Increasing the appeal and utilization of services for alcohol and drug problems: What consumers and their social networks prefer

Background: A large gap exists in the United States between population need and the utilization of treatment services for substance-related problems. Surveying consumer preferences may provide valuable information for developing more attractive services with greater reach and impact on population health. Methods: A state-level telephone survey using random digit dialling sampling methods assessed preferences for available professional, mutual help, and lay resources, as well as innovative computerized and self-help resources that enhance anonymity (N=439 households in Alabama). Results: Respondents preferred help that involved personal contact compared to computerized help or self-help, but were indifferent whether personalized help was dispensed by professional or lay providers. Attractive service features included lower cost, insurance coverage, confidentiality, rapid and convenient appointments, and addressing functional problems and risks of substance misuse. Respondents in households with a member who misused substances rated services more negatively, especially if services had been used. Conclusion: The findings highlight the utility of viewing substance misusers and their social networks as consumers, and the implications for improving the system of care and for designing and marketing services that are responsive to user preferences are discussed. (C) 2007 Elsevier B.V. All rights reserved.