Alcohol use problems have important public health sequelae, and are associated with a number of relationship-oriented negative outcomes, including relationship discord and intimate partner violence (IPV). Thus, problematic alcohol use has implications for both the identified patient, as well as those who are engaged in close relationships with alcohol abusing individuals. Consistent with the notion that alcohol use occurs within a family system, growing evidence suggests that behavioral couple therapy for alcoholism decreases IPV and increases relationship satisfaction more effectively than individual treatments for alcohol problems. However, despite the existence of highly efficacious treatments for problematic alcohol use and attendant improvements in relationship and non-relationship domains, recruitment of couples into treatment has proven difficult, particularly in community settings. Few studies have evaluated the barriers to entry for couples' treatment of alcohol problems with resulting difficulty in targeting factors that prevent couples from entering and engaging in available efficacious treatments. In order for researchers and clinicians to effectively disseminate treatments to individuals who are in need of services, research evaluating barriers to treatment entry is required. This study aims to contribute to knowledge of barriers to treatment entry by following steps identified within the NIH Roadmap network project: Patient-Reported-Outcomes Measurement Information System (PROMIS). PROMIS incorporates item banking, qualitative interviews, and quantitative methods to develop items that distinguish between individuals who seek versus those who do not seek treatment. We will conduct these information gathering procedures with patients in three treatment settings, with their partners, and with experts in the treatment of alcohol problems and of relationship discord. Based on data we collect through item banking and qualitative interviews, we will develop items for a self-report measure of barriers to treatment entry. Following item derivation, we will test items in the field with a sample of patients and partners, and conduct quantitative item analysis using item response theory methods to evaluate the psychometric properties of items. In sum, the proposed study involves a mixed methods approach to gathering information about barriers to entry for couples' treatment of alcohol problems, followed by psychometric assessment of items. Administration of the developed items will permit the identification and targeting of barriers to entry into couples' treatment of problematic alcohol use within diverse treatment settings. ? ? ?
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| Schonbrun, Yael Chatav; Strong, David R; Wetle, Terrie et al. (2011) A qualitative investigation of barriers to entry into couples' treatment for alcohol problems. J Subst Abuse Treat 41:399-406 |
