1. Juvenile Justice Research: From Start to Finish Rebecca Monk Beyda, MD, MS Juvenile Justice Special Interest Group SAHM 2015 Annual Meeting

2. 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.

3. Objectives Discuss importance of research with detained youth Review barriers to research in the juvenile justice center Propose strategies to address barriers

4. Detained youth Committee on Adolescence. Health Care for Youth in the Juvenile Justice System. Pediatrics. 2011; 128;1219

5. 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.htmlhttp://www.hhs.gov/ohrp/humansubjects/guidance/45cfr46.html Accessed 3/2/15.

6. Getting Started Developing relationships with Juvenile Justice Center Developing relationships with detained youth Vulnerable population Vulnerable time Other experiences getting started?

7. 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.

8. 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 Submit Test of Cure Follow up TOC results 21 days

9. Research approval University IRB Juvenile Justice Center IRB Juvenile Board

10. 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

11. 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

12. Participant retention Incentives Youth Transfer Certified Facility in different county Youth Release Test of Cure Results Survey with youth

13. 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”

14. 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.

15. Other strategies Quality Improvement projects Expedited review Contraception QI project Chart reviews Expedited review Electronic medical records Other strategies?

16. 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

17. Comments/Questions? Rebecca Monk Beyda, MD, MS Rebecca.M.Beyda@uth.tmc.edu