Preventing Opioid Use Among Justice-Involved Youth as They Transition to Adulthood: Leveraging Safe Adults (LeSA)

防止参与司法的青少年在向成年过渡时使用阿片类药物：利用安全成年人 (LeSA)

基本信息

批准号：
10209094
负责人：
DANICA K KNIGHT
金额：
$ 446.03万
依托单位：
TEXAS CHRISTIAN UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-09-30 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10209094
关键词：
Address Administrator Adolescence Adolescent Adult Aging Alcohol or Other Drugs use Behavior Cessation of life Child Communities Complex Control Groups Criminal Justice Educational Intervention Effectiveness Effectiveness of Interventions Elements Enrollment Ensure Evidence based intervention Extended Family Family Family member Feedback Fentanyl Focus Groups Healthcare Heroin Hospitalization Hybrids Informal Social Control Intervention Investments Justice Manuals Mediating Mental disorders National Institute of Drug Abuse Nomenclature Opioid Outcome Overdose Parents Penetration Phase Populations at Risk Preventive Intervention Process Protocols documentation Public Health Randomized Readiness Rehabilitation Centers Risk Risk Factors Role Safety Secure Structure Subgroup Substance Use Disorder Surveys System Techniques Testing Training Trauma Trust Vehicle crash Vulnerable Populations Work Youth base cognitive reappraisal comparative contextual factors control trial cost cost effectiveness design effectiveness implementation study effectiveness testing emotion regulation empowered experience family support improved innovation juvenile justice system opioid misuse opioid overdose opioid use opioid use disorder prescription opioid misuse prevent recidivism recruit response social social relationships tool trial comparing

项目摘要

Project Summary/Abstract Across the US, substance use (SU) is a significant public health concern. Rates of opioid use disorders have increased exponentially, with 60% of overdoses attributed to heroin and illicit synthetics. Although opioid use among youth is low compared to adults, experimentation and regular use increases later in adolescence as youth transition to adulthood. Juvenile justice (JJ)-involved youth represent a particularly vulnerable population, as they often experience mental health disorders, dysfunctional family/social relationships, and complex trauma, placing them at greater risk for SU and substance use disorders (SUDs). To ensure that these youth do not become another opioid statistic, innovative and effective prevention interventions are needed. We propose to adapt and test an intervention for preventing initiation and/or escalation of opioid misuse among older JJ-involved adolescents. The target enrollment group will be youth aging out of JJ (16-18 years) who are transitioning to their communities after a period of detainment in a secure treatment or correctional facility. Trust-based Relational Intervention® (TBRI®; a relational, attachment-based intervention that promotes emotional regulation through interaction with responsive adults) will be adapted as a prevention intervention targeting youth at risk for SU (especially non-medical use of opioids). Safe adults (e.g., parent/guardian) will be trained in behavior management techniques for empowering youth to appropriately express their needs, connecting them with others in pro-social ways, and correcting or reshaping undesirable behavior. The proposed Effectiveness/Implementation study will be conducted in 3 phases. Phase 1 will adapt elements of TBRI for JJ youth, develop intervention manuals and study protocols, examine the acceptability of the adapted intervention, and test the feasibility of the proposed study protocol (e.g., agency and youth recruitment). Feedback from 15 youth/safe adult dyads will be solicited as part of this phase. Phase 2 will examine both the effectiveness of TBRI for preventing opioid misuse and the comparative utility of three support formats: (1) TBRI Training only, (2) TBRI Training + Structured Coaching, or (3) TBRI Training + Responsive Coaching (triggered by the youth’s need/risk). A total of 360 youth/safe adult dyads will be recruited from 6 participating JJ facilities over a 3-year period, and followed for 18 months post-release (20 youth-adult dyads/year per facility). This design enables a comparison of TBRI versus SRP (using a stepped-wedge design where each facility serves as its own control) plus a randomized control trial comparing 3 TBRI support formats. Phase 3 will examine barriers and facilitators of TBRI sustainment. Sixty JJ staff (10 from each agency) will provide input annually via focus groups and surveys. TCU will work with administrators and staff at each JJ facility to implement a sustainment plan, which will include developing in-house TBRI expertise (i.e., staff training and implementation assistance). Successful completion of study aims will provide a test of the adapted intervention and will facilitate sustainment by providing training and implementation support to participating facilities.

项目摘要/摘要在整个美国，药物使用（SU）是一个重要的公共健康问题。呈指数增长，有60％的过量归因于海洛因和非法合成剂与成年人相比，青年中的年轻人很低，青春期后期的经验和常规使用会增加青年过渡到成年。因为他们经常经历精神健康障碍，功能失调的家庭/社会关系以及复杂创伤，使他们面临更大的SU和药物使用障碍的风险（SUD）。我们不需要另一个阿片类药物统计，创新和有效的预防干预措施提议适应和测试以及国际以防止滥用的启动和/或升级年龄较大的JJ涉及青少年。在安全治疗或矫正设施中被拘留一段时间后，过渡到社区。基于信任的关系干预®（TBRI®；基于关系，基于依恋的干预措施通过与反应迅速成年人的互动来调节情绪调节）将被改编为预防干预针对有SU的年轻人（尤其是非医学使用阿片类药物）。接受了行为管理技术的培训，以使青年能够适当地表达自己的需求，以亲社会方式将它们与他人联系，并纠正或重塑不良行为支撑有效性/实施研究将分为3个阶段。 JJ青年的TBRI，制定干预手册和研究方案，检查适用干预并测试支撑研究方案的可行性（例如代理和青年招聘）。作为此阶段的一部分，将征求15名青年/安全成年二元组的反馈。 TBRI预防阿片类药物滥用和三种支持格式的比较效用的有效性：（1）仅TBRI培训，（2）TBRI培训 +结构化教练，或（3）TBRI培训 +响应式教练（由年轻人的下一个/风险触发）。 JJ设施在3年内，随后释放18个月（20个青年成年二元/年PERS 设施）。设施是自身的控制）加上比较3个TBRI支持格式的随机控制试验将检查TBRI维持的障碍和促进者。每年通过焦点组和调查输入。实施一项维持计划，其中包括开发内部TRI专业知识（即员工培训和和实施帮助）。并通过为参与设施提供培训和实施支持来愿意维持。