Substance Abuse, Substance Dependence, Substance-Related Disorders, Substance Related Problem, Substance Use, Substance Use Disorders
Conditions
Keywords
drug use, drug addiction, drug habituation, drug use disorders, organic mental disorders, substance-induced, substance abuse, substance addiction, substance dependence, substance use disorders
Brief summary
Developed from adapting and combining two evidence-based programs, Project CONNECT (a linkage-to-services program that targets barriers within the probation and substance abuse treatment systems) and TIES (a program that teaches family engagement skills to providers), Family CONNECT is a linkage-to-services program that targets both family and system-level factors to increase youth use of and retention in substance use services. Using Linkage Specialists embedded within probation departments, Family CONNECT will be implemented in two NYS probation departments. This proposed study will evaluate the impact of Family CONNECT on (1) youth referral from probation to substance abuse treatment, (2) youth and family engagement in substance abuse treatment, (3) youth enrollment/retention in substance abuse treatment, and (4) youth substance use and recidivism. Counts of youth referred, youth who start treatment, and youth retained in treatment will be obtained from the juvenile justice agency for 6-months pre-implementation of Family Connect (i.e. baseline) and during the implementation period of e-Connect; counts of youth recidivism will be obtained 6 months following the completion of Family Connect. This study will also identify family and probation organizational factors influencing Family CONNECT implementation in probation settings. 50 caregiver-youth dyads and up to 36 probation officers will be recruited as participants in the study. Caregiver-youth dyads will be evaluated at baseline, 2 and 6 months; probation officers at baseline, 6, 12, and 18 months; linkage specialists at baseline, 6, 12, and 18 months.
Interventions
BEHAVIORALFamily CONNECT
Linkage specialists, who are clinical social workers and embedded within the probation departments, will work with specifically caregiver-youth dyads in the Family CONNECT arm to link youth to substance use services.
Sponsors
National Institute on Drug Abuse (NIDA)
New York State Psychiatric Institute
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Intervention model description
This study is a randomized control trial. Caregiver-youth dyads are randomized to either the control (standard of care) or experimental (Family CONNECT) group based on the youth's probation officer (randomization occurs at the level of the youth's probation officer). If randomized to the control (standard of care) group, caregiver-youth dyads will work with their probation officer as usual to link to substance use services. If randomized to the experimental (Family CONNECT) group, caregiver-youth dyads will work with a linkage specialist to link to substance use services. Youth in both groups will be compared to a baseline stand of care collected during the pre-implementation period.
Eligibility
Sex/Gender
ALL
Age
10 Years to 18 Years
Healthy volunteers
No
Inclusion criteria
Youth: Inclusion Criteria 1. Between 10-18 years of age 2. English speaking 3. A caregiver who will participate in the study 4. MAYSI-2 score of ≥ 4 on any MAYSI-2 subscale; YASI mental health and substance use screen items; or other documented evidence of mental health or substance use problem 5. Currently on probation
Exclusion criteria
1. Cognitively unable to complete the interview Caregiver: Inclusion criteria 1. Youth's legal guardian (or permission from legal guardian) 2. Youth who will participate 3. English speaking
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Youth Enrolled in Substance Use Treatment | Two years (study implementation period) | Count of youth participants enrolled in substance use treatment based on self-report or administrative records |
| Youth Enrolled in Any Behavioral Health Treatment | Two years (study implementation period) | Number of youth enrolled in any behavioral health treatment (incl. mental health and substance use) within the past 6 months |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Youth Referred for Substance Use Treatment | Two years (study implementation period) | Number of youth referred to substance use treatment |
| Youth Referred for Any Behavioral Health Treatment | two years (implementation period) | Number of youth who are referred to any behavioral health treatment |
Other
| Measure | Time frame | Description |
|---|---|---|
| Youth Initiated Substance Use Treatment | Two years (study implementation period) | Number of youth who attended an additional substance use treatment appointment following intake. |
| Youth Initiated Any Behavioral Health Treatment | two years (study implementation period) | Number of youth who attended an additional behavioral health treatment appointment following intake. |
Participant flow
Recruitment details
Participants were recruited by study staff, following probation officer referral, between December 2015-May 2017 in two county probation agencies. Probation officers were randomized into either the treatment of SOC arm so that probation officers worked exclusively with either youth in the treatment or SOC arm to avoid cross-contamination across study arms.
Pre-assignment details
Following recruitment, if the youth-caregiver dyad were working with a probation officer (PO) that was in the treatment arm, they were linked with the Linkage Specialist and began the intervention. If they were working with a PO who was in the control arm, they were linked to services in the usual way. Study completion occurred when dyads completed their 6 month survey, and were linked to treatment (experimental arm only)
Participants by arm
| Arm | Count |
|---|---|
| Standard of Care - Youth This arm is comprised of youth from caregiver-youth dyads randomized to work with the youth's probation officer as usual to link youth to substance use services. | 4 |
| Family CONNECT - Youth This arm is comprised of youth from caregiver-youth dyads randomized to work with linkage specialists to link youth to substance use services.
Family CONNECT: Linkage specialists, who are clinical social workers and embedded within the probation departments, will work with specifically caregiver-youth dyads in the Family CONNECT arm to link youth to substance use services. | 18 |
| Family Connect - Caregiver This arm is comprised of caregivers from caregiver-youth dyads randomized to work with linkage specialists to link youth to substance use services.
Family CONNECT: Linkage specialists, who are clinical social workers and embedded within the probation departments, will work with specifically caregiver-youth dyads in the Family CONNECT arm to link youth to substance use services. | 15 |
| Standard of Care - Caregiver This arm is comprised of caregivers from caregiver-youth dyads randomized to work with the youth's probation officer as usual to link youth to substance use services | 4 |
| Total | 41 |
Baseline characteristics
| Characteristic | Family CONNECT - Youth | Family Connect - Caregiver | Standard of Care - Youth | Standard of Care - Caregiver | Total |
|---|---|---|---|---|---|
| Age, Categorical <=18 years | 18 Participants | 0 Participants | 4 Participants | 0 Participants | 22 Participants |
| Age, Categorical >=65 years | 0 Participants | 1 Participants | 0 Participants | 0 Participants | 1 Participants |
| Age, Categorical Between 18 and 65 years | 0 Participants | 14 Participants | 0 Participants | 4 Participants | 18 Participants |
| Age, Continuous | 14.9 years STANDARD_DEVIATION 1.1 | 46.2 years STANDARD_DEVIATION 10.5 | 15.5 years STANDARD_DEVIATION 1 | 39.5 years STANDARD_DEVIATION 8.6 | 15.1 years STANDARD_DEVIATION 1.1 |
| County County 1 | 14 Participants | 11 Participants | 4 Participants | 0 Participants | 29 Participants |
| County County 2 | 4 Participants | 4 Participants | 0 Participants | 4 Participants | 12 Participants |
| Ethnicity (NIH/OMB) Hispanic or Latino | 8 Participants | 2 Participants | 0 Participants | 1 Participants | 11 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 10 Participants | 13 Participants | 4 Participants | 2 Participants | 29 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 1 Participants | 1 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 13 Participants | 9 Participants | 4 Participants | 3 Participants | 29 Participants |
| Race (NIH/OMB) White | 5 Participants | 6 Participants | 0 Participants | 1 Participants | 12 Participants |
| Region of Enrollment United States | 18 participants | 15 participants | 4 participants | 4 participants | 41 participants |
| Sex: Female, Male Female | 8 Participants | 12 Participants | 1 Participants | 4 Participants | 25 Participants |
| Sex: Female, Male Male | 10 Participants | 3 Participants | 3 Participants | 0 Participants | 16 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 4 | 0 / 18 | 0 / 4 | 0 / 15 |
| other Total, other adverse events | 0 / 4 | 0 / 18 | 0 / 4 | 0 / 15 |
| serious Total, serious adverse events | 0 / 4 | 0 / 18 | 0 / 4 | 0 / 15 |
Outcome results
Primary
Youth Enrolled in Any Behavioral Health Treatment
Number of youth enrolled in any behavioral health treatment (incl. mental health and substance use) within the past 6 months
Time frame: Two years (study implementation period)
Population: Youth on probation with identified substance use need
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Standard of Care- YOUTH | Youth Enrolled in Any Behavioral Health Treatment | Attended intake appointment | 2 Participants |
| Standard of Care- YOUTH | Youth Enrolled in Any Behavioral Health Treatment | No intake | 2 Participants |
| Family CONNECT- YOUTH | Youth Enrolled in Any Behavioral Health Treatment | Attended intake appointment | 15 Participants |
| Family CONNECT- YOUTH | Youth Enrolled in Any Behavioral Health Treatment | No intake | 3 Participants |
p-value: 0.148Fisher Exact
Primary
Youth Enrolled in Substance Use Treatment
Count of youth participants enrolled in substance use treatment based on self-report or administrative records
Time frame: Two years (study implementation period)
Population: Youth on probation with identified substance use need
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Standard of Care- YOUTH | Youth Enrolled in Substance Use Treatment | Enrolled | 0 Participants |
| Standard of Care- YOUTH | Youth Enrolled in Substance Use Treatment | Did not enroll | 4 Participants |
| Family CONNECT- YOUTH | Youth Enrolled in Substance Use Treatment | Enrolled | 12 Participants |
| Family CONNECT- YOUTH | Youth Enrolled in Substance Use Treatment | Did not enroll | 6 Participants |
Secondary
Youth Referred for Any Behavioral Health Treatment
Number of youth who are referred to any behavioral health treatment
Time frame: two years (implementation period)
Population: Youth on probation with identified substance use need
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Standard of Care- YOUTH | Youth Referred for Any Behavioral Health Treatment | Referred to Behavioral Health | 4 Participants |
| Standard of Care- YOUTH | Youth Referred for Any Behavioral Health Treatment | No Referral | 0 Participants |
| Family CONNECT- YOUTH | Youth Referred for Any Behavioral Health Treatment | Referred to Behavioral Health | 17 Participants |
| Family CONNECT- YOUTH | Youth Referred for Any Behavioral Health Treatment | No Referral | 1 Participants |
p-value: 0.818Fisher Exact
Secondary
Youth Referred for Substance Use Treatment
Number of youth referred to substance use treatment
Time frame: Two years (study implementation period)
Population: Youth on probation with identified substance use need
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Standard of Care- YOUTH | Youth Referred for Substance Use Treatment | Referred | 0 Participants |
| Standard of Care- YOUTH | Youth Referred for Substance Use Treatment | No referral | 4 Participants |
| Family CONNECT- YOUTH | Youth Referred for Substance Use Treatment | Referred | 17 Participants |
| Family CONNECT- YOUTH | Youth Referred for Substance Use Treatment | No referral | 1 Participants |
p-value: <0.01Fisher Exact
Other Pre-specified
Youth Initiated Any Behavioral Health Treatment
Number of youth who attended an additional behavioral health treatment appointment following intake.
Time frame: two years (study implementation period)
Population: Youth on probation with identified substance use need
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Standard of Care- YOUTH | Youth Initiated Any Behavioral Health Treatment | Initiated Treatment | 2 Participants |
| Standard of Care- YOUTH | Youth Initiated Any Behavioral Health Treatment | Did not initiate treatment | 2 Participants |
| Family CONNECT- YOUTH | Youth Initiated Any Behavioral Health Treatment | Initiated Treatment | 9 Participants |
| Family CONNECT- YOUTH | Youth Initiated Any Behavioral Health Treatment | Did not initiate treatment | 9 Participants |
p-value: 0.625Fisher Exact
Other Pre-specified
Youth Initiated Substance Use Treatment
Number of youth who attended an additional substance use treatment appointment following intake.
Time frame: Two years (study implementation period)
Population: Youth on probation with identified substance use need
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Standard of Care- YOUTH | Youth Initiated Substance Use Treatment | Did not initiate treatment | 4 Participants |
| Standard of Care- YOUTH | Youth Initiated Substance Use Treatment | Initiated Treatment | 0 Participants |
| Family CONNECT- YOUTH | Youth Initiated Substance Use Treatment | Did not initiate treatment | 10 Participants |
| Family CONNECT- YOUTH | Youth Initiated Substance Use Treatment | Initiated Treatment | 8 Participants |