Juvenile Justice Research: From Start to FinishRebecca Monk Beyda, MD, MSJuvenile Justice Special Interest GroupSAHM 2015 Annual Meeting
Boston University School of Medicine asks all individuals involved in the development and presentation of Continuing Medical Education (CME) activities to disclose all relationships with commercial interests. This information is disclosed to CME activity participants. Boston University School of Medicine has procedures to resolve apparent conflicts of interest. In addition, presenters are asked to disclose when any discussion of unapproved use of pharmaceuticals and devices is being discussed.
I, Rebecca M. Beyda, have no commercial relationships to disclose.
Objectives• Discuss importance of research with detained youth• Review barriers to research in the juvenile justice center• Propose strategies to address barriers
Detained youth
Chlamydia (females)
Traumatic injury Illegal drug use Any mental health disorder
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
15%
50%
85%
67%
Health needs of youth in the Juvenile Justice System
Committee on Adolescence. Health Care for Youth in the Juvenile Justice System. Pediatrics. 2011; 128;1219
Research with special populations
• Code of Federal Regulations• Title 45: Part 46: Subpart C Additional protections pertaining to research involving prisoners• Title 45: Part 46: Subpart D Additional protections for children involved as subjects in research
Code of Federal Regulations. U.S. Department of Health & Human Services. http://www.hhs.gov/ohrp/humansubjects/guidance/45cfr46.html Accessed 3/2/15.
Getting Started• Developing relationships with Juvenile Justice Center• Developing relationships with detained youth• Vulnerable population• Vulnerable time
• Other experiences getting started?
Barriers to Research
Design Research approval Recruitment
Project Execution
Participant retention
Dissemination of findings
Lane, C., Goldstein, N.E.S., Hilbrun, K., Cruise, K.R., Pennacchia, D. “Obstacles to Research in Residential Juvenile Justice Facilities: Recommendations for Researchers.” Behavioral Sceinces and the Law. Jan-Feb 2012; 30(1): 49-68.
Design• Quality improvement projects• Population selection: Minorities and males over-represented• Location/facility selection:• Short-term (average stay 18 days)• Long-term (average stay 6 months)
• Example: Azithromycin efficacy in treatment of Chlamydia trachomatis
Screen Urine GC/CT
Treat positive CT
SubmitTest of Cure
Follow up TOC results
21 days
Recruitment• Benefit/risk to youth• Parental/guardian permission• Waiver of parental/guardian permission• Confidential information• No more than minimal risk
• Youth assent
Azithro and
Assent
Project execution• Working with youth • Issues of abuse or neglect• Sexual activity or drug use in the institution• Perceived impact on his/her case• Researcher should stress voluntary nature of research
• Working with detention center facilities• Policies• Staff
Participant retention
• Incentives• Youth Transfer• Certified• Facility in different county
• Youth Release
Test of Cure
Results
Survey with
youth
Dissemination of findings• Encountering resistance to publication of research findings• De-identify institution• Send draft manuscript to detention center IRB prior to
submission
• Ex: “Large urban detention center in the southwest region of the United States”
Barriers to Research
Design Research approval Recruitment
Project Execution
Participant retention
Dissemination of findings
Lane, C., Goldstein, N.E.S., Hilbrun, K., Cruise, K.R., Pennacchia, D. “Obstacles to Research in Residential Juvenile Justice Facilities: Recommendations for Researchers.” Behavioral Sceinces and the Law. Jan-Feb 2012; 30(1): 49-68.
Other strategies• Quality Improvement projects• Expedited review• Contraception QI project
• Chart reviews• Expedited review• Electronic medical records
• Other strategies?
Research from start to finish • Research in detention facilities: Needed and feasible• Collaborate with the juvenile justice center IRB and request meetings • Anticipate delays and remain persistent• All working toward the goal of improving health care for
detained youth