Evaluating an ACEs-Targeting Advocate Model of a Substance Use Prevention Program

项目摘要/摘要 早期接触不良童年经历(ACE)，如父母使用药物，会增加 未来物质使用和药物过量的可能性，导致物质的代际循环- 相关的王牌，如果不中断，可以无限期地继续。社区层面的干预措施可能会缓和 通过提供一系列家庭支持服务和药物使用之间的关系 治疗，以缩小差距，改善社区的覆盖范围和服务联系。虽然 研究表明，有效地降低ACE和药物使用的患病率和影响 需要同时解决家庭和社区层面的因素，但在 与有效结合这两个因素以防止药物使用的干预措施有关的证据基础 还有王牌。国际RTI及其现有合作伙伴、新泽西州预防网络和 RWJ Barnabas Health将评估一项干预措施，该干预措施整合了新泽西州既定的、基于证据的 加强家庭计划(SFP)，由受过临床培训、了解创伤情况的家庭倡导者(FA) 将帮助家庭获取社区资源。具体地说，这项研究将使用混合类型1 有效性-新泽西州20个社区经历了不成比例的实施设计 药物使用负担和ACE以实现研究目标：对 在社区内实施的预防方法，包括努力减轻 ACEs暴露的危害和防止未来的ACEs，同时旨在防止物质使用和 服药过量。本研究有三个目的：(1)采用整群随机对照试验检验 SFP+FA对10个社区的药物使用、过量用药和ACE的干预 10个社区；(2)在综合框架的指导下进行强有力的进程评估 开展实施研究，以探索实施障碍和促进者；以及(3)进行成本评估 评估以准确估计实施SFP和SFP+FA所需的成本，并评估成本- 相对于单独使用SFP，SFP+FA的有效性。调查结果将提供最佳帮助方式的路线图 受影响不成比例的社区防止药物使用、过量用药和Ace。

PROJECT SUMMARY/ABSTRACT Early exposure to Adverse Childhood Experiences (ACEs), such as parental substance use, increases the likelihood of future substance use and drug overdose, resulting in an intergenerational cycle of substance- related ACEs that can continue indefinitely if left uninterrupted. Community-level interventions may moderate the relationship between ACEs and substance use by providing an array of family support services and treatments to reduce disparities and improve reach and service linkages in the community. Although research suggests that effectively decreasing the prevalence and impact of ACEs and substance use requires addressing both family- and community-level factors in tandem, there is a critical gap within the evidence base pertaining to interventions that effectively integrate the two factors to prevent substance use and ACEs. RTI International and its established partners, the New Jersey Prevention Network and RWJBarnabas Health, will evaluate an intervention integrating New Jersey’s established, evidence-based Strengthening Families Program (SFP) with clinically trained, trauma-informed Family Advocates (FAs) who will assist families in accessing community resources. Specifically, this study will use a Hybrid Type 1 effectiveness-implementation design across 20 New Jersey communities experiencing a disproportionate burden of substance use and ACEs to address the Research Objective: Conduct rigorous evaluations of prevention approaches implemented within communities that incorporate efforts to mitigate the harms of ACEs exposure and prevent future ACEs, while aiming to prevent substance use and overdose. The study has three aims: (1) use a cluster randomized controlled trial to test effectiveness of the SFP+FA intervention on substance use, overdose, and ACEs in 10 communities compared with SFP only in 10 communities; (2) conduct a robust process evaluation informed by the Consolidated Framework for Implementation Research to explore implementation barriers and facilitators; and (3) conduct a cost evaluation to accurately estimate the costs required to implement SFP and SFP+FA and assess the cost- effectiveness of SFP+FA relative to SFP alone. Findings will provide a roadmap about the best ways to help disproportionately affected communities prevent substance use, overdose, and ACEs.