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

项目概要/摘要 认识到目前在涉及司法的个人中存在类阿片危机，需要在适当时候进行干预， 司法和社区健康的交叉点，目前的研究建议探索积极的成果 与多级混合实施方法相关联。该战略利用便利的 协作（辅导）、培训和跨系统数据共享，以利用 刑事司法和社区行为健康（CBH）机构间合作。的最终目标 拟议的项目是改善当地社区的公共卫生和安全成果，以重新进入司法- 涉及有使用阿片类药物史（或有使用阿片类药物风险）的个人。我们的具体目标是：（1）增加 获得和保留适当的CBH和医疗（MAT）服务，以重新进入司法所涉及的 有阿片类药物使用史或有阿片类药物使用风险的个体，2）改善相关结局（包括成本） 与公共健康和安全; 3）比较两种实施方法的系统级结果 旨在增加服务的启动和接收，以实现和服务成果;以及4） 研究这两种方法对涉及正义的个人结果的影响。拟定研究 审查实施和实施效果，寻求回答的问题， 实施战略（自下而上相对于横向级联）对于快速获取证据最为有效- 在司法实践中。该研究还探讨了哪种实施战略最 有效地增加服务联系和启动，服务保留，并改善阿片类药物相关的公众 健康安全成果。将使用混合3型研究设计，主要目的是比较两种 实施战略和两个层面（客户和系统）的两项干预措施，以及一个次要目标， 评估与试验相关的客户层面结局。研究设计将整合2种稳健的方法 （阶梯式楔形和群集随机试验），并将包括18个临床研究绩效研究中心 位于德克萨斯州、新墨西哥州和伊利诺斯州的（社区）。建议的多站点JCOIN CRC应用程序 包括由多名PI、研究者和合作伙伴组成的经验丰富的团队，并将为 JCOIN网络，努力建立一个全国调查人员联盟，审查有前途的方法 旨在提高司法系统的能力，以更有效地解决阿片类药物问题， 疫情

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.