Mississippi TRIALS Research Center

药物治疗提供者没有广泛使用循证实践。该研究中心申请TRIALS合作协议资助机制的目标是促进密西西比州毒品法庭项目中青少年罪犯门诊环境中两种药物治疗EBP的采用和常规实践。药物治疗提供者已经对客户进行艾滋病毒教育，并推荐进行艾滋病毒检测。我们还将促进将循证艾滋病毒预防干预措施与青少年戒毒治疗服务相结合。为了实现这一目标，两个州一级的机构，少年司法和心理健康，在拟议的研究概念的发展合作。实施框架认为，组织变革是分阶段进行的，需要有意识的和持续的努力才能发生，我们采用了基于阶段的方法，在实施过程的每个阶段采用不同的实施战略。根据我们对青少年罪犯的艾滋病预防经验，我们对密西西比公共部门治疗系统的了解，以及青年法庭法官所希望的药物治疗干预类型，我们选择了12个疗程的动机增强疗法与认知行为疗法相结合（MET/CBT 12）、家庭支助网络干预和成为负责任的青少年（BART）艾滋病毒/性传播疾病预防方案，作为将实施的强化基本做法。 为了最大限度地提高青少年毒品法庭项目和治疗提供者参与整个5年研究的可能性，不仅实施，而且在拨款撤回后维持使用这些EBP，我们建议与每个青少年毒品法庭项目建立合作伙伴关系，并促进当地实施规划小组（第1阶段），提供培训，向治疗提供者提供指导和绩效反馈（第2和第3阶段），并向毒品法庭方案利益攸关方提供有关服务提供、青年成果、成本和成本效益的具体信息（第4阶段）。我们计划使用混合的方法来检查上下文，组织和其他因素假设影响实施，并使用各种统计方法来测试不同的假设模型的实施过程的每个阶段。通过跟踪毒品法庭计划在实施过程的各个阶段的进展，并划定实施促进者和障碍，我们的研究概念将有助于实施科学。拟议的项目有可能对密西西比州EBP的传播产生重大影响，因为青年法庭法官将希望采用青少年药物治疗和艾滋病毒预防干预措施，这些措施被他们的同龄人试用并发现有效。此外，在密西西比进行的实施研究的结果有EBP在其他资源贫乏的环境中实施的影响。

Evidence-based practices (EBPs) are not widely used by drug treatment providers. The goal of this Research Center application for the TRIALS Cooperative Agreement funding mechanism is to promote the adoption and routine practice of two drug treatment EBPs in outpatient settings for juvenile offenders in drug court programs in Mississippi. Drug treatment providers already educate clients about HIV and make referrals for HIV testing. We will also promote the integration of an evidence-based HIV prevention intervention with adolescent drug treatment services. To attain this goal, two state-level agencies, juvenile justice and mental health, collaborated in the development of the proposed research concept. Drawing on implementation frameworks that view organizational change as taking place in stages, requiring intentional and sustained effort to occur, we take a stage-based approach in which different implementation strategies are employed at each stage of the implementation process. Based on our HIV prevention experience with juvenile offenders, our knowledge of the public sector treatment system in Mississippi, and the types of drug treatment interventions desired by youth court judges, we selected the 12 session version of Motivational Enhancement Therapy combined with Cognitive Behavioral Therapy (MET/CBT12), the Family Support Network (FSN) intervention and Becoming a Responsible Teen (BART) HIV/STD prevention program as the EBPs to be implemented. To maximize the likelihood that juvenile drug court programs and treatment providers will participate throughout the 5-year study and will not only implement, but sustain the use of these EBPs after grant funding is withdrawn, we propose to develop a collaborative partnership with each juvenile drug court program and to facilitate local implementation planning groups (stage 1), provide training, coaching and performance feedback to treatment providers (stages 2 & 3), and provide site-specific information to drug court program stakeholders on service delivery, youth outcomes, costs and cost effectiveness (stage 4). We plan to use mixed methods for examining contextual, organizational, and other factors hypothesized to influence implementation and to use various statistical approaches to test a different hypothesized model for each stage of the implementation process. By tracking the progress of drug court programs across all stages of the implementation process and delineating the implementation facilitators and barriers, our research concept will contribute to implementation science. The proposed project has the potential to make a significant impact on the diffusion of EBPs in Mississippi as youth court judges will want to adopt adolescent drug treatment and HIV prevention interventions tried and found effective by their peers. Furthermore, results of implementation research conducted in Mississippi have implications for EBP implementation in other resource-poor settings.