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(即药物使用障碍，SUD)是从青春期到青年成年期的三倍，这使得这一过渡期对SUD的发生和发展至关重要。研究支持早期干预、持续监测、支持和持续护理的必要性，以最大限度地减少SUD持续时间和影响。然而，与成年人不同的是，青年连续照护系统仍然不发达。上大学是经济稳定的关键，但校园内吸毒/酗酒的高流行率，再加上这一人生阶段的规范性挑战(新的自由，较少的监管)，使得大学对于处于SUD缓解期(处于恢复期)的年轻人来说是一个高复发风险环境。大学在30年前启动了基于校园的大学生康复计划(CRPS)，允许康复学生延长他们参与持续护理的时间，而不必推迟或放弃他们的教育目标。CRP将戒酒住房、现场同伴支持小组和由一小部分工作人员提供的咨询结合在一起。对校园物质使用的日益担忧以及联邦机构对建立以社区为基础的青少年连续护理体系的关注在过去十年中推动了CRP的5倍增长，从2000年的4个增加到今天的13个州的21个，8个新的CRP将于2011年秋季开业。CRP符合专家建议的持续护理模式，特别是符合教育部确保从高中到大学再到毕业后护理的连续性的目标。CRP现场水平的记录显示了有希望的结果，但该模型尚未得到系统检验。CRP的快速增长突显了对此类服务的需求，但各个独立启动的项目在可能影响学生成绩的关键方面可能存在很大差异--例如，药物/酒精使用监测做法、参与要求、服务的全面性。人们越来越注意到，缺乏CRP标准、正式模式和系统评估阻碍了更广泛的采用。教育部最近呼吁对CRP学生的药物使用和学业成绩进行前瞻性研究，以了解高等教育系统对康复学生的反应。因此，现在是对合作伙伴关系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以假设为导向的研究的规划：需要关于CRP的多样性及其共同要素的数据，关于CRP服务的学生，他们特定的复发风险和服务需求的数据。这项发展性R21研究旨在为通过R01进行全面系统评估提供知识库。利用我们获得CRP的独特途径和我们的研究专长，我们将实现以下发展目标：(1)描述CRP(N=29)的多样性，以确定随后将接受系统评估的共同因素；(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、特定的复发风险和服务需求，以向假设提供关于评估研究中潜在的CRP元素的信息。 公共卫生相关性：确定有效的战略，帮助年轻人预防复发和促进康复，对他们的未来以及国家的健康和经济至关重要。大学教育是经济稳定的关键，但对于正在从药物/酒精使用障碍中得到缓解的年轻人来说，大学是对康复的严重威胁，因为校园里的药物使用水平很高。这项发展性研究将收集数据，为对大学康复计划进行严格的假设驱动评估奠定基础。大学恢复计划是一种创新的、日益流行的基于校园的复发预防方法，正在引起大学和联邦机构的高度兴趣，但尚未经过实证检验。

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. PUBLIC HEALTH RELEVANCE: Identifying effective strategies to help prevent relapse and promote recovery among young people is critical to their future and to the nation's health and economy. A college education is key to economic stability but for young people in remission ('recovery') from a drug/alcohol use disorder, college represents a serious threat to recovery because of high levels of substance use on campus. This developmental study will collect data to lay the groundwork for a rigorous hypothesis-driven evaluation of Collegiate Recovery Programs, an innovative and increasingly prevalent campus based relapse prevention approach that is generating high interest among universities and federal agencies but has not been empirically examined.