Substance Abuse Research Development Program
for Underserved Populations
Abstract: Methods to Study Ethnicity and Faith-Based Treatment
James Alan Neff, Ph.D., Clayton T. Shorkey, Ph.D., Christopher Ellison, Ph.D., Principal Investigators
An Administrative Supplement for Health Disparities Research is sought to expand the scope and to recruit additional African American and Hispanic/Latino subjects for a pilot project dealing with Ethnicity and Spiritual Change in Faith-Based Substance Abuse Treatment being conducted as part of the University of Texas at Austin Substance Abuse Research Development Program. Because little is known about the effectiveness of these faith-based treatment programs, the goal of the Faith-Based Treatment pilot study is to identify conceptions of spirituality and spiritual change in addition to identifying key program elements felt related to 1) engagement and retention in the programs, 2) spiritual change, and 3) alcoholism/substance abuse recovery. The ultimate goal of the pilot project is to develop methodologies to develop an R01 application to conduct a large scale prospective study of spiritual change mechanisms taking place during alcoholism/substance abuse treatment in these faith-based programs. This prospective proposal would explore the linkages of faith-based program elements, mediating spiritual change dimensions, and substance abuse treatment outcomes, particularly in minority populations served by many of these programs.
To date, the Faith-Based Treatment project has received limited support through the Research Development Program to develop working collaborations with local faith-based treatment programs and to assess the feasibility of conducting preliminary focus group studies of concepts of spirituality among staff and clients of faith-based alcoholism and substance abuse treatment programs in the Central Texas area. Two years of supplemental funding for the project are sought to expand the scope of the pilot project to develop and pilot test culturally appropriate measures of spirituality for use in an R01 application. Funds are sought specifically to acquire expert consultation from nationally known researchers in the areas of spirituality and minorities as well as to develop and test out instrumentation using both qualitative and quantitative methodologies. Funds will support additional focus groups with faith-based programs specifically targeting African American and Hispanic/Latino substance abusers as well as to support collection of interview data with a sample of roughly 250 faith-based program participants (approximately 80 non-Hispanic whites, 80 African Americans, and 80 Hispanic/Latinos) to allow examination of psychometric properties of possible spirituality and other measures developed and/or modified on the basis of focus group data. Analyses of the quantitative survey data will also allow an assessment of the sensitivity of the new measures to detect differences in spirituality dimensions between ethnic groups as well as between new and long-term participants in faith-based programs.
The goal of the supplemented pilot project is to develop both qualitative (subjective) and quantitative (empirical) methods to study spiritual change in faith-based programs involving minority populations. The proposed project will involve 4 to 6 faith-based programs selected to represent a range of spiritual orientations, including licensed and unlicensed programs. Specific aims include:
1) Bringing in nationally known consultants in the areas of qualitative methodology and concept mapping (Bill Trochim; Cornell University), spirituality and religious coping (Kenneth Pargament; Bowling Green State University), the measurement of spirituality among African-Americans (John Wallace; University of Michigan), and the development of culturally-grounded measures of spirituality and religiosity (Neil Krause; University of Michigan). These consultants will provide critical expertise regarding state-of-the-art methodologies to studying spirituality in minority groups.
2) Developing and testing procedures to collect qualitative information from program staff and clients regarding conceptions of spirituality and spiritual change, in addition to identifying key program elements felt related to engagement and retention in the program, spiritual change, and substance abuse recovery. This pilot component will also involve the application of concept mapping techniques (Trochim, 1993, Johnsen, Biegel, and Shafran, 2000) to focus group data in order to quantitatively explore the dimensionality of spirituality in these populations. Results of the focus group/concept mapping component will inform development of multi-dimensional measures of spirituality appropriate to these groups. Analyses of the concept mapping data will also compare differences between types of faith-based programs in terms of conceptions of spirituality.
3) Developing and pilot testing procedures to collect quantitative data from program participants. We will conduct interviews with a sample of approximately 250 individuals participating in faith-based programs to pilot test newly developed spirituality instruments. These interviews will provide methodological information regarding the effectiveness of recruitment procedures and participation rates. Data analyses will assess the psychometric properties of spirituality measures in this population and will further assess the utility of measures in detecting differences in spirituality between ethnic groups and between new vs. long-term program participants. These analyses will provide data for sample size and power estimation for the R01 to be developed.
Expected outcomes include clarification of key dimensions of spirituality, meaning, and key spiritual elements of the programs that contribute to effectively engaging African-American and Hispanic/Latino alcohol and substance abusers in treatment. The pilot project will provide data to support submission of an R01 to NIDA to conduct a prospective study, following individuals through the treatment process, looking at changes in spirituality and substance abuse behavior during treatment (with post-treatment follow-up interviews at 6, 12, and 18 months). The proposed R01 will link both individual level variables (e.g., spirituality) and program level variables (e.g., use of lay vs. professional staff, use of 12-step vs. other approaches, spiritual orientation) as they relate to treatment outcomes (e.g., attaining and maintaining sobriety). While funding for the present developmental work could be sought via an R21 exploratory grant mechanism, it is emphasized that funding through an Administrative Supplement will yield data more quickly at lower cost than an R21.
Literature Cited:
Trochim, W. (1993). The Concept System. Ithaca, NY: Concept Systems
Johnsen, J., Biegel, D., and Shafran, R. (2000). Concept mapping in mental health: Uses and adaptations. Evaluation and Program Planning, 23:67-75.
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