Recovery Within a Community-based Residential Treatment for Substance Use Problems: Program Theory Development and the Impact of COVID-19
Notice bibliographique
Résumé
Community-based residential treatment for substance use disorders (SUDs) has mixed effectiveness in reducing substance use and substance-related problems, which has been hypothesized to be due to the variability of program offerings across treatments. Further, due to the recent COVID-19 pandemic, community-based residential treatment centres have had to adapt their programming in order to follow necessary infection control mandates, leading to considerable changes in programming. The purpose of the present dissertation was twofold: 1) to develop a realist program theory of a community-based residential treatment centre in order to understand what components of treatment are most effective, who benefits from treatment, and why; and 2) to document and synthesize the experiences of stakeholders at a treatment centre during COVID-19. The present dissertation was completed in collaboration with Renascent, a community-based residential treatment program located in Toronto, Canada. In order to meet the first purpose, a realist evaluation was conducted using qualitative interviews (N=27) with program stakeholders. The results of the thematic analysis identified four overarching organizational contexts and 11 Context-Mechanism-Outcome (CMO) configurations that comprise the program theory. The CMOs were grouped into three themes (i.e., relational, psychological, and diversity), underscoring the multiple pathways in which recovery is achieved for individuals with SUDs. Study two involved a qualitative investigation of the experiences of key stakeholders at the treatment centre during COVID-19 using an inductive approach. Interviews were conducted with stakeholders (N=13) and analyzed using thematic analysis. The interviews and subsequent analysis identified a number of themes (i.e., service accessibility, difficulties with interpersonal connection, and increased stress experienced by frontline staff). Across the two studies, the importance of building peer recovery relationships, creating structure, and inter-agency collaborations was highlighted. The results of both studies provide a template as to how implementation of novel practices can occur and how tensions can be overcome through collaboration. The results of the present dissertation offer a significant contribution to the literature in understanding how, why, and for whom community-based residential treatment for SUDs is effective, while also providing timely data on the experiences of attending and implementing treatment during a pandemic.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,022 | 0,012 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,003 | 0,002 |
| Études des sciences et des technologies | 0,006 | 0,019 |
| Communication savante | 0,009 | 0,006 |
| Science ouverte | 0,004 | 0,007 |
| Intégrité de la recherche | 0,002 | 0,004 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».