Adoption of Family-Driven Substance Use Services in the Juvenile Justice System: A Pre-Implementation Assessment

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PROJECT SUMMARY/ABSTRACT Less than one-third of justice-involved youth (JIY) with an identified substance use (SU) need initiate treatment services. One of the most prominently cited barriers to JIY initiation and engagement in SU treatment is the lack of family involvement in the service delivery process. Improving family engagement in service delivery is currently a national priority area for juvenile justice (JJ) systems, but there is very little guidance for implementation in this setting. To begin filling this gap, the trainee will conduct a comprehensive, theoretically informed pre-implementation assessment with families and JJ staff, to understand family- and organizational- level barriers and facilitators to adoption of a family-driven care framework for SU service delivery. Family- driven care involves: (1) partnering with families to make SU service decisions, (2) implementing formal ways for families to inform organizational SU practices/policy, (3) providing SU support services for family members, and (4) enhancing cultural responsiveness and family inclusion in SU services. The specific aims are to (1) conduct five focus groups (including a total of 30-40 participants) with family members of JIY to understand their perceptions of the family-driven framework as well as their needs and recommendations for engaging families in SU services in the JJ system; and (2) guided by the Consolidated Framework for Implementation Research (CFIR), conduct a multiple-case study of 20 community supervision offices in Georgia, to understand the cross-case variability in organizational factors that may influence readiness to implement family-driven SU services. Achieving the aims of this study will provide targeted recommendations and contextualized implementation planning for integrating a feasible and acceptable family-driven SU intervention in JJ systems. In addition, this work will support the training of Ms. Piper, who is devoted to a research career in the implementation of evidence-based behavioral health interventions for JIY. Ms. Piper's 3-year training plan includes: (1) refining methodological skills in implementation science, 2) enhancing understanding of JJ research, including SU programs for youth involved in the legal system, and 3) strengthening skills in advanced and innovative qualitative methodology. The team of mentors, Drs. Sales (Primary Sponsor), Escoffery (Co- Sponsor), Brody (Co-Sponsor), and Cragun (Consultant), will lend their expertise to train and mentor Ms. Piper in implementation science, juvenile justice research, adolescent substance use, family-based approaches, and qualitative methods. Moreover, Ms. Piper will not only leverage her connection to the Georgia Department of Juvenile Justice but also to resources at Emory University, including the Center for the Health of Incarcerated Persons, the Network for Evaluation and Implementation Science, the Women and Children's Center, and the Center for Translational and Prevention Sciences. The candidate, the mentorship team, and the environment are uniquely suited to effectively achieve the proposed research and training aims.