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 机构提供的针对青少年药物滥用的家庭治疗服务的有效性 设置。尽管基于家庭的生态干预（FBEI）在对照试验中取得了成功，但这种高度 有前途的服务方法尚未在 ASA 人群的纯现场条件下进行测试。 受控有效性研究总是会改善培训、监督和服务提供条件 在合作地点努力确保治疗的依从性和一致性。另一种策略是 推进传播科学是对社区诊所进行严格的自然主义研究 在日常护理过程中实施循证实践。拟议的研究将遵循此 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”策略 在一家社区心理健康中心，该中心已将 FBEI 作为常规护理标准。的 研究将使用随机设计来比较自然 FBEI 服务与照常服务 (SAD) ASA。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 门诊治疗标准。 SAD条件 将包含城市社区中 ASA 最常见的三个服务场所： 以医院为基础 流动心理健康诊所、药物咨询/成瘾专科诊所和社区心理健康 中心。该研究的主要目的是检查 FBEI 与 SAD 的有效性并进行比较 FBEI 遵守前一 FBEI 阶段设定的绩效基准的强度和结果 二、疗效试验。第二个目标是比较成本效益、服务利用率和消费者 FBEI 与 SAU 的满意度。多特征、多方法的评估设计将包括青少年和 在基线和 3、6 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 在这两种情况下从自我报告和提供者机构收集。该研究将产生第一个 广泛认可的 ASA 治疗方法在现实世界中是否有效且可行的证据 条件，并且在结果和成本效益方面优于 SAU。一个重要的二次产量将是 增加 SAU 条件下常用社区方法的稀缺知识库。

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.