Racial Differences in Veterans' Satisfaction With Addiction Treatment Services.
OBJECTIVE
Racial minorities experience lower rates of alcohol treatment completion than whites. Treatment satisfaction is an important factor in alcohol treatment retention, yet few studies have explored the satisfaction of racial minorities while in treatment. This study examined racial differences in addiction treatment satisfaction and explored factors that might mediate or moderate racial differences in satisfaction.


METHODS
We surveyed non-Hispanic black and non-Hispanic white veterans with an alcohol-related diagnosis about addiction treatment services at a large Veterans Affairs medical center. Treatment satisfaction was measured using the 8-item Client Satisfaction Questionnaire, dichotomized as low versus non-low satisfaction in analyses. The χ and logistic regression methods were used to test for associations of race and sociodemographic characteristics with treatment satisfaction.


RESULTS
Among 271 black and 304 white veterans with an alcohol-related diagnosis, race was not statistically associated with treatment satisfaction in bivariate analyses (P > 0.05). However, we identified significant interactions of race with mental health diagnoses in predicting treatment satisfaction in multivariable analyses (adj odds ratio = 0.55; 95% confidence interval [CI] = 0.39-0.78). In post hoc comparisons among veterans with zero mental health diagnoses, black veterans had a greater probability of reporting low satisfaction than whites (marginal difference = 0.13; 95% CI = 0.04-0.22). In veterans with 4 or more diagnoses, whites had a greater probability than blacks of reporting low satisfaction (marginal difference = 0.28, 95% CI = 0.10-0.46). Regardless of race, past homelessness was associated with low satisfaction (adj odds ratio = 2.09; 95% CI = 1.19-3.67).


CONCLUSIONS
Racial minorities, veterans with unstable housing, and white veterans with co-occurring mental health disorders may be at risk of experiencing low treatment satisfaction.
VA Center for Health Equity Research and Promotion (ALJ, AJG, LRMH), Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA; Mental Illness Research, Education and Clinical Center (BHH, CJA, GLH), Education, and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA; Department of Sociology (CJA), Duquesne University, Pittsburgh, PA; and Department of Psychiatry (GLH) and Division of General Internal Medicine, Department of Medicine (AJG, LRMH), University of Pittsburgh School of Medicine, Pittsburgh, PA.
Audrey L
AL
Jones
Barbara H
BH
Hanusa
Cathleen J
CJ
Appelt
Gretchen L
GL
Haas
Adam J
AJ
Gordon
Leslie R M
LR
Hausmann
D000328:Adult; D001741:Black or African American / Q000523:psychology*; D005260:Female; D006703:Ill-Housed Persons / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000523:psychology*; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology*; D044465:White People / Q000523:psychology*