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.
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?
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
TRIPLE
Enrollment
839
Emory University
Atlanta, Georgia, United States
Chestnut Health Systems
Bloomington, Illinois, United States
University of Kentucky
Lexington, Kentucky, United States
National Institute on Drug Abuse
Rockville, Maryland, United States
Service Cascade: % Referred to Substance Use Treatment
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.
Time frame: 120 weeks
Staff Perception: Value of Evidenced Based Substance Use Treatment
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.
Time frame: 120 weeks
Service Cascade: % Screened for Substance Use Problems
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.
Time frame: 120 weeks
Service Cascade: % Clinically Assessed for Substance Use Problems
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.
Time frame: 120 weeks
Service Cascade: % In Need of Substance Use Treatment
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.
Time frame: 120 weeks
Service Cascade: % Initiating Substance Use Treatment
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Mississippi State University
Starkville, Mississippi, United States
Columbia University
New York, New York, United States
Temple University
Philadelphia, Pennsylvania, United States
Texas Christian University
Fort Worth, Texas, United States
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.
Time frame: 120 weeks
Service Cascade: % Engaged in Substance Use Treatment
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.
Time frame: 120 weeks
Service Cascade: % With Substance Use Treatment Continuing Care
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.
Time frame: 120 weeks
Service Quality: Timing of Screening or Clinical Assessment
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.
Time frame: 120 weeks
Service Quality: Timing of Substance Use Treatment Initiation
Calculated from juvenile justice and substance use treatment agency records as the mean days from referral to and initiation of substance use treatment.
Time frame: 120 weeks
Service Quality: Number of Evidence Based Practices
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.
Time frame: 120 Weeks
Staff Perception: Value of Evidenced Based Screening
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.
Time frame: 120 weeks
Staff Perception: Value of Evidenced Based Clinical Assessment
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.
Time frame: 120 weeks
Staff Perception: Value of Evidenced Based Substance Use Prevention
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.
Time frame: 120 weeks
Staff Perception: Value of Evidenced Based HIV Risk Prevention
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.
Time frame: 120 weeks