Improving the Accuracy, Utility, and Equity of Risk Assessment in the Juvenile Justice System: A Mixed-Method Study

项目摘要 预防青少年犯罪，特别是参与暴力犯罪，是一项重要的公共卫生目标。数据- 驱动的风险评估是（a）优先考虑需求和（B）选择哪些临床服务是 每年约有200万青少年卷入少年司法系统。最终，这些 数据分析工具生成“风险评分”，指导行为和心理健康服务的转诊。尽管他们 然而，这些结构化风险评估的广泛使用仍然存在严重的局限性。其中包括：（a）测量 从不良童年经历（ACE）中脱离背景的动态过程，（B）评估的有效性值得怀疑 风险在不同的青少年人口，和（c）一个狭隘的关注暴力行为，很少考虑到关键的 心理健康问题（例如，情绪困扰，物质）作为结果。解决这些局限性的答案是 为一个更了解创伤、文化能力和临床有用的风险评估过程奠定基础， 为涉及少年司法系统的弱势青少年提供服务。 拟议的研究旨在通过一种新颖的混合方法研究方法来解决这些目标。第一阶段 研究中，我们将进行定性访谈，以确定青少年和照顾者如何参与青少年 司法系统认识到风险的途径和总体行为和情绪健康的弹性。重点 这些访谈的目的是了解（a）什么样的ACE对涉及少年司法的青少年的福祉最突出， (b)哪些机制解释了ACE和心理健康之间的联系，以及（c）谁对ACE最敏感。为 第二个研究目标，我们将进行二次数据分析，以确定当前风险评估的风险和优势 评估介导和/或缓和创伤暴露和适应不良结果之间的关系， 这些风险和优势将更有可能从事暴力犯罪、物质使用和/或 在未来经历情绪困扰。新颖的分析策略被用来检验这些模型的鲁棒性 交叉的身份第三个目标是综合我们两种方法论范式的发现， 研究如何以社区为基础，对青少年风险的emic观点收敛和分歧与一个有效的方面， 科学的，风险的数学模型目前使用的少年司法系统。集体调查结果将作为 随机对照试验（RCT）的基础，该试验根据 我们的研究为涉及少年司法的青少年提供了一个更精确、更吸引人的评估和转介过程， 以及前瞻性纵向研究，旨在量化我们定性研究的独特发现。

Project Summary Preventing adolescent delinquency, especially engagement in violence perpetration, is a critical public health aim. Data- driven risk assessments are the dominant paradigm for (a) prioritizing need and (b) selecting which clinical services are needed for the approximate 2 million adolescents involved with the juvenile justice system annually. Ultimately, these data analytic tools generate a “risk score” that guide referrals for behavioral and mental health services. Despite their widespread use, however, critical limitations for these structured risk assessments persist. These include (a) measuring dynamic processes decontextualized from adverse childhood experiences (ACEs), (b) questionable validity in assessing risk in diverse adolescent populations, and (c) a narrow focus on violent behavior, with little consideration of critical mental health concerns (e.g., emotional distress, substance) as outcomes. Addressing these limitations is the answer to laying the foundation for a more trauma-informed, culturally-competent, and clinically useful risk assessment process to emerge for vulnerable adolescents involved in the juvenile justice system. The proposed study seeks to address these aims via a novel, mixed method research approach. In the first phase of the study, we will conduct qualitative interviews to determine how adolescents and caregivers involved with the juvenile justice system perceive the pathways for risk and resilience for overarching behavioral and emotional health. An emphasis of these interviews is to understand (a) what ACEs are most salient to juvenile justice-involved adolescents’ well-being, (b) which mechanisms explain the link between ACEs and mental health, and (c) who is most sensitive to ACEs. For the second study aim, we will conduct secondary data analyses to determine which risks and strengths assessed in current risk assessments mediate and/or moderate the relation between trauma-exposure and maladaptive outcomes and how well these risks and strengths classify individuals who are more likely to engage in violence perpetration, substance use, and/or experience emotional distress in the future. Novel analytic strategies are used to examine how robust these models are across intersecting identities. The third aim seeks to synthetize the findings from our two methodological paradigms to examine how community-based, emic perspectives on juvenile risk converge and diverge with validated facets of a scientific, etic model of risk currently utilized by the juvenile justice system. Collective findings will serve as the foundation for a randomized controlled trial (RCT) that tests if as assessment protocol based on the indices identified in our study leads to a more precise and engaging assessment and referral process for juvenile justice-involved adolescents, as well as prospective longitudinal research that seeks to quantify findings unique to our qualitative study.