支持为涉及刑事法律的吸毒者服务的康复支持工作者的实施策略。

Mai T. Pho , Alida Bouris , Erin D. Carreon , MoDena Stinnette , Maggie Kaufmann , Valery Shuman , Dennis P. Watson , Antonio D. Jimenez , Borris Powell , Charlie Kaplan , Stacy Zawacki , Stefanie Morris , Julio Garcia , Ashley Hafertepe , Katy Hafertepe , Harold A. Pollack , John A. Schneider , Basmattee Boodram
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引用次数: 0

摘要

导言:为吸毒者(PWUD)提供社会支持干预的康复支持工作者(RSWs)经常面临各种挑战,这些挑战可能会危及这支重要工作队伍的福祉、效率和可持续性。迄今为止,有关用于支持戒毒康复工作者的实施策略类型的报道很少。我们描述并评估了一套多方面的实施策略,以支持《降低伊利诺伊州阿片类药物死亡率》(Reducing Opioid Mortality in Illinois,ROMI),这是一项同伴康复指导和个案管理(PRC-CM)配对干预措施,针对的是城市和农村环境中最近涉及刑事法律问题的残疾人:方法:ROMI 采用了远程、中心和辐条管理的多方面实施策略包,以支持同伴康复指导员和个案管理者向涉及刑事法律问题的残疾人提供循证服务。核心战略包括(a) 综合培训;(b) 个别临床督导;(c) 小组咨询;以及 (d) 中央技术援助。我们采用混合方法对实施策略包进行了评估,包括对干预人员进行定性访谈,以探讨他们对每个策略组成部分的体验,以及对督导和小组咨询会议期间讨论的主题进行定量编码,以估计问题的优先次序和策略类型之间的主题平衡:在 2019 年 1 月至 2024 年 1 月期间,该研究采访了 8 名 PRC-CM 人员,并对 568 次会议(79 次小组咨询和 489 次个别督导)的讨论主题进行了定量编码。这种 "枢纽-辐条 "模式允许集中接触技术高超的督导人员,也允许地理位置偏远的团队共享知识。个人督导过程中提供的治疗空间和情感支持是 PRC-CM 的重要资源。小组磋商通过动态和有针对性的培训,促进了友情、相互支持和持续学习。对资源限制和服务对象面临的系统性障碍的不满仍然是 PRC-CM 的主要关切,而技术援助战略并未完全解决这一问题:了解支持复杂干预措施实施者所需的实施策略的实际组成部分和个人优势,例如为涉及刑事法律的残疾人提供社会支持和导航,这阐明了现实世界中的实施可能需要的组织和专业能力:NCT04925427.
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Implementation strategies to support recovery support workers serving criminal legal involved people who use drugs

Introduction

Recovery support workers (RSWs) who provide social support interventions for people who use drugs (PWUD) often face challenges that can jeopardize the well-being, efficacy and sustainability of this essential workforce. To date, little has been reported on the types of implementation strategies used to support RSWs. We describe and evaluate a multifaceted implementation strategy package to support Reducing Opioid Mortality in Illinois (ROMI), a paired peer recovery coach and case manager (PRC-CM) intervention for PWUD with recent criminal-legal involvement in urban and rural settings.

Methods

ROMI utilized a remote, hub and spoke-administered multifaceted implementation strategy package to support PRCs-CMs to deliver evidence-based services to PWUD with criminal-legal involvement. The core strategies included: (a) comprehensive training; (b) individual clinical supervision; (c) group consultation; and (d) centralized technical assistance. We evaluated the implementation strategy package using a mixed-methods design including qualitative interviews with the intervention staff to explore their experiences with each strategy component, as well as a quantitative coding of topics discussed during supervision and group consultation meetings to estimate prioritization of issues and balance of topics between strategy type.

Results

Between January 2019 and January 2024, the study interviewed 8 PRC-CMs and quantitatively coded 568 sessions (79 group consultations and 489 individual supervisory) for discussion themes. The hub-and-spoke model allowed for centralized access to highly skilled supervisory staff as well as knowledge sharing across geographically remote teams. The therapeutic space to process feelings and emotional support provided during individual supervision was noted to be an essential resource by PRC-CMs. Group consultation facilitated camaraderie, mutual support and continual learning through dynamic and responsive trainings. Frustrations around resource limitations and systemic barriers facing their clients remained a dominant concern for PRCs-CMs, and was incompletely addressed by the technical assistance strategy.

Conclusion

Understanding the practical components and individual strengths of the implementation strategies required to support the implementers of complex interventions such as social support and navigation for PWUD with criminal-legal involvement elucidates the organizational and professional capacities that may be required for real world implementation.

Trial registration

NCT04925427
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来源期刊
Journal of substance use and addiction treatment
Journal of substance use and addiction treatment Biological Psychiatry, Neuroscience (General), Psychiatry and Mental Health, Psychology (General)
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