Preventing Parental Opioid and/or Methamphetamine Addiction within DHS-Involved Families: FAIR

预防国土安全部相关家庭中父母阿片类药物和/或甲基苯丙胺成瘾：FAIR

• 批准号: 10208316
• 负责人: Lisa Saldana
• 金额: $ 332.32万
• 依托单位: OREGON SOCIAL LEARNING CENTER, INC.
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-30 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10208316
• 关键词: Accounting; Address; Adopted; Adoption; Affect; Age; Alcohol or Other Drugs use; Ambulatory Care; Amphetamines; Behavior; Case Management; Charge; Child; Child Abuse and Neglect; Child Rearing; Child Welfare; Collaborations; Country; County; Development; Disease; Drug abuse; Effectiveness; Environment; Family; Family Relationship; Future; Goals; Health Services Accessibility; Home environment; Housing; Human; Hybrids; Incentives; Intervention; Laws; Leadership; Medicaid; Mental Health; Mental Health Services; Methamphetamine; Methamphetamine dependence; Methods; Opiate Addiction; Opioid; Oregon; Outcome; Overdose; Parents; Phase; Policies; Prevention; Prevention program; Preventive; Process; Protocols documentation; Public Health; Randomized; Randomized Clinical Trials; Resources; Risk; Risk Factors; Science; Series; Services; Statutes and Laws; Stream; Substance Use Disorder; Substance abuse problem; System; Testing; Time; Work; aged; base; care systems; child services; cost; design; effectiveness clinical trial; effectiveness evaluation; effectiveness testing; effectiveness trial; experience; falls; foster care; health economics; high risk; implementation science; improved; intervention cost; meetings; methamphetamine use; opioid abuse; opioid use; prevent; prevention service; programs; recruit; response; rural counties; scale up; skills; skills training; therapy development; treatment program

PROJECT SUMMARY/ABSTRACT Over the last 5 years, many states across the country have experienced an increase in children involved in the foster care system as a result of young parental opioid and methamphetamine misuse and disorder. In 2017, the child welfare system received 4.1 million referrals for approximately 7.5 million children, with parental drug abuse and child neglect accounting for the large majority of cases. This is particularly true in Oregon, where over 55% of cases involve parents under the age of 30, and over 60% of cases in the foster care system are associated with parental drug abuse. The Families Actively Improving Relationships (FAIR) program is a recently developed, rigorously evaluated, intensive outpatient treatment program for parents involved in the child welfare system for parental opioid and/or amphetamine type substance use disorder–methamphetamine (OUD; MUD). Outcomes from the FAIR effectiveness trial suggest the potential for FAIR to be adapted as a prevention program for parents involved with child welfare and self-sufficiency systems, and to be implemented in counties with low service availability and access. This UG3/UH3 exploratory-developmental phased project dedicates a year of activities toward collaborating with Oregon state Department of Human Services (DHS) partners and leadership to develop a plan for adaptation, recruitment, and implementation of FAIR for prevention. During the UG3 phase, the investigative team—with expertise in intervention development and clinical effectiveness trials, implementation science, decision science, health economics, and including DHS leadership—will work in collaboration with the Coordinating Center to (UG3 Aim 1) Develop strategies to identify, reach, and engage parents involved in the DHS system, aged 16 to 30, who are at-risk for escalation of misuse or development of OUD and/or MUD; and (UG3 Aim 2) Develop and adapt FAIR to prevent initiation of opioid and/or methamphetamine misuse and escalation to disorder. Following the completion of a set of concrete milestones during the first year, the UGH phase of the project will conduct a Hybrid I randomized clinical trial, to evaluate the adapted FAIR program and its implementation. Across two counties, parents referred by DHS for opioid or methamphetamine use or misuse with risk for escalation (n = 240), will be recruited and followed longitudinally for 24 months. Parents will be randomized to receive the adapted FAIR as prevention, or standard case management and referral (STAND). Overarching goals of this phase are to test the effectiveness of the adaptations designed in the UG3 phase and to build upon state collaborations— specifically, to: (UH3 Aim 1) Evaluate the effectiveness of FAIR in preventing DHS-involved parents, aged 16 to 30, from initiating misuse or escalating opioid and/or methamphetamine use; (UH3 Aim 2) Examine and assess the implementation of FAIR in the county-driven DHS system to inform sustainability plans; and (UH3 Aim 3) Assess the implementation and intervention costs associated with the adoption of FAIR. Outcomes from this project will inform further refinement of protocols and the potential for broader scale-up of FAIR.

项目总结/摘要 在过去的五年里，全国许多州都经历了儿童参与的增加， 由于年轻的父母滥用阿片类药物和甲基苯丙胺和精神紊乱，寄养系统受到严重影响。在2017年， 儿童福利系统收到410万份转介，涉及约750万名儿童， 虐待和忽视儿童占绝大多数案件。在俄勒冈州尤其如此， 超过55%的案件涉及30岁以下的父母，超过60%的寄养案件是 与父母吸毒有关家庭积极改善关系（FAIR）计划是一个 最近开发的，经过严格评估的，针对参与儿童疾病的父母的强化门诊治疗计划， 针对父母阿片类和/或苯丙胺类物质使用障碍的儿童福利系统-甲基苯丙胺 (OUD; MUD）。FAIR有效性试验的结果表明，FAIR有可能被改编为 针对参与儿童福利和自给自足系统的父母的预防计划，并将实施 在服务可用性和访问率较低的县。UG 3/UH 3勘探开发阶段项目 致力于与俄勒冈州人类服务部（DHS）合作一年的活动 合作伙伴和领导层制定一个适应计划，招聘和实施公平， 预防在UG 3阶段，调查小组----具有干预发展方面的专门知识， 临床有效性试验，实施科学，决策科学，卫生经济学，包括DHS 领导层-将与协调中心合作，制定战略， 识别、接触并动员参与国土安全部系统的年龄在16至30岁之间、有升级风险的父母 OUD和/或MUD的误用或开发;以及（UG 3目标2）开发和调整FAIR以防止引发 滥用阿片类药物和/或甲基苯丙胺并升级为紊乱。在完成了一套 在第一年的具体里程碑，该项目的UGH阶段将进行混合I随机 临床试验，以评估适应FAIR计划及其实施。在两个县，父母 由DHS转介的阿片类药物或甲基苯丙胺使用或滥用的升级风险（n = 240），将 招募并纵向随访24个月。父母将随机接受调整后的FAIR， 标准病例管理和转诊（STAND）。本阶段的总体目标是测试 在UG 3阶段设计的适应性的有效性，并建立在国家合作的基础上- 具体而言：（UH 3目标1）评价FAIR在预防16岁父母参与DHS方面的有效性 至30岁，从开始滥用或逐步增加阿片类药物和/或甲基苯丙胺的使用;（UH 3目标2）检查和 评估在县驱动的DHS系统中实施FAIR，以告知可持续性计划;以及（UH 3 目标3）评估与采用公平投资回报率相关的实施和干预成本。的成果 该项目将为进一步完善协议和扩大FAIR的潜力提供信息。