Juvenile Justice Translational Research on Interventions for Adolescents in the Legal System: Multi-site Implementation Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 839
- 试验地点
- 15
- 主要终点
- Service Cascade: % Referred to Substance Use Treatment
研究概览
简要总结
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.
详细描述
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:
- Does the Core and/or Enhanced Intervention reduce unmet need by increasing Cascade retention related to screening, assessment, treatment initiation, engagement and continuing care?
- Does the addition of the Enhanced Intervention components further increase the percentage of youth retained in the Cascade relative to the Core components?
- Does the addition of the Enhanced Intervention components improve service quality relative to Core sites?
- Do staff perceptions of the value of best practices increase over time, and are increases more pronounced in Enhanced sites?
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- Triple (Participant, Investigator, Outcomes Assessor)
盲法说明
Pairs of sites were optimally randomize based on 10,000 trials to the two conditions by the coordinating center. The assignment (to core or core+enhanced) was not revealed to the local research center or site until after completion of the core. Thus it is double blind.
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- 未提供
排除标准
- 未提供
研究组 & 干预措施
Control
During the Baseline Control data is collected in all 36 sites at the agency, staff, and youth level on the 6 months prior to the interventions in Arms 2 & 3 to document what practice was before the study.
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.
干预措施: Core (Behavioral)
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).
干预措施: Core (Behavioral)
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).
干预措施: Enhanced (Behavioral)
结局指标
主要结局
Service Cascade: % Referred to Substance Use Treatment
时间窗: 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
时间窗: 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.
次要结局
- Service Cascade: % In Need of Substance Use Treatment(120 weeks)
- Service Cascade: % Initiating Substance Use Treatment(120 weeks)
- Service Cascade: % With Substance Use Treatment Continuing Care(120 weeks)
- Service Cascade: % Engaged in Substance Use Treatment(120 weeks)
- Service Quality: Timing of Screening or Clinical Assessment(120 weeks)
- Staff Perception: Value of Evidenced Based Screening(120 weeks)
- Service Cascade: % Screened for Substance Use Problems(120 weeks)
- Service Cascade: % Clinically Assessed for Substance Use Problems(120 weeks)
- Service Quality: Timing of Substance Use Treatment Initiation(120 weeks)
- Service Quality: Number of Evidence Based Practices(120 Weeks)
- Staff Perception: Value of Evidenced Based Clinical Assessment(120 weeks)
- Staff Perception: Value of Evidenced Based Substance Use Prevention(120 weeks)
- Staff Perception: Value of Evidenced Based HIV Risk Prevention(120 weeks)
研究者
Michael L. Dennis, Ph.D.
Coordinating Center Multi-PI
Chestnut Health Systems