Abstract
BackgroundYouth involved in the juvenile justice system (YIJJ) have high rates of substance use problems; however, rates of YIJJ engagement in substance use services is low. Barriers to service engagement include lack of appropriate screening and connection to services by the juvenile justice system, as well as lack of resources for delivering evidence-based treatment in community-based settings. To address these barriers, this paper describes a protocol for a type 1 hybrid design to (1) implement universal substance use screening for YIJJ; (2) implement and evaluate the feasibility and effectiveness of a brief, three-session substance use interventions based in motivational interviewing for youth with mild/moderate substance use: Teen Intervene (an individual-based intervention); (3) implement ENCOMPASS, an evidence-based substance use intervention based in motivational enhancement and cognitive behavioral therapy for youth with severe substance use; and (4) evaluate facilitators and barriers to implementing these interventions for mild to severe substance use among YIJJ in community mental health centers (CMHC).Methods/designUsing a hybrid type 1 clinical effectiveness-implementation design, we will collaborate with CMHCs and juvenile justice in two rural Indiana counties. Guided by the EPIS (exploration, preparation, implementation, sustainability) framework, we will measure factors that affect implementation of substance use screening in juvenile justice and implementation of substance use interventions in CMHCs utilizing self-reports and qualitative interviews with juvenile justice and CMHC staff pre- and post-implementation. YIJJ with mild/moderate substance use will receive a brief interventions and YIJJ with severe substance use will receive ENCOMPASS. We will measure the effectiveness of a brief and comprehensive intervention by assessing changes in substance use across treatment. We anticipate recruiting 160 YIJJ and their caregivers into the study. We will assess intervention outcomes utilizing baseline, 3-, and 6-month assessments.DiscussionFindings have the potential to improve screening and intervention services for YIJJ.
Highlights
Youth involved in the juvenile justice system (YIJJ) have high rates of substance use problems; rates of YIJJ engagement in substance use services is low
Overview of study design and objectives In order to address service connection and availability of community-based substance use evidence-based interventions (EBI) for YIJJ, we propose to partner with community mental health centers and juvenile justice systems in two Midwestern counties to: (1) implement universal substance use screening for probation youth to determine substance use risk level and appropriate treatment needed; (2) implement and evaluate the feasibility and effectiveness of a brief substance use intervention for youth with mild/moderate substance use problems in community mental health centers; and (3) implement a comprehensive adolescent-specific evidencebased substance use treatment in community mental health centers
Youth in the juvenile justice system (YIJJ) report high rates of substance use and behavioral health problems; are less likely to receive services compared to their non-offending peers
Summary
Youth involved in the juvenile justice system (YIJJ) present with substance use disorders (SUDs) and mental health problems at significantly higher rates than nonoffending peers in the community [1,2,3,4]. Overview of study design and objectives In order to address service connection and availability of community-based substance use EBIs for YIJJ, we propose to partner with community mental health centers and juvenile justice systems in two Midwestern counties to: (1) implement universal substance use screening for probation youth (at the point of arrest) to determine substance use risk level and appropriate treatment needed; (2) implement and evaluate the feasibility and effectiveness of a brief substance use intervention for youth with mild/moderate substance use problems in community mental health centers; and (3) implement a comprehensive adolescent-specific evidencebased substance use treatment in community mental health centers. We propose to utilize a hybrid type 1 clinical-effectiveness-implementation trial [37] in order to evaluate facilitators and barriers to implementing this approach as well as test the effectiveness of these interventions in reducing substance use among YIJJ
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