Justice Community Opioid Innovation Network (JCOIN): TCU Clinical Research Center

项目摘要/摘要 认识到目前在涉及司法的个人中存在阿片类药物危机，需要在 司法和社区健康的交集，目前的研究建议探索积极的结果 与多层次混合实施方法相关联。这一战略充分利用了 协作(指导)、培训和跨系统数据共享，以努力利用 刑事司法和社区行为健康(CBH)机构间合作。的最终目标是 拟议的项目是改善当地社区的公共卫生和安全结果，以重新进入司法系统- 涉及有阿片类药物使用史(或有使用阿片类药物风险)的个人。我们的具体目标是增加 获得和保留适当的CBH和医疗(MAT)服务，以重新进入司法领域 有阿片类药物使用史或有阿片类药物使用风险的个人，2)改善相关结果(包括成本) 与公共健康和安全有关；3)比较系统级成果的两种实施方法 旨在增加实施和服务成果方面的服务启动和接收；以及4) 审查这两种方法对涉及正义的个人结果的影响。建议进行的研究 审查执行和执行--有效性，试图回答以下问题 实施策略(自下而上与水平级联)对于快速获取证据最为有效- 在司法环境中以实践为基础。这项研究还考察了哪种实施策略是最多的 有效地增加服务联系和启动、服务保留和改善与阿片类药物相关的公众 健康安全结果。将使用混合型3研究设计，主要目的是比较两个 在两个层面(客户和系统)实施战略和两项干预措施，次要目标是 评估与试验相关的客户级别的结果。研究设计将整合两种稳健的方法 (阶梯式楔形和整群随机试验)，将包括18个临床研究绩效站点 (社区)位于德克萨斯州、新墨西哥州和伊利诺伊州。建议的多站点JCOIN CRC应用 包括一个由多名PI、调查人员和合作伙伴组成的经验丰富的团队，并将为 JCOIN网络，努力建立一个由研究有希望的方法的国家调查人员组成的联盟 旨在提高司法系统的能力和能力，以便更有效地处理阿片类药物问题 流行病。

Project Summary/Abstract Recognizing the current opioid crisis among justice-involved individuals and the need to intervene at the intersection of justice and community health, the current study proposes to explore positive outcomes associated with a multi-level hybrid implementation approach. The strategy capitalizes on facilitated collaboration (coaching), training, and cross-system data sharing in an effort to leverage improvements in criminal justice and community behavioral health (CBH) interagency collaboration. The ultimate goal of the proposed project is to improve local community public health and safety outcomes for reentering justice- involved individuals who have a history of (or are at risk for) using opioids. Our specific aims are to 1) increase access to and retention in appropriate CBH and medical (MAT) services for reentering justice-involved individuals who have a history of or are at risk for opioid use, 2) improve outcomes (including costs) associated with public health and safety; 3) compare two implementation approaches on systems-level outcomes designed to increase service initiation and receipt with respect to implementation and service outcomes; and 4) examine the impact of these two approaches on justice-involved individual outcomes. The proposed study examines both Implementation and Implementation-Effectiveness, seeking to answer the questions of which implementation strategy (bottom up versus horizontal cascading) is most effective for rapid uptake of evidence- based practices within justice settings. The study also examines which implementation strategy is most effective for increasing service linkage and initiation, services retention, and improved opioid-related public health safety outcomes. A Hybrid Type 3 study design will be used and include a primary aim to compare two implementation strategies and two interventions at two levels (client and system), and a secondary aim to assess client-level outcomes associated with the trial. The study design will integrate 2 robust methodologies (stepped wedge and cluster randomized trial), and will include 18 clinical research performance sites (communities) located in Texas, New Mexico and Illinois. The proposed multi-site JCOIN CRC application includes a highly experienced team of Multiple PIs, investigators, and partners, and will contribute to the JCOIN network in an effort to establish a national consortium of investigators examining promising approaches designed to improve the capabilities and capacity of the justice system to more effectively address the opioid epidemic.