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参与少年司法(YJJ)有药物使用 精神障碍(SUD)，YJJ在司法系统中的渗透率上升。这一发现令人震惊。 鉴于美国青少年中肥胖症的患病率为7%。因此，能够 为YJJ提供有效的SUD治疗是有意义的。尽管针对SODS的循证干预(EBI) 存在，一般很少有年轻人，特别是YJJ，可以使用EBI。此外，有证据表明， 在少年司法系统内获得sud治疗方面的种族/族裔差异(JJ)，从而使种族/少数民族 与白人同龄人相比，年轻人在JJ内部被转介到物质使用服务的可能性较小。 然而，从转诊到转诊的整个SUD治疗级联过程中可能存在类似的差异 在JJ内完成治疗，保证需要在这一领域内进行更有针对性的研究。初级阶段 拟议的少数群体补编的目标是在母项目内开展的工作的基础上再接再厉， 传播成瘾预防和治疗联盟(ADAPT)，解决YJJ的障碍 通过以下方式实现SUD护理级联(即转诊至治疗、治疗启动和参与) 审查是否存在种族/民族差异的每一个接触点内的级联关怀 YJJ。我们将检查青少年司法部和社区精神卫生中心的数据 (CMHC)在印第安纳州的三个农村县(巴塞洛缪、门罗和 波特)，并比较了黑人和拉丁裔/a青年和非西班牙裔白人青年在五个方面的差异 确定了SUD护理级联的联系点：筛查、需求评估和识别、转诊、 启动和利用。我们假设更少的黑人和拉丁裔/a YJJ将被筛查和参考 与非西班牙裔白种人YJJ相比，SUD治疗以及启动或利用治疗。它也一直是 医学研究所指出，许多来源，包括但不限于卫生保健系统作为 整体而言，医疗保健提供和患者促成了医疗保健治疗中的种族和民族差异。 因此，JJ和CMHC在YJJ的SUD治疗中有相似的来源是合理的。 因此，拟议的少数群体补编的第二个和第三个目标将是采用一种多制度、多部门和多部门的办法。 确定系统和个人层面上的障碍和优势的方法方法。A的优势是 多系统、多方法检查种族/民族YJJ的SUD护理级联将提供 有机会找出JJ系统和CMHC之间联盟中可能中断的联系。此外， 鉴于EBI在以文化适应的方式实施时最有效，以满足需求 在青少年和家庭中，我们的研究结果将能够告诉我们如何在这些人中实施SSD的EBI YJJ的人口。