TY - JOUR
T1 - An Overlapping Systems Conceptual Framework to Evaluate Implementation of a Behavioral Health Intervention for Justice–Involved Youth
AU - Bowser, Diana
AU - Henry, Brandy F.
AU - McCollister, Kathryn E.
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by the National Institute on Drug Abuse (NIDA) at the National Institutes of Health (NIH; R21DA044378). JJ–TRIALS data collection was funded under the JJ–TRIALS cooperative agreement, funded by NIDA at NIH. The authors gratefully acknowledge the collaborative contributions of NIDA and support from the following grant awards: Chestnut Health Systems (U01DA036221), Columbia University (U01DA036226), Emory University (U01DA036233), Mississippi State University (U01DA036176), Temple University (U01DA036225), Texas Christian University (U01DA036224), University of Kentucky (U01DA036158), and University of Miami (U01DA036233) subaward to Brandeis University. NIDA Science Officer on this project is Tisha Wiley. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the NIDA, NIH, or the participating universities or JJ systems.
PY - 2019
Y1 - 2019
N2 - Background: Nearly 65% of justice–involved youth have a substance use and/or mental health disorder. Although evidence–based practices have been established for adolescents with co–occurring mental health and substance use disorders, these practices are not widely used in juvenile justice agencies due to environmental and organizational complexities. Methods: Our study builds on Juvenile Justice—Translational Research on Interventions for Adolescents in the Legal System (JJ–TRIALS), a multi–site cooperative research initiative of juvenile justice and partnering behavioral health agencies. We also integrate state and county–level data to support broader assessment of key drivers of implementation success. Results: We present an economics/systems conceptual model describing how the environmental context, systems organization, and economic costs of implementation can affect implementation outcomes. Comparison of intervention condition (Core vs Enhanced) and pre–implementation costs (High vs Low) found differences in insurance reimbursements and types, as well as agency staffing characteristics. Discussion: Implementing new procedures or policies at a systems level must consider implementation outcomes in a broad context. Factors such as population demographics, primary care and behavioral health treatment capacity, unemployment rates, and public funding for treatment and other services are important in determining intervention success and sustainability.
AB - Background: Nearly 65% of justice–involved youth have a substance use and/or mental health disorder. Although evidence–based practices have been established for adolescents with co–occurring mental health and substance use disorders, these practices are not widely used in juvenile justice agencies due to environmental and organizational complexities. Methods: Our study builds on Juvenile Justice—Translational Research on Interventions for Adolescents in the Legal System (JJ–TRIALS), a multi–site cooperative research initiative of juvenile justice and partnering behavioral health agencies. We also integrate state and county–level data to support broader assessment of key drivers of implementation success. Results: We present an economics/systems conceptual model describing how the environmental context, systems organization, and economic costs of implementation can affect implementation outcomes. Comparison of intervention condition (Core vs Enhanced) and pre–implementation costs (High vs Low) found differences in insurance reimbursements and types, as well as agency staffing characteristics. Discussion: Implementing new procedures or policies at a systems level must consider implementation outcomes in a broad context. Factors such as population demographics, primary care and behavioral health treatment capacity, unemployment rates, and public funding for treatment and other services are important in determining intervention success and sustainability.
KW - drug misuse
KW - health services research
KW - juvenile delinquency
KW - mental health
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U2 - 10.1177/1178632919855037
DO - 10.1177/1178632919855037
M3 - Article
AN - SCOPUS:85083863993
VL - 12
JO - Health Services Insights
JF - Health Services Insights
SN - 1178-6329
ER -