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)确定需求的优先顺序和(B)选择哪些临床服务的主导模式 每年约有200万青少年参与少年司法系统。最终，这些 数据分析工具生成指导行为和心理健康服务转诊的“风险分数”。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限制。这些措施包括：(A)测量 从不良童年经历(ACE)中去除背景的动态过程，(B)评估的有效性值得怀疑 不同青少年人群的风险，以及(C)狭隘地关注暴力行为，很少考虑严重的 作为结果的精神健康问题(例如，情绪困扰、实质问题)。解决这些限制是解决问题的答案 为更了解创伤、文化能力和临床有用的风险评估流程奠定基础 为参与少年司法系统的弱势青少年提供援助。 这项拟议的研究试图通过一种新颖的混合方法研究方法来解决这些目标。在第一阶段， 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 司法系统感知总体行为和情绪健康的风险和韧性的途径。一个重点 这些面谈的目的是了解(A)什么是青少年司法方面最突出的因素--涉及青少年的福祉， (B)哪些机制解释了ACEs与精神健康之间的联系；及。(C)谁对ACEs最敏感。对于 第二个研究目标，我们将进行二次数据分析，以确定哪些风险和优势被评估为当前风险 评估中介和/或调节创伤暴露和适应不良结果之间的关系，以及效果如何 这些风险和优势将更有可能从事暴力行为、使用药物和/或 体验未来的情感苦恼。新的分析策略被用来检验这些模型的健壮性 跨越交叉的身份。第三个目标是综合我们两个方法论范式的发现，以 研究以社区为基础、主旋律的青少年风险观点如何与经过验证的 青少年司法系统目前使用的科学、科学的风险模型。集体调查结果将作为 一项随机对照试验(RCT)的基础，该试验根据 我们的研究导致对涉及青少年司法的青少年进行更准确和更有吸引力的评估和转介过程， 以及寻求量化我们定性研究独特结果的前瞻性纵向研究。

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.