Adolescent Treatment Services: Young Adult Outcomes

描述（由申请人提供）：

DESCRIPTION (provided by applicant): Admissions of 12 to 17-year olds to publicly funded substance abuse treatment rose by 46 percent between 1995 and 1998. Nearly all of this growth was attributable to referrals by the criminal justice system. Treatment might reduce delinquent adolescents' otherwise high risk of social and behavioral problems in young adulthood, but the long-term effects of treatment services for adolescents are currently unknown. Our objective is to assess the effects of adolescent treatment on key outcomes observed during young adulthood, the critical developmental period during which many people discontinue a variety of problem behaviors, while others establish lifelong patterns of drug use, crime and poor economic functioning. We will examine treatment effects on drug problems, HIV risk behaviors, health, criminal activity, health service utilization, psychosocial and economic functioning, and developmental transitions. Long-term outcomes will be efficiently studied by capitalizing on an ongoing study of delinquent youths (N=449) who have been followed for up to 30 months after referral by Probation to either a residential drug treatment program (Phoenix Academy) or to residential group homes that were less effective in reducing drug use and other problems. We propose four additional survey waves conducted 66, 78, 90, and 102-months after participants' initial interviews. Testing hypotheses drawn from developmental theories of substance use and service utilization, we will: 1) estimate the magnitude of Phoenix Academy treatment effects on key outcomes, relative to those of non-Phoenix Academy treatment, as youths enter young adulthood; 2) estimate the effect of specific theoretically important developmental transitions during young adulthood on key outcomes, and test whether Phoenix Academy treatment has an indirect effect on key outcomes mediated by its effect on these developmental transitions; 3) estimate the relative Phoenix Academy treatment effect on later substance abuse treatment utilization, and test whether any such effect is mediated by client cognitions regarding treatment services or substance abuse; 4) identify multivariate latent classes of outcome trajectories; characterize the service utilization and economic functioning patterns associated with each class; and estimate the relative Phoenix Academy treatment effect on the associations between latent classes and service utilization and economic functioning.