Characterization and evaluation of addiction recovery community centers

描述（由申请人提供）：酒精和其他药物使用障碍的慢性复发性质产生了持续护理模式，类似于初级保健机构中看到的长期疾病管理模式，如糖尿病和高血压。在过去十年中，为了支持对成瘾的康复管理，出现了一系列康复支持服务，包括康复社区组织（rco）和康复社区中心（rcc），其目的是提供切实的社区康复支持，以维持缓解，帮助建立康复资本和提高生活质量。在全国范围内，有80多个rcc，在美国新英格兰地区，这些rcc的密度很高（k=34）。尽管这些中心日益增长，越来越受欢迎，并得到市、州和联邦机构的支持，但人们对这些中心提供的服务的类型、性质和范围、服务对象、服务时间和效果知之甚少。这项研究的最终目的是评估在美国社区提供rcc的临床和公共卫生效果以及成本效益。作为第一步，这项探索性/发展性R21调查有三个相互关联的目标：1)使用标准化措施系统地表征rcc，以帮助跨中心和州的交叉比较；2)进行横断面调查，以描述当前RCC客户的特征（NH 510），并评估对RCC的看法和经验；3)对RCC模型进行概念验证调查，从影响最大/质量最高的RCC （k H 5）的子组中跟踪新客户样本（N=300），为期3个月，以评估客户的利用率/终止率，并测试RCC模型的有效性

DESCRIPTION (provided by applicant): The chronic relapsing nature of alcohol and other drug use disorders has given rise to models of continuing care that are analogous to the long-term disease management models seen in primary care settings, such as for diabetes and hypertension. During the past ten years, in order to support recovery management in addiction, an array of recovery support services have emerged including recovery community organizations (RCOs) and recovery community centers (RCCs) with the aim of providing tangible community-based recovery support that will sustain remission and help build recovery capital and enhance quality of life. Nationally, there are more than 80 RCCs with a high density of these evident in the New England region of the United States (k=34). Despite their increasing growth, popularity, and support from city, state, and federal agencies, very little is known regarding the types, nature, and scope of services such centers provide, to whom they are provided, over what period, and to what effect. The ultimate aim of this proposed line of investigation is to evaluate the clinical and public health effects and cost-effectiveness of providing RCCs in US communities. As a first step, this exploratory/ developmental R21 investigation has three linked aims: 1) To systematically characterize RCCs using standardized measures to aid cross-comparison across centers and states; 2) Administer a cross-sectional survey to characterize current RCC clients (NH 510) and assess perceptions of and experiences with RCCs; and 3) Conduct a proof- of-concept investigation of the RCC model by following a sample of new clients (N=300) from a sub-group of the highest impact/quality RCCs (k H 5)over a 3 month period to assess clients' utilization/discontinuation rates, and test for the effects of RCC utilization on abstinence and remission and the accrual of recovery capital and enhanced quality of life. Controlling for baseline predictors of outcomes (e.g., addiction severity recovery motivation, psychiatric symptoms) we will estimate the effects of frequency of RCC use on outcomes using mixed model analyses. If this initial exploratory/developmental study finds evidence of recovery benefits for individuals using the best RCCs, it would provide preliminary validation of the RCC concept. This would then lay the foundations for further experimental research efforts to determine the extent to which addiction treatment, criminal justice, social welfare and other agencies might facilitate linkage with RCCs and whether and how such linkage ultimately helps sustain recovery and prevent costly re-hospitalizations and re-incarceration.