Juvenile Justice Translational Research on Interventions for Adolescents in the Legal System
- Conditions
- Substance Use Disorders
- Interventions
- Behavioral: CoreBehavioral: Enhanced
- Registration Number
- NCT02672150
- Lead Sponsor
- Chestnut Health Systems
- Brief Summary
This is a multi site experiment to evaluate the impact of various strategies for increasing the use of evidence based screening, assessment and linkage to substance use treatment. All sites collect baseline data and receive a core intervention. Half are then randomly assigned to get an additional year of coaching to facilitate implementation.
- Detailed Description
Background: The Juvenile Justice-Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS) study is a cooperative implementation science initiative involving the National Institute on Drug Abuse, six Research Centers, a Coordinating Center, and Juvenile Justice Partners representing seven U.S. states. The pooling of resources across Centers enables a robust implementation study design involving 36 juvenile justice agencies and their behavioral health partner agencies, coproducing a study protocol that has potential to advance implementation science, meets the needs of all constituencies (funding agency, researchers, partners, study sites), and can be implemented with fidelity across the cooperative can be challenging.
Methods/design: The JJ-TRIALS primary study uses a head-to-head cluster randomized trial with a phased rollout to evaluate the differential effectiveness of two conditions (Core and Enhanced) in 36 sites located in 7 states. Core strategies for promoting change are compared to an Enhanced strategy that incorporate all core strategies plus active facilitation. Target outcomes include improvements in evidence-based screening, assessment, and linkage to substance use treatment.
Primary Research Questions:
1. Does the Core and/or Enhanced Intervention reduce unmet need by increasing Cascade retention related to screening, assessment, treatment initiation, engagement and continuing care?
2. Does the addition of the Enhanced Intervention components further increase the percentage of youth retained in the Cascade relative to the Core components?
3. Does the addition of the Enhanced Intervention components improve service quality relative to Core sites?
4. Do staff perceptions of the value of best practices increase over time, and are increases more pronounced in Enhanced sites?
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 839
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Core Core In the second phase (after baseline) all 36 sites receive a Core condition that includes five interventions: (1) JJ-TRIALS Orientation Meetings, (2) Needs Assessment, (3) Behavioral Health Training, (4) Site Feedback Report, (5) Goal Achievement Training, (6) Monthly Site Check-ins, and (7) Quarterly Reports. As part of Goal Achievement Training, sites receive assistance in using their Site Feedback Reports to select goals to meet their local needs. Sites are trained on using Data-Driven Decision Making (DDDM) to inform decisions (e.g., selecting a goal, monitoring progress) and enlisting DDDM templates and tools (developed as part of the project) to plan and implement proposed changes. these principles to their improvement efforts during the implementation phase. Enhanced Enhanced While the core intervention and DDDM are expected to facilitate change, organizations may need additional support to apply these principles to their improvement efforts during the implementation phase. In the third phase (after Core), 1/2 of the sites are randomly assigned to an Enhanced condition that provides continuing support for the use of DDDM tools by adding research staff facilitation of DDDM over a 12-month period and formalized Local Change Teams (LCTs) featuring representation from the JJ agency and a local BH provider, with meetings facilitated by research staff). Enhanced Core While the core intervention and DDDM are expected to facilitate change, organizations may need additional support to apply these principles to their improvement efforts during the implementation phase. In the third phase (after Core), 1/2 of the sites are randomly assigned to an Enhanced condition that provides continuing support for the use of DDDM tools by adding research staff facilitation of DDDM over a 12-month period and formalized Local Change Teams (LCTs) featuring representation from the JJ agency and a local BH provider, with meetings facilitated by research staff).
- Primary Outcome Measures
Name Time Method Service Cascade: % Referred to Substance Use Treatment 120 weeks Calculated from juvenile justice and substance use treatment agency records as the number of youth referred to substance use treatment divided by the number of youth identified as need of substance use treatment.
Staff Perception: Value of Evidenced Based Substance Use Treatment 120 weeks Calculated from staff surveys at juvenile justice and substance use treatment agencies as the average staff ranking of the perceived "value" of using of evidence-based substance use treatment services.
- Secondary Outcome Measures
Name Time Method Service Cascade: % In Need of Substance Use Treatment 120 weeks Calculated from juvenile justice and substance use treatment agency records as the number of youth identified (via screening, clinical assessment or other sources) as "In Need of Substance Use Treatment" divided by the number of youth entering the juvenile justice system.
Service Cascade: % Initiating Substance Use Treatment 120 weeks Calculated from juvenile justice and substance use treatment agency records as the number of youth "Initiating" Substance Use Treatment within 90 days of referral" divided by the number referred to treatment from the juvenile justice system.
Service Cascade: % With Substance Use Treatment Continuing Care 120 weeks number of youth "Continuing" to receive substance use treatment services forCalculated from juvenile justice and substance use treatment agency records as the 90 days or more divided by the number initiating treatment.
Service Cascade: % Engaged in Substance Use Treatment 120 weeks Calculated from juvenile justice and substance use treatment agency records as the number of youth "Engaged" in Substance Use Treatment for 6 weeks or more weeks divided by the number initiating treatment.
Service Quality: Timing of Screening or Clinical Assessment 120 weeks Calculated from juvenile justice and substance use treatment agency records as the mean days from entry into the justice system to the first of screening or clinical assessment for substance use problems.
Staff Perception: Value of Evidenced Based Screening 120 weeks Calculated from staff surveys at juvenile justice and substance use treatment agencies as the average staff ranking of the perceived "value" of using of evidence-based screening.
Service Cascade: % Screened for Substance Use Problems 120 weeks Calculated from juvenile justice and substance use treatment agency records as the number of youth "Screened" for substance use problems divided by the number of youth entering the juvenile justice system.
Service Cascade: % Clinically Assessed for Substance Use Problems 120 weeks Calculated from juvenile justice and substance use treatment agency records as the number of youth "Clinically Assessed" for substance use problems divided by the number of youth entering the juvenile justice system.
Service Quality: Timing of Substance Use Treatment Initiation 120 weeks Calculated from juvenile justice and substance use treatment agency records as the mean days from referral to and initiation of substance use treatment.
Service Quality: Number of Evidence Based Practices 120 Weeks Based on agency surveys and youth records from juvenile justice and substance use treatment agencies, the number of steps using 1 or more evidenced based practices in each of the following steps along the service cascade: screening, clinical assessment, referral, substance use treatment.
Staff Perception: Value of Evidenced Based Clinical Assessment 120 weeks Calculated from staff surveys at juvenile justice and substance use treatment agencies as the average staff ranking of the perceived "value" of using of evidence-based clinical assessment.
Staff Perception: Value of Evidenced Based Substance Use Prevention 120 weeks Calculated from staff surveys at juvenile justice and substance use treatment agencies as the average staff ranking of the perceived "value" of using of evidence-based substance use prevention.
Staff Perception: Value of Evidenced Based HIV Risk Prevention 120 weeks Calculated from staff surveys at juvenile justice and substance use treatment agencies as the average staff ranking of the perceived "value" of using of evidence-based HIV Risk prevention.
Trial Locations
- Locations (8)
Emory University
🇺🇸Atlanta, Georgia, United States
National Institute on Drug Abuse
🇺🇸Rockville, Maryland, United States
Temple University
🇺🇸Philadelphia, Pennsylvania, United States
Columbia University
🇺🇸New York, New York, United States
Texas Christian University
🇺🇸Fort Worth, Texas, United States
University of Kentucky
🇺🇸Lexington, Kentucky, United States
Mississippi State University
🇺🇸Starkville, Mississippi, United States
Chestnut Health Systems
🇺🇸Bloomington, Illinois, United States