Integrated Continuity of Care for Adolescent Drug Users

青少年吸毒者综合连续性护理

• 批准号: 7114943
• 负责人: Nancy Jainchill
• 金额: $ 51.28万
• 依托单位: NATIONAL DEVELOPMENT AND RESEARCH INSTITUTES, INC.
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-20 至 2009-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7114943
• 关键词: adolescence (12-20); clinical research; drug abuse; drug abuse therapy; family therapy; high risk behavior /lifestyle; human subject; human therapy evaluation; longitudinal human study; patient oriented research; questionnaires; relapse /recurrence

DESCRIPTION (provided by applicant): The current application is a resubmission of a proposal submitted and reviewed by NIDA-F (1 R01DA017218-01). The overall objective of this project is to address the problem of relapse among adolescents who have been in modified residential therapeutic community (TC) treatment programs. To this end, we propose to evaluate the effectiveness of an enhanced aftercare (EA) intervention compared with standard aftercare (SA) services. The enhanced aftercare condition includes an evidence-based family therapy, Functional Family Therapy (FFT) provided along with the standard services. For many high-risk youth it has been necessary to place them in residential settings such as TCs for treatment. Heretofore these programs have been seen as a stand-alone, well-established treatment modality. The findings suggest they may be a necessary but not sufficient condition for successful treatment for many of these youth. The proposed project conceptualizes TCs not as a "stand alone" intervention, but as part of a more holistic, integrated treatment that models a continuity of care approach, which extends and enhances the therapeutic process beyond the residential context. Planned analyses address 4 specific aims to investigate the impact of the proposed Enhanced Aftercare treatment model as compared to Standard Aftercare. Aim 1 compares the impact of the EA condition to SA on post-treatment outcome measures. Aim 2 examines whether the level of goal attainment achieved during the TC residency period predicts post-treatment outcomes both across and within the aftercare conditions; analyses assess the premise that the gains achieved during TC residency are more likely to be preserved in EA. Aim 3 examines the effects of client pre-intervention moderating factors (e.g., pretreatment risk and protective status) on TC goal attainment and post-treatment outcomes in each aftercare condition using structural equations models. Aim 4 assesses the impact of participation in aftercare services (i.e., service dosage) during the aftercare period for the EA and SA conditions on 12-month post-aftercare treatment behavioral outcomes. This project reflects a core premise that a treatment model that integrates complementary strategies, i.e., modified residential TC treatment and an enhanced aftercare protocol providing Functional Family Therapy, will have an additive, if not synergistic effect on reducing or eliminating [drug use/abuse and other problem behaviors among adolescents after completing treatment.

描述(由申请人提供)： 目前的申请是NIDA-F提交和审查的一项提案的重新提交(1 R01DA017218-01)。该项目的总体目标是解决已在改良的住宅治疗社区(TC)治疗计划中复发的青少年的问题。为此，我们建议评估加强善后护理(EA)干预与标准善后护理(SA)服务的成效。加强后护理条件包括循证家庭治疗，功能性家庭治疗(FFT)与标准服务一起提供。对于许多高危青年来说，有必要将他们安置在TCS等寄宿环境中接受治疗。到目前为止，这些计划一直被视为一种独立的、成熟的治疗方式。研究结果表明，对于这些年轻人中的许多人来说，他们可能是成功治疗的必要条件，但不是充分条件。拟议的项目将TCS概念化，而不是将其作为更全面、更综合的治疗的一部分，该治疗借鉴了连续性护理方法，将治疗过程扩展并增强到居住环境之外。有计划的分析涉及4个具体目标，以调查拟议的增强型善后治疗模式与标准善后护理相比的影响。目的1比较EA和SA对治疗后结局指标的影响。目的2检验在住院期间达到的目标水平是否可以预测治疗后的结果。分析评估的前提是，在住院期间取得的成果更有可能在EA中得到保留。目的3使用结构方程模型检验患者干预前调节因素(如治疗前风险和保护状态)对TC目标实现和治疗后结果的影响。目的4评估在EA和SA条件下的善后期间参与善后服务(即服务剂量)对善后治疗12个月后行为结果的影响。该项目反映了一个核心前提，即整合互补战略的治疗模式，即改进的住院TC治疗和提供功能性家庭治疗的强化的善后方案，将在青少年完成治疗后减少或消除[药物使用/滥用和其他问题行为]方面产生附加的、如果不是协同的效果。