Organizational and Environmental Factors Influencing the Implementation of Evidence Based Practices in Juvenile Justice Settings

项目摘要/摘要 药物使用、艾滋病毒危险行为和犯罪活动给青少年司法带来了许多挑战。 系统。解决未得到满足的物质使用障碍(SUD)和精神健康需求是高度优先事项之一 涉及司法的青少年群体需要在青少年司法和行为健康之间作出协调努力 机构支持基于证据的筛查、评估、转诊和与护理的联系。这是协调的 对于大多数青少年司法和行为健康机构来说，这种方法是不熟悉的，这些机构传统上是 缓刑/监测和物质使用/保健服务的提供分开。这种脱节的一部分可能 是出于对少年司法所需额外资源的财政关切，以及 行为健康机构，以确保青少年获得建议的循证服务。 这种脱节的第二部分可能与更广泛的背景有关，即青少年如何有效和高效地 司法系统能够与行为健康系统相结合。很少有研究检查过 改善行为健康服务交付的组织、环境和其他系统障碍 少年司法环境。为了解决这一知识差距，这项提议利用了一个独特的机会 与少年司法合作--法律系统中对青少年干预的翻译研究(JJ- 试验)，这是一个由国家药物滥用研究所资助的多地点合作研究倡议。JJ- 试验研究方案包括两个随机分配的实施干预措施，核心和增强， 重点是改善筛查、评估、转诊和与行为健康服务的联系 在青少年司法青少年中患有SUD。为了扩大JJ-Trials的研究影响，目前的提案 寻求资金，以研究环境和组织特征的变化-除了 与实施核心和强化干预措施相关的因素--影响行为健康服务 不同青少年司法和行为健康的利用和结果(如累犯、药物使用) 设置。目标1是开发一个重叠的系统分析框架，以确定组织和 与SUD循证实践的吸收和渗透相关的环境因素 在不同的青少年司法环境中。目标2是分析系统因素的边际影响， 除了对核心或增强型实施干预措施进行随机化外，还对行为健康 服务利用和青年成果。拟议的研究结果将提供第一个 关于资金、执行资源、机构的作用的多系统和多机构观点 特点，以及促进采用以证据为基础的做法的其他关键因素 司法中的其他危险行为涉及青少年。

PROJECT SUMMARY/ABSTRACT Substance use, HIV risk behaviors, and criminal activity have created numerous challenges for juvenile justice systems. Addressing unmet substance use disorder (SUD) and mental health needs among the high priority population of justice-involved youth requires a coordinated effort between juvenile justice and behavioral health agencies to support evidence based screening, assessment, referral, and linkage to care. This coordinated approach is unfamiliar to most juvenile justice and behavioral health agencies that traditionally operate as separate silos of probation/monitoring and substance use/health services delivery. Part of this disconnect may be the result of financial concerns regarding the additional resources required by juvenile justice and behavioral health agencies to ensure youth receive the recommended continuum of evidence based services. A second part of this disconnect may relate to the broader context of how effectively and efficiently the juvenile justice system is able to integrate with the behavioral health system. Few studies have examined organizational, environmental, and other system barriers to improved behavioral health services delivery in juvenile justice settings. To address this knowledge gap, this proposal takes advantage of a unique opportunity to work with Juvenile Justice -Translational Research on Interventions for Adolescents in the Legal System (JJ- TRIALS), a multisite cooperative research initiative funded by the National Institute on Drug Abuse. The JJ- TRIALS research protocol features two randomly assigned implementation interventions, Core and Enhanced, which are focused on improving screening, assessment, referral, and linkage to behavioral health services among juvenile justice youth with SUD. To broaden the research impact of JJ-TRIALS, the current proposal seeks funding to examine how the variation in environmental and organizational characteristics – in addition to factors associated with implementing the Core and Enhanced interventions – impact behavioral health services utilization and outcomes (e.g. recidivism, substance use) across different juvenile justice and behavioral health settings. Aim 1 is to develop an overlapping systems analysis framework to identify organizational and environmental factors associated with uptake and penetration of evidence based practices for SUD among diverse juvenile justice settings. Aim 2 is to analyze the marginal impact of system factors, in addition to randomization to Core or Enhanced implementation interventions, on behavioral health services utilization and youth outcomes. The results of the proposed research will provide the first multisystem and multiagency perspective on the role of funding, implementation resources, agency characteristics, and other key factors in facilitating the adoption of evidence based practices targeting SUD and other risky behaviors among justice involved youth.