Alliance to Disseminate Addiction Prevention and Treatment (ADAPT): A Statewide Learning Health System to Reduce Substance Use among Justice-Involved Youth in Rural Communities.

项目摘要 印第安纳州在药物过量死亡和胡赛尔人滥用阿片类药物和其他风险方面排名全国第13位 物质使用障碍（SUD）不太可能得到必要的服务;印第安纳州-一个主要是农村的州- 在每名成瘾者的行为健康治疗提供者数量上排名第46位。通过靶向 在一个中西部州的农村县，我们的研究团队试图解决其震中的国家阿片类药物危机。 我们还将重点关注阿片类药物相关危害风险最大的人群： 少年司法系统。在被捕的青少年中，78%最近使用过非法药物。我们的研究 YJJ的死亡率是从未被捕过的年轻人的1.5倍， YJJ的死因是吸毒过量我们提出的项目的主要目标，传播成瘾联盟， 预防和治疗（ADAPT）旨在解决YJJ有效SUD治疗的障碍，如 物质使用护理级联。我们将通过创建学习健康（LHS）联盟来实现我们的目标 在印第安纳州的8个农村地区， 个县这些合作的JJ-CMHC伙伴关系将促进SUD风险识别和服务 JJ的连接，并能够及时启动和参与由JJ提供的循证SUD治疗 CMHC。我们采用LHS联盟模式来发展强生和CMHC之间的联盟。我们有 通过实施捆绑治疗方法以改善筛查，最大限度地预防类阿片使用， 资源分配、劳动力发展和循证干预措施，这些措施针对一系列 SUD风险水平。我们假设，ADAPT -LHS联盟和传播的组合， 有针对性的SUD EBI-随着时间的推移，将对SUD和累犯的结果产生积极影响。我们将开始 对这次干预的评价。因此，本附录的目的是收集LHS和EBI的成本数据 扩张.我们将通过完成该项目的主要目标来评估ADAPT的好处。通过 通过收集成本数据，我们还将能够评估这种模式的成本效益，并评估 执行费用。我们将利用我们在实施科学，以社区为基础的研究， 临床试验，成本效益研究，并连接管理数据库，用于研究评估 这些干预措施对犯罪累犯和药物使用结果的影响，包括向阿片剂过渡 吸毒和鸦片过量通过将成本效益和实施模式纳入其中， 我们会继续进行这方面的工作，并将其扩展至其他司法管辖区。

PROJECT SUMMARY Indiana ranks 13th nationally in drug overdose deaths and Hoosiers at risk for opioid misuse and other substance use disorders (SUDs) are unlikely to receive necessary services; Indiana - a largely rural state - ranks 46th in number of behavioral health treatment providers per individuals suffering addictions. By targeting rural counties in a Midwest state, our research team seeks to address the national opioid crisis at its epicenter. We will also focus on a population among those at greatest risk for opioid-related harms: youth involved in the juvenile justice system (YJJ). Among arrested youth, 78% have recently used illicit substances. Our research has shown that YJJ die at 1.5 times the rate of youth who have never been arrested, and a leading cause of YJJ death is drug overdose. The primary goal of our proposed project, Alliances to Disseminate Addiction Prevention and Treatment (ADAPT), is to address barriers to effective SUDs treatment of YJJ as identified by the substance use care cascade. We will accomplish our goal by creating a Learning Health (LHS) alliance between the juvenile justice system (JJ) and community mental health centers (CMHCs) in 8 rural Indiana counties. These collaborative JJ-CMHC partnerships will facilitate SUD risk identification and service connection by JJ and enable timely initiation and engagement in evidence-based SUD treatment provided by CMHCs. We have employed a LHS alliance model to develop alliances between JJ and CMHCs. We have maximized opioid use prevention efforts by implementing a bundled treatment approach to improve screening, resource allocation, workforce development and evidence-based interventions (EBIs) that target a range of SUD risk levels. We hypothesize that ADAPT – a combination of the LHS alliances and dissemination of targeted SUD EBIs – will positively affect SUD and recidivism outcomes over time. We will begin our evaluation of this intervention. Thus, the goal of this supplement is to gather cost data on the LHS and EBI expansion. We will be evaluating the benefit of ADAPT by completing the main aims of this project. By gathering cost data, we will also be able to evaluate the cost effectiveness of this model and evaluate the implementation costs. We will utilize our expertise in implementation science, community-based research, clinical trials, cost-effectiveness research, and linking administrative databases, for research to assess the impact of these interventions on criminal recidivism and substance use outcomes, including transition to opiate use disorders and opiate overdose. By incorporating cost effectiveness and implementation models into this work, we will be well poised to sustain this intervention and expand it to additional jurisdictions.