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, The National Institute on Drug Abuse (NIDA) funded the
Juvenile Justice – Translational Research on interventions for Adolescents in the Legal System (JJ-TRIALS), a 5-year cooperative designed to support implementation research that improves the continuum of substance abuse and HIV services for youth under juvenile justice supervision. TCU-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 5-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 design a set of implementation studies that will not only achieve the goals of system-wide improvement in service and implementation outcomes, but will also contribute to implementation science through the development of new strategies and tools, novel theoretical and methodological advances, and new measurement approaches.