Collaborating to Implement Cross-System Interventions in Child Welfare and Substance Use

合作实施儿童福利和药物使用方面的跨系统干预措施

• 批准号: 9973212
• 负责人: ALICIA C BUNGER
• 金额: $ 27.3万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-15 至 2022-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9973212
• 关键词: Address; Administrator; Adoption; Alcohol or Other Drugs use; Caregivers; Child; Child Welfare; Collaborations; Communities; Complex; Contracts; Country; County; Data; Decision Making; Effectiveness; Epidemic; Evidence based intervention; Foundations; Funding; Future; Goals; Group Interviews; Health; Health Services Accessibility; Heroin; Human; Hybrids; Improve Access; Intervention; Lawyers; Literature; Methods; Modeling; National Institute of Drug Abuse; Ohio; Opioid; Outcome; Parents; Penetration; Pilot Projects; Positioning Attribute; Process; Recovery; Reporting; Research; Resources; Risk; Rural; Rural Community; Services; Specific qualifier value; Strategic Planning; Surveys; System; Testing; Time; To specify; Work; addiction; brief screening; comparative; effective intervention; effective therapy; effectiveness testing; evidence base; experience; experimental study; flexibility; foster care; implementation strategy; implementation trial; improved; improved outcome; innovation; maltreatment; operation; opioid epidemic; opioid mortality; opioid use; scale up; service delivery; sobriety; synthetic opioid; theories; tool; treatment organization

PROJECT SUMMARY/ABSTRACT As a result of the emerging national opiate crisis, child welfare agencies have experienced an increase in the number of children in foster care as parental substance use puts children at greater risk of maltreatment. Child welfare agencies are well positioned to help identify and connect parents with substance use treatment. Promising evidence-based interventions exist that that emphasize brief screening, linkage to treatment, and integration across child welfare and substance use treatment systems, including the START model (Sobriety Treatment and Recovery Teams). Successful implementation of START depends on strong collaboration between substance use treatment and child welfare systems. To improve implementation and future scale-up of START, there is a need for effective collaborative strategies that support integration of county child welfare and substance use treatment systems, which has potential to benefit those with highly complex substance use service needs involved in other health and human service systems. Our long-term goal is to test the effectiveness of collaborative strategies that promote the adoption, implementation, and sustainment of START and other cross-system treatment innovations. This study begins to address this goal by developing a multifaceted and feasible decision support guide for collaborative strategy selection for executive leaders. To do so, we will conduct a multisite longitudinal, mixed methods study that builds on the Ohio START project, a naturally occurring implementation initiative in 17 predominantly rural southern-Ohio counties funded by the Ohio Attorney General’s Office. Aim 1: During the first two years of the study, we will examine the strategies associated with START implementation (penetration and fidelity) and service delivery outcomes (substance use assessment, timely access to treatment, number of sessions), given system and organizational features. We will conduct a convergent mixed methods study with the 17 counties and draw on worker surveys, administrator reports, administrative data, and group interviews. Data will be integrated and analyzed using Qualitative Comparative Analysis (QCA). Aim 2: In the second year of the study, we will develop a decision support guide to facilitate selection of collaborative strategies. An expert panel comprised of implementation experts, and stakeholders from the substance use treatment child welfare system will convene to synthesize findings from the literature and Aim 1, to specify a START implementation strategy. Aim 3: During the final stage of the study, we will assess the acceptability, appropriateness, and feasibility of the START implementation strategy. We will compare the feasibility of the decision support guide to general implementation supports from the perspective of child welfare agency directors from outside of the 17 county region, and pilot the decision support guide in up to 3 counties. The proposed research will lay the foundation for a future R01 application to test the decision making guide’s effectiveness in a larger scale-up initiative.

项目总结/摘要 由于新出现的全国鸦片剂危机，儿童福利机构增加了 由于父母使用药物使儿童面临更大的虐待风险，寄养儿童的人数增加。 儿童福利机构处于有利地位，可以帮助识别父母并将其与药物使用治疗联系起来。 有希望的循证干预措施存在，强调简短的筛查，与治疗的联系， 整合儿童福利和药物使用治疗系统，包括START模式（清醒 治疗和康复团队）。裁武条约的成功执行取决于强有力的合作 药物滥用治疗和儿童福利制度之间的联系改进执行工作和今后的扩大工作 在START中，需要有效的合作战略来支持县儿童福利的整合 和物质使用治疗系统，这有可能使那些使用高度复杂物质的人受益 其他卫生和人类服务系统所涉及的服务需求。 我们的长期目标是测试促进采用的协作策略的有效性， 实施和维持START和其他跨系统治疗创新。这项研究开始于 通过制定一个多方面的、可行的协作战略决策支持指南来实现这一目标 选拔行政领导人。为此，我们将进行一项多中心纵向混合方法研究， 建立在俄亥俄州START项目的基础上，该项目是一个自然发生的实施计划，在17个主要是农村地区 由俄亥俄州总检察长办公室资助的南部俄亥俄州县。目标1：在第一个两年期内， 研究，我们将研究与START实施相关的战略（渗透和保真度）， 服务提供成果（药物使用评估、及时获得治疗、治疗次数）， 制度和组织特点。我们将与17个县进行一项趋同混合方法研究， 并利用工人调查、管理员报告、管理数据和小组访谈。数据将 采用定性比较分析（QCA）进行分析。目标2：在研究的第二年， 我们将制定决策支持指南，以促进协作策略的选择。一个专家小组 由执行专家和药物使用治疗儿童福利系统的利益攸关方组成 将召开会议，综合从文献和目标1中得出的结果，以具体说明《削减战略武器条约》的执行战略。 目标3：在研究的最后阶段，我们将评估以下方面的可接受性、适当性和可行性： 《削减战略武器条约》执行战略。我们将比较决策支持指南的可行性， 从17个县以外的儿童福利机构主任的角度提供执行支助 在最多3个县试行决策支助指南。这项研究将为 用于未来的R 01应用程序，以测试决策指南在更大规模扩展计划中的有效性。