Alliance to Disseminate Addiction Prevention and Treatment (ADAPT): A Statewide Learning Health System to Reduce Substance Use among Justice-Involved Youth in Rural Communities.

传播成瘾预防和治疗联盟 (ADAPT)：一个全州范围的学习健康系统，旨在减少农村社区参与司法的青少年的药物使用。

• 批准号: 10403069
• 负责人: Matthew Aalsma
• 金额: $ 12.12万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 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 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10403069
• 关键词: Address; Adolescent; Area; Biological Models; Caring; Case Management; Case Manager; Community Mental Health Centers; County; Data; Development; Disease; Dissemination and Implementation; Drug Screening; Evidence based intervention; Evidence based treatment; Foundations; Funding; Future; Goals; Health; Health Personnel; Health Services; Health Services Research; Health system; Healthcare; Human Resources; Improve Access; Indiana; Individual; Intervention; Interview; Justice; Knowledge; Learning; Link; Medicaid; Mental Health; Modeling; National Institute of Drug Abuse; Opioid; Pathway interactions; Prevention; Provider; Qualitative Research; Recovery; Research; Research Methodology; Research Personnel; Research Training; Resources; Risk; Role; Rural; Rural Community; Service delivery model; Services; Specialist; Substance Use Disorder; Testing; Training; Treatment Efficacy; Visit; Work; Youth; addiction; administrative database; adolescent substance use; behavioral health; career; clinical efficacy; cost effective; design; experience; implementation strategy; improved; insurance claims; juvenile justice system; opioid epidemic; parent grant; peer; recruit; reduced substance use; rural area; rural counties; rural setting; scale up; skills; substance use; substance use treatment; transportation access; uptake

PROJECT SUMMARY Youth who are involved in the juvenile justice system (YJJ) are at particular risk for opioid-related harms, given their high rates of mental health and substance use disorders (SUDs) compared to youth who have never been arrested. Although evidence-based interventions (EBIs) for SUDs exist, few youth in general, and YJJ specifically, access EBIs. This is a particular difficulty in rural settings, where shortages of behavioral health specialists, limited access to transportation and other resources, and recruitment and retention challenges present additional barriers to behavioral health care. This difficulty is compounded during the opioid crisis, as adolescent use of opioids is more prevalent in rural areas where opportunities for substance use treatment are severely lacking. Indiana, specifically, ranks 46th in number of behavioral health treatment providers per individuals suffering addictions. The funded parent grant, Alliances to Disseminate Addiction Prevention and Treatment (ADAPT), seeks to improve the clinical efficacy of treatment for rural YJJ. Specifically, the parent grant employs a Learning Health System model to develop alliances between the juvenile justice system and community mental health centers (CMHCs) in 8 rural counties and implement a bundled treatment approach to improve use of EBIs for SUDs. This Diversity Supplement proposes to expand this work in two ways. First, we will characterize EBIs for SUDs in rural CMHCs, including the services provided and the workforce involved. We will conduct qualitative interviews with staff and leaders at rural CMHCs to identify specific strategies used to implement EBIs for SUDs in rural settings, describe the providers involved and their roles in implementing these tasks, and define the rationale for the identified service-delivery model. Second, we will compare the youth SUD services provided and the workforce involved across more rural and less rural settings. Using linked administrative data from juvenile justice agencies, CMHC visits, and Medicaid insurance claims in participating counties, we will describe service and workforce variables relevant to the implementation of EBIs for SUDs, and compare SUD services between less rural and more rural areas. The results of this project will provide a fuller picture of current SUD treatment practices and guide future EBIs in rural settings. Specifically, results will inform future task-shifting model of care research to leverage lay health workers, case managers, and peer recovery coaches in the delivery of EBIs with fidelity in rural CMHCs.

项目概要 参与少年司法系统 (YJJ) 的青少年尤其面临阿片类药物相关伤害的风险，因为 与从未接触过此类疾病的年轻人相比，他们的心理健康和药物滥用障碍 (SUD) 发病率较高 被捕。尽管针对 SUD 的循证干预措施 (EBI) 存在，但一般青年人很少，而且 YJJ 具体来说，访问 EBI。这在农村地区尤其困难，因为那里缺乏行为健康 专家、获得交通和其他资源的机会有限以及招聘和保留方面的挑战 给行为保健带来了额外的障碍。在阿片类药物危机期间，这一困难变得更加复杂，因为 在农村地区，青少年使用阿片类药物更为普遍，那里药物滥用治疗的机会较少 严重缺乏。具体来说，印第安纳州的行为健康治疗提供者数量排名第 46 位。 患有成瘾症的人。资助的家长补助金，传播成瘾预防联盟和 治疗（ADAPT），旨在提高农村YJJ治疗的临床疗效。具体来说，家长 赠款采用学习健康系统模型来发展少年司法系统和青少年司法系统之间的联盟 在8个农村县建立社区精神卫生中心（CMHC），对贫困人口实行捆绑式治疗。 改善 SUD 的 EBI 的使用。本多样性补充建议以两种方式扩展这项工作。首先，我们 将描述农村 CMHC 中 SUD 的 EBI 特征，包括提供的服务和涉及的劳动力。我们 将与农村 CMHC 的工作人员和领导进行定性访谈，以确定用于 在农村地区实施 SUD 的 EBI，描述所涉及的提供者及其在实施这些措施中的作用 任务，并定义已确定的服务交付模型的基本原理。二、我们来对比一下青年SUD 在更多和更少农村地区提供的服务和劳动力参与。使用链接 来自少年司法机构、CMHC 访问以及参与医疗补助保险索赔的行政数据 县，我们将描述与 SUD 实施 EBI 相关的服务和劳动力变量，以及 比较较少农村地区和较多农村地区之间的 SUD 服务。该项目的成果将提供更全面的 描绘当前 SUD 治疗实践并指导农村地区未来的 EBI。具体而言，结果将告知 未来护理研究的任务转移模型，以利用非专业卫生工作者、病例管理者和同伴康复 教练在农村 CMHC 中忠实地提供 EBI。