Long-term Outcomes and Economic Impact of the Detention to Community Model

拘留社区模式的长期成果和经济影响

基本信息

项目摘要

DESCRIPTION (provided by applicant): Given the severe and often life-long consequences linked to drug abuse, criminal involvement, and risky sexual behavior in childhood and adolescence, early intervention is considered by many to be crucial to halt the progression of these devastating problems. Family-based treatments have shown strong short-term outcomes on drug abuse and delinquency in adolescence, yet evidence for their long-term effects into young adulthood is limited. This study builds upon promising preliminary findings of the NIDA-funded Criminal Justice Drug Abuse Treatment Studies (CJDATS) "Detention to Community" (DTC) study. The DTC study developed and tested short-term (up to 9 month) effects of an innovative and integrative family-based intervention, Multidimensional Family Therapy (MDFT) in comparison to Enhanced Services as Usual (ESAU) among young offenders in detention and as they returned home to the community. Existing data from the parent project show strong preliminary effects of MDFT on youths' drug use, delinquency, and HIV-associated risk factors, thus further study of the interventions' potential to impact youths' trajectories into young adulthood seems a critical next step. The current study proposes to conduct comprehensive assessments of the 154 DTC participants on a range of outcomes at 2, 3, 4, and 5 years post-detention release, as well as protective factors that may influence these long-term outcomes. A comprehensive economic evaluation is also being proposed to examine the long-term benefits and costs and cost effectiveness of MDFT vs. ESAU. A final aspect of the study concerns the examination of how repeated treatment episodes and incarcerations during the 5-year follow-up period may interact with and help account for long-term intervention effects. The study has four aims: (1) To compare the long-term effectiveness of Multidimensional Family Therapy (MDFT) vs. Enhanced Services as Usual (ESAU) in reducing drug use, criminal behaviors, arrests and incarcerations, STD and HIV infection, HIV-associated risk behaviors, and mental health problems and promoting protective factors among a sample of youths recruited in juvenile detention centers; (2) To examine the relationship between protective factors (family, peer, educational/vocational functioning), and outcomes during the five-year post-detention period; (3) To evaluate and compare the long-term economic costs, benefits, and cost effectiveness to society and to the juvenile justice system of MDFT and ESAU; and (4) To examine the cumulative effects of repeated treatment episodes and incarcerations on targeted outcomes from adolescence into young adulthood. A multiple-domain and method assessment approach, including laboratory confirmed tests of HIV and STD incidence and substance use, and latent growth curve modeling techniques will be used to examine study hypotheses regarding adolescents' change over time. The study has significant potential to improve interventions and service delivery systems by providing new knowledge about the long-term effective and cost-efficiency of comprehensive, integrative interventions for drug abusing juvenile offenders at high risk for HIV. PUBLIC HEALTH RELEVANCE: Longitudinal studies confirm that many adolescents in the juvenile justice system experience chronic drug abuse, criminal involvement, HIV/STD-associated adverse health outcomes, and mental health disorders well into adulthood, however evidence for the long-term effectiveness of interventions designed to halt these devastating trajectories is sorely lacking. The proposed study, which tests the long-term effectiveness and economic impact of an innovative, integrative family-based intervention for juveniles in detention and in the community, has significant potential to yield new knowledge about the long-term effects of comprehensive effective services for multiply impaired teens. These findings may provide new knowledge that: (1) clinical scientists can use to further develop integrative interventions for youths involved in the juvenile justice system, and (2) policy makers and clinical administrators can use to guide decisions about health care policy and implementation of clinically effective and economically viable interventions.
描述(由申请人提供):鉴于与儿童和青少年时期的药物滥用,犯罪参与和危险性行为有关的严重且往往是终身的后果,许多人认为早期干预对阻止这些破坏性问题的进展至关重要。以家庭为基础的治疗对青少年的药物滥用和犯罪有很强的短期效果,但其对青年的长期影响的证据有限。这项研究建立在NIDA资助的刑事司法药物滥用治疗研究(CJDATS)“拘留社区”(DTC)研究的初步结果的基础上。DTC研究开发并测试了一种创新的综合性家庭干预措施-多维家庭治疗-的短期(长达9个月)效果,并将其与加强服务作为社区服务(ESAU)进行了比较。来自母项目的现有数据显示,MDFT对青少年吸毒、犯罪和艾滋病毒相关风险因素的初步影响很大,因此,进一步研究干预措施对青少年进入青年期的影响似乎是关键的下一步。目前的研究建议对154名DTC参与者在拘留释放后2年,3年,4年和5年的一系列结果以及可能影响这些长期结果的保护因素进行全面评估。还提议进行一项全面的经济评价,以审查MDFT与ESAU的长期效益和成本以及成本效益。本研究的最后一个方面涉及检查5年随访期间重复治疗事件和监禁如何与长期干预效果相互作用并有助于解释长期干预效果。这项研究有四个目标:(1)比较多维家庭治疗(MDFT)与强化服务作为替代疗法(ESAU)在减少吸毒、犯罪行为、逮捕和监禁、性病和艾滋病毒感染、艾滋病毒相关危险行为和心理健康问题以及促进青少年拘留中心招募的青少年样本中的保护因素方面的长期有效性;(2)研究保护因素之间的关系(家庭、同伴、教育/职业功能),以及拘留后五年期间的结果;(3)评估和比较MDFT和ESAU对社会和少年司法系统的长期经济成本、收益和成本效益;以及(4)检查重复治疗事件和监禁对从青春期到青年期的目标结果的累积影响。一个多领域和方法的评估方法,包括实验室确认的测试艾滋病毒和性病的发病率和物质使用,和潜在的增长曲线建模技术将被用来检查研究假设,随着时间的推移,青少年的变化。该研究具有改进干预措施和服务提供系统的巨大潜力,因为它提供了关于对艾滋病毒高风险吸毒少年犯采取全面综合干预措施的长期有效性和成本效益的新知识。公共卫生相关性:纵向研究证实,少年司法系统中的许多青少年经历了长期吸毒、犯罪、艾滋病毒/性传播疾病相关的不良健康后果和精神健康障碍,直到成年,但非常缺乏旨在阻止这些破坏性轨迹的干预措施的长期有效性的证据。拟议的研究,测试的长期有效性和经济影响的一种创新的,综合的家庭为基础的干预措施,在拘留和社区的青少年,有很大的潜力,以产生新的知识的长期影响的综合有效的服务多重受损的青少年。这些研究结果可能提供新的知识,(1)临床科学家可以用来进一步开发综合干预青少年司法系统中涉及的青少年,和(2)政策制定者和临床管理人员可以用来指导医疗保健政策和实施临床有效的和经济上可行的干预措施的决定。

项目成果

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CYNTHIA Lyn ROWE其他文献

CYNTHIA Lyn ROWE的其他文献

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{{ truncateString('CYNTHIA Lyn ROWE', 18)}}的其他基金

Family Intervention for Teen Drinking and Alcohol-related Crises in the ER
急诊室青少年饮酒和酒精相关危机的家庭干预
  • 批准号:
    7788004
  • 财政年份:
    2010
  • 资助金额:
    $ 50.43万
  • 项目类别:
Family Intervention for Teen Drinking and Alcohol-related Crises in the ER
急诊室青少年饮酒和酒精相关危机的家庭干预
  • 批准号:
    8270524
  • 财政年份:
    2010
  • 资助金额:
    $ 50.43万
  • 项目类别:
Family Intervention for Teen Drinking and Alcohol-related Crises in the ER
急诊室青少年饮酒和酒精相关危机的家庭干预
  • 批准号:
    8662121
  • 财政年份:
    2010
  • 资助金额:
    $ 50.43万
  • 项目类别:
Family Intervention for Teen Drinking and Alcohol-related Crises in the ER
急诊室青少年饮酒和酒精相关危机的家庭干预
  • 批准号:
    8462174
  • 财政年份:
    2010
  • 资助金额:
    $ 50.43万
  • 项目类别:
Family Intervention for Teen Drinking and Alcohol-related Crises in the ER
急诊室青少年饮酒和酒精相关危机的家庭干预
  • 批准号:
    8068178
  • 财政年份:
    2010
  • 资助金额:
    $ 50.43万
  • 项目类别:
Long-term Outcomes and Economic Impact of the Detention to Community Model
拘留社区模式的长期成果和经济影响
  • 批准号:
    7894972
  • 财政年份:
    2009
  • 资助金额:
    $ 50.43万
  • 项目类别:
Family-Based Drug Services for Young Disaster Victims
为年轻灾害受害者提供的家庭毒品服务
  • 批准号:
    7146237
  • 财政年份:
    2006
  • 资助金额:
    $ 50.43万
  • 项目类别:
Family-Based Drug Services for Young Disaster Victims
为年轻灾害受害者提供的家庭毒品服务
  • 批准号:
    7416693
  • 财政年份:
    2006
  • 资助金额:
    $ 50.43万
  • 项目类别:
Family-Based Drug Services for Young Disaster Victims
为年轻灾害受害者提供的家庭毒品服务
  • 批准号:
    7212099
  • 财政年份:
    2006
  • 资助金额:
    $ 50.43万
  • 项目类别:
COMORBIDITY AND ADOLESCENT DRUG ABUSE TREATMENT
合并症和青少年药物滥用治疗
  • 批准号:
    6232990
  • 财政年份:
    2000
  • 资助金额:
    $ 50.43万
  • 项目类别:

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