CASE MANAGEMENT PROJECT FOR RURAL DRUG ABUSE

农村毒品滥用案件管理项目

• 批准号: 2853955
• 负责人: JAMES A. HALL
• 金额: $ 3.61万
• 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 2000-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2853955
• 关键词: behavioral /social science research tag; 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.

这项研究将开发和评估案例管理系统以改进 现有药物滥用治疗计划的交付和可及性 在爱荷华州。 案例管理模型解决了农村面临的问题 客户和使用三个创新组件的专业人员对待专业人员： 1。使用先前测试和成功的病例管理模型 该项目的主要研究员James Hall Dr. James Hall开发 该设计的目的是帮助保留滥用药物的治疗 作为Project Pars（积极的青少年生活技能）的一部分，NIDA资助 圣地亚哥的研究项目。 该模型将适应 爱荷华州治疗计划服务的人群。 2。使用计算机电信组件作为一种方式 改善沟通并帮助克服服务障碍。 这 计划是由Farrokh Alemi博士在NIDA主持下制定的。 该组件将允许客户通过“ 800”电话号码到 访问计算机系统，该系统将提供（a）信息，（b） 通过电话经理或与其他一组其他人进行咨询 有类似问题的客户，以及（c）会议或其他会议的提醒 治疗的成分。 3。将测试两个案件经理的“位置”以确定 对以下服务的影响：（a）在 治疗机构（内部现场）与（b）隶属关系和位置 外部独立机构（外部站点）中的经理。 这 实验设计的组成部分将有助于回答这个问题 由爱荷华州的州官员提出的，对案件管理感兴趣 服务是对酒精和药物治疗的增强。 该研究将评估案件管理在公开中的功效 - 在两个主要农村集水区中资助的药物治疗计划 在爱荷华州。 这两个集水区为八个县提供了服务 是爱荷华州县的相当代表。 一个县是标准 大都市统计报告区，一个县是半农村， 六个定义为农村。 还选择了集水区 种族/种族代表。 阶乘实验设计 将使用。 客户将被随机分配给实验 （1）药物治疗局雇用的案件经理的因素； （2） 由组织独立于药物雇用的案件经理 治疗机构； （3）计算机案例管理； （4）标准药物 治疗。 治疗结果和治疗过程将在 为了评估案件管理的功效和成本效益 在农村药物治疗中。 客户将至少遵循12个月。 案件管理的功效将通过比较客户群来衡量 在以下变量上：（1）治疗辍学率，（2）治疗 合规性，（3）对吸毒/滥用和/或犯罪行为的累犯， （4）社交功能，（5）成本效益等。多元 统计数据将用于控制影响结果的变量 作为合并症的精神病条件。