Abstract
BackgroundAcross Ohio, parental substance abuse has contributed to a marked increase in the number of children in foster care. Children exposed to parental substance use have a higher likelihood of physical abuse and neglect, and consequently a variety of physical, psychological and cognitive problems. The Enhancing Permanency in Children and Families (EPIC) program is a collaborative effort between the Ohio State University College of Social Work, two county offices of the Ohio Department of Job and Family Services, two juvenile courts and local behavioral health agencies. The goal of EPIC is to use three evidence-based and evidence-informed practices to reduce abusive and neglectful parenting, reduce addiction severity in parents, and improve permanency outcomes for families involved with the child welfare system due to substance abuse.MethodsEPIC is a quasi-experimental study. Under the program, child welfare-involved adults who screen positive for substances are matched with a peer recovery supporter. Participants are also incentivized to participate in family treatment drug court, medications for opioid use disorders and home-based parenting supports. Participating adults (N = 250) are matched with comparison groups from counties participating in a separate intervention (Ohio START) and to those receiving treatment as usual, resulting in a final sample of 750 adults. Primary outcomes including addiction severity, child trauma symptoms, resilience, and attachment are assessed at baseline and at program completion. Additional outcomes include timely access to treatment services, length of placement in out-of-home care and recidivism into the child welfare system.DiscussionThis intervention formalizes cross-system collaboration between child welfare, behavioral health and juvenile courts to support families affected by addiction. The use of three evidence-based or evidence-informed strategies presents the opportunity to determine specific strategies that are most effective for reducing addiction severity. Lastly, the intervention combines several sources of funding to bolster sustainability beyond the life of the Regional Partnership Grant (RPG).Trial registrationNCT04700696. Registered January 7, 2021-retrospectively registered.
Highlights
A significant proportion of children in the United States are exposed to substance-using parents, with prior estimates suggesting 12% of children live in a household where at least one parent is abusing or dependent on alcohol or other drugs [1]
Study components Enhancing Permanency in Children and Families (EPIC) participants are incentivized to participate in (1) family treatment drug court (FTDC), with medications for opioid use disorders (MOUD); (2) peer recovery support and (3) home-based parenting supports based on the Nurturing Parenting Program [20]
Evaluation design To evaluate EPIC, a quasi-experimental design will be employed through a two-stage sampling procedure. This design provides the ability to assess (1) the effects of EPIC on access to services for the families in the two intervention counties, and (2) the independent effects of additional services provided under EPIC that may be over and above interventions provided by Ohio START and treatment as usual (TAU)
Summary
Background A significant proportion of children in the United States are exposed to substance-using parents, with prior estimates suggesting 12% of children live in a household where at least one parent is abusing or dependent on alcohol or other drugs [1]. Children exposed to parental substance misuse experience higher risks for any array of physical, cognitive, psychological, and social harms [2]. Some of these adverse consequences are likely due to parental drug abuse or dependence being associated with a higher likelihood of child physical abuse or neglect, when the perpetrator is a biological parent [3, 4]. Children exposed to parental substance use have a higher likelihood of physical abuse and neglect, and a variety of physical, psychological and cognitive problems. The goal of EPIC is to use three evidence-based and evidence-informed practices to reduce abusive and neglectful parenting, reduce addiction severity in parents, and improve permanency outcomes for families involved with the child welfare system due to substance abuse
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