Youth involved in the Juvenile Justice System (JJS) have higher rates of substance use/disorder (SU/D) than those in the general population (25%-50% vs. 10%). Well over half of JJS youth do not receive SU services due to barriers at individual/family-, and system-levels; yet, few evidence-based service delivery models address multilevel barriers to treatment. This project proposes to augment the protocols of an evidence-based linkage program for youth on probation that addresses barriers at the systems level (Project CONNECT) with those of an efficacious program of evidence-based engagement strategies that help providers work with families to increase access to care (TIES). This will create a new service delivery model implemented in probation settings that targets both family and system-level factors to increase youth's use of and retention in SU services. Because training probation officers (POs) to deliver new family engagement strategies not currently part of their roles and potentially at odds with the probation context may compromise adoption and sustainability, we will use embedded Linkage Specialists to assist POs in improving service linkage/uptake. The proposed Principal Investigator is an Early Stage Investigator with significant experience working within probation settings in New York State (NYS) and is supported by a strong multi-disciplinary team of senior researchers to achieve the study aims. Working in two NYS counties, specific aims are (1) to augment CONNECT cross-system linkage protocols for screening/referral with adapted TIES family engagement strategies to create an innovative service delivery model for youth (Family CONNECT) implemented in probation settings; (2) to examine, in a pilot-test with n=50 families, the impact of Family CONNECT on improving cross-system referral; youth and family engagement; youth enrollment/retention in SU treatment; and (secondary outcomes) effect on youth SU and recidivism; and (3) to elucidate family and organizational- level factors that influence Family CONNECT implementation in probation settings to inform a larger trial. We propose a two-phase study. Phase 1: Service Model Adaptation (Aim1), will involve (a) in-depth interviews with n=24 adolescents on probation and their caregivers; n=5 probation department staff; and n=5 substance abuse treatment program staff to understand multi-level facilitators and barriers to service use and b) adaption of Family CONNECT, informed by formative work, in youth/caregiver and staff work groups. In Phase 2: Pilot Test and Implementation Evaluation (Aims 2 and 3), we will pilot test Family CONNECT with n=50 youth-caregiver dyads, randomized at the level of PO to Family CONNECT or standard of care to explore family-, staff-, and organizational-level factors influencing feasibility, acceptability, and potential sustainability of the program in probation settings. Because treatment of SU/D can reduce rates of recidivism and other poor outcomes, a focus on linkage and uptake of SU services by JJS youth is paramount to public as well as correctional health.
Youth in the juvenile justice system (JJS) are at high risk for substance use/disorder (SU/D), yet 50%-80% of JJS youth do not receive necessary SU services that are critical to reduce recidivism and improve other key psychosocial outcomes. Intensive efforts to improve linkage to and use of SU services for JJS youth are needed that address family- as well as JJS- and behavioral health system-level barriers to service use. The current project addresses a critical public as well as correctional health problem by adapting existing evidence- based practices to create a novel service delivery model that targets family-level in addition to systems-level factors to increase uptake of SU services by JJS youth.
