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The Assessment of Wellness and Nutrition in Residential Alcohol and Drug
Treatment Programs
A Dissertation Proposal Presented to the Faculty of the Heller School for Social Policy
and Management, Brandeis University, Waltham, Massachusetts
by
Barbara Koffske Reid, M.Ed., MA, LMFT
Nutrition plays a vital role in creating health and alleviating the burden of disease,
particularly chronic physical and mental health conditions. Among the most persistent
and costly diseases is alcohol and drug addiction, a chronic relapsing brain disease that
often co-occurs with a host of physical and mental health problems, one of the most
common being depression (NIDA, 2008). People with alcohol and other drug abuse
problems often have compromised nutritional status (Breslow et al., 2010), which may be
the result of lifestyle and the effects of substances of abuse. The literature suggests that
addressing aspects of wellness and nutrition can be instrumental in achieving better
mental/behavioral health, in addition to the impact on overall health (Bidlack, 1996).
What is not known is whether residential substance abuse programs are incorporating this
evidence into their treatment approaches.
The goal of this study is to understand what residential substance abuse treatment
programs in Massachusetts are doing to integrate wellness and specifically nutrition into
treatment. We will determine what efforts are underway to address wellness and
nutrition, such as the types of foods and wellness activities within programs and the level
of knowledge program directors have about nutrition.
Rogers’ theory on the diffusion of innovation (Rogers, 2003) provides a model that is
well suited to understand how residential treatment programs come to adopt
wellness/nutrition into their day to day work with clients. It seeks to explain how ideas
or innovations that are perceived as new are adopted. While nutrition is not a new
concept as it relates to health, it is new in that it has not traditionally been an integral part
of substance abuse treatment. The study aims to understand how these innovations have
been adopted or why they have not.
To the best of the author’s knowledge, no other data has been collected on wellness and
nutrition efforts within residential substance abuse treatment; therefore a survey tool was
developed based on the literature relevant to the diffusion of innovations, mental health,
substance abuse, wellness, and nutrition, in addition to consultation with providers within
the field. Program directors of all 66 licensed residential treatment programs in
Massachusetts will be asked to complete the survey, and 4-6 will be asked to participate
in a more detailed interview. Both qualitative and quantitative methods will be used. The
quantitative analysis will include univariate, bivariate and multivariate analysis.
Regression will be used to examine relationships between the theory-driven independent
variables and the outcome of interest, wellness and nutrition activities.
Nutrition and wellness initiatives can aid in increasing the quality of life for those with
substance abuse problems by reducing health risk factors and increasing protective
factors. Nutrition has been found to have an impact on co-occurring conditions that are
common among substance abusers, which may positively impact the process of recovery.
This research has implications for the way treatment is delivered in residential programs,
the allocation of resources, and the training/education of providers of substance abuse
services. Understanding the practices, perceptions, knowledge and organizational
influences that currently exist with regard to wellness and nutrition will aid in directing
future research and interventions that will work to create environments that promote
health.
Dissertation Committee:
Sharon Reif, Ph.D., Chairperson
Constance Horgan, Ph.D.
Jennifer Perloff, Ph.D.
Janet Forrester, Ph.D.
Associate Professor, Dept. Public Health & Community Medicine, Friedman School of
Nutrition, Tufts University School of Medicine
Proposal Hearing:
Monday, March 7, 2011
10:00AM – 12:00 PM
Heller Breakout Room G55