Texas Research Initiative for Adolescents in the Legal System (TRIALS)

德克萨斯州法律系统青少年研究计划（试验）

• 批准号: 8880169
• 负责人: DANICA K KNIGHT
• 金额: $ 60.93万
• 依托单位: TEXAS CHRISTIAN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-07-01 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8880169
• 关键词: AIDS/HIV problem; Address; Adolescent; Adoption; Alcohol or Other Drugs use; Area; Caring; Client; Clinic; Clinical; Clinical Services; Collaborations; Communities; Continuity of Patient Care; County; Data; Development; Effectiveness; Elements; Evaluation; Evidence based practice; Feedback; Focus Groups; Funding; Goals; Health; Health Personnel; Health Services Accessibility; Healthcare; Home environment; Individual; Institutes; Intervention; Interview; Justice; Lead; Legal system; Mental Health; Methods; Modeling; National Institute of Drug Abuse; Outcome; Outcome Measure; Penetration; Pharmaceutical Preparations; Phase; Population; Problem behavior; Process; Provider; Psyche structure; Public Health; Quality of Care; Randomized; Readiness; Research; Risk; Sampling; Secure; Services; Specific qualifier value; Strategic Planning; Structure; Substance abuse problem; Supervision; Surveys; System; Techniques; Testing; Texas; Training; Work; Youth; adolescent substance use; base; compare effectiveness; design; evidence base; experience; implementation research; improved; in vivo; juvenile delinquent; juvenile justice system; meetings; member; parole; probation; prototype; satisfaction; screening; substance abuse treatment; systems research; treatment planning; uptake

Implementation of evidence-based practices (EBPs) within juvenile justice (JJ) settings has been limited. Service delivery occurs within disconnected practice settings (e.g., parole/probation, drug treatment, public health), with limited continuity of care. Effective strategies are needed for implementing EBPs to improve service delivery to adolescents under juvenile justice supervision and promote sustainable changes across large, multifaceted systems. The goal of the TRIALS initiative is to support implementation research that improves the continuum of substance abuse and HIV/AIDS services for adolescents in the legal system. Our research concept focuses on improving HIV/AIDS testing and referral within the JJ continuum. Using a randomized cluster design, the effectiveness of Community-wide (CW) and Horizontal Cascading (HC) implementation strategies will be compared. Both involve a Plan-Do-Study-Act approach that promotes change at the community level through training, the use of Community Change Teams (CCT), and guidance from external coaches. In the CW condition, JJ and other professionals (actively involved in overseeing and/or providing services for juveniles) will be asked to collaborate with multiple substance use treatment provider agencies within a specified community in the development of strategic plans to address gaps in the service delivery continuum. These individuals will be invited to participate in CCT training and planning efforts. Implementation of strategic plans will be allowed to proceed without additional coaching or implementation intervention strategies. In the HC condition, along with JJ and other professionals actively involved in providing services to juveniles, CCT membership will include a single treatment provider agency. The CCT will be tasked with developing a �prototype� for carrying out the strategic plan within the participating treatment provider agency. Once implemented successfully, the prototype will serve as a model for systematic roll out to the other providers in the community, with CCT members functioning as �in-vivo� coaches. The research concept involves random assignment of 40 clusters of providers (e.g., Community/county) to either the CW or HC study condition. Using mixed-methods, data will be collected at the community, provider, staff, and client levels. The degree to which implementation strategies, organizational readiness for change, and interagency collaboration promote implementation, service, and client outcomes will be examined using multilevel analytic techniques. In collaboration with the Texas Juvenile Justice Department, we have established an interdisciplinary team to design meaningful studies that will identify implementation strategies that are viewed as valuable, acceptable, feasible, and sustainable by the field.

在少年司法 (JJ) 环境中基于证据的做法 (EBP) 的实施受到限制。 服务提供发生在互不相关的实践环境中（例如假释/缓刑、戒毒治疗、公共场所） 健康），但需要有效的策略来实施 EBP 来改善护理的连续性。 在少年司法监督下向青少年提供服务并促进整个社会的可持续变革 TRIALS 计划的目标是支持大型、多方面的系统的实施研究。 改善法律系统中针对青少年的药物滥用和艾滋病毒/艾滋病服务的连续性。 研究概念的重点是在 JJ 连续体中改进艾滋病毒/艾滋病检测和转诊。 随机集群设计、社区范围（CW）和水平级联（HC）的有效性 将比较实施策略，两者都涉及促进变革的计划-实施-研究-行动方法。 通过培训、使用社区变革团队 (CCT) 以及来自社区的指导，在社区层面实现 在 CW 条件下，JJ 和其他专业人员（积极参与监督和/或） 为青少年提供服务）将被要求与多个药物使用治疗提供者合作 特定社区内的机构制定战略计划以解决服务差距 这些人将被邀请参加 CCT 培训和规划工作。 无需额外辅导或实施即可继续实施战略计划 在HC情况下，JJ和其他专业人士积极参与提供干预策略。 CCT 成员将包括一个单一的治疗提供机构。 开发“原型”以在参与的治疗提供者内执行战略计划 一旦成功实施，原型将作为系统推广到其他机构的模型。 社区中的提供者，CCT 成员充当“体内”教练 研究概念。 涉及将 40 个提供者集群（例如社区/县）随机分配到 CW 或 HC 研究 将使用混合方法在社区、提供者、员工和客户层面收集数据。 战略的实施程度、组织对变革的准备程度以及机构间协作 将使用多层次分析技术来检查促进实施、服务和客户成果。 我们与德克萨斯州少年司法部合作，建立了一个跨学科团队 设计有意义的研究，确定被认为有价值、可接受、 可行且可持续的领域。