Developing SUPPORT, a Community-Driven, Recovery-Oriented System of Care

项目摘要/摘要 缺乏针对返乡囚犯的循证SUD治疗和服务。物质使用 以人为本的恢复(支持)方案是一种社区驱动、以恢复为导向的方法 到药物滥用护理，有可能解决这一服务缺口。支持是仿照 印第安纳州的获得恢复(ATR)计划，尽管有积极的一面，但由于缺乏联邦支持而关闭 改善客户的恢复结果。支持建立在ATR的局限性之上，因为它将：Focus 特别是针对重新进入监狱的人口；是社区驱动的，而不是国家管理的；要求直接 服务人员必须是经过认证的同伴康复教练；为客户提供一整年而不是六个月的服务；以及 利用电子数据采集系统，而不是纸质调查，改进以数据为导向的决策。 该项目的最终目标是建立作为有效和可扩展恢复的支持-- 以护理为导向的系统。在启动大型临床试验之前，我们必须采取的一个必要步骤是 支持干预措施的开发和试点测试。与此相对应，本研究有三个目标 最初的任务。目标1是发展支持。我们将利用从过去的印第安纳州ATR收集的定性数据 客户和供应商以及与顾问的学习会议，以确定如何最好地开发和修订正式的 干预的政策、程序和保真度指导方针。目标2是进行试点测试，以评估 R01研究的可行性。我们将在印第安纳州中部的一家机构进行试点测试，该机构为 返回囚犯，使用随机分配将支持客户与通常接收的客户进行比较 治疗。我们将在多个点收集这两组人的定量数据，并收集定性数据 从支持客户到更好地了解他们的计划体验。目标3是确定 执行障碍，为今后的传播活动提供信息。我们将进行半结构化电话 与模式的潜在采用者进行访谈，以通过确定可能的 印第安纳州以外地区的可复制性的障碍和推动者。为了实现这些目标，这项研究的发展 评价框架采用持续的数据收集和快速反应。由此产生的研究将调查 与类似的SUD计划相比，支持改善客户端恢复结果的有效性 缺少模型的关键元素。该项目将增加与以恢复为导向的科学知识 服务，这是目前缺乏的一个研究领域。这种模式的发展也将是 考虑到目前政策和政策中注重恢复的护理，利益攸关方群体的利益 治疗。

PROJECT SUMMARY/ABSTRACT There is a lack of evidence-based SUD treatment and services targeting returning inmates. Substance Use Programming for Person-Oriented Recovery (SUPPORT) is a community-driven, recovery-oriented approach to substance abuse care which has the potential to address this service gap. SUPPORT is modeled after Indiana’s Access to Recovery (ATR) program, which was closed due to lack of federal support despite positive improvements in clients’ recovery outcomes. SUPPORT builds on the limitations of ATR in that it will: focus specifically on a prison reentry population; be community-driven, rather than state administered; require direct service staff be certified peer recovery coaches; provide clients a full year of services instead of 6-months; and utilize an electronic data capture system, rather than paper surveys, to improve data-driven decision making. The ultimate goal of this project is the establishment of SUPPORT as an effective and scalable recovery- oriented system of care. A necessary step we must take before launching a large clinical trial is the development and pilot testing of the SUPPORT intervention. This study has three aims corresponding to this initial task. Aim 1 is to develop SUPPORT. We will utilize qualitative data collected from past Indiana ATR clients and providers and learning meetings with advisors to determine how to best develop and revise formal policies, procedures, and fidelity guidelines for the intervention. Aim 2 is to conduct a pilot test to assess feasibility for an R01 study. We will conduct a pilot test at a Central Indiana agency that provides services to returning inmates, using random assignment to compare SUPPORT clients to clients receiving usual treatment. We will collect quantitative data for both groups at multiple points and also collect qualitative data from SUPPORT clients to better understand their program experiences. Aim 3 is the identification of implementation barriers to inform future dissemination activities. We will conduct semi-structured phone interviews with potential adopters of the model to improve SUPPORT’s transferability by identifying possible barriers and facilitators to replicability beyond Indiana. To accomplish these aims, the study’s developmental evaluation framework uses continuous data collection and rapid response. The resulting study will investigate the effectiveness of SUPPORT for improving client recovery outcomes to a similar SUD program that is missing key elements of the model. This project will increase scientific knowledge related to recovery-oriented services, an area of research that is currently lacking. The development of such a model will also be of interests to a variety of stakeholder groups given the current focus on recovery-oriented care in policy and treatment.