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

项目概要/摘要 在刑事司法系统内对有效戒毒治疗的需求未得到满足“是一个重大的问题， 根据NIDA的2016-2020战略计划，“这是一个干预高危人群的机会”。该计划 还鼓励制定和评价执行战略， 刑事司法系统。这个指导以患者为导向的研究职业发展奖（K23）将 为申请人准备必要的技能，以启动一个独立的研究计划，重点审查 实施战略，以支持接受基于证据的精神健康干预措施， 物质使用者申请人的培训目标如下：1）发展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措施相关的知识，3）提高技能 这是成功的研究生涯所必需的。这些培训目标将通过以下方式实现： 指导研究和学习，教学和体验式学习，以及密集的外部培训。因为 严重的创伤暴露、物质使用和司法介入在监狱中绝大多数同时发生 人口，申请人的研究计划将旨在推进实施黄金标准的知识 心理治疗创伤，认知加工疗法（CPT），在监狱设置。她还将检查 监狱提供的CPT是否减少了药物使用，精神症状和累犯。的三项具体 本研究的目的是：1）利用形成性评价来识别可能影响实施的因素， （2）使CPT适应被监禁的吸毒者，并制定一个以便利为基础的 实施指南，以支持其吸收，和3）进行参与者随机混合II试验，以评估 对被监禁的吸毒者进行CPT的有效性和实施结果。如果发现有效，广泛- CPT的大规模实施可能会改善170多万被监禁的美国人的健康， 吸毒和创伤暴露 本申请中提出的工作将在阿肯色州医学科学大学进行， 在以下国家专家的指导下，为早期调查人员提供丰富的背景： Drs. JoAnn Kirchner和Geoffrey Curran负责实施科学，Nickolas Zaller博士负责药物使用及其 与刑事司法系统重叠，Debra Kaysen博士负责CPT及其在低资源环境中的适应 环境和物质使用者。最后，申请人将朝着她的目标取得进展， 通过1）推进CPT的基础知识，成为刑事司法实施科学家 在刑事司法系统内的实施和作为吸毒治疗的有效性，以及2）出版 研究执行科学在刑事司法环境中的应用。

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.