Structural factors affecting Asians and Pacific Islanders in community-based substance use treatment: Treatment providers’ perspectives.

Asians and Pacific Islanders (API) have large disparities in utilization of substance use treatment compared to other racial groups. This CTN platform study analyzed factors that shape API experiences accessing and engaging in community-based treatment from the perspective of treatment providers. Semi-structured interviews were conducted with 40 treatment providers who work with API clients in treatment programs in the Western States and Pacific Nodes of the CTN (San Francisco and Los Angeles). Transcribed interview data was analyzed in ATLAS.ti using a content analysis approach.

There were three main findings. First, treatment providers found the API category itself is too broad and heterogeneous to meaningfully explain substance use patterns. Second, beyond race/ethnicity, structural factors such as poverty, neighborhood, housing, and age had an impact on API substance use. Third, factors such as family, immigration status, religion, language, stigma played complex roles in API treatment experiences, contingent on how client, programs, and providers attended to differences in these categories.

Conclusions: From the perspective of the treatment providers interviewed, there are multiple, intersecting factors that shaped their API clients’ experiences in substance use treatment. Future research can more closely examine and measure the role of structural factors and the potential for structural interventions in API treatment experience, and more research is needed to explore how substance use stigma operates within API communities as well.

Related protocols: CTN-0038-Ot