Quantifying Community Level Behavioral Health Professional Capacity to Prevent and Treat Substance Use Disorder in Colorado Open Access

Holloway, Stephen (Summer 2018)

Permanent URL: https://etd.library.emory.edu/concern/etds/zw12z534t?locale=en
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Abstract

The United States is experiencing an epidemic of substance use disorder, which has resulted in substantial avoidable health care costs, suppressed workforce participation, lowered quality of life, and extraordinary rates of preventable mortality. In response, effective public health intervention requires improving access to secondary and tertiary prevention services provided by behavioral health professionals.

This thesis proposes a model to conduct quantitative assessment of community level needs by predicting the demand for substance use disorder treatment at small geographies and comparing that predicted demand with the estimated supply of treatment services. By evaluating the ratio of need to supply in a two-step floating catchment area framework, this model enables discrete, localized spatial evaluation of substance use disorder workforce capacity in a way not previously attempted. The resulting continuous surface output map analysis reveals localized and variant detail across a gradient of relative treatment capacity in Colorado.

When applied to public health practice, this assessment model will facilitate greater understanding of substance use disorder treatment needs in Colorado, more efficient targeting of workforce resources, and support for longitudinal evaluation of public health interventions that promote increased supply of secondary and tertiary treatment services in underserved communities. If this model improves public health decision making regarding workforce investments, morbidity and mortality attributable to substance use disorder may decrease in Colorado.

Table of Contents

ACKNOWLEDGEMENTS (v)

LIST OF FIGURES (vii)

LIST OF ABBREVIATIONS, ACRONYMS AND INITIALISMS (viii)

CHAPTER 1: INTRODUCTION (1)

Introduction And Rationale (1)

Problem Statement (11)

Theoretical Framework (11)

Purpose Statement (12)

Research Objectives (13)

Statement Of Significance (13)

Definition Of Terms (14)

CHAPTER 2: REVIEW OF LITERATURE (18)

Introduction (18)

Federal Health Workforce Needs Assessment (18)

Alternative Behavioral Health Workforce Needs Assessment Models (24)

Summary Of Current Problem And Study Relevance (34)

CHAPTER 3: METHODOLOGY (36)

Introduction (36)

Population (36)

Protection Of Human Subjects (37)

Research Design (37)

Procedures And Analysis Methodology (38)

Instruments (45)

Data Sources (46)

CHAPTER 4: RESULTS (47)

Introduction (47)

Key Findings (48)

Other Findings (56)

Summary (57)

CHAPTER 5: IMPLICATIONS AND RECOMMENDATIONS (58)

Introduction (58)

Summary Of Study (58)

Discussion Of Key Results (59)

Limitations (60)

Implications (63)

Recommendations (64)

Conclusion (66)

References (67)

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