Effects Among
Specific Client Populations Should be Examined
Many of the research recommendations contained in this report could
be restated to apply to specific sub-populations of clients. For example,
while it is important to study the factors related to insurance coverage
in the aggregate population, it is also important to study how these factors
operate among women, among clients with co-occurring mental disorders,
or among low-income clients. Barriers to insurance or limitations of insurance
coverage may have particular relevance for some of these groups. Similarly,
research on barriers to treatment access should be conducted both with
reference to the overall population and with reference to populations
likely to experience greater access barriers. We are some distance from
knowing which treatments offer the best promise of effectiveness, but
we are even farther from knowing whether some treatment modalities, settings,
intensities, or goals are more or less effective among particular groups
such as ethnic minorities, homeless inebriates, depressed alcoholics,
or elderly clients. Likewise, the cost-effectiveness of differing treatment
strategies can be expected to vary among these groups.
As a general principle, NIAAA recognizes the need to support research
that focuses on client populations as well as research on the aggregate
population. Relationships among organizational factors, financing arrangements,
treatment outcomes, costs, and access may differ for different client
populations, and research should try to identify and explain these differences.
It may not be necessary to restate each of the research recommendations
in a way that specifically highlights its applicability to client diversity,
but it should be clearly understood that studies of specific client populations
are a necessary and integral part of all branches of services research
inquiry.
