Preventing opioid use among justice-involved youth as they transition to adulthood: leveraging safe adults (LeSA).
Preventing opioid use among justice-involved youth as they transition to adulthood: leveraging safe adults (LeSA).
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DOI：
10.1186/s12889-021-12127-3
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发表时间：
2021-11-20
影响因子：
4.5
通讯作者：
Knight K
中科院分区：
文献类型：
--
作者：
Knight DK;Yang Y;Joseph ED;Tinius E;Young S;Shelley LT;Cross DR;Knight K
青少年司法 (JJ) 青少年面临阿片类药物和其他物质使用 (SU)、家庭/社会关系功能失调以及复杂创伤的高风险。利用安全成人 (LeSA) 项目的目的是检查基于信任的关系干预®（TBRI®；通过提供情感和工具指导、支持和角色塑造来利用家庭系统）在青少年从安全居住设施释放后预防阿片类药物和其他 SU 的有效性。有效性实施混合 1 型设计用于测试 TBRI 预防 JJ 青少年非医疗使用阿片类药物的有效性（在地点层面延迟启动；在参与者层面进行随机对照试验），并深入了解作为 JJ 重返协议一部分的 TBRI 实施的设施层面障碍。招募包括两个样本（有效性：360 名青少年/护理人员二人组；实施：203 名 JJ 工作人员），为期 3 年，来自两个州的 9 个地点。参与者资格包括愿意接受社区监督并在安全的 JJ 设施中接受护理、没有自杀风险且有一名护理人员愿意参与的 15 至 18 岁青少年。有效性数据来自 (1) 青少年和看护者关于背景、SU、社会心理功能和青少年与看护者关系的自我报告（第 0、3、6、12 和 18 个月）、青少年释放后每月登记以及看护者关于青少年心理/行为症状的报告，以及 (2) JJ 设施记录（例如累犯、治疗利用情况）。忠诚度评估包括会后检查清单和 TBRI 策略使用措施。实施数据在四年内收集了四次，包括 (1) JJ 员工关于设施和员工特征、创伤知情护理和 TBRI 策略的使用的自我报告，以及 (2) 焦点小组（一线员工、领导层）关于创伤知情策略的使用、新干预措施的采用以及 TBRI 实践的渗透、维持和扩展。 LeSA 研究正在测试 TBRI 作为一种手段，帮助护理人员帮助防止 JJ 青少年使用阿片类药物和其他 SU。 TBRI 的多个组成部分为护理人员提供了补充和扩大住院护理期间收益的机会。如果有效并成功实施，LeSA 协议将有助于将 TBRI 的应用扩展到更广泛的受众，并为在跨越多种背景的复杂系统中实施多组件干预措施提供指导。临床试验.govNCT04678960； 2020年11月11日注册； https://clinicaltrials.gov/ct2/show/NCT04678960。
Juvenile justice (JJ) youth are at high risk of opioid and other substance use (SU), dysfunctional family/social relationships, and complex trauma. The purpose of the Leveraging Safe Adults (LeSA) Project is to examine the effectiveness of Trust-Based Relational Intervention® (TBRI®; leveraging family systems by providing emotional and instrumental guidance, support, and role modeling) in preventing opioid and other SU among youth after release from secure residential facilities. An effectiveness-implementation Hybrid Type 1 design is used to test the effectiveness of TBRI for preventing non-medical use of opioids among JJ-youth (delayed-start at the site level; a randomized controlled trial at participant level) and to gain insight into facility-level barriers to TBRI implementation as part of JJ re-entry protocols. Recruitment includes two samples (effectiveness: 360 youth/caregiver dyads; implementation: 203 JJ staff) from nine sites in two states over 3 years. Participant eligibility includes 15 to 18-year-olds disposed to community supervision and receiving care in a secure JJ facility, without active suicide risk, and with one caregiver willing to participate. Effectiveness data come from (1) youth and caregiver self-report on background, SU, psychosocial functioning, and youth-caregiver relationships (Months 0, 3, 6, 12, and 18), youth monthly post-release check-ins, and caregiver report on youth psychological/behavioral symptoms, and (2) JJ facility records (e.g., recidivism, treatment utilization). Fidelity assessment includes post-session checklists and measures of TBRI strategy use. Collected four times over four years, implementation data include (1) JJ staff self-report on facility and staff characteristics, use of trauma-informed care and TBRI strategies, and (2) focus groups (line staff, leadership separately) on use of trauma-informed strategies, uptake of new interventions, and penetration, sustainment, and expansion of TBRI practices. The LeSA study is testing TBRI as a means to empower caregivers to help prevent opioid use and other SU among JJ-youth. TBRI’s multiple components offer an opportunity for caregivers to supplement and extend gains during residential care. If effective and implemented successfully, the LeSA protocol will help expand the application of TBRI with a wider audience and provide guidance for implementing multi-component interventions in complex systems spanning multiple contexts. ClinicalTrials.govNCT04678960; registered November 11, 2020; https://clinicaltrials.gov/ct2/show/NCT04678960.
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