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青少年司法与行为健康领域的物质使用预防服务:一项全国性调查的结果

Substance use prevention services in juvenile justice and behavioral health: results from a national survey.

作者信息

Funk Rodney, Knudsen Hannah K, McReynolds Larkin S, Bartkowski John P, Elkington Katherine S, Steele Ellen H, Sales Jessica M, Scott Christy K

机构信息

Chestnut Health Systems, 448 Wylie Drive, Normal, IL, 61761, USA.

College of Medicine, Department of Behavioral Science and Center on Drug and Alcohol Research, University of Kentucky, 845 Angliana Avenue, Room 204, Lexington, KY, 40508, USA.

出版信息

Health Justice. 2020 May 13;8(1):11. doi: 10.1186/s40352-020-00114-6.

Abstract

BACKGROUND

This study examined the national availability of substance use prevention (SUP) within juvenile justice (JJ) and their primary behavioral health (BH) providers, and the relationships between the availability of SUP and agency-level measures of organizational structure, staffing, and youth characteristics. A three-stage national probability sampling process was used to select participants for a national survey that included, among other facets of community supervision (CS) and BH practices, questions on agency characteristics, youth characteristics, whether the agency/provider directly provided SUP services, and whether the agency/provider directly provided substance use and/or mental health treatment. This paper focuses on SUP services along with agency/provider and youth characteristics related to providing SUP.

RESULTS

The response rate for both CS agencies (n = 195) and BH providers (n = 271) was 96%. Complex samples logistic regression initially examined univariate associations of each variable and identified candidates for a final multivariate model. Overall, only one-third of CS and BH providers reported offering SUP services, with BH providers being significantly more likely than CS agencies to provide SUP services. In addition, likelihood of SUP was significantly lower among agencies where the substance use distribution of the caseload was below the median. Controlling for master's level staff and the substance use distribution, CS agencies were about 67% less likely to offer SUP when compared to BH providers.

CONCLUSIONS

Given the high rates of substance use among justice-involved youth and that substance use is an established risk for several negative behaviors, outcomes, and health conditions, these findings suggest that evidence-based prevention services should likely be expanded in justice settings, and perhaps included as part of CS programs, even when youth do not initially present with SU service needs.

摘要

背景

本研究调查了少年司法(JJ)系统及其主要行为健康(BH)服务提供者中物质使用预防(SUP)服务的全国可及性,以及SUP服务的可及性与机构层面的组织结构、人员配备和青少年特征衡量指标之间的关系。采用三阶段全国概率抽样程序来选择参与一项全国性调查的对象,该调查除了社区监督(CS)和BH实践的其他方面外,还包括有关机构特征、青少年特征、机构/服务提供者是否直接提供SUP服务,以及机构/服务提供者是否直接提供物质使用和/或心理健康治疗的问题。本文重点关注SUP服务以及与提供SUP相关的机构/服务提供者和青少年特征。

结果

CS机构(n = 195)和BH服务提供者(n = 271)的回复率均为96%。复杂样本逻辑回归最初检验了每个变量的单变量关联,并确定了最终多变量模型的候选变量。总体而言,只有三分之一的CS机构和BH服务提供者报告提供SUP服务,BH服务提供者比CS机构提供SUP服务的可能性显著更高。此外,在案件量中物质使用分布低于中位数的机构中,SUP的可能性显著更低。在控制硕士水平工作人员和物质使用分布的情况下,与BH服务提供者相比,CS机构提供SUP的可能性低约67%。

结论

鉴于涉司法青少年中物质使用的高发生率,且物质使用是多种负面行为、结果和健康状况的既定风险因素,这些研究结果表明,即使青少年最初没有物质使用服务需求,基于证据的预防服务也可能应在司法环境中扩大,甚至可能作为CS项目的一部分纳入。

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