While effective assessments and interventions exist for youth with substance use problems, uptake of evidence-based principles and practices within juvenile justice (JJ) settings has been limited. Service delivery typically occurs within disjointed practice settings (e.g., juvenile correctional centers, community-based drug treatment), and continuity of care can be challenging. Effective strategies are needed for implementing evidence-based practices to enhance service delivery for juvenile offenders and promote sustainable change across large, multifaceted systems.
In 2013, NIDA funded the Juvenile Justice-Translational Research on interventions for Adolescents in the Legal System (JJ-TRIALS), a cooperative designed to support implementation research improving the continuum of substance use and HIV services for youth under juvenile justice supervision. The IBR is one of seven research centers selected. Each center is partnering with juvenile justice agencies. The Texas Juvenile Justice Department (TJJD) and Nancy Arrigona of the Council of State Governments – Justice Center serve as TCU’s partners.
The six-year project includes two primary components – a National Survey and an integrated set of Implementation Science Research Studies. The National Survey elicits information on substance use and HIV screening, assessment, prevention, and treatment services available to youth in community settings. Surveys are being elicited in 2014 and 2016 from juvenile probation/parole agencies, treatment service providers, and judges. The information is being used to determine the state of the juvenile services continuum nationally in order to identify service gaps and inform public policy.
In the primary implementation study, a cluster-randomized design (with a phased roll-out) is being used to evaluate the effectiveness of two bundles of Implementation Strategies for improving substance use services available to juvenile offenders. Research questions address whether strategies for promoting organizational change are effective for lowering unmet needs of youth and ensuring that change efforts are efficient and productive. Targeted service outcomes include agency-level performance measures such as increases in the proportion of juveniles receiving substance use screening and assessment services, the proportion of youth with an identified need receiving a referral, the proportion of youth initiating treatment based on need, and the degree to which youth engage in treatment services. Implementation outcomes include documentation of progress toward site-selected goals, staff attitudes toward new practices, as well as qualitative measures of the change process.
Cooperative efforts are currently underway to publish papers on the set of implementation studies that not only achieved the goals of system-wide improvement in service and implementation outcomes, but also contributed to implementation science through the development of new strategies and tools, novel theoretical and methodological advances, and new measurement approaches.
Becan, J.E., Horan Fisher, J., Johnson, I.D., Bartkowski, J. P., Seaver, R., Gardner, S.K., Aarons, G.A., Renfro, T.L., Muiruri, R., Blackwell, L., Piper, K.N., Wiley, T.A., Knight, D.K. (in press). Improving Substance Use Services for Juvenile Justice-Involved Youth: Com- plexity of Process Improvement Plans in a Large Scale Multisite Study. Administration and Policy in Mental Health and Mental Health Services Research.
Belenko, S., Knight, D. K., Wasserman, G., Dennis, M. L., Wiley, T., Taxman, F. S., Oser, C., Dembo, R. Robertson, A. A., & Sales, J. (2017). The Juvenile Justice Behavioral Health Services Cascade: A new framework for measuring unmet substance use treat- ment services needs among adolescent offenders. Journal of Substance Abuse Treat- ment, 74, 80-91. doi.org/10.1016/j.jsat.2016.12.012
Dennis, M.L., Smith, C.N., Belenko, S., Knight, D., McReynolds, L., Rowan, G., … Wiley,T. (2019). Operationalizing a behavioral health services cascade of care model: Lessons learned from a 33-site implementation in juvenile justice community supervision. Federal Probation Journal, 83(2), 52-64.
Gardner, S. K., Elkington, K. S., Knight, D. K., Huang, S., DiClemente, R. J., Spaulding, A. C., Oser, C. B., Robertson, A. A., & Baird-Thomas, C. (2019). Juvenile Justice Staff Attitudes about HIV/STI Prevention, Testing, and Treatment Linkage. Health & Jus- tice, 7(15). doi: 10.1186/s40352-019-0096-7
Knight, D. K., Belenko, S., Wiley, T., Robertson, A. A., Arrigona, N., Dennis, M., Bart- kowski, J. P., McReynolds, L. S., Becan, J. E., Knudsen, H. K., Wasserman, G. A., Rose, E., DiClemente, R., Leukefeld, C., & the JJ-TRIALS Cooperative. (2016). Juvenile Justice—Translational Research on Interventions for Adolescents in the Legal Sys- tem (JJ-TRIALS): A cluster randomized trial targeting system-wide improvement in substance use services. Implementation Science, 11(1), 57. doi.org/10.1186/s13012- 016-0423-5
Knight, D. K., Joe, G. W., Morse, D. T., Smith, C., Knudsen, H., Johnson, I. Wasserman, G., Arrigona, N., McReynolds, L., Becan, J. E., Leukefeld., C., & Wiley, T. (2019). Organizational context and individual adaptability in promoting perceived importance and use of best practices for substance use. Journal of Behavioral Health Services & Research. doi: 10.1007/s11414-018-9618-7