title: Determinants of 12-step group affiliation and moderators of the affiliation-abstinence relationship.
abstract: This study examined characteristics of substance use disorder (SUD) outpatients at intake to treatment (N=345) that were associated with more 12-step group attendance and involvement, Steps worked, and acceptance of 12-step philosophy at a 6-month follow-up (N=281, 81.4%). Patient characteristics covered the domains of sociodemographics, SUD severity, personal functioning, and previous help received. Distinguishing baseline characteristics of patients who attended more 12-step group meetings during follow-up were being less-educated, more engaged in religious practices, and more extroverted and interpersonally competent, and having had more previous 12-step group exposure. These patient characteristics were generally similar to those associated with more 12-step meeting involvement and philosophy acceptance. More 12-step meeting attendance and involvement were related to abstinence at 6 months. Associations of attendance with abstinence were stronger among patients who were younger, white, less-educated, unstably employed, less religious, and less interpersonally skilled. These patients may have had fewer available social resources and so benefitted more from the fellowship and support for abstinence that 12-step group members often provide. We suggest methods by which treatment providers may encourage 12-step group affiliation among patients likely to benefit from it on substance use outcomes.
authors.affiliation: Center for Health Care Evaluation, Department of Veterans Affairs Health Care System, and Stanford University Medical Center, VA Health Care System, 795 Willow Road (152-MPD), Menlo Park, CA 94025, USA. ctimko@stanford.edu
authors.forename: Christine
authors.initials: C
authors.lastname: Timko
authors.forename: Rachel
authors.initials: R
authors.lastname: Billow
authors.forename: Anna
authors.initials: A
authors.lastname: DeBenedetti
mesh_terms: D000436:Alcoholics Anonymous; D003469:Culture; D003710:Demography; D005120:Extraversion, Psychological; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D012944:Social Support; D019966:Substance-Related Disorders / Q000534:rehabilitation*; D013695:Temperance; D013997:Time Factors