IOWA CASE MANAGEMENT PROJECT FOR RURAL DRUG ABUSE

爱荷华州农村毒品滥用案件管理项目

• 批准号: 2121423
• 负责人: JAMES A. HALL
• 金额: $ 59.3万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 1994
• 资助国家: 美国
• 起止时间: 1994-09-30 至 1999-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2121423
• 关键词: criminal behavior; drug abuse therapy; functional ability; health care cost /financing; health care model; health care service availability; health care service evaluation; human morbidity; human subject; interview; mental health counseling; model design /development; patient care management; relapse /recurrence; rural area; telecommunications; therapy compliance; urinalysis

This study will develop and evaluate a case management system to improve the delivery and accessibility of existing drug abuse treatment programs in Iowa. The case management model addresses the problems faced by rural clients and treating professionals with three innovative components: 1. Use of a previously tested and successful model of case management developed by Dr.James Hall, the Principal Investigator of this project, which was devised to help retain drug abusing adolescents in treatment as part of Project PALS (Positive Adolescent Life Skills), a NIDA-funded research project in San Diego. This model will be adapted to the populations served by the Iowa treatment programs. 2. Use of a computerized telecommunications component as a way to improve communication and help overcome obstacles to services. This program has been developed by Dr. Farrokh Alemi under NIDA auspices. This component will allow clients, through an "800" telephone number to access a computerized system which will provide (a) information, (b) counseling via telephone with the case manager or with a group of other clients with similar concerns, and (c) reminders of meetings or other components of treatment. 3. Two "locations" of case managers will be tested to determine the impact on services of: (a) affiliation and location of the manager within the treating agency (internal site) versus (b) affiliation and location of the manager in an outside independent agency (external site). This component of the experimental design will help to answer the question posed by state officials in Iowa who are interested in case management services as an enhancement to alcohol and drug treatment. The study will evaluate the efficacy of case management in publicly- funded drug treatment programs in two predominantly rural catchment areas in Iowa. Eight counties are served by these two catchment areas, which are fairly representative of Iowa counties. One county is a Standard Metropolitan Statistical Reporting area, one county is semi-rural, and six are defined as rural. Catchment areas were also selected with racial/ethnic representation in mind. A factorial experimental design will be used. Clients will be randomly assigned to the experimental factors of (1) case manager employed by the drug treatment agency; (2) case manager employed by an organization independent of the drug treatment agency; (3) computerized case management; and (4) standard drug treatment. Treatment outcome and treatment process will be monitored in order to assess the efficacy and cost effectiveness of case management in rural drug treatment. Clients will be followed at least 12 months. Efficacy of case management will be measured by comparing client groups on variables such as: (1) treatment drop-out rates, (2) treatment compliance, (3) recidivism to drug use/abuse and/or to criminal behavior, (4) social functioning, (5) cost-effectiveness, etc. Multivariate statistics will be used to control for variables affecting outcome such as comorbid psychiatric conditions.

本研究将开发和评估案例管理系统，以改进 现有药物滥用治疗方案的实施和可及性 在爱荷华州。 个案管理模式解决农村面临的问题 为客户和专业人士提供三个创新组件： 1. 使用先前经过测试且成功的案例管理模型 由该项目的首席研究员 James Hall 博士开发， 旨在帮助吸毒青少年继续接受治疗 作为 PALS（积极青少年生活技能）项目的一部分，该项目由 NIDA 资助 圣地亚哥的研究项目。 该模型将适应 爱荷华州治疗计划所服务的人群。 2. 使用计算机化电信组件作为一种方式 改善沟通并帮助克服服务障碍。 这 该计划是由 Farrokh Alemi 博士在 NIDA 的支持下开发的。 该组件将允许客户通过“800”电话号码 访问计算机化系统，该系统将提供（a）信息，（b） 通过电话与案件经理或其他小组进行咨询 有类似问题的客户，以及 (c) 会议或其他事项的提醒 治疗的组成部分。 3. 将测试案件管理者的两个“地点”，以确定 对服务的影响： (a) 管理人员的隶属关系和所在位置 处理机构（内部站点）与 (b) 隶属关系和地点 外部独立机构（外部站点）的经理。 这 实验设计的组成部分将有助于回答这个问题 由对案件管理感兴趣的爱荷华州官员提出 加强酒精和药物治疗的服务。 该研究将评估案件管理在公开场合的有效性 资助两个主要农村地区的戒毒治疗方案 在爱荷华州。 这两个集水区为八个县提供服务 相当具有代表性的爱荷华州县。 一县为标准 大都市统计报告区，1 个县为半农村县，以及 六个被定义为农村。 还选择了集水区 考虑到种族/民族代表性。 析因实验设计 将被使用。 客户将被随机分配到实验组 （一）戒毒机构聘用的案件管理员； (2) 案件经理受雇于独立于药品的组织 治疗机构； (3) 计算机化案件管理； (4)标准药品 治疗。 治疗结果和治疗过程将受到监测 以评估案件管理的功效和成本效益 在农村戒毒治疗中。 客户将被跟踪至少 12 个月。 案例管理的有效性将通过比较客户群体来衡量 变量例如：(1) 治疗退出率，(2) 治疗 遵守规定，(3) 吸毒/滥用和/或犯罪行为累犯， (4) 社会功能，(5) 成本效益等。 多元 统计数据将用于控制影响结果的变量，例如 作为共病精神疾病。