Rural Drug Abuse Treatment: Organizations, Counselors, and Client Outcomes

The primary goal of this revised K01 application is to further develop a productive independent research career in substance abuse treatment. The major changes in this revised application include the addition of an ecological theoretical framework, supplementary didactic and experiential qualitative training, as well as improved recruitment and analytic strategies. Additional training will enhance Dr. Carrie Oser's experience in organizational-level models to encompass a multi-level perspective and broaden her research focus to rural areas. The proposed training goals will provide additional instruction in: (1) the cultural nuances of rural communities, (2) qualitative research methods, (3) advanced statistical training specific to multi-level modeling (e.g., HLM, SEM), and (4) the conduct of ethical research. Dr. Carrie Oser will be sponsort:;d by Dr. Carl Leukefeld, who has experience in rural substance abuse research. The overall goal of this revised research plan is to better understand counselor contextual and organizational contributions to rural treatment outcomes in public treatment facilities. The specific aims are: (1) to describe the characteristics of rural clients, as compared to urban clients; (2) to examine the characteristics and treatment practices of rural counselors, as compared to those employed in urban facilities; (3) to identify the organizational characteristics of state-funded treatment facilities in rural counties, as compared to urban, utilizing a PDA-based data collection methodology; (4) to develop two-level hierarchical linear models from an ecological perspective to predict rural treatment outcomes and urban treatment outcomes; (5) to separately examine the proportional contributions of client-level factors, counselor contextual factors, and organizational factors to rural treatment outcomes and urban treatment outcomes using an ecological theoretical framework. This project will significantly contribute to understanding community treatment and client outcomes in rural and urban counties. The focus on treatment outcomes within rural public treatment facilities is a logical transition from Dr. Oser's graduate work on the adoption of innovative pharmacological treatments within privately-funded treatment organizations. This proposed project will allow for a practical application of the substantive knowledge and analytical skills acquired from the K01 training activities and will ultimately culminate in the development of future investigator initiated NIDA grant applications.