Juvenile Justice Translational Research on Interventions for Adolescents in the Legal System

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

839 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-07-01

Study Completion Date

2019-06-30

Brief Summary

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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.

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Detailed Description

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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?

Conditions

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Substance Use Disorders

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Staff from 34 juvenile community supervision agencies were observed for a 6 month baseline period than trained over 4 months on using a behavioral health service cascade model to screen, identify, and refer youth to substance use treatment. Half the sites were randomized to 12 additional months of facilitation. Sites were then monitored for an additional 4 month maintenance phase.

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

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.

Study Groups

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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.

Group Type NO_INTERVENTION

No interventions assigned to this group

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.

Group Type ACTIVE_COMPARATOR

Core

Intervention Type 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).

Group Type EXPERIMENTAL

Core

Intervention Type BEHAVIORAL

Enhanced

Intervention Type BEHAVIORAL

Interventions

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Core

Intervention Type BEHAVIORAL

Enhanced

Intervention Type BEHAVIORAL

Other Intervention Names

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GAT, DDDM DDDM, Facilitation

Eligibility Criteria

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Inclusion Criteria

Specific site inclusion criteria include: (a) ability to provide youth service records, (b) service to youth under community supervision, (c) access to treatment provider(s) if treatment is not provided directly by the JJ agency, (d) participation in requisite intervention training/activities,(e) minimum average case flow of 10 youth per month, (f) minimum of 10 staff per site, and (g) a senior JJ staff member who agrees to serve as site leader/liaison during the study. Study sites are geographically dispersed and were identified by state JJ agencies (and not selected for particular substance use or related BH service needs).

Youth inclusion criteria include: all youth entering the juvenile justice system during the period within the exception of those who are already in treatment at the time that they are referred to the juvenile justice agency.

Staff inclusion criteria include: all staff actively working with the youth under community supervision in the site with exclusion only of higher level administrative or regional staff over multiple units..

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Responsible Party

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Michael L. Dennis, Ph.D.

Coordinating Center Multi-PI

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Tisha R Wiley, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

National Institute on Drug Abuse (NIDA)

Gail A Wasserman, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Columbia University

Ralph DiClemente, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Emory University

Gene H Brody, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Emory University

Angela A Robertson, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Mississippi State University

Steven R Belenko, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Temple University

Danica K Knight, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Texas Christian University

Carl G Leukefeld, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

University of Kentucky

Michael L Dennis, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Chestnut Health Systems

Christy K Scott, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Chestnut Health Systems

Locations

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Emory University

Atlanta, Georgia, United States

Site Status

Chestnut Health Systems

Bloomington, Illinois, United States

Site Status

University of Kentucky

Lexington, Kentucky, United States

Site Status

National Institute on Drug Abuse

Rockville, Maryland, United States

Site Status

Mississippi State University

Starkville, Mississippi, United States

Site Status

Columbia University

New York, New York, United States

Site Status

Temple University

Philadelphia, Pennsylvania, United States

Site Status

Texas Christian University

Fort Worth, Texas, United States

Site Status

Countries

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United States

References

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Jones SD, Bartkowski JP, Belenko S, Becan JE, Taxman FS, Wasserman GA, Aarons GA, McReynolds LS, Dolbear C, Xu X. Site engagement in implementation research: Introducing SEAMLIS as a conceptual and measurement framework. Health Justice. 2025 Jul 5;13(1):44. doi: 10.1186/s40352-025-00349-1.

Reference Type DERIVED

PMID: 40616691 (View on PubMed)

Nelson V, Wood J, Belenko S, Pankow J, Piper K. Conditions of successful treatment referral practices with justice-involved youth: Qualitative insights from probation and service provider staff involved in JJ-TRIALS. J Subst Use Addict Treat. 2024 Jul;162:209358. doi: 10.1016/j.josat.2024.209358. Epub 2024 Mar 27.

Reference Type DERIVED

PMID: 38548060 (View on PubMed)

Belenko S, Dembo R, Knight DK, Elkington KS, Wasserman GA, Robertson AA, Welsh WN, Schmeidler J, Joe GW, Wiley T. Using structured implementation interventions to improve referral to substance use treatment among justice-involved youth: Findings from a multisite cluster randomized trial. J Subst Abuse Treat. 2022 Sep;140:108829. doi: 10.1016/j.jsat.2022.108829. Epub 2022 Jun 19.

Reference Type DERIVED

PMID: 35751945 (View on PubMed)

Marks KR, Leukefeld CG, Dennis ML, Scott CK, Funk R; JJ-TRIALS Cooperative. Geographic differences in substance use screening for justice-involved youth. J Subst Abuse Treat. 2019 Jul;102:40-46. doi: 10.1016/j.jsat.2019.04.005. Epub 2019 Apr 13.

Reference Type DERIVED

PMID: 31202287 (View on PubMed)

Fisher JH, Becan JE, Harris PW, Nager A, Baird-Thomas C, Hogue A, Bartkowski JP, Wiley T; JJ-TRIALS Cooperative. Using Goal Achievement Training in juvenile justice settings to improve substance use services for youth on community supervision. Health Justice. 2018 Apr 30;6(1):10. doi: 10.1186/s40352-018-0067-4.

Reference Type DERIVED

PMID: 29713840 (View on PubMed)

Becan JE, Bartkowski JP, Knight DK, Wiley TRA, DiClemente R, Ducharme L, Welsh WN, Bowser D, McCollister K, Hiller M, Spaulding AC, Flynn PM, Swartzendruber A, Dickson MF, Fisher JH, Aarons GA. A model for rigorously applying the Exploration, Preparation, Implementation, Sustainment (EPIS) framework in the design and measurement of a large scale collaborative multi-site study. Health Justice. 2018 Apr 13;6(1):9. doi: 10.1186/s40352-018-0068-3.

Reference Type DERIVED

PMID: 29654518 (View on PubMed)

Belenko S, Knight D, Wasserman GA, Dennis ML, Wiley T, Taxman FS, Oser C, Dembo R, Robertson AA, Sales J. The Juvenile Justice Behavioral Health Services Cascade: A new framework for measuring unmet substance use treatment services needs among adolescent offenders. J Subst Abuse Treat. 2017 Mar;74:80-91. doi: 10.1016/j.jsat.2016.12.012. Epub 2016 Dec 31.

Reference Type DERIVED

PMID: 28132705 (View on PubMed)

Knight DK, Belenko S, Wiley T, Robertson AA, Arrigona N, Dennis M, Bartkowski JP, McReynolds LS, Becan JE, Knudsen HK, Wasserman GA, Rose E, DiClemente R, Leukefeld C; JJ-TRIALS Cooperative. Juvenile Justice-Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS): a cluster randomized trial targeting system-wide improvement in substance use services. Implement Sci. 2016 Apr 29;11:57. doi: 10.1186/s13012-016-0423-5.

Reference Type DERIVED

PMID: 27130175 (View on PubMed)