Preventing Parental Opioid and/or Methamphetamine Addiction within DHS-Involved Families: FAIR

预防国土安全部相关家庭中父母阿片类药物和/或甲基苯丙胺成瘾：FAIR

• 批准号: 10208316
• 负责人: Lisa Saldana
• 金额: $ 332.32万
• 依托单位: OREGON SOCIAL LEARNING CENTER, INC.
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-30 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10208316
• 关键词: Accounting; Address; Adopted; Adoption; Affect; Age; Alcohol or Other Drugs use; Ambulatory Care; Amphetamines; Behavior; Case Management; Charge; Child; Child Abuse and Neglect; Child Rearing; Child Welfare; Collaborations; Country; County; Development; Disease; Drug abuse; Effectiveness; Environment; Family; Family Relationship; Future; Goals; Health Services Accessibility; Home environment; Housing; Human; Hybrids; Incentives; Intervention; Laws; Leadership; Medicaid; Mental Health; Mental Health Services; Methamphetamine; Methamphetamine dependence; Methods; Opiate Addiction; Opioid; Oregon; Outcome; Overdose; Parents; Phase; Policies; Prevention; Prevention program; Preventive; Process; Protocols documentation; Public Health; Randomized; Randomized Clinical Trials; Resources; Risk; Risk Factors; Science; Series; Services; Statutes and Laws; Stream; Substance Use Disorder; Substance abuse problem; System; Testing; Time; Work; aged; base; care systems; child services; cost; design; effectiveness clinical trial; effectiveness evaluation; effectiveness testing; effectiveness trial; experience; falls; foster care; health economics; high risk; implementation science; improved; intervention cost; meetings; methamphetamine use; opioid abuse; opioid use; prevent; prevention service; programs; recruit; response; rural counties; scale up; skills; skills training; therapy development; treatment program

PROJECT SUMMARY/ABSTRACT Over the last 5 years, many states across the country have experienced an increase in children involved in the foster care system as a result of young parental opioid and methamphetamine misuse and disorder. In 2017, the child welfare system received 4.1 million referrals for approximately 7.5 million children, with parental drug abuse and child neglect accounting for the large majority of cases. This is particularly true in Oregon, where over 55% of cases involve parents under the age of 30, and over 60% of cases in the foster care system are associated with parental drug abuse. The Families Actively Improving Relationships (FAIR) program is a recently developed, rigorously evaluated, intensive outpatient treatment program for parents involved in the child welfare system for parental opioid and/or amphetamine type substance use disorder–methamphetamine (OUD; MUD). Outcomes from the FAIR effectiveness trial suggest the potential for FAIR to be adapted as a prevention program for parents involved with child welfare and self-sufficiency systems, and to be implemented in counties with low service availability and access. This UG3/UH3 exploratory-developmental phased project dedicates a year of activities toward collaborating with Oregon state Department of Human Services (DHS) partners and leadership to develop a plan for adaptation, recruitment, and implementation of FAIR for prevention. During the UG3 phase, the investigative team—with expertise in intervention development and clinical effectiveness trials, implementation science, decision science, health economics, and including DHS leadership—will work in collaboration with the Coordinating Center to (UG3 Aim 1) Develop strategies to identify, reach, and engage parents involved in the DHS system, aged 16 to 30, who are at-risk for escalation of misuse or development of OUD and/or MUD; and (UG3 Aim 2) Develop and adapt FAIR to prevent initiation of opioid and/or methamphetamine misuse and escalation to disorder. Following the completion of a set of concrete milestones during the first year, the UGH phase of the project will conduct a Hybrid I randomized clinical trial, to evaluate the adapted FAIR program and its implementation. Across two counties, parents referred by DHS for opioid or methamphetamine use or misuse with risk for escalation (n = 240), will be recruited and followed longitudinally for 24 months. Parents will be randomized to receive the adapted FAIR as prevention, or standard case management and referral (STAND). Overarching goals of this phase are to test the effectiveness of the adaptations designed in the UG3 phase and to build upon state collaborations— specifically, to: (UH3 Aim 1) Evaluate the effectiveness of FAIR in preventing DHS-involved parents, aged 16 to 30, from initiating misuse or escalating opioid and/or methamphetamine use; (UH3 Aim 2) Examine and assess the implementation of FAIR in the county-driven DHS system to inform sustainability plans; and (UH3 Aim 3) Assess the implementation and intervention costs associated with the adoption of FAIR. Outcomes from this project will inform further refinement of protocols and the potential for broader scale-up of FAIR.

项目摘要/摘要 在过去的五年中，全国许多州的儿童参与了 寄养系统是由于年轻的父母阿片类药物和甲基苯丙胺的失误和混乱而导致的。 2017年， 儿童福利系统接受了约750万儿童的410万转介，并接受了父母毒品 虐待和儿童忽视了大部分案件。在俄勒冈州尤其如此 超过55％的案件涉及30岁以下的父母，寄养系统中有60％以上的病例是 与父母滥用药物有关。家庭积极改善关系（公平）计划是一个 最近开发的，严格评估，密集的门诊治疗计划，针对参与的父母 父母阿片类药物和/或苯丙胺型药物使用障碍 - 甲基苯丙胺的儿童福利系统 （Oud;泥）。公平效率试验的结果表明，公平有可能被改编为 针对与儿童福利和自给自足系统有关的父母的预防计划，并要实施 在服务可用性低和访问的县中。这个UG3/UH3探索性开发项目 将一年的活动致力于与俄勒冈州人类服务部（DHS）合作 合作伙伴和领导层制定适应，招聘和实施公平计划的计划 预防。在UG3阶段，调查小组 - 具有干预开发方面的专业知识和 临床有效性试验，实施科学，决策科学，健康经济学以及包括DHS 领导 - 将与协调中心合作（UG3 AIM 1）制定策略 识别，与16至30岁的DHS系统的父母识别，接触并聘请父母，他们处于升级状态 小姐或开发Oud和/或泥浆； （UG3 AIM 2）开发和适应公平以防止启动 阿片类药物和/或甲基苯丙胺的失误和升级为无序。完成一组 在第一年的具体里程碑，该项目的UGH阶段将进行混合I 临床试验，以评估改编的公平计划及其实施。在两个县，父母 由DHS转诊用于阿片类药物或甲基苯丙胺的使用或MISSIDE或MISSUSE升级的风险（n = 240）将为 招募并纵向24个月。父母将被随机接受适应的公平 预防或标准案例管理和推荐（展位）。此阶段的总体目标是测试 在UG3阶段设计的改编的有效性，并以国家合作为基础 具体而言，要：（UH3 AIM 1）评估公平在防止DHS涉及父母的有效性，年龄16岁 到30，从开始滥用或升级阿片类药物和/或甲基苯丙胺的使用； （UH3 AIM 2）检查和 评估在县驱动的国土发展部系统中的公平实施，以告知可持续性计划； （UH3） 目标3）评估与采用公平相关的实施和干预成本。结果 该项目将为协议的进一步改进和更广泛的公平规模扩大。