Juvenile Offender HIV Prevention and Drug Abuse Services

青少年罪犯艾滋病毒预防和药物滥用服务

基本信息

批准号：
8091407
负责人：
Howard Arthur Liddle
金额：
$ 64.66万
依托单位：
UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-08-01 至 2014-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8091407
关键词：
AIDS prevention Address Administrator Adolescence Adolescent Alcoholism Area Back Characteristics Chronic Client Clinical Clinical effectiveness Commit Communication Communities Comorbidity Cost-Benefit Analysis Crime Decision Making Development Drug Addiction Drug Delivery Systems Drug abuse Drug usage Economics Educational Intervention Effectiveness of Interventions Emotional Bonds Enrollment Environment Equilibrium Ethnic group Family Family psychotherapy FarGo Foundations Funding Geographic Locations Growth HIV HIV Infections HIV/STD Health Health Policy Health system Home environment Impairment Imprisonment Incidence Institutes Institution Institutionalization Intake International Intervention Investments Justice Knowledge Laboratories Life Light Longitudinal Studies Mediating Mediator of activation protein Mental Health Methods Modeling Movement Outcome Outpatients Parenting behavior Parents Pharmaceutical Preparations Policy Maker Preventive Intervention Process Public Health Race Randomized Randomized Clinical Trials Randomized Controlled Trials Rehabilitation therapy Reliance Research Research Priority Residential Treatment Risk Risk Behaviors Risk Reduction Safety Sampling Studies Schools Self Efficacy Services Sexually Transmitted Diseases Site Societies Solutions Substance Use Disorder Supervision Symptoms System Techniques Teenagers Testing Therapeutic Intervention Time Unemployment Unsafe Sex Wolves Youth addiction adolescent substance abuse base community intervention condoms cost effective cost effectiveness criminal behavior economic impact effective intervention effective therapy emerging adult evidence base follow-up high risk improved innovation juvenile delinquent juvenile justice system meetings offender peer prevention service programs recidivism safer sex service intervention sex risk sexually active skills social socioeconomics substance abuse treatment treatment duration treatment program

项目摘要

DESCRIPTION (provided by applicant): Responding to RFA-DA-09-007, we propose to conduct a randomized clinical trial to determine the clinical effectiveness, moderators and mechanisms of change, and economic impact of an integrative, family-based intervention that concurrently targets changes in HIV/STD-associated risk behaviors, drug abuse, delinquency, arrest and mental health outcomes for juvenile offenders committed to a juvenile justice day treatment program. 250 sexually active youths with documented substance use disorders enrolled in a school-based, juvenile justice day treatment facility will comprise the study sample. Eligible youths will be randomized to the experimental intervention. Day Treatment Multidimensional Family Therapy-HIV (DT-MDFT-HIV) or Day Treatment Services as Usual (DT-SAU). This study is distinguished by its setting, a juvenile justice administered day treatment program, and by the experimental intervention's promise in simultaneously reducing multiple adolescent problems-HIV-associated risk behaviors, drug abuse, and criminal behavior. Interventions targeting each of these problem areas are typically delivered separately, perpetuating well documented problems of service fragmentation in juvenile justice, addictions treatment, and health systems. Given the empirically-established relationships among high risk sex, drug abuse, and delinquency; the need for new service delivery systems that can efficiently deliver comprehensive interventions to multiply impaired youths; and the need for innovative juvenile justice alternatives to residential placement and incarceration, the proposed study has the potential to successfully address an urgent public health, public safety, and research priority. The study has four aims: (1) Clinical Outcomes - to compare the effects of the family-based and the group-based interventions on HIV risk/STD rates, drug use, delinquency and mental health outcomes, (2) Moderators of Outcome - to determine if the more comprehensive and integrated experimental intervention, MDFT-HIV, is more effective with more severely impaired youths, (3) Mediators of Outcome - to determine if hypothesized mechanisms of action of MDFT-HIV mediated changes in outcomes over time, and (4) Economic Analyses - to evaluate and compare the economic costs, benefits, and cost effectiveness to society and to the juvenile justice system of MDFT-HIV and SAU. A multiple time point (intake, 3, 6, 12, and 24 month follow-up), multiple domain and method assessment approach and latent growth curve modeling techniques will be used to examine study hypotheses regarding adolescent and family change over time. The study has significant potential to improve interventions and service delivery systems by providing new knowledge about effective and cost-efficient interventions for drug abusing juvenile offenders at high risk for HIV infection. PUBLIC HEALTH RELEVANCE: The proposed study tests an innovative, integrative, and comprehensive family-based intervention within a juvenile day treatment setting that concurrently targets drug problems, HIV-associated risk behaviors, delinquency, and mental health functioning of juvenile offenders. The study has the potential to yield new knowledge about how to offer comprehensive effective services for these multiply impaired teens by addressing gaps in the juvenile justice system related to service fragmentation, lack of effective services, and over-reliance on institutionalization to deter crime. Policy makers and clinical administrators may use these findings to guide decisions about health care policy and implementation of clinically effective and economically viable interventions.

DESCRIPTION (provided by applicant): Responding to RFA-DA-09-007, we propose to conduct a randomized clinical trial to determine the clinical effectiveness, moderators and mechanisms of change, and economic impact of an integrative, family-based intervention that concurrently targets changes in HIV/STD-associated risk behaviors, drug abuse, delinquency, arrest and mental health outcomes for juvenile offenders committed to a juvenile justice day treatment 程序。 250个具有记录在案的物质使用障碍的性活跃的年轻人参加了学校的少年司法日治疗设施将构成研究样本。符合条件的年轻人将被随机地进行实验干预。一日治疗多维家庭治疗HIV（DT-MDFT-HIV）或日间治疗服务（DT-SAU）。这项研究以其环境，少年司法治疗日期治疗计划以及实验干预措施同时减少多个青少年问题与HIV相关的风险行为，毒品滥用和犯罪行为的承诺的诺言。针对每个问题领域的干预措施通常是分开交付的，这会使少年司法，成瘾治疗和卫生系统中有充分文献记载的服务分裂问题。鉴于高风险性，药物滥用和犯罪之间的经验关系；需要有效地提供全面干预措施以增加受损的年轻人的新服务提供系统的需求；以及拟议的研究需要创新的少年司法替代方案，有可能成功地解决紧急的公共卫生，公共安全和研究重点。这项研究具有四个目的：（1）临床结果 - 比较基于家庭和基于群体的干预措施对艾滋病毒风险/性病的率，药物使用，违法和心理健康结果的影响，（2）结果的调节者 - 确定更全面和综合的实验性干预者是否有效，MDFT -hiv，MDFT -HIV是否有效，是否有效地确定 - 是否有效地确定（3）Yeards（3），是否有效，是否有效，是否有效，是否有效，是否有效，是否有效，是否有效，是否有效，是否有效，是否有效，是否有效，是否有效，是否有效，是否有效，是否有效，是否有效，是否有效，是否有效，是否有效，是否有效，是否有效，是否有效，是否有效，是否有效，是否有效，是否有效，是否有效，是否有效，是否有效，是否有效，是否有效，是否有效，是否有效，是否有效，是否有效，是否有效地降级（3）。 MDFT-HIV的作用机制随着时间的推移介导的结果变化，以及（4）经济分析 - 评估和比较对社会的经济成本，收益和成本效益以及MDFT-HIV和SAU的少年司法系统。多个时间点（摄入量，3、6、12和24个月随访），多个领域和方法评估方法以及潜在的生长曲线建模技术将用于检查有关青少年和家庭随时间变化的研究假设。该研究通过提供有关滥用艾滋病毒感染风险高的少年罪犯的有效和成本效益的干预措施的新知识，从而提高干预措施和服务提供系统的重要潜力。公共卫生相关性：拟议的研究在少年一天的治疗环境中测试了一种创新，综合和全面的基于家庭的干预措施，同时针对毒品问题，与艾滋病毒相关的风险行为，犯罪行为以及少年犯罪者的心理健康功能。这项研究有可能通过解决与服务分裂，缺乏有效的服务以及对制度化对制度化的制度化相关的少年司法系统中的差距，从而产生有关如何为这些倍数受损的青少年提供全面有效服务的新知识。政策制定者和临床管理人员可以使用这些发现来指导有关医疗保健政策的决策，并实施临床有效且经济上可行的干预措施。