Multilevel Effects of Environmental and Neighborhood Factors on Sober Living House Resident 12-Month Outcomes.

IF 2.4 3区 医学 Q2 PSYCHOLOGY Journal of studies on alcohol and drugs Pub Date : 2023-11-01 Epub Date: 2023-07-11 DOI:10.15288/jsad.22-00307
Meenakshi S Subbaraman, Elizabeth Mahoney, Jane Witbrodt, Katherine J Karriker-Jaffe, Amy A Mericle, Douglas L Polcin
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Abstract

Objective: Sober living houses (SLHs) are abstinence-based environments designed for individuals in recovery to live with others in recovery. Research shows that SLHs help some individuals maintain recovery and that certain SLH-related factors may be particularly protective. Here we assess how SLH housing and neighborhood characteristics are related to abstinence and psychiatric symptoms over time.

Method: Baseline, 6-month, and 12-month data were collected from 557 SLH residents. Multilevel mixed models tested associations between house and neighborhood characteristics and individual-level percent days abstinent (PDA) and the number of psychiatric symptoms (measured with the Psychiatric Diagnostic Screening Questionnaire [PDSQ]) as outcomes. Final models adjusted for sex, age, and race/ethnicity; ratings of house characteristics; and objective measurements of neighborhood-level exposures.

Results: Both PDA and PDSQ improved significantly (ps ≤ .05) over time in both unadjusted and adjusted models. More self-help groups and fewer alcohol outlets within one mile were significantly protective for PDA, whereas walkability was significantly related to worse PDA and PDSQ (ps ≤ .05). For house-level factors, better ratings of house maintenance were related to significantly fewer psychiatric symptoms, whereas higher scores on SLH's safety measures and personal or residence identity were related to more psychiatric symptoms (ps ≤ .05). No house-level factor was significantly related to PDA.

Conclusions: Neighborhood-level factors such as increased availability of self-help groups and fewer nearby alcohol outlets may increase abstinence among individuals living in SLHs. House-level factors related to better maintenance may also facilitate improved mental health.

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环境和邻里因素对清醒生活屋居民12个月预后的多层次影响。
目的:清醒之家(SLH)是一种基于禁欲的环境,专为康复中的个人设计,与康复中的其他人一起生活。研究表明,SLH有助于一些人保持恢复,某些SLH相关因素可能具有特别的保护作用。在这里,我们评估了随着时间的推移,SLH住房和社区特征如何与禁欲和精神症状相关。方法:从557名SLH居民中收集基线、6个月和12个月的数据。多水平混合模型测试了家庭和社区特征与个人水平的禁欲天数百分比(PDA)和精神症状数量(用精神病诊断筛查问卷[PDSQ]测量)之间的相关性。根据性别、年龄和种族/民族进行调整的最终模型;房屋特征评级;以及邻居水平暴露的客观测量。结果:随着时间的推移,在未调整和调整的模型中,PDA和PDSQ都有显著改善(ps≤.05)。一英里内更多的自助团体和更少的酒精出口对PDA有显著的保护作用,而步行能力与较差的PDA和PDSQ显著相关(ps≤.05)。对于家庭层面的因素,更好的房屋维护评级与显著减少的精神症状有关,而SLH的安全措施和个人或居住身份得分越高,则与更多的精神症状有关(ps≤.05)。没有家庭水平因素与PDA显著相关。结论:社区层面的因素,如自助团体的增加和附近酒精店的减少,可能会增加SLH患者的禁欲程度。与更好的维护相关的家庭层面因素也可能有助于改善心理健康。
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来源期刊
CiteScore
4.80
自引率
5.90%
发文量
224
审稿时长
3 months
期刊介绍: The Journal of Studies on Alcohol and Drugs began in 1940 as the Quarterly Journal of Studies on Alcohol. It was founded by Howard W. Haggard, M.D., director of Yale University’s Laboratory of Applied Physiology. Dr. Haggard was a physiologist studying the effects of alcohol on the body, and he started the Journal as a way to publish the increasing amount of research on alcohol use, abuse, and treatment that emerged from Yale and other institutions in the years following the repeal of Prohibition in 1933. In addition to original research, the Journal also published abstracts summarizing other published documents dealing with alcohol. At Yale, Dr. Haggard built a large team of alcohol researchers within the Laboratory of Applied Physiology—including E.M. Jellinek, who became managing editor of the Journal in 1941. In 1943, to bring together the various alcohol research projects conducted by the Laboratory, Dr. Haggard formed the Section of Studies on Alcohol, which also became home to the Journal and its editorial staff. In 1950, the Section was renamed the Center of Alcohol Studies.
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