Mississippi TRIALS Research Center

循证实践(EBP)并没有被药物治疗提供者广泛使用。该研究中心申请审判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针对青少年罪犯的两种药物治疗EBP在门诊环境中的采用和常规做法。药物治疗提供者已经对客户进行了艾滋病毒知识教育，并为艾滋病毒检测提供了转介。我们还将促进以证据为基础的艾滋病毒预防干预与青少年药物治疗服务的结合。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--合作制定了拟议的研究概念。根据认为组织变革是分阶段进行的实施框架，我们采取以阶段为基础的办法，在实施进程的每个阶段采用不同的实施战略。基于我们对少年犯的艾滋病毒预防经验，我们对密西西比州公共部门治疗系统的了解，以及青少年法院法官所希望的药物治疗干预措施的类型，我们选择了12节版本的动机增强治疗结合认知行为治疗(MET/CBT12)、家庭支持网络(FSN)干预和成为负责任的青少年(BART)艾滋病毒/性传播疾病预防计划作为EBPS实施。 为了最大限度地提高青少年毒品法庭计划和治疗提供者参与整个为期5年的研究的可能性，并且不仅将实施，而且在赠款资金撤回后继续使用这些EBP，我们建议与每个青少年毒品法庭计划发展合作伙伴关系，并促进当地的实施规划小组(阶段1)，向治疗提供者提供培训、指导和绩效反馈(阶段2和3)，并向毒品法庭计划的利益相关者提供关于服务交付、青年结果、成本和成本效益的现场特定信息(阶段4)。我们计划使用混合方法来检查背景、组织和其他假设影响实施的因素，并使用各种统计方法为实施过程的每个阶段测试不同的假设模型。通过跟踪毒品法庭项目在实施过程的所有阶段的进展情况，并勾勒出实施的促进者和障碍，我们的研究理念将有助于实施科学。拟议的项目有可能对EBPS在密西西比州的传播产生重大影响，因为青年法院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，他们的同龄人尝试并发现有效。此外，在密西西比州进行的实施研究的结果对在其他资源匮乏的环境中实施EBP也有影响。

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.