Reducing Parental Substance Use and Enhancing Family Resilience Among Rural Families Through Ohio START

NCT ID: NCT07278427

Last Updated: 2025-12-12

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Total Enrollment: 400 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2026-02-01
• Study Completion Date: 2030-08-31

Brief Summary

The goal of this observational study is to learn about the roles played by parental activity spaces and social networks in reducing parental substance use and promoting child and family health outcomes in the context of Ohio START (Sobriety, Treatment, and Reducing Trauma) for families in rural areas. This study will investigate if substance use treatment service referrals and family peer mentoring services provided by Ohio START lead to positive changes in parental activity spaces and social networks, and if these positive changes lead to better child and family outcomes. The main questions it aims to answer are:

• Does having behavioral health services (referred by Ohio START workers) close to where parents spend their time help with substance use recovery and child health?
• Does peer mentor support through Ohio START help parents build stronger social connections and family resilience, and does this lead to better long-term family health?
• Do these associations differ in rural areas compared to urban areas?

Participants will:

• Answer survey questions about their substance use, parenting, child health, and family well-being across three waves (Wave 1: when they enroll in the study, Wave 2: 6-month follow-up, and Wave 3: 12-month follow-up)
• Share information about places they go regularly (such as work, stores, and healthcare visits)
• Share information about people in their support network

Detailed Description

Co-occurring parental substance use disorder (SUD) and child maltreatment are key risk factors associated with poor health outcomes among children and families in rural areas. Importantly, rural communities face geographic, economic, and social challenges that limit their access to SUD treatment services. Ohio Sobriety, Treatment, and Reducing Trauma (Ohio START) is a family-centered child welfare service delivery intervention that builds on cross-system collaboration with behavioral health service organizations to provide timely access to SUD treatment services for parents involved with the child welfare system. Ohio START also supports parents' journey to SUD recovery through family peer mentors -individuals with lived experience in SUD recovery and previous child welfare involvement- who offer intensive recovery support. When Ohio START child welfare caseworkers refer parents to SUD treatment services located within or near the places parents regularly visit (i.e., activity spaces), parents may be more likely to engage in treatment consistently and experience improvements in their health and family well-being. Similarly, when parents actively engage with family peer mentors, who help them connect with treatment and recovery communities, they may experience positive shifts in their activity spaces and social networks. Yet, it remains unclear how access to SUD treatment services within parents' activity spaces and greater engagement with family peer mentors influence child and family health outcomes, especially among low-income families in rural areas. These are important questions that, if answered, could enhance interventions to better serve families in rural communities. Capitalizing on a unique opportunity to leverage the ongoing Ohio START initiative and access child welfare-involved families in rural areas, we seek to collect novel, longitudinal activity space and social networks data from 400 families engaging in Ohio START. The study has three specific aims: (1) to determine whether the overlap between parental activity spaces and child welfare workers' referral networks (i.e., proximity and availability of SUD treatment providers) predicts intermediate (i.e., SUD treatment service use, family resilience) and long-term (i.e., parent substance use, child psychosocial-behavioral health, child maltreatment) family health outcomes; (2) to examine how parents' engagement with family peer mentors is associated with changes in the attributes of parental activity spaces and social networks over time and how these changes, in turn, are associated with family health outcomes; (3) to test whether rurality moderates the effects of SUD treatment referral networks, activity spaces, and social networks on family health outcomes. The proposed project will produce valuable knowledge that can be used to modify START and other family-level intervention efforts to mitigate risks and maximize protection in parents' activity spaces and social networks to enhance family resilience, prevent child maltreatment, and promote child well-being in rural communities.

Conditions

Substance Use Disorder (SUD); Rural Health; Family Resilience; Child Maltreatment; Child Well-beiing; Substance Use Recovery

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: PROSPECTIVE

Study Groups

Rural parents receiving Ohio START services

Parents who have entered the child welfare system due to co-occurring parental substance use and child maltreatment and who are currently enrolled in Ohio START (Ohio Sobriety, Treatment, and Reducing Trauma). The study is conducted in the context of Ohio START, a children-services-led initiative and evidence-informed intervention model currently operating in 57 counties in the state of Ohio. If both parents from the same family receive the Ohio START intervention, both are eligible to participate.

Ohio START (Ohio Sobriety, Treatment, and Reducing Trauma)

Intervention Type: BEHAVIORAL

Ohio START launched in 2017 in response to the opioid epidemic and is led by the Public Children Services Association of Ohio (PASCO). Ohio START integrates child welfare and substance use treatment systems to enhance access to treatment for parents who come into the child welfare system with addictions. Ohio START capitalizes on collaboration between the child welfare system and behavioral health providers in order to reduce parent wait times for treatment for referrals, increase parent engagement and retention in treatment, and enhance coordination of resources and support for parents and children. Another key aspect of START is the use of family peer mentors as a social network intervention. Parents are paired with family peer mentors who, through weekly visits, support participating families and enhance coordination of resources. Family peer mentors are required to have a minimum of a weekly face-to-face visit with parents for 90 days.

Interventions

Ohio START (Ohio Sobriety, Treatment, and Reducing Trauma)

Ohio START launched in 2017 in response to the opioid epidemic and is led by the Public Children Services Association of Ohio (PASCO). Ohio START integrates child welfare and substance use treatment systems to enhance access to treatment for parents who come into the child welfare system with addictions. Ohio START capitalizes on collaboration between the child welfare system and behavioral health providers in order to reduce parent wait times for treatment for referrals, increase parent engagement and retention in treatment, and enhance coordination of resources and support for parents and children. Another key aspect of START is the use of family peer mentors as a social network intervention. Parents are paired with family peer mentors who, through weekly visits, support participating families and enhance coordination of resources. Family peer mentors are required to have a minimum of a weekly face-to-face visit with parents for 90 days.

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• age 18 or older;
• currently enrolled in Ohio START;
• are unemployed or have family income at or below the federal poverty level,
• designated as the primary parent in the Ohio START case plan.

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

NIH

Sponsor Role: collaborator

University of Michigan

OTHER

Sponsor Role: collaborator

Ohio State University

OTHER

Sponsor Role: lead

Responsible Party

Susan Yoon

Associate Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

The Ohio State University

Columbus, Ohio, United States

Countries

United States

Central Contacts

Susan Yoon, PhD

Role: CONTACT

yoon.538@osu.edu

614-292-3289

Elinam Dellor, PhD

Role: CONTACT

dellor.1@osu.edu

614-292-3085

Facility Contacts

Susan Yoon, PhD

Role: primary

yoon.538@osu.edu

614-292-3289

Elinam Dellor, PhD

Role: backup

dellor.1@osu.edu

614-292-3085

References

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Reference Type: BACKGROUND

PMID: 17446567 (View on PubMed)

Seay K. How Many Families in Child Welfare Services Are Affected by Parental Substance Use Disorders? A Common Question that Remains Unanswered. Child Welfare. 2015;94(4):19-51.

Reference Type: BACKGROUND

PMID: 26827475 (View on PubMed)

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Reference Type: BACKGROUND

PMID: 23209385 (View on PubMed)

Kantor GK, Holt MK, Mebert CJ, Straus MA, Drach KM, Ricci LR, MacAllum CA, Brown W. Development and preliminary psychometric properties of the multidimensional neglectful behavior scale-child report. Child Maltreat. 2004 Nov;9(4):409-28. doi: 10.1177/1077559504269530.

Reference Type: BACKGROUND

PMID: 15538039 (View on PubMed)

Goodman R. Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry. 2001 Nov;40(11):1337-45. doi: 10.1097/00004583-200111000-00015.

Reference Type: BACKGROUND

PMID: 11699809 (View on PubMed)

Fortney J, Booth BM. Access to substance abuse services in rural areas. Recent Dev Alcohol. 2001;15:177-97. doi: 10.1007/978-0-306-47193-3_10. No abstract available.

Reference Type: BACKGROUND

PMID: 11449741 (View on PubMed)

Other Identifiers

1R01HD119145-01

Identifier Type: NIH

Identifier Source: secondary_id

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1R01HD119145

Identifier Type: NIH

Identifier Source: org_study_id

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