""key informants"""""""" with a longer open-ended instrument oriented toward explanatory insight and ethnographic detail. Intensive analysis of the sample 1 data, aided by extrapolation from sample 2, will emphasize index construction and hypothesis testing to achieve the study's specific aims.
