Models of Campus-based Relapse prevention and student characteristics

校园防旧病复发模式及学生特征

• 批准号: 8280582
• 负责人: Kitty Harris
• 金额: $ 28.21万
• 依托单位: NATIONAL DEVELOPMENT AND RESEARCH INSTITUTES, INC.
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-15 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8280582
• 关键词: Acute; Address; Admission activity; Adolescence; Adoption; Adult; Age; Alcohol consumption; Alcohol or Other Drugs use; Beryllium; Caring; Characteristics; Clinical; Communities; Continuity of Patient Care; Counseling; Data; Development; Dimensions; Disease remission; Drug usage; Early treatment; Economics; Education; Elements; Enrollment; Ensure; Environment; Evaluation; Evaluation Studies; Expert Systems; Faculty; Freedom; Future; Generations; Goals; Growth; Health; High Prevalence; Housing; Individual; Institution; Knowledge; Life; Life Style; Modeling; Monitor; Onset of illness; Outcome; Peer Pressure; Performance; Pharmaceutical Preparations; Policies; Prevention approach; Prospective Studies; Publishing; Recording of previous events; Records; Recovery; Relapse; Reporting; Research; Research Infrastructure; Research Support; Resources; Risk; Services; Site; Solid; Source; Staging; Stress; Students; Substance Use Disorder; Suggestion; Supervision; Support Groups; System; Time; Universities; Variant; Youth; addiction; alcohol use disorder; base; care systems; clinical care; college; comparison group; cost; critical period; design; disorder later incidence prevention; experience; falls; group counseling; high school; innovation; interest; knowledge base; peer; premature; prevent; programs; rapid growth; response; service utilization; sobriety; success; university student; young adult

DESCRIPTION (provided by applicant): Drug and alcohol use disorders (i.e., 'substance use disorders', SUD) triple from adolescence to young adulthood, making this transitional period critical to SUD onset and progression. Research supports the need for early intervention, ongoing monitoring, support, and continuing care to minimize SUD duration and impact. Yet unlike for adults, the youth continuum of care system remains underdeveloped. College attendance is key to financial stability but the high prevalence of drug/alcohol use on campus, paired with the normative challenges of this life stage (new freedoms, less supervision) make college a high relapse risk context for youths in SUD remission ('in recovery'). Universities started campus-based Collegiate Recovery Programs (CRPs) 30 years ago to allow recovering students to extend their participation in continuing care without having to postpone or surrender their educational goals. CRPs combine sober housing, onsite peer support groups and counseling provided by a small staff. Growing concerns about substance use on campus and federal agencies' focus on building a community-based youth continuum of care system have fueled a 5-fold increase in CRPs in the past decade, from 4 in 2000 to 21 in 13 states today with 8 new CRPs opening in Fall 2011. CRPs are consistent with the continuing care paradigm experts recommend, and notably, with the Department of Education's goal of ensuring a continuity of care from high school to college to post-graduation. CRP site-level records suggest promising outcomes but the model has not been systematically examined. The rapid CRP growth underlines the need for such services but individual programs, all started independently, likely vary greatly on key dimensions that may influence student outcomes - e.g., drug/alcohol use monitoring practices, participation requirements, comprehensiveness of services. The lack of CRP standards, formal model and systematic evaluation are increasingly noted as hindering wider adoption. The Department of Education recently called for prospective studies on CRP students' substance use and academic outcomes to inform the higher education system's response to recovering students. Thus the time has come for a systematic and rigorous evaluation of CRPs. However a large scale resource-intensive evaluation is premature as we lack important knowledge to guide the planning of a hypothesis-driven study: Data are needed about the diversity of CRPs and their common elements, about the students CRPs serve, their specific relapse risks and service needs. This developmental R21 study is designed to provide that knowledgebase preparatory to a full scale systematic evaluation through an R01. Capitalizing on our unique access to CRPs and our research expertise, we will address the following developmental aims: (1) Characterize the diversity of CRPs (N = 29) to identify common elements that will be subsequently subjected to systematic evaluation; (2) Describe CRP students' (N = 700) clinical history to guide the selection of a suitable comparison group, and their CRP experience, specific relapse risks and service needs to inform hypotheses about CRP elements underlying student outcomes in the evaluation study. PUBLIC HEALTH RELEVANCE: Identifying effective strategies to help prevent relapse and promote recovery among young people is critical to their future and to the nation's health and economy. A college education is key to economic stability but for young people in remission ('recovery') from a drug/alcohol use disorder, college represents a serious threat to recovery because of high levels of substance use on campus. This developmental study will collect data to lay the groundwork for a rigorous hypothesis-driven evaluation of Collegiate Recovery Programs, an innovative and increasingly prevalent campus based relapse prevention approach that is generating high interest among universities and federal agencies but has not been empirically examined.

描述（由申请人提供）：药物和酒精使用障碍（即“物质使用障碍”，SUD）从青春期到青年期增加三倍，使这一过渡时期对SUD的发病和发展至关重要。研究支持早期干预、持续监测、支持和持续护理的必要性，以尽量减少SUD的持续时间和影响。然而，与成年人不同的是，青少年连续护理系统仍然不发达。大学出勤率是经济稳定的关键，但校园内药物/酒精使用的高流行率，加上这一人生阶段的规范挑战（新的自由，更少的监督），使得大学成为SUD缓解（“康复”）青年的高复发风险环境。30年前，大学开始了以校园为基础的大学康复计划（CRPs），允许康复的学生延长他们对持续护理的参与，而不必推迟或放弃他们的教育目标。crp结合了清醒的住房，现场同伴支持小组和一小部分工作人员提供的咨询。对校园内药物使用的日益关注，以及联邦机构对建立以社区为基础的青少年连续护理系统的关注，在过去十年中推动了crp的5倍增长，从2000年的4个增加到今天的13个州的21个，其中8个新的crp将于2011年秋季开放。crp与专家推荐的持续护理模式是一致的，值得注意的是，与教育部确保从高中到大学再到毕业后的持续护理的目标是一致的。CRP位点水平的记录显示了有希望的结果，但该模型尚未得到系统的检验。CRP的快速增长强调了对此类服务的需求，但所有独立启动的个别项目可能在可能影响学生成果的关键方面存在很大差异，例如，药物/酒精使用监测实践、参与要求、服务的全面性。缺乏CRP标准、正式模型和系统评价日益被认为是阻碍广泛采用的因素。教育部最近呼吁对CRP学生的物质使用和学业成绩进行前瞻性研究，以告知高等教育系统对康复学生的反应。因此，现在是对crp进行系统和严格评估的时候了。然而，大规模的资源密集型评估还为时过早，因为我们缺乏重要的知识来指导假设驱动研究的规划：需要关于crp的多样性及其共同要素、关于crp服务的学生、他们特定的复发风险和服务需求的数据。这项发展性R21研究旨在通过R01为全面系统评估提供知识库。利用我们对crp的独特获取途径和我们的研究专长，我们将实现以下发展目标：(1)表征crp的多样性（N = 29），以确定随后将进行系统评估的共同要素；(2)描述CRP学生（N = 700）的临床病史，以指导选择合适的对照组，以及他们的CRP经历、特定的复发风险和服务需求，为评估研究中影响学生结果的CRP因素提供假设。