Quality Community Services for Adolescent Drug Abuse

拟议研究的最终目标是测试有效性、实施质量和成本 某机构开展青少年药物滥用家庭治疗服务的效果评价 布景。尽管基于家庭的生态干预(FBEI)在对照试验中取得了成功，但这一高度 前景看好的服务方法尚未在纯田间条件下与ASA种群进行测试。 受控有效性研究总是能改善培训、监督和服务交付条件 在合作地点，以努力确保治疗的坚持和一致性。另一种替代战略 推进传播学是对社区诊所的严格自然主义研究，已经 在常规护理过程中实施循证做法。拟议的研究将遵循这一点 通过调查一线治疗师提供的ASA服务的质量和影响来实施“自下而上”战略 在一家以社区为基础的精神健康中心，已经将FBEI作为常规护理标准。这个 研究将使用随机设计来比较自然主义的FBEI服务和正常服务(SAD) 阿萨克。参与者(N=260)将从当地高中、强化项目和青少年中招募 正义计划。符合条件的青少年将符合ASAM的门诊治疗标准。SAD的情况 将包含ASA在城市社区最常见的三个服务场所：基于医院的 门诊精神卫生诊所、药物咨询/成瘾专科诊所和社区精神卫生 中锋。这项研究的主要目的是检验FBEI和SAD的有效性，并比较 FBEI遵从性的强度和达到前一个FBEI阶段设定的性能基准的结果 II疗效试验。次要目标是比较成本效益、服务利用率和消费者 对FBEI和SAU的满意度。多特质、多方法评估设计将包括青少年和 在基线和3个月、6个月和12个月的随访中进行家长访谈。成本和服务利用率数据将 在这两种情况下，从Self Report和提供商机构收集。这项研究将产生第一个 广泛认可的ASA治疗方法在现实世界中是否有效和可行的证据 并在结果和成本效益上优于SAU。一个重要的次要收益率将是 在SAU条件下，在常用的社区方法上增加稀缺的知识库。

The ultimate objective of the proposed study is to test the effectiveness, implementation quality, and cost effectiveness of family-based treatment services for adolescent substance abuse delivered in an agency setting. Despite the success of family-based ecological interventions (FBEI) in controlled trials, this highly promising services approach has not been tested under pure field conditions with ASA populations. Controlled effectiveness research invariably enhances training, supervision, and service delivery conditions in partnering sites in an effort to ensure treatment adherence and consistency. An alternative strategy for advancing dissemination science is rigorous naturalistic research on community clinics that already implement evidence-based practices in the course of routine care. The proposed study will follow this "bottom up" strategy by investigating the quality and impact of ASA services delivered by front-line therapists in a community-based mental health center that already features FBEI as the routine standard of care. The study will use a randomized design to compare naturalistic FBEI services to services as usual (SAD) for ASA. Participants (N = 260)will be recruited from local high schools, enrichment programs, and juvenile justice programs. Eligible adolescents will meet ASAM criteria for outpatient treatment. The SAD condition will contain the three most common service venues for ASA in urban communities: hospital-based ambulatory mental health clinics, drug counseling/addictions specialty clinics, and community mental health centers. The primary aims of the study are to examine the effectiveness of FBEI versus SAD and to compare the strength of FBEI adherence and outcomes to performance benchmarks set during a previous FBEI Stage II efficacy trial. The secondary aims are to compare cost effectiveness, services utilization, and consumer satisfaction in FBEI versus SAU. A multitrait, multimethod assessment design will include adolescent and parent interviews at baseline and 3, 6, and 12 months follow-up. Cost and service utilization data will be collected from self report and from provider agencies in both conditions. The study will yield the first evidence on whether a widely endorsed treatment approach for ASA is potent and feasible in real-world conditions and superior to SAU in outcomes and cost-benefit. An important secondary yield will be increasing the scarce knowledge base on commonly practiced community approaches in the SAU condition.