Leveraging Implementation Science to Increase Access to Trauma Treatment for Incarcerated Drug Users

项目摘要/摘要 刑事司法系统内对有效治疗上瘾的需求未得到满足“是一个重要的 根据NIDA的2016-2020年战略计划，“为高危人群提供干预机会”。这个计划 还鼓励制定和评价执行战略，以满足 刑事司法系统。这项以患者为导向的导师研究职业发展奖(K23)将 为申请者准备必要的技能，以启动以考试为重点的独立研究计划 支持监狱服刑人员采用循证心理健康干预措施的实施战略 吸毒者。申请者的培训目标如下：1)培养实施科学方面的专业知识 研究方法，2)增加与药物使用者干预相关的知识，3)提高技能 对于一个成功的研究事业来说是必要的。这些培训目标将通过以下方式相结合实现 指导研究和学习，授课和体验式学习，强化外部培训。因为 严重创伤暴露、吸毒和伸张正义在监狱中同时发生。 申请人的研究计划将旨在促进关于实施金本位的知识 心理治疗创伤，认知加工疗法(CPT)，在监狱环境中。她还将审查 监狱交付的CPT是否减少了药物使用、精神症状和再犯罪率。三个具体 本研究的目的是：1)使用形成性评价来识别可能影响实施的因素，并 监狱对CPT的接受，2)使CPT适用于被监禁的吸毒者，并开发以促进为基础的 实施指南，以支持其采用；以及3)进行参与者-随机混合II试验，以评估 服刑吸毒者CPT的有效性和实施效果。如果发现是有效的，广泛的- 大规模实施CPT可能会改善170多万被监禁的美国人的健康，这些人与 正在发生的药物使用和创伤暴露。 本申请书中建议的工作将在阿肯色大学医学科学分校进行 在下列国家专家的指导下，为早期调查人员提供丰富的背景知识： 乔安·基什内尔博士和杰弗里·柯伦博士负责实施科学，尼科拉斯·扎勒博士负责药物使用及其 与刑事司法系统重叠，Debra Kaysen博士为CPT及其在低资源环境下的适应 上下文和物质用户之间的关系。在结束时，申请者将朝着她的目标前进 通过以下方式成为刑事司法实施科学家：1)提高刑事司法实施的基础知识 在刑事司法系统内的执行情况和作为治疗成瘾的有效性和2)出版 实施科学在刑事司法环境中的应用研究。

Project Summary/Abstract The unmet need for effective addiction treatment within the criminal justice system “represents a significant opportunity to intervene with a high-risk population” according to NIDA's 2016-2020 strategic plan. The plan also encourages the development and evaluation of implementation strategies that address the needs of the criminal justice system. This Mentored Patient-Oriented Research Career Development Award (K23) will prepare the applicant with the skills necessary to launch an independent research program focused examining implementation strategies to support the uptake of evidence-based mental health interventions for incarcerated substance users. The applicant's training goals are as follows: 1) develop expertise in implementation science research methods, 2) increase knowledge relevant to interventions for substance users, and 3) enhance skills necessary for a successful research career. These training goals will be achieved through a combination of mentored research and study, didactic and experiential learning, and intensive externship training. Because severe trauma exposure, substance use, and justice-involvement overwhelmingly co-occur in prison populations, the applicant's research plan will aim to advance knowledge on implementation of a gold-standard psychotherapy for trauma, Cognitive Processing Therapy (CPT), in the prison setting. She will also examine whether prison-delivered CPT reduces drug use, psychiatric symptoms, and recidivism. The three specific aims in this research are: 1) Use formative evaluation to identify factors that may influence implementation and uptake of CPT in prisons, 2) Adapt CPT for incarcerated drug users and develop a facilitation-based implementation guide to support its uptake, and 3) conduct a participant-randomized Hybrid II trial to assess effectiveness and implementation outcomes of CPT with incarcerated drug users. If found to be effective, wide- scale implementation of CPT may improve the health of over 1.7 million incarcerated Americans who have co- occurring substance use and trauma exposure. The work proposed in this application will be conducted at the University of Arkansas for Medical Sciences, a rich context for early stage investigators, under the guidance of mentoring from the following national experts: Drs. JoAnn Kirchner and Geoffrey Curran for implementation science, Dr. Nickolas Zaller for drug use and its overlap with the criminal justice system, and Dr. Debra Kaysen for CPT and its adaptation in low-resource contexts and with substance users. At its conclusion, the applicant will have progressed toward her goal of becoming a criminal justice implementation scientist by 1) advancing foundational knowledge on CPT implementation within the criminal justice system and effectiveness as treatment for addiction and 2) publishing research on application of implementation science in criminal justice settings.