Models of Campus-based Relapse prevention and student characteristics

描述（由申请人提供）：药物和酒精使用障碍（即，“物质使用障碍”（SUD）从青春期到青年期的三倍，使这一过渡期对SUD的发病和进展至关重要。研究支持需要早期干预，持续监测，支持和持续护理，以尽量减少SUD的持续时间和影响。然而，与成年人不同的是，青年连续护理系统仍然不发达。上大学是财务稳定的关键，但校园内吸毒/酗酒的高流行率，加上这一生命阶段的规范性挑战（新的自由，更少的监督），使大学成为SUD缓解（“恢复”）青年复发的高风险背景。30年前，大学开始了以校园为基础的大学生康复计划（CRP），允许康复学生延长他们对持续护理的参与，而不必推迟或放弃他们的教育目标。CRPs结合了联合收割机清醒的住房，现场同伴支持小组和咨询提供的一个小的工作人员。对校园物质使用的日益关注和联邦机构对建立以社区为基础的青年连续护理系统的关注，在过去十年中推动了CRP的5倍增长，从2000年的4个增加到今天13个州的21个，2011年秋季有8个新的CRP开放。CRP与专家建议的持续护理模式是一致的，特别是与教育部的目标一致，即确保从高中到大学再到毕业后的护理的连续性。CRP站点水平的记录表明有希望的结果，但该模型尚未进行系统的检查。CRP的快速增长强调了对此类服务的需求，但所有独立启动的个别项目可能在可能影响学生成绩的关键方面存在很大差异-例如，药物/酒精使用监测做法、参与要求、服务的全面性。人们日益注意到，CRP标准、正式模式和系统评价的缺乏阻碍了更广泛的采用。教育部最近呼吁对CRP学生的物质使用和学术成果进行前瞻性研究，以告知高等教育系统对恢复学生的反应。因此，现在是对CRPs进行系统和严格评估的时候了。然而，大规模的资源密集型评估还为时过早，因为我们缺乏重要的知识来指导假设驱动研究的规划：需要有关CRPs及其共同元素的多样性，有关CRPs服务的学生，他们特定的复发风险和服务需求的数据。本开发性R21研究旨在通过R 01为全面系统评价提供知识基础准备。利用我们对CRPs的独特访问和我们的研究专长，我们将实现以下发展目标：（1）描述CRPs的多样性（N = 29），以确定随后将进行系统评价的共同要素;（2）描述CRP学生（N = 700）的临床病史，以指导选择合适的对照组，以及他们的CRP经验，具体的复发风险和服务需求，以告知有关CRP元素的基础上的学生在评估研究成果的假设。

DESCRIPTION (provided by applicant): Drug and alcohol use disorders (i.e., 'substance use disorders', SUD) triple from adolescence to young adulthood, making this transitional period critical to SUD onset and progression. Research supports the need for early intervention, ongoing monitoring, support, and continuing care to minimize SUD duration and impact. Yet unlike for adults, the youth continuum of care system remains underdeveloped. College attendance is key to financial stability but the high prevalence of drug/alcohol use on campus, paired with the normative challenges of this life stage (new freedoms, less supervision) make college a high relapse risk context for youths in SUD remission ('in recovery'). Universities started campus-based Collegiate Recovery Programs (CRPs) 30 years ago to allow recovering students to extend their participation in continuing care without having to postpone or surrender their educational goals. CRPs combine sober housing, onsite peer support groups and counseling provided by a small staff. Growing concerns about substance use on campus and federal agencies' focus on building a community-based youth continuum of care system have fueled a 5-fold increase in CRPs in the past decade, from 4 in 2000 to 21 in 13 states today with 8 new CRPs opening in Fall 2011. CRPs are consistent with the continuing care paradigm experts recommend, and notably, with the Department of Education's goal of ensuring a continuity of care from high school to college to post-graduation. CRP site-level records suggest promising outcomes but the model has not been systematically examined. The rapid CRP growth underlines the need for such services but individual programs, all started independently, likely vary greatly on key dimensions that may influence student outcomes - e.g., drug/alcohol use monitoring practices, participation requirements, comprehensiveness of services. The lack of CRP standards, formal model and systematic evaluation are increasingly noted as hindering wider adoption. The Department of Education recently called for prospective studies on CRP students' substance use and academic outcomes to inform the higher education system's response to recovering students. Thus the time has come for a systematic and rigorous evaluation of CRPs. However a large scale resource-intensive evaluation is premature as we lack important knowledge to guide the planning of a hypothesis-driven study: Data are needed about the diversity of CRPs and their common elements, about the students CRPs serve, their specific relapse risks and service needs. This developmental R21 study is designed to provide that knowledgebase preparatory to a full scale systematic evaluation through an R01. Capitalizing on our unique access to CRPs and our research expertise, we will address the following developmental aims: (1) Characterize the diversity of CRPs (N = 29) to identify common elements that will be subsequently subjected to systematic evaluation; (2) Describe CRP students' (N = 700) clinical history to guide the selection of a suitable comparison group, and their CRP experience, specific relapse risks and service needs to inform hypotheses about CRP elements underlying student outcomes in the evaluation study.