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Juvenile Offender HIV Prevention and Drug Abuse Services

青少年罪犯艾滋病毒预防和药物滥用服务

基本信息

批准号：
8468153
负责人：
Howard Arthur Liddle
金额：
$ 57.91万
依托单位：
UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-08-01 至 2014-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8468153
关键词：
AIDS prevention Address Administrator Adolescence Adolescent Alcoholism Area Back Characteristics Chronic Client Clinical Clinical effectiveness Commit Communication Communities Comorbidity Cost-Benefit Analysis Crime Decision Making Development Drug Addiction Drug Targeting Drug abuse Drug usage Economics Educational Intervention Effectiveness of Interventions Emotional Bonds Enrollment Environment Equilibrium Ethnic group Family Family psychotherapy FarGo Foundations Funding Geographic Locations Growth HIV HIV Infections HIV risk HIV/STD Health Health Policy Health system Home environment Impairment Imprisonment Incidence Institutes Institution Institutionalization Intake International Intervention Investments Justice Knowledge Laboratories Life Light Longitudinal Studies Mediating Mediator of activation protein Mental Health Methods Modeling Movement Outcome Outpatients Parenting behavior Parents Pharmaceutical Preparations Policy Maker Preventive Intervention Process Public Health Race Randomized Randomized Clinical Trials Randomized Controlled Trials Rehabilitation therapy Reliance Research Research Priority Residential Treatment Risk Behaviors Risk Reduction Safety Sampling Studies Schools Self Efficacy Services Sexually Transmitted Diseases Site Societies Solutions Substance Use Disorder Supervision Symptoms System Techniques Teenagers Testing Therapeutic Intervention Time Unemployment Unsafe Sex Wolves Youth addiction adolescent substance abuse base community intervention condoms cost effective cost effectiveness criminal behavior economic impact effective intervention effective therapy emerging adult evidence base follow-up high risk improved innovation juvenile delinquent juvenile justice system meetings offender peer prevention service programs recidivism safer sex service intervention sex risk sexually active skills social socioeconomics substance abuse treatment treatment duration treatment program

项目摘要

DESCRIPTION (provided by applicant): Responding to RFA-DA-09-007, we propose to conduct a randomized clinical trial to determine the clinical effectiveness, moderators and mechanisms of change, and economic impact of an integrative, family-based intervention that concurrently targets changes in HIV/STD-associated risk behaviors, drug abuse, delinquency, arrest and mental health outcomes for juvenile offenders committed to a juvenile justice day treatment program. 250 sexually active youths with documented substance use disorders enrolled in a school-based, juvenile justice day treatment facility will comprise the study sample. Eligible youths will be randomized to the experimental intervention. Day Treatment Multidimensional Family Therapy-HIV (DT-MDFT-HIV) or Day Treatment Services as Usual (DT-SAU). This study is distinguished by its setting, a juvenile justice administered day treatment program, and by the experimental intervention's promise in simultaneously reducing multiple adolescent problems-HIV-associated risk behaviors, drug abuse, and criminal behavior. Interventions targeting each of these problem areas are typically delivered separately, perpetuating well documented problems of service fragmentation in juvenile justice, addictions treatment, and health systems. Given the empirically-established relationships among high risk sex, drug abuse, and delinquency; the need for new service delivery systems that can efficiently deliver comprehensive interventions to multiply impaired youths; and the need for innovative juvenile justice alternatives to residential placement and incarceration, the proposed study has the potential to successfully address an urgent public health, public safety, and research priority. The study has four aims: (1) Clinical Outcomes - to compare the effects of the family-based and the group-based interventions on HIV risk/STD rates, drug use, delinquency and mental health outcomes, (2) Moderators of Outcome - to determine if the more comprehensive and integrated experimental intervention, MDFT-HIV, is more effective with more severely impaired youths, (3) Mediators of Outcome - to determine if hypothesized mechanisms of action of MDFT-HIV mediated changes in outcomes over time, and (4) Economic Analyses - to evaluate and compare the economic costs, benefits, and cost effectiveness to society and to the juvenile justice system of MDFT-HIV and SAU. A multiple time point (intake, 3, 6, 12, and 24 month follow-up), multiple domain and method assessment approach and latent growth curve modeling techniques will be used to examine study hypotheses regarding adolescent and family change over time. The study has significant potential to improve interventions and service delivery systems by providing new knowledge about effective and cost-efficient interventions for drug abusing juvenile offenders at high risk for HIV infection.

描述（申请人提供）：响应RFA-DA-09-007，我们建议进行一项随机临床试验，以确定临床有效性、调节因素和变化机制，以及以家庭为基础的综合干预措施的经济影响，该干预措施同时针对HIV/STD相关风险行为、药物滥用、青少年犯罪、逮捕和精神健康结果的少年犯致力于少年司法日治疗方案。250名性活跃的青少年与记录的物质使用障碍登记在学校，少年司法日治疗设施将包括研究样本。符合条件的年轻人将被随机分配到实验干预组。日间治疗多维家庭治疗-艾滋病毒（DT-MDFT-HIV）或日间治疗服务（DT-SAU）。这项研究的特点是它的设置，青少年司法管理的一天的治疗计划，并通过实验干预的承诺，同时减少多种青少年问题，艾滋病毒相关的风险行为，药物滥用和犯罪行为。针对每个问题领域的干预措施通常是单独提供的，使少年司法、戒毒治疗和卫生系统中有据可查的服务分散问题长期存在。鉴于高风险性行为，药物滥用和犯罪之间的关系，需要新的服务提供系统，可以有效地提供全面的干预措施，以多重受损的青少年，并需要创新的少年司法替代住宅安置和监禁，拟议的研究有可能成功地解决一个紧迫的公共卫生，公共安全和研究的优先事项。这项研究有四个目标：（1）临床结果-比较以家庭为基础的干预措施和以群体为基础的干预措施对艾滋病毒风险/性病率、吸毒、犯罪和心理健康结果的影响，（2）结果调节因素-确定更全面和综合的实验性干预措施MDFT-艾滋病毒对更严重受损的青年是否更有效，（3）结果的中介因素-确定MDFT-HIV的假设作用机制是否随时间推移介导结果的变化，以及（4）经济分析-评价和比较经济成本、收益，和成本效益的社会和少年司法系统的MDFT艾滋病毒和SAU。将使用多个时间点（入组、3、6、12和24个月随访）、多领域和方法评估方法以及潜在生长曲线建模技术来检查关于青少年和家庭随时间变化的研究假设。该研究提供了关于对艾滋病毒感染高风险的吸毒少年犯采取有效和具有成本效益的干预措施的新知识，从而具有改进干预措施和服务提供系统的巨大潜力。