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

Research approval

University IRB

Juvenile Justice

Center IRB

Juvenile Board

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

Comments/Questions?

Rebecca Monk Beyda, MD, MSRebecca.M.Beyda@uth.tmc.edu