DATOS OUTPATIENT TREATMENT RESEARCH CENTER

申请者摘要：建议建立门诊治疗研究中心 它将专门评估门诊服务，包括 美沙酮维持和戒毒模式。重点将放在 治疗期间和治疗后摄入量的二次分析 作为DATOS系列研究的一部分获得的后续记录。它 将作为负责以下任务的两个Datos现场研究中心之一 进行独立(但协调)的研究，以解决 特定于医疗模式的问题(例如，分别针对门诊和 居民治疗环境)，并实现广泛的概念整合 以及调查结果的应用。将继续设立达托斯协调中心 后续数据收集和相关评估研究以及 利用实地研究的投入进行成本效益评估 中锋。这一组织计划将利用特殊的 不同研究团队的优势，并确保他们共同努力 开展互补性、非重复性研究。 历次大规模、多点治疗评估的经验 将从概念上指导工作，特别是处理过程和 基于艾滋病高危人群药物滥用治疗的结果研究 NIDA资助的治疗研究减少项目(DATAR) 加强社区门诊项目示范助学金。 作为DATAR的一部分开发和实施的分析框架 美沙酮门诊治疗研究将得到应用和阐述 特别注意DATOS-成人档案。这个 将在五年计划中应用的增量研究计划将 关注结果标准的四个连续维度：早期治疗 辍学(&lt；90天)，治疗期间表现，1年随访 结果，以及第3年的随访结果。治疗期间的标准将是 强调计划参与度和合规性指标，同时跟进 标准将强调毒品使用、艾滋病毒/艾滋病风险、犯罪行为、 就业和心理社会调整措施。的主要领域 预测变量将包括社会人口统计学、吸毒史、 心理社会背景(精神病理学、认知缺陷、工作和 社交技能)、治疗动机(治疗病史、就绪性、 法律压力)、支持系统(家人和朋友)、治疗 参与度(停留时间、出席率、关系融洽的迹象 客户和咨询师之间)和程序环境(人员结构， 政策、程序)。本评价框架的一般要素 将适用于所有DATOS系列数据库。 主要目标包括：(1)描述处理过程 和来自典型项目的结果，(2)客户的识别， 与治疗参与度相关的计划和服务交付因素 和结果，以及(3)开发统计模型以帮助 澄清预测指标和结果衡量标准之间的相互关系。这个 结果将导致政策的治疗改进战略 发展。

APPLICANT'S ABSTRACT: An Outpatient Treatment Research Center is proposed that will specialize in the evaluation of outpatient services, including methadone maintenance and drug free modalities. The focus will be on secondary analysis of intake during treatment, and post-treatment follow-up records obtained as part of the DATOS family of studies. It will serve as one of two DATOS Field Research Centers responsible for conducting independent (but coordinated) studies that will address modality-specific issues (i.e., separately for outpatient and residential treatment settings) and achieve broad conceptual integration and application of findings. A DATOS Coordinating Center will continue followup data collection and related assessment studies as well as conduct cost-benefit evaluations with inputs from the Field Research Centers. This organizational plan will take advantage of special strengths of various research teams and ensure that together they conduct complementary, non-duplicative studies. Experience from previous large-scale and multisite treatment evaluations will guide the work conceptually, especially treatment process and outcome research based on the Drug Abuse Treatment for AIDS-Risk Reduction project (DATAR), a NIDA-funded treatment research demonstration grant for enhancing community- based outpatient programs. The analytical framework developed and implemented as part of DATAR studies on outpatient methadone treatment will be applied and elaborated with special attention devoted to the DATOS-Adult files. The incremental research plan to be applied across the 5-year project will focus on four sequential dimensions of outcome criteria: early treatment dropouts (<90 days), during-treatment performance, year 1 followup outcomes, and year 3 followup outcomes. During-treatment criteria will emphasize program engagement and compliance indicators, while followup criteria will emphasize drug use, HIV/AIDS risks, criminality, employment, and psychosocial adjustment measures. Major domains of predictor variables will include sociodemographics, drug use history, psychosocial background (psychopathology, cognitive deficits, work and social skills), treatment motivation (treatment history, readiness, legal pressures), support systems (family and friends), therapeutic engagement (length of stay, session attendance, indications of rapport between client and counselor), and program environment (staff structure, policies, procedures). General elements of this evaluation framework will apply to all DATOS-family databases. The major objectives include: (1) the description of treatment process and outcomes from typical programs, (2) identification of client, program, and service delivery factors related to treatment engagement and outcomes, and (3) development of statistical models that help clarify interrelationships among predictor and outcome measures. The results will lead to treatment improvement strategies for policy development.