Leveraging Implementation Science to Increase Access to Trauma Treatment for Incarcerated Drug Users

项目摘要/摘要 来自父母补助金：刑事司法系统内对有效成瘾治疗的未得到满足的需求 根据美国国家开发协会2016-2020年的报告，“这是对高危人群进行干预的一个重要机会” 战略规划。该计划还鼓励制定和评估执行战略，以 解决刑事司法系统的需要。指导了以患者为中心的研究生涯 发展奖(K23)将为申请者准备必要的技能，以启动独立 研究计划的重点是检查支持采用循证证据的实施战略 监禁药物使用者的心理健康干预。申请者的培训目标如下：1) 发展实施科学研究方法方面的专门知识，2)增加与以下方面相关的知识 对药物使用者的干预，以及3)提高成功研究事业所需的技能。这些 培训目标将通过辅导性研究和学习相结合、授课和 体验式学习和强化的外部培训。因为严重的创伤暴露，药物使用，以及 司法介入在监狱人口中占压倒性多数，申请者的研究计划将旨在 关于实施创伤、认知加工的黄金标准心理治疗的高级知识 治疗(CPT)，在监狱环境中。她还将审查监狱交付的CPT是否减少了毒品使用， 精神症状和累犯。本研究的三个具体目的是：1)使用形成性评价 确定可能影响监狱实施和采用CPT的因素，2)使CPT适用于 监禁吸毒者，并制定以便利为基础的实施指南，以支持吸食吸毒者；以及3) 进行参与者随机混合II试验，以评估CPT的有效性和实施结果 和被监禁的吸毒者。如果发现是有效的，大范围实施CPT可能会改善 超过170万被监禁的美国人的健康，这些人同时使用药物和接触创伤。 本申请书中建议的工作将在阿肯色大学医学科学分校进行 在下列国家专家的指导下，为早期调查人员提供丰富的背景知识： 乔安·基什内尔博士和杰弗里·柯伦博士负责实施科学，尼科拉斯·扎勒博士负责药物使用及其 与刑事司法系统重叠，Debra Kaysen博士为CPT及其在低资源环境下的适应 上下文和物质用户之间的关系。在结束时，申请者将朝着她的目标前进 通过以下方式成为刑事司法实施科学家：1)提高刑事司法实施的基础知识 在刑事司法系统内的执行情况和作为治疗成瘾的有效性和2)出版 实施科学在刑事司法环境中的应用研究。

Project Summary/Abstract From the parent grant: The unmet need for effective addiction treatment within the criminal justice system “represents a significant opportunity to intervene with a high-risk population” according to NIDA’s 2016-2020 strategic plan. The plan also encourages the development and evaluation of implementation strategies that address the needs of the criminal justice system. This Mentored Patient-Oriented Research Career Development Award (K23) will prepare the applicant with the skills necessary to launch an independent research program focused on examining implementation strategies to support the uptake of evidence-based mental health interventions for incarcerated substance users. The applicant’s training goals are as follows: 1) develop expertise in implementation science research methods, 2) increase knowledge relevant to interventions for substance users, and 3) enhance skills necessary for a successful research career. These training goals will be achieved through a combination of mentored research and study, didactic and experiential learning, and intensive externship training. Because severe trauma exposure, substance use, and justice-involvement overwhelmingly co-occur in prison populations, the applicant’s research plan will aim to advance knowledge on implementation of a gold-standard psychotherapy for trauma, Cognitive Processing Therapy (CPT), in the prison setting. She will also examine whether prison-delivered CPT reduces drug use, psychiatric symptoms, and recidivism. The three specific aims in this research are: 1) Use formative evaluation to identify factors that may influence implementation and uptake of CPT in prisons, 2) Adapt CPT for incarcerated drug users and develop a facilitation-based implementation guide to support its uptake, and 3) conduct a participant-randomized Hybrid II trial to assess effectiveness and implementation outcomes of CPT with incarcerated drug users. If found to be effective, wide-scale implementation of CPT may improve the health of over 1.7 million incarcerated Americans who have co-occurring substance use and trauma exposure. The work proposed in this application will be conducted at the University of Arkansas for Medical Sciences, a rich context for early stage investigators, under the guidance of mentoring from the following national experts: Drs. JoAnn Kirchner and Geoffrey Curran for implementation science, Dr. Nickolas Zaller for drug use and its overlap with the criminal justice system, and Dr. Debra Kaysen for CPT and its adaptation in low-resource contexts and with substance users. At its conclusion, the applicant will have progressed toward her goal of becoming a criminal justice implementation scientist by 1) advancing foundational knowledge on CPT implementation within the criminal justice system and effectiveness as treatment for addiction and 2) publishing research on application of implementation science in criminal justice settings.