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

项目总结 参与少年司法系统(少年司法系统)的青年特别容易受到与阿片类药物有关的伤害。 与从未经历过的年轻人相比，他们的精神健康和物质使用障碍(SODS)的比率很高 被逮捕了。尽管存在对肥胖症的循证干预(EBI)，但总体上很少有年轻人和YJJ 具体地说，访问EBI。这在农村环境中尤其困难，因为那里缺乏行为健康 专家、交通和其他资源有限，以及征聘和留住方面的挑战 给行为保健带来了额外的障碍。这一困难在阿片类药物危机期间变得更加复杂，因为 青少年使用阿片类药物在农村地区更为普遍，那里有机会接受药物使用治疗 严重缺乏。具体而言，印第安纳州的行为健康治疗提供者数量排在第46位。 染上毒瘾的人。受资助的父母赠款、传播成瘾预防和 治疗(ADAPT)，旨在提高农村YJJ治疗的临床疗效。具体地说，父代 格兰特使用学习卫生系统模式来发展少年司法系统和 在8个农村县建立社区精神卫生中心，并实施捆绑治疗方法 提高肥皂水的EBI使用率。这份多样性副刊建议以两种方式扩大这项工作。首先，我们 将描述农村母婴健康中心中的肥胖症EBI的特征，包括所提供的服务和所涉及的劳动力。我们 将对农村社区卫生服务中心的工作人员和领导进行定性访谈，以确定用于 在农村环境中为SUD实施EBI，描述涉及的供应商及其在实施这些方面的角色 任务，并定义已确定的服务交付模式的基本原理。第二，我们会比较年轻的南德 在更多的农村和更少的农村环境中提供的服务和参与的劳动力。使用链接 青少年司法机构的行政数据、CMHC访问和参与的医疗补助保险索赔 县，我们将描述与实施用于SUDS的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。这个项目的成果将提供一个更全面的 了解当前的SUD治疗做法，并指导未来农村地区的EBI。具体地说，结果将通知 未来护理研究的任务转移模式，以利用非专业卫生工作者、病例管理人员和同伴康复 教练员在农村社区医疗中心提供逼真的EBI服务。

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.