Quality of Care in the Therapeutic Community

描述：(申请人提供) 治疗社区内的护理质量是一项创新的研究 主题，这一主题构成了重大挑战，因为 治疗社区中的治疗过程。这项研究的目标是 改善治疗社区的护理质量，并将实现 通过三个具体目标：目标1--提炼和收集有效性证据 一种客户级治疗社区治疗过程监控仪 A.)评估测量模型和项目性能的不变性 特定客户亚群(即成人与青少年；男性与 女性；社区与监狱)和管理模式(即，纸张和 铅笔VS计算机化)，b.)创建流程的简化版本 保持完整性和测量精度的监测仪器 原始乐器，c.)检查对以下问题的响应之间的关联 修改后的过程监控工具和客户的方案评估 治疗进度(治疗和治疗阶段的时间)，控制 客户案例组合；目标2-验证改进的过程监控仪器 通过检查客户反应的变化作为治疗过程的一种衡量标准 随着时间的推移，以及客户响应和 1)特定的近端和远端客户结果(例如，治疗保留和 节制)和2)计划活动和环境，为客户控制 病例组合；目标3-检查治疗社区计划如何利用 中来自客户端级进程监视仪器的信息 持续质量改进框架，旨在实现增量 在提供的护理质量和随后的客户结果方面有所改善。 这项研究将与凤凰屋项目和治疗客户一起进行 在全国范围内，都准备好加强我们对治疗的理解 在护理质量框架内的社区治疗过程，并 展示实施持续质量改进的有前景的模式 治疗社区和其他药物滥用治疗的方法 程序。

DESCRIPTION: (provided by applicant) Quality of care within the therapeutic community is an innovative research topic, and one that poses significant challenges given the complexity of treatment process in the therapeutic community. The goal of this study is to improve quality of care in the therapeutic community and will be achieved through three Specific Aims: Aim 1 - To refine and gather validity evidence for a client-level therapeutic community treatment process monitoring instrument by a.) evaluating measurement model and item performance invariance across specific client sub-populations (i.e., adults vs. adolescents; males vs. females; community vs. prison) and modes of administration (i.e., paper and pencil vs. computerized), b.) creating a shortened version of the process monitoring instrument that maintains the integrity and measurement precision of the original instrument, c.) examining the association between responses to the revised process monitoring instrument and program assessment of client treatment progress (time in treatment and treatment phase), controlling for client case-mix; Aim 2 - To validate the refined process monitoring instrument as a measure of treatment process by examining the change in client responses to the instrument over time, and the association between client responses and 1) specific proximal and distal client outcomes (e.g., treatment retention and abstinence) and 2) program activities and environment, controlling for client case-mix; Aim 3 - To examine how therapeutic community programs make use of information from a client-level process monitoring instrument within a continuous quality improvement framework that is designed to make incremental improvements in the quality of care provided and in subsequent client outcomes. This study, to be conducted with Phoenix House programs and treatment clients across the nation, is well-poised to enhance our understanding of therapeutic community treatment process within a quality of care framework and to demonstrate a promising model for implementing Continuous Quality Improvement approaches in therapeutic community and other substance abuse treatment programs.