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.

项目概要/摘要 过去 5 年来，全国许多州参与儿童教育的人数有所增加 2017 年，由于年轻父母滥用阿片类药物和甲基苯丙胺而导致寄养系统失灵。 儿童福利系统收到了 410 万份转诊，为大约 750 万儿童提供了父母药物 虐待和忽视儿童占大多数案件，这在俄勒冈州尤其如此。 超过 55% 的案件涉及 30 岁以下的父母，超过 60% 的寄养系统案件是由 与父母滥用药物有关的家庭积极改善关系 (FAIR) 计划是一项 最近为参与该疾病的家长制定了经过严格评估的强化门诊治疗计划 针对父母阿片类药物和/或安非他明类物质使用障碍的儿童福利系统——甲基苯丙胺 （OUD；MUD）FAIR 有效性试验的结果表明 FAIR 具有被改编为一种方法的潜力。 为参与儿童福利和自给自足系统的家长制定预防计划，并予以实施 该 UG3/UH3 探索性开发分阶段项目。 致力于与俄勒冈州人类服务部 (DHS) 合作一年的活动 合作伙伴和领导层制定适应、招聘和实施 FAIR 的计划 在 UG3 阶段，调查团队拥有干预开发和预防方面的专业知识。 临床有效性试验、实施科学、决策科学、卫生经济学，包括国土安全部 领导力——将与协调中心合作（UG3 目标 1）制定战略 识别、接触并接触参与 DHS 系统、年龄在 16 至 30 岁、有升级风险的家长 滥用或开发 OUD 和/或 MUD；以及（UG3 目标 2）开发和调整 FAIR 以防止启动； 完成一组后，滥用阿片类药物和/或甲基苯丙胺并升级为紊乱。 第一年的具体里程碑，该项目的 UGH 阶段将进行混合 I 随机 临床试验，以评估改编后的 FAIR 计划及其在两个县的家长的实施情况。 因阿片类药物或甲基苯丙胺使用或滥用而有升级风险而被 DHS 转介的 (n = 240)，将 招募并纵向跟踪 24 个月的家长将被随机接受改编后的 FAIR。 此阶段的总体目标是测试。 UG3阶段设计的适应措施的有效性以及建立在国家合作基础上的—— 具体来说，为了：（UH3 目标 1）评估 FAIR 在预防 16 岁父母参与 DHS 方面的有效性 至 30，从开始滥用或升级阿片类药物和/或甲基苯丙胺使用（UH3 目标 2）检查并 评估 FAIR 在县驱动的 DHS 系统中的实施情况，为可持续发展计划提供信息；以及 (UH3) 目标 3) 评估与采用 FAIR 结果相关的实施和干预成本。 该项目将为协议的进一步完善和 FAIR 更广泛规模化的潜力提供信息。