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

根据国家统计数据，超过三分之一的青少年司法（YJJ）有物质使用 疾病（SUD），在整个司法系统渗透率YJJ之间的比率增加。这一发现令人震惊 鉴于美国普通人群青少年中SUD的患病率为7%。因此， 提供有效的SUD治疗与YJJ相关。尽管SUD的循证干预（EBI） 存在，一般来说，很少有年轻人，特别是YJJ，访问EBI。此外，有证据表明， 在少年司法中获得SUD待遇方面的种族/族裔差异，例如种族/族裔少数群体 与他们的白色同龄人相比，青少年不太可能被转介到JJ内的物质使用服务。 然而，在SUD治疗级联中，从转诊到 在JJ内完成治疗，证明需要在该领域进行更有针对性的研究。主 拟议的少数族裔补助金的目标是在母项目内开展的工作的基础上， 传播成瘾预防和治疗联盟（ADAPT），解决了YJJ的障碍 实现SUD护理级联（即，转诊治疗、治疗启动和参与）， 审查在一系列护理中的每个接触点是否存在种族/族裔差异， YJJ我们将检查青少年司法部和社区精神健康中心的数据 （CMHC）在三个农村印第安纳州县（巴塞洛缪、门罗和 波特），并比较黑人和拉丁美洲/青年和非西班牙裔白色青年之间的差异， 确定了与SUD护理级联的接触点：筛查、需求评估和识别、转诊， 启动和使用。我们假设接受筛查和转诊的黑人和拉丁裔/a YJJ会减少 与非西班牙裔白色YJJ相比，SUD治疗以及启动或利用治疗。还已经 医学研究所指出，许多来源，包括但不限于医疗保健系统， 总体而言，卫生保健提供者和患者的健康状况造成了卫生保健治疗方面的种族和民族差异。 因此，在JJ和CMHC中相似的来源与YJJ的SUD治疗相关是合理的。 因此，拟议的少数民族补助金的第二个和第三个目标是采用一种多制度、多层次的办法， 方法的方法，以确定在系统和个人层面的障碍和优势。的优点 多系统，多方法的方法来检查SUD照顾级联种族/民族YJJ将提供一个 有机会识别强生系统和CMHC之间的联盟中潜在的断裂链接。此外，委员会认为， 考虑到EBI在以文化适应的方式实施时最有效， 青年和家庭，我们的研究结果将能够告知如何EBI为SUD实施，其中 YJJ的人口。

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.