Family Engagement, Cross-System Linkage to SU treatment for Juvenile Probationers

 描述（由申请人提供）：青少年司法系统（JJS）中涉及的青少年比一般人群（25%-50%对10%）有更高的物质使用/障碍（SU/D）率。由于个人/家庭和系统层面的障碍，超过一半的JJS青年没有接受SU服务;然而，很少有基于证据的服务提供模式解决治疗的多层次障碍。该项目建议增加一个基于证据的联系方案的协议，为青年缓刑，解决障碍，在系统层面（项目ECOECT）与那些有效的基于证据的参与战略，帮助供应商与家庭合作，以增加获得护理（TIES）的方案。这将创建一个在试用环境中实施的新的服务提供模式，以家庭和系统层面的因素为目标，以增加青年对SU服务的使用和保留。由于培训缓刑官员（PO）提供新的家庭参与战略目前不是他们的角色的一部分，并可能与缓刑环境不一致，可能会损害采用和可持续性，我们将使用嵌入式链接专家，以协助PO改善服务联系/吸收。 拟定的主要研究者是一名早期研究者，在纽约州（NYS）的试用环境中具有丰富的工作经验，并得到强大的多学科高级研究人员团队的支持，以实现研究目标。在纽约州的两个县开展工作，具体目标是：（1）通过调整TIES家庭参与战略，加强儿童健康教育和培训方案的筛查/转诊跨系统联系协议，为青年创造一个创新的服务提供模式（2）在50个家庭的试点测试中，研究家庭干预措施对改善跨系统转诊、青年和家庭参与的影响;青年入组/保留在SU治疗;和（次要结果）对青年SU和累犯的影响;和（3）阐明家庭和组织层面的因素，影响在缓刑环境中实施家庭治疗，为更大的试验提供信息。我们建议进行两阶段研究。第一阶段：服务模式适应（目标1），将涉及（a）与n=24名缓刑青少年及其照顾者、n=5名缓刑部门工作人员和n=5名药物滥用治疗计划工作人员进行深入访谈，以了解多层次的促进者和使用服务的障碍，以及B）适应 通过青年/照顾者和工作人员工作组的形成性工作了解家庭教育。在第2阶段：试点测试和实施评估（目标2和3），我们将试点测试家庭ECOECT与n=50的青少年照顾者的二人组，随机在PO的家庭ECOECT或护理标准的水平，探索家庭，员工和组织层面的因素影响的可行性，可接受性和潜在的可持续性的程序在试用设置。由于SU/D的治疗可以降低累犯率和其他不良后果，因此JJS青年对SU服务的联系和吸收的关注对公共卫生和惩教卫生至关重要。

 DESCRIPTION (provided by applicant): Youth involved in the Juvenile Justice System (JJS) have higher rates of substance use/disorder (SU/D) than those in the general population (25%-50% vs. 10%). Well over half of JJS youth do not receive SU services due to barriers at individual/family-, and system-levels; yet, few evidence-based service delivery models address multilevel barriers to treatment. This project proposes to augment the protocols of an evidence-based linkage program for youth on probation that addresses barriers at the systems level (Project CONNECT) with those of an efficacious program of evidence-based engagement strategies that help providers work with families to increase access to care (TIES). This will create a new service delivery model implemented in probation settings that targets both family and system-level factors to increase youth's use of and retention in SU services. Because training probation officers (POs) to deliver new family engagement strategies not currently part of their roles and potentially at odds with the probation context may compromise adoption and sustainability, we will use embedded Linkage Specialists to assist POs in improving service linkage/uptake. The proposed Principal Investigator is an Early Stage Investigator with significant experience working within probation settings in New York State (NYS) and is supported by a strong multi-disciplinary team of senior researchers to achieve the study aims. Working in two NYS counties, specific aims are (1) to augment CONNECT cross-system linkage protocols for screening/referral with adapted TIES family engagement strategies to create an innovative service delivery model for youth (Family CONNECT) implemented in probation settings; (2) to examine, in a pilot-test with n=50 families, the impact of Family CONNECT on improving cross-system referral; youth and family engagement; youth enrollment/retention in SU treatment; and (secondary outcomes) effect on youth SU and recidivism; and (3) to elucidate family and organizational- level factors that influence Family CONNECT implementation in probation settings to inform a larger trial. We propose a two-phase study. Phase 1: Service Model Adaptation (Aim1), will involve (a) in-depth interviews with n=24 adolescents on probation and their caregivers; n=5 probation department staff; and n=5 substance abuse treatment program staff to understand multi-level facilitators and barriers to service use and b) adaption of Family CONNECT, informed by formative work, in youth/caregiver and staff work groups. In Phase 2: Pilot Test and Implementation Evaluation (Aims 2 and 3), we will pilot test Family CONNECT with n=50 youth-caregiver dyads, randomized at the level of PO to Family CONNECT or standard of care to explore family-, staff-, and organizational-level factors influencing feasibility, acceptability, and potential sustainability of the program in probation settings. Because treatment of SU/D can reduce rates of recidivism and other poor outcomes, a focus on linkage and uptake of SU services by JJS youth is paramount to public as well as correctional health.