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.

项目摘要 参与青少年司法系统（YJJ）的年轻人特别有与阿片类药物有关的危害的风险 与从未有过的年轻人相比 被捕。尽管存在基于循证的SUD的干预措施（EBI），但总体上很少有青年和YJJ 具体来说，访问EBIS。这是在农村环境中的特殊困难，行为健康短缺 专家，有限的运输和其他资源的机会，以及招聘和保留挑战 为行为医疗保健提供了其他障碍。在阿片类药物危机期间，这种困难变得更加复杂， 在农村地区，青少年使用阿片类药物更普遍 严重缺乏。特别是，印第安纳州的行为健康治疗提供者的数量排名第46 患有成瘾的人。资助的父母赠款，联盟，以传播预防成瘾和 治疗（适应）旨在提高农村YJJ治疗的临床疗效。具体来说，父母 格兰特采用学习卫生系统模型来建立少年司法系统和 在8个农村县的社区心理健康中心（CMHC），并实施捆绑的治疗方法 改善EBIS对SUDS的使用。这种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EBIS，包括提供的服务和所涉及的劳动力。我们 将对农村CMHC的员工和领导人进行定性访谈，以确定用于 在农村环境中为SUD实施EBI，描述所涉及的提供商及其在实施这些方面的作用 任务，并定义已确定的服务交付模型的理由。其次，我们将比较青年SUD 提供的服务以及涉及更多农村和较少农村环境的劳动力。使用链接 少年司法机构，CMHC访问和医疗补助保险索赔的行政数据 县，我们将描述与实施EBI有关的服务和劳动力变量，以及 比较农村和更多农村地区之间的SUD服务。该项目的结果将提供更全面的 当前的SUD治疗实践的图片并指导农村环境中的未来EBI。具体而言，结果将告知 未来的任务转移护理研究模型，以利用外行健康工作者，案例经理和同行恢复 在CMHC农村的忠诚中提供EBI的教练。