学习卫生系统和物质使用护理在涉及司法的年轻人中取得的级联成就:一个集群随机化的阶段临床试验
Matthew C Aalsma1, Katherine Schwartz1, Dayu Sun2
1Department of Pediatrics, Indiana University School of Medicine, Indianapolis.
JAMA network open
|February 10, 2026
概括
学习卫生系统 (LHS) 的干预改善了青少年法律系统 (YLS) 中青少年的物质使用障碍 (SUD) 护理. 这种方法减少了查,服务启动和风险青年参与的延迟.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 药物使用障碍 药物使用障碍
背景情况:
- 青少年法律系统 (YLS) 的青少年有高的物质使用和障碍 (SU/D) 率,但与社区行为健康服务的参与度较低.
- 护理级联框架强调了系统层面的缺陷,即将这些年轻人与必要的治疗联系起来.
研究的目的:
- 评估跨系统学习健康系统 (LHS) 干预措施在改善YLS参与的青少年的SU/D护理级联结果方面的有效性.
主要方法:
- 一个集群随机化,阶梯试验涉及8个县超过9个月的间隔.
- 由青少年缓刑和心理健康代表组成的LHS团队,应用了持续质量改进原则.
- 链接的行政YLS和医疗补助数据被用于跟踪5731名青少年 (年龄11-17岁) 从被捕到2025年3月.
主要成果:
- 在LHS干预显著减少了逮捕和SU/D风险查之间的时间 (HR, 1.67).
- 在缩短从逮捕到服役启动和参与的时间方面观察到显著的改善,特别是在研究中被逮捕的年轻人中.
- 该研究跟踪了连锁步骤,包括查,识别,转诊,启动和参与服务.
结论:
- 学习健康系统 (LHS) 的干预有效地改善了参与青年法律系统 (YLS) 的青少年的SU / D护理级联的及时性.
- 该模型展示了一个成功的战略,用于整合法律和行为健康系统,以解决关键护理差距.
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