Department of Health Management and Policy, Drexel University Dornsife School of Public Health, Philadelphia (Purtle, Nelson, Henson); Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York City (Horwitz, Hoagwood); Brown School at Washington University in St. Louis, St. Louis (McKay).
Psychiatr Serv. 2022 Apr 1;73(4):388-395. doi: 10.1176/appi.ps.202000919. Epub 2021 Aug 13.
Understanding public policy makers' priorities for addressing youth substance use and the factors that influence these priorities can inform the dissemination and implementation of strategies that promote evidence-based decision making. This study characterized the priorities of policy makers in substance use agencies of U.S. states and counties for addressing youth substance use, the factors that influenced these priorities, and the differences in priorities and influences between state and county policy makers.
In 2020, a total of 122 substance use agency policy makers from 35 states completed a Web-based survey (response rate=22%). Respondents rated the priority of 14 issues related to youth substance use and the extent to which nine factors influenced these priorities. Data were analyzed as dichotomous and continuous variables and for state and county policy makers together and separately.
The highest priorities for youth substance use were social determinants of substance use (87%), adverse childhood experiences and childhood trauma (85%), and increasing access to school-based substance use programs (82%). The lowest priorities were increasing access to naloxone for youths (49%), increasing access to medications for opioid use disorder among youths (49%), and deimplementing non-evidence-based youth substance use programs (41%). The factors that most influenced priorities were budget issues (80%) and state legislature (69%), federal (67%), and governor priorities (65%). Issues related to program implementation and deimplementation were significantly higher priorities for state than for county policy makers.
These findings can inform the tailoring of dissemination and implementation strategies to account for the inner- and outer-setting contexts of substance use agencies.
了解公共政策制定者解决青少年物质使用问题的优先事项，以及影响这些优先事项的因素，可以为促进基于证据的决策的战略传播和实施提供信息。本研究描述了美国各州和县物质使用机构政策制定者解决青少年物质使用问题的优先事项、影响这些优先事项的因素，以及州和县政策制定者在优先事项和影响方面的差异。
2020 年，共有来自 35 个州的 122 名物质使用机构政策制定者完成了一项基于网络的调查（回应率=22%）。受访者对 14 个与青少年物质使用相关的问题的优先程度以及 9 个影响这些优先程度的因素进行了评分。数据以二项和连续变量进行分析，并对州和县政策制定者进行了综合和分别分析。
青少年物质使用的最高优先事项是物质使用的社会决定因素（87%）、不良儿童经历和儿童创伤（85%）以及增加获得基于学校的物质使用计划的机会（82%）。青少年获得纳洛酮的机会最低（49%），青少年获得阿片类药物使用障碍治疗的机会最低（49%），取消非基于证据的青少年物质使用计划的机会最低（41%）。影响优先事项的最重要因素是预算问题（80%）和州立法机关（69%）、联邦（67%）和州长的优先事项（65%）。与计划实施和取消有关的问题是州政策制定者比县政策制定者更优先考虑的问题。
这些发现可以为传播和实施战略的调整提供信息，以考虑物质使用机构的内部和外部环境背景。
