Bridging Disciplinary Boundaries (January 11 - 14, 2007)

PURPOSE: The purpose of this study is to determine how individual and organizational level acculturation factors affect Hispanics' length of retention in substance abuse treatment. It is well-documented that remaining in substance abuse treatment is associated with better treatment outcomes. However, Hispanics report more challenges to complete treatment compared to Whites. From an organizational cultural competence perspective, culturally consistent practices are more likely to retain clients in needed services. METHODS: This study uses the data from the National Treatment Improvement Evaluation Study (NTIES). This data provided an analytical sample of 476 Hispanics treated by 49 service delivery units. RESULTS: Univariate analysis shows that race/ethnicity is significantly associated with duration in treatment. Specifically, Hispanics have shorter treatment duration compared to Whites. In Hispanic clients, individual acculturation factors, such as born in the U.S. and language spoken are negatively correlated with duration. Meanwhile, organizational level acculturation factors that are positively associated with length of retention included; percentage of male staff, percentage of minority staff, having a minority director, number of Hispanics admits in the reference year, the number of female admits in the reference year, percentage of black clinicians and percentage of clients who were the same race as clinicians. Furthermore, this study also used a mixed linear model to test how organizations' cultural variables affect clients' length of treatment retention. Hispanics who were older, less educated and with prior drug use reported shorter retention rates. In addition, clients who did not receive the intensity of services needed were the most likely to disengage from services as well. Considering organizations' structure, organizations that had an ethnic minority director, had a higher percentage of male staff, and that used client-counselor ethnic matching reported the highest rates of retention of Hispanics. These findings are consistent with the organizational cultural competence perspective; ethnic and gender representation in service providers plays a significant role in Hispanic clients' retention. IMPLICATIONS: Given the widely acknowledged poor access and retention rates in the Hispanic population, these findings are relevant to the design of treatment organizations and the delivery of services for Hispanic clients.