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: 10442044
• 负责人: Matthew Aalsma
• 金额: $ 13.83万
• 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/10442044
• 关键词: Address; Adolescent; Area; Caring; Community Mental Health Centers; County; Data; Data Reporting; Evidence based intervention; Family; General Population; Goals; Health; Health Services Accessibility; Health system; Healthcare; Healthcare Systems; Hispanics; Human Resources; Improve Access; Indiana; Individual; Institute of Medicine (U.S.); Interview; Justice; Latino; Learning; Link; Methods; Minority; National Institute of Drug Abuse; Needs Assessment; Not Hispanic or Latino; Outcome; Parents; Patients; Penetration; Personnel Staffing; Population; Prevalence; Prevention; Process; Reporting; Research; Research Support; Rural; Rural Community; Services; Source; Substance Use Disorder; Surveys; System; Treatment outcome; Trust; Work; Youth; addiction; base; cultural competence; ethnic minority population; health disparity; health equity; interest; juvenile justice system; parent project; peer; prevent; provider factors; racial and ethnic; racial and ethnic disparities; recidivism; reduced substance use; response; screening; service delivery; service utilization; statistics; substance use; substance use treatment; system-level barriers; treatment comparison

Based on national statistics, more than a third of youth involved in juvenile justice (YJJ) have a substance use disorder (SUD), with rates increasing among YJJ across justice system penetration. This finding is staggering given that the US prevalence rate of SUDs is 7% among general population adolescents. Thus, the ability to provide effective SUD treatment is pertinent for YJJ. Although evidence-based interventions (EBIs) for SUDs exist, few youth in general, and YJJ specifically, access EBIs. Moreover, there is evidence to suggest racial/ethnic disparities in access to SUD treatment within juvenile justice (JJ), such that racial/ethnic minority youth are less likely to be referred to substance use services within JJ compared to their White peers. However, it is plausible similar disparities exist throughout the SUD treatment cascade from referral to treatment completion within JJ, warranting the need for more focused research within this area. The primary goal of the proposed minority supplement is to build off of the work conducted within the parent project, Alliances to Disseminate Addiction Prevention and Treatment (ADAPT), which addresses barriers to YJJ achieving the SUD care cascade (i.e., referral to treatment, treatment initiation, and engagement), by examining whether there are racial/ethnic disparities within each point of contact within the cascade of care for YJJ. We will examine data across the department of juvenile justice and community mental health centers (CMHCs) who provide SUD treatment for YJJ within three rural Indiana counties (Bartholomew, Monroe, and Porter), and compare differences between Black and Latino/a youth and non-Hispanic White youth on five defined contact points with the SUD care cascade: screening, needs assessment and identification, referral, initiation, and utilization. We hypothesize that fewer Black and Latino/a YJJ will be screened and referred to SUD treatment, as well as initiate or utilize treatment compared to non-Hispanic White YJJ. It has also been noted by the Institute of Medicine, that many sources, including but not limited to the health care system as a whole, health care provides, and patients, contribute to racial and ethnic disparities in health care treatment. Thus, it is plausible that similar sources are relevant within JJ and CMHCs in the treatment of SUD for YJJ. Thus, the second and third aim of the proposed minority supplement will be to employ a multi-system, multi- method approach to identify barriers and strengths at both the system and individual-level. The advantage of a multi-system, multi-method approach to examining the SUD care cascade for racial/ethnic YJJ will provide an opportunity to identify potential broken links in the alliances between the JJ system and CMHCs. Moreover, given that EBIs are most effective when implemented in a culturally adapted manner that addresses the needs of youth and families, our findings will be able to inform how EBIs for SUD are implemented among this population of YJJ.

根据国家统计数据，超过三分之一的青少年司法青年（YJJ）具有药物使用 疾病（SUD），跨司法系统穿透的YJJ之间的比率增加。这个发现令人震惊 鉴于美国的一般人群青少年的美国SUD患病率为7％。因此，能够 提供有效的SUD治疗与YJJ有关。尽管基于证据的干预措施（EBIS） 存在，一般很少的青年，而YJJ特别是访问EBIS。而且，有证据表明 种族/族裔差异在少年司法（JJ）中获得SUD治疗的差异，因此种族/族裔少数民族 与白人同龄人相比，JJ内的青年不太可能被转介到JJ内的药物使用服务。 但是，在整个SUD治疗级联中，从推荐到 JJ内的治疗完成，需要在该领域内进行更多集中研究。主要 拟议中的少数族裔补充的目标是建立母公司项目中的工作， 联盟传播预防和治疗（Adapt），该联盟解决了YJJ的障碍 通过 检查在护理级联的每个接触点内是否存在种族/种族差异 yjj。我们将研究少年司法和社区心理健康中心的数据 （CMHC）在印第安纳州三个乡村（Bartholomew，Monroe和Monroe和 搬运工），并比较黑人和拉丁美洲人/一个青年和非西班牙裔白人青年之间的差异 与Sud Care Cascade定义的联系点：筛选，需求评估和身份证明，转介，转介， 启动和利用。我们假设将筛选并参考的黑人和拉丁裔/YJJ更少 与非西班牙裔白色YJJ相比，SUD治疗以及开始或使用治疗。也一直 医学研究所指出，许多来源，包括但不限于医疗保健系统 整个医疗保健提供和患者，导致医疗保健治疗中的种族和种族差异。 因此，在JJ和CMHC中相关的类似来源在YJJ的SUD处理中是合理的。 因此，提议的少数族裔补充剂的第二和第三目的是采用多系统的多系统 识别系统和个体级别的障碍和优势的方法。一个优势 多系统，多方法检查种族/民族YJJ的泡沫护理级联 确定JJ系统与CMHC之间联盟中潜在的链接的机会。而且， 鉴于以文化适应的方式实施EBI是最有效的，以满足需求 在青年和家庭中，我们的发现将能够告知如何实施EBIS的EBIS YJJ的人口。