Dissertations, Theses, and Capstone Projects

Date of Degree

9-2021

Document Type

Dissertation

Degree Name

Ph.D.

Program

Nursing

Advisor

Linda Scheetz

Committee Members

Lorie Goshin

Elizabeth Cohn

Jermaine Jones

Alexis Kuerbis

Subject Categories

Epidemiology | Health Services Administration | Health Services Research | Nursing | Other Public Health | Public Health and Community Nursing

Keywords

opioid use disorder, treatment utilization, young adults, Andersen Behavioral Model, logistic regression

Abstract

Background

Opioid use disorder is a life-threatening medical condition and an ongoing public health problem in the United States. Treatment is necessary to combat opioid use disorder and to minimize the health-associated problems. Opioid use disorder is treatable with life-extending medications. Studies that examined treatment utilization among young adults with opioid use disorder in the United States was scarce. This study investigated the characteristics posited in the Andersen Behavioral Model of health utilization which may be associated with treatment utilization, among young adults with opioid use disorder in the United States. The urgency posed by the continuing opioid crisis in the United States underscores the timeliness of this study. The research question was: What are the predisposing, enabling, and needs characteristics as posited in the Andersen Behavioral Model that are significantly associated with treatment utilization among young adults with opioid use disorder in the United States?

Theoretical Framework

The Andersen Behavioral Model of health utilization guided the study. The Andersen Behavioral Model posited multiple population characteristics which may be associated with treatment utilization.

Methods

A secondary analysis of the 2017 National Survey on Drug Use and Health dataset was conducted. Records of young adults with a diagnosis of opioid use disorder (n = 1,021) were filtered from the secondary dataset. A dichotomous variable in the dataset, treatment utilization, served as the outcome variable. Covariates were derived from the predisposing, enabling and needs characteristics posited in the Andersen Behavioral Model, and available in the secondary dataset. A hierarchical binary logistic regression model was used to analyze the association between potential covariates and treatment utilization for opioid use disorder.

Results

The most concerning finding was that more than 90% of this study’s sample did not utilize treatment. Further, young adults were more likely to utilize treatment if they had an arrest history. Significant associations were observed with the predisposing characteristics race/ethnicity, employment status, and household size.

Conclusion

To plan effectively and comprehensively, and to formulate strategies for enhancing opioid use disorder treatment utilization among young adults in the United States, it may be necessary to fully explore the population characteristic arrest history, in addition to other significant associations reported. Existing treatment strategies should be assessed to determine their usefulness and efficiency.

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