Family Engagement, Cross-System Linkage to Substance Use Treatment for Juvenile Probationers -- Phase 3
Phase: NA
Conditions: Substance Use, Substance Abuse, Substance Use Disorders, Substance-Related Disorders, Substance Dependence, Substance Related Problem
Sponsor: New York State Psychiatric Institute

Family Engagement, Cross-System 
Linkage to Substance Use Treatment 
for Juvenile Probationers -- Phase 3 
 
NCT03048552 
 
Study Protocol 
1/1/2016 

v.1/1/2016 
 
Study Protocol 
Study Aims. Working with two county probation departments that have adolescent SU services, we propose the 
following Specific Aims:  
1.  To examine, in a pilot-test, the impact of Family CONNECT on improving (i) cross-system (probation-SU 
agency) referral; (ii) family engagement; (iii) enrollment and retention of youth/families in SU treatment; and 
(iv) secondary outcomes of reducing youth SU and recidivism.  
3.   To elucidate multi-level factors (e.g., family, staff, and organizational-level) that influence implementation of 
Family CONNECT in probation settings to inform a larger trial. 
 
Overview of study design.  We propose to pilot-test a service delivery model for youth on probation that targets 
probation-, treatment system- and family-level factors to increase uptake of SU services; and to understand the 
organizational elements required to successfully implement this adapted model in juvenile probation settings (see 
Timeline in Budget Justification).  Guided by the CFIR framework and GPM,  Pilot Test and Implementation 
Evaluation, youth on probation (n=50) and their caregivers (n=50) will participate in a pilot of Family CONNECT 
to examine its preliminary impact on cross-systems referral, family engagement, and retention of youth/families in 
SU treatment.  We will explore family-, staff-, and organizational-level factors that influence Family CONNECT 
feasibility, acceptability, and sustainability in probation settings (Year 2; Year 3, Months 1-6). Youth-caregiver 
dyads will be randomized at the level of probation officer (PO) to Family CONNECT or standard of care (SOC).  
Youth and caregivers will be assessed at baseline, and 2 and 6 months post-baseline.  Probation staff will be 
assessed before implementation of Family CONNECT and at 6, 12 and 18 months post-training.   
Study location and participants.  The sample will be recruited from two county probation departments:  Staffed 
by approximately 39 juvenile probation employees collectively with 600 youth annually: 65% male, 51% white, 32% 
African American, 11% Hispanic, mean age 15.0 years.  Current SU screening, identification, and referral practices:  
Both departments screen all youth for SU and MH problems within the first month of assignment to probation 
supervision, using the validated Massachusetts Youth Screening Instrument-2 (MAYSI-2)90 to identify potential 
behavioral health needs.  The PO communicates SU treatment needs to the youth and family and makes needed 
referrals.  Neither site uses any kind of cross-system linkage protocol, but both are aware of this need and extremely 
interested in filling this gap.  Given current use of MAYSI-2, increasing use of evidence-based screeners and 
identification of youth SU is not an outcome of the proposed study, but will remain part of the Family CONNECT 
training (Section 3.3.7.2).  
Inclusion criteria.  Youth: 10-17 years old; currently on probation; MAYSI-2 score of ≥4, indicating ‘probable 
clinical significance,’90 or documented evidence of problem SU or SU service need.  Caregiver: legal guardian (birth 
parents, relatives, and adoptive parents; foster care parents cannot provide legal consent for their child to 
participate in research in NYS).  Probation and SU treatment staff: currently employed at participating probation 
departments or SU treatment agencies.  For Phase 2, youth inclusion criteria will be the same as in Phase 1, with 
the additional criteria that all youth must have been screened/identified as having SU problems as defined by a 
score of ≥4 on the MAYSI-2 but NOT currently and regularly attending SU treatment within the past month.  
 Exclusion Criteria: Youth and caregivers: medical or psychiatric illness requiring hospitalization at the time; 
serious suicidal or homicidal ideation; or been placed on probation for a serious violent offense (to ensure the 
safety of participants and research staff). 
    
Pilot and Implementation Evaluation.  
Recruitment and Enrollment.  Youth on probation (n=50) in Dutchess and Ulster County probation departments 
and their primary adult caregivers (n=50) will be recruited through PO referral using the recruitment procedures 
used in the formative phase.  Interested caregivers will be asked to provide written permission and consent for 
youth and caregiver participation and youth to provide written assent.  Although all POs will be involved in proposed 
study due to randomization at the level of PO, we will recruit POs with active caseloads (n=21) to complete brief 
assessment using the same recruitment procedures used in the formative phase.  Considerable effort will be taken 
to ensure that youth and caregivers do not feel coerced to participate in Family CONNECT and staff do not feel 
coerced to complete assessments. 
 Enrollment and tracking.  During Year 1, a participant tracking system will be created using established 
strategies from our team’s prior studies tracking SU youth and JJ-involved families.  Data include contact 
information, 2-3 people who know how to contact them, regular requests for updates, ways to contact while 
maintaining confidentiality, etc. (Section 5, Human Subjects).  We will send thank you notes after each interview, 

v.1/1/2016 
 
personalized birthday cards to youth and caregivers if appropriate, and project newsletters.  Families will be 
compensated for participation in accordance with standard remuneration procedures in this population. 
Randomization.  We will employ cluster randomization at the level of the PO using a computerized 
randomization program: 50% of POs at any given site will be assigned to Family CONNECT and 50% to SOC.  All 
caregivers of youth with SU problems based on the MAYSI-2 but not currently in treatment will be informed about 
the study by the PO upon delivery of information that the youth requires SU treatment.  Experimental and control 
manipulations are implemented in the same setting, and thus contamination may be an issue.  However, cross-
family interactions (e.g., in waiting areas) are not expected to result in significant contamination since families tend 
to have limited interactions with each other. POs in the experimental arm and Linkage Specialists will be instructed 
not to assist POs in the SOC arm in any way.  POs randomized to SOC may experience decreased morale or a 
desire to increase performance to match POs in the experimental arm.  To offset this, we will clearly articulate to 
the POs that the study is not an evaluation of their job performance but rather an evaluation of the potential added 
value that a Linkage Specialist confers with respect to increasing youth enrollment in SU treatment.  Despite these 
precautions some contamination may occur. To identify any possible contamination, we will 1) collect process data 
from all POs on interactions with Linkage specialists and job satisfaction as part of our implementation assessment 
(Section 3.3.8.3) and also collect department-wide data on key referral and uptake outcomes for 6 months prior to 
the implementation of Family CONNECT to identify any changes occurring in the SOC condition (Section 3.3.8.1) 
We chose to randomize at the level of the PO for three reasons: 1) Randomizing by youth would create 
situations where a PO was working both with youth assigned to Family CONNECT (and Linkage Specialist) and 
with youth in SOC with considerable contamination potential.  2) Randomizing by site with only two sites is arguably 
not randomization and would not permit us to separate considerable site effects from differences in the two arms.  
Although frequency matching of participants would minimize some site effects, the limits to recruitment would be 
too restrictive in this pilot.  Randomizing by site would also give us only limited ability to examine system-level 
factors that influence implementation of Family CONNECT.  3) Conducting a pre-post design (no randomization) 
would incur temporal and historical effects (e.g., regression to the mean; changes in services policy), limiting our 
ability to infer a causal influence of Family CONNECT on our proposed outcomes. 
Family CONNECT.  Family connect will be adapted using protocols from CONNECT and TIES.  In addition, 
based other successful models of embedded linkage or family support specialists78,79, we will design Family 
CONNECT to be delivered by POs with a Linkage Specialist who is embedded in the probation department.  There 
will be one Linkage Specialist at each study site who will have prior experience  working with families/youth with 
SU/D problems and/or JJ involvement and hold a Masters degree in clinical social work or a related field.  It is 
anticipated that s/he will assume the linkage and potentially the referral roles of the PO in CONNECT and conduct 
the engagement strategies originally conducted by a provider in TIES.  POs will screen and inform youth and 
caregivers about any SU treatment needs; POs and Linkage Specialist will work with the research team during the 
training to develop standard protocols for referring youths to SU treatment and establish formalized relationships 
with partnering substance abuse treatment agencies.  
Protocol Training.  The Drs. Elkington, Wasserman, and McReynolds will train the POs and Linkage Specialists 
in three 1-day workshops.  Workshops will review (1) adolescent SU and its correlated risks (e.g., recidivism, 
common co-occurring disorders), evidence-based treatments, and family role in risk and prevention; (2) how 
clinicians arrive at a DSM diagnosis, reviewing symptom profiles and criteria for SUD and other related disorders 
(e.g., PTSD) with substantially elevated prevalence in JJ youth; (3) screening for SU and mental health problems 
in youth; (4) effective communication techniques with behavioral health providers/agencies, establishing formalized 
relationships with partnering SU treatment agencies, and developing standard protocols for referring youths to SU 
treatment; (5) engaging families and youth, identifying barriers to treatment, and increasing motivation to access 
services; (6) coordinating with SU treatment agencies/clinicians to monitor youth progress and treatment retention.  
POs will join the first two training workshops, receiving training through topic #4.  Linkage Specialists will receive 
additional training in TIES-derived intensive engagement strategies and monitoring techniques.  Knowledge of 
these topics will be evaluated with pre and post-test training assessments.  
 Protocol.  Following training, the PO and Linkage Specialist will establish memoranda of understanding with 
community SU treatment agencies.  The Linkage Specialist will meet with the youth’s PO after study enrollment.  
After identification of appropriate service agency(ies), the Linkage Specialist will refer the youth to a partnering SU 
treatment agency and other support services as necessary.  S/he will meet with the family at the probation office 
and/or family’s home to complete a family needs assessment and identify facilitators and barriers to treatment.  
S/he will use adapted TIES strategies to increase treatment motivation, decrease perceived barriers, and develop 
strategies to overcome practical barriers to attending treatment.  The Linkage Specialist will be the liaison among 
the family, SU treatment provider, and youth’s PO, addressing engagement problems with family and/or clinician, 
tracking youth attendance in treatment and informing the PO, and facilitating communication between the PO and 
clinician. The Linkage Specialist will track frequency of sessions and contacts and complete standardized process 

v.1/1/2016 
 
measures to describe and evaluate each session or contact with families and providers (Section 3.3.8.3).  The PI 
will supervise the Linkage Specialists weekly via phone/Skype.   
Outcome Evaluation 
      Assessments.  Table 1 presents all measures, categorized according to outcomes defined in Aims 2 or by 
GPM or CFIR constructs with information on a) the domain/model construct and measure, b) the variable and 
measure psychometric properties, and c) time point administered and respondent (also see Appendix A for 
measures).  Selected measures have been successfully used with JJS youth, SU youth or similar populations; the 
battery will be finalized following the adaptation of Family CONNECT.   
Implementation assessment.  A multi-method comprehensive framework approach will allow us to identify 
implementation features that promote optimal fit of Family CONNECT in the probation context.  In addition to 
assessments in Table 3, we will develop the following assessments once the model is finalized.  Feasibility:  In 
addition to examining Family CONNECT’s performance indicators, we will develop a TIES-based feasibility 
checklist measuring 3 types of program delivery obstacles: obstacles to youth/family participation (e.g., time, 
competing priorities); concrete obstacles (e.g., transportation); and site/ staffing obstacles (e.g., turnover, 
time/space constraints).  Youth and caregivers will be assessed at 2 and 6 months post-baseline, and POs and 
Linkage Specialists at 6, 12, and 18 months post-training.  Fidelity: To assess the relationship between planned 
and actual implementation, we will design a checklist-based monitoring system with assessments completed by 
Linkage Specialists after each treatment agency referral, family session, or SU treatment provider/PO contact to 
quantify activities completed and next steps. Linkage Specialists will also record new circumstances that may 
influence the family system and threaten fidelity (e.g., loss/gain of employment; youth/family criminal involvement).  
Acceptability:  Linkage Specialists will complete a checklist evaluating their experience working in the probation 
department, with POs, and with SU treatment providers and usefulness of engagement strategies with 
youth/families.  Probation staff will complete a measure assessing experience working with an embedded Linkage 
Specialist; perception of screening protocol as part of job description; and overall job satisfaction.  
Table 1. Family CONNECT Assessments                                           (BL=baseline; MIS=management information system) 
Domain/Measures 
Description/Variables/Psychometric properties 
Time/Respondent 
Linkage and referral main outcomes 
Referrals 
Count of youth referred to SU treatment  
Pre-implementation; BL, 2 
mos., 6 mos.,  
JJ agency MIS 
Engage families/youth 
Evaluation of Probation Services 
Scale  
28 items; adaptation of Working Alliance Inventory (WAI)100 to assess: 1) 
agreement on goals, tasks and development of bond with PO; 2) 
usefulness of services/referrals provided by probation department. Used 
in co-I Wasserman’s prior work 
BL, 2 & 6 mos.  
Youth and caregiver 
Evaluation of Linkage and 
Referral Services Scale  
18 items; adaptation of Evaluation of Probation Services Scale  to 
assess: agreement on goals, tasks and development of bond with 
Linkage Specialist. 
Baseline, 2& 6 mos. 
Youth and caregiver 
Enroll and Retain 
Enroll 
Count of youth who started substance use treatment (completed intake + 
1 session) 
Pre-implementation; BL, 2 
mos., 6 mos.  
JJ agency MIS 
Retain 
Count of youth retained at least 6 weeks/4 sessions of treatment 
Implementation Outcomes (see also Section 3.3.8.3) 
Acceptability 
Client Satisfaction 
Questionnaire-8101 
8 items; assesses satisfaction and usefulness of services received. 
Validity and reliability have been well-established (α=.83-.93) 
BL, 2 mos., 6 mos. 
Caregiver 
Therapeutic Alliance Scale for 
Children-revised (TASC-r)102,103 
and for Caregivers (TASCP)104 
12 items; assesses alliance between youth and therapist (TASC-r) and 
caregiver and therapist (TASCP) in 2 domains: affective bond and 
collaboration on therapeutic tasks/goals. Good validity/reliability have 
been demonstrated (α=.81-.82 TASC; α=.85-.88 TASCP) 
BL, 2 mos., 6 mos.  
Youth and caregiver 
Potential sustainability 
Program Sustainability 
Assessment Tool (PSAT)105 
20 items; assesses: 1) political support; 2) partnerships; 3) organizational 
capacity; 4) program evaluation; 5) communications. Validity and reliability 
have been well-established (α=.79-.92) 
Pre-implementation; 6, 
12, 18-mos post-training  
Staff, Linkage Specialist 
GPM: Family predisposing and enabling factors; youth’s SU treatment need 
Youth SU/D  
Global Assessment of Individual 
Needs (GAIN)106 
Assesses SUD and frequency and quantity of alcohol, marijuana, and 
other drugs (e.g. cocaine, heroin, ecstasy) over past 30 days, year and 
lifetime. Well tested diagnostic tool for children and adolescents107. 
BL, 2 mos., 6 mos.  
Youth 
Youth recidivism 
Count of youth (re)arrests and/or probation violations 
2 mos., 6 mos.  
JJ agency MIS  
Demographics 
22 items; age, gender, race/ethnicity, family composition/structure, 
education, parental employment/household income, residential changes 
educational placement, justice involvement, primary caregiver. 
BL, 2 mos., 6 mos.  
Youth and caregiver 

v.1/1/2016 
 
Data Management and Analysis.   
Primary data analysis overview. A primary goal of this pilot study is to prepare for a large scale trial of Family 
CONNECT by determining important parameters with sufficient accuracy to allow reliable estimates of sample size 
and power for the subsequent study. Key study parameters include means and standard deviations for continuous 
endpoints (e.g. number of referrals); proportions for dichotomous endpoints (e.g. youth enrolled in services); 
response profiles for longitudinal studies (e.g. performance improvement or degradation); potential mediators of 
service delivery model outcome (e.g. perceived need for treatment); and potential correlates of implementation 
outcomes (e.g. organization culture; staff attitudes; treatment motivation). Estimation of design parameters with 
point and confidence interval estimates will be considered highly important. Large sample sizes are not required to 
locate these parameters approximately, but adequately, for planning the subsequent trial; tests of study hypotheses 
in this pilot will likely not have sufficient statistical power. Therefore, consistent with the R34 mechanism, a key role 
for statistical planning of this pilot study is to ensure that the critical parameters for the larger trial are estimated as 
accurately and as informatively as possible. Certain principles then follow: (1) If alterations are necessary to 
address measurement or performance problems, these will be permitted in an effort to establish optimal procedures 
and design parameters before a future trial, precisely so that no changes in protocol will be required during a future 
trial; and, (2) Estimation of critical design parameters with point and confidence interval estimates will be considered 
highly important, as large sample sizes are not required to locate these parameters adequately when planning for 
a subsequent trial. As a result, we are not powered to estimate small effect sizes or carry out sophisticated statistical 
analyses; rather, we seek to estimate key study parameters with sample means and proportions with two-sided 
90% confidence intervals.  
Number of youth enrolled in treatment within the past 6 months is the primary outcome of the service delivery 
model, assessed at 6-months post baseline. Other linkage and engagement variables that will be examined 
include: number of youth with SU problems referred for treatment (referral), working alliance between family and 
PO and family and Linkage Specialist (engagement), and number of youth retained in treatment for at least 4 
sessions/6 weeks (retention). Implementation outcomes that will be examined include feasibility, acceptability and 
potential sustainability. In addition, potential correlates of implementation as specified by the CFIR will be 
examined, such as organization culture and climate, staff attitudes, agency interconnectedness.  Finally, mediators 
associated with service use that are specified by the GPM model will also be examined, including motivation for 
treatment, perceived barriers to treatment, caregiver SU problems. As noted in Table 3, this study yields many 
variables. We, thus, focus on a few of primary interest to illustrate our analytic approach. Attrition and missing data.  
Based on the PIs K01 award, we anticipate minimal attrition (~15%). We will compare those who did versus did 
not complete FU on key predictors from the baseline assessment to check for possible bias. 
Analysis Plan for Specific Aim 2. Prior to conducting our multivariate analyses, we will examine study 
Barriers to treatment 
Barriers to Treatment 
Participation Scale108 
44 items; 4 subscales of barriers to participation: a) stressors and 
obstacles; b) treatment demands; c) perceived relevance of treatment; d) 
relationship with therapist. Widely used in services outcome research and 
validity and reliability well-established (α=0.94.)108 
BL, 2 mos., 6 mos.  
Caregiver  
Motivation and perceived SU 
treatment need 
Motivation for Youth’s Treatment 
Scale (MYTS)109 
8 items; assesses intrinsic motivation for treatment with 2 subscales: 
problem recognition and readiness to participate in treatment.  
Psychometric properties have been established (α=0.84-0.89)109 
BL, 2 mos., 6 mos.  
Youth and caregiver  
Service utilization 
GAIN  
Prior and current service utilization; type of services; frequency of service 
use; length of stay 
BL, 2 mos., 6 mos.  
Youth and caregiver 
CJS and other system  
involvement 
Demographics; GAIN 
6-items; assesses number of times youth’s caregivers have been in jail 
or prison; age of youth first and last time 
Assesses youth removal from home; legal custody of youth 
BL, 2 mos., 6 mos.  
Youth and caregiver 
GPM: Family predisposing and enabling factors; youth’s SU treatment need 
Caregiver SU/MH problems 
Beck Depression Inventory110 State-
Trait Anxiety Inventory111,112Clinical 
Diagnostic Questionnaire113 
Depression and Anxiety symptoms, PTSD and Substance Use 
Disorders. Use of well validated and reliable instruments, widely used in 
treatment and services research. 
BL, 2 mos., 6 mos.  
Caregiver  
Family conflict/support 
Family Environment Scale114 
 
Caregiver Strain Questionnaire-
Short form115 
18 items; assess family functioning: cohesion and conflict. Well validated, 
used with delinquent youth (α=0.61-0.78).114,116,117 
7-items; assess strain caregiver experiences providing for a youth with 
behavioral health needs. Subscales =objective & internalized strain; 
validity and reliability well-established (α=0.82-0.90)118 
BL, 2 mos., 6 mos.  
Youth and caregiver 
BL, 2 mos., 6 mos.  
Caregiver 
CFIR: Inner setting and characteristics of individuals 
Organizational and staff 
characteristics  
National Criminal Justice 
Treatment Practices (NCJTP) 
survey119 
1) mission and goals of correctional programs; 2) organizational climate 
and culture for providing services; 3) organizational capacity and needs; 
4) opinions of administrators, staff regarding rehabilitation, punishment, 
and services provided to offenders; 5) treatment policies and procedures; 
and 6) working  relationships between correctional and other agencies. 
Psychometric properties established119 
Pre-implementation; 6, 
12- and 18-mos. post-
training 
Staff and Linkage 
Specialist 

v.1/1/2016 
 
variables using descriptive statistics and test for differences across demographic characteristics (e.g., 
race/ethnicity, age, education) using t-tests, ANOVAs, and Chi-squares, as appropriate. As participants will be 
randomized into two groups (at the level of the PO), systematic baseline differences are not expected; however, in 
the event that some parameters differ across conditions at baseline, they will be included as covariates in 
subsequent multivariate models. We will calculate descriptive summary statistics corresponding to the study 
variables at each follow-up (FU) to understand any temporal patterns, as well as compare the two groups in terms 
of average change from baseline to 6-months post-baseline (averaged across 3 time points).  
We will use the general framework of generalized linear mixed models (GLMM) to model the longitudinal 
outcome trajectories123-125. Note that some of our outcomes are binary, some count and some continuous traits and 
thus need to be treated differently. The general form of the GLMM will be (𝜇𝜇𝑖𝑖𝑖𝑖)=𝛽𝛽0𝑖𝑖+𝛽𝛽cov 𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝑖𝑖𝑖𝑖+ 𝛽𝛽timeTime𝑗𝑗+ 
𝛽𝛽𝑇𝑇𝑇𝑇𝑇𝑇𝑇𝑇𝑇𝑇𝑇𝑇𝑖𝑖+ 𝛽𝛽Trt x time 𝑟𝑟𝑟𝑟𝑖𝑖 × Time𝑗𝑗, where 𝜇𝜇𝑖𝑖𝑖𝑖 is the mean response corresponding to subject i on time j (baseline and 
two follow-ups), g denotes the link function (identity for continuous outcome, logit for binary outcome and natural 
log for count outcomes); 𝑇𝑇𝑇𝑇𝑡𝑡𝑖𝑖 =1 if the i-th subject is in the FAMILY CONNECT group and 0 if the i-th subject is in 
the SOC group. The variable can be coded in different ways depending upon how one wants to model the effect 
of time on the mean response. For example, for characterizing only pre vs. post effect time can be coded as a 
binary indicator with 0 representing baseline and 1 representing post-randomization; Assuming a linear time trend, 
time can be coded as 0,1,2 or it can be simply coded as a categorical variable representing the distinct effect of 
each FU as compared to the baseline. The interaction coefficients 𝛽𝛽𝑇𝑇rt X Time  are of interest, measuring the 
difference in the rate of change in outcome across the two treatment groups at each follow-up assessment. If the 
baseline outcome measure is included as a part of the covariates on the right hand side of the above equation, 
then we only have three repeated measures on the left hand side of the model (j=1,2) and we can look at average 
treatment effect across visits without including the 𝑇𝑇𝑇𝑇𝑇𝑇× 𝑇𝑇𝑇𝑇𝑇𝑇𝑇𝑇 interaction term. In this particular case, the GLMM 
analysis with continuous outcome will be equivalent to a repeated measures analysis of covariance after adjusting 
for baseline values. The subject-specific random intercepts 𝛽𝛽0𝑖𝑖 are assumed to be normally distributed with a 
common variance, and they account for within-person correlation. Maximum likelihood estimation will be used for 
fixed effect parameters. Models will be compared according to information criterion like AIC, BIC. For some binary 
outcomes, we will perform an aggregate analysis after collapsing across the repeated measures using simple 
logistic regression comparing whether the probability of being enrolled in services over the entire FU period is 
different across treatment groups, after adjusting for baseline values. To ensure robustness, we will also apply an 
exchangeable working correlation structure to its corresponding generalized estimating equation (GEE) model.  For 
the purposes of this R34 we will examine key study parameters within these three domains: 
Domain1 (enrollment and retention outcomes): Differences between youth involved in Family CONNECT and 
those in the SOC comparison condition with respect to the following variables at 2- and 6-months post baseline: a) 
youth who began SU treatment (y/n) (completed intake + attended 1 session); b) youth who attended 4 
sessions/remained in treatment for 6 weeks (y/n); c) total number of SU treatment sessions attended.  
 
Domain 2 (cross-system referral and engagement outcomes): Differences between youth and families involved 
in Family CONNECT and those in the SOC comparison condition with respect to the following variables at 2- and 
6-months post baseline: a) youth referred to SU treatment (y/n); b) youth/caregiver engagement. 
 
Domain 3 (secondary outcomes): Differences between youth and families involved in Family CONNECT and 
those in the SOC comparison condition with respect to the following variables at 2 and 6 months post-baseline: a) 
youth (re)arrest (y/n); youth probation violation (y/n); c) any SU (y/n) and d) frequency of SU in past 30-days 
Analysis Plan for Specific Aim 3. Using our theoretically informed model (see Figure 1) as a blueprint126, we 
will use SEM to begin to unpack what theoretical constructs and pathways were influential in the intervention, and 
aid us to refine our conceptual model for the larger RCT. For example, it is possible that Family CONNECT will 
have more positive effect on service referral and engagement outcomes when operating in a probation department 
that is more supportive innovative concepts. Here, organizational culture would appear to modify the impact of 
Family CONNECT on youth service referral and engagement outcomes. We will examine the Lagrange Multiplier 
and Wald Tests to consider the deletion or inclusion of paths127; ultimately, however, the deletion or inclusion of 
paths will be informed by theoretical underpinnings. Once the model is identified, we will test for group differences 
between intervention conditions in latent constructs and in the proposed paths between these constructs. This 
method will allow us to estimate the intervention effects on the constructs directly as well as their relationships to 
one another.128 We will use three goodness-of-fit indices: Bentler-Bonnet’s Normed Fit Index, Bentler-Bonnet’s 
Non-Normed Fit Index, and the Comparative Fit Index. We will also verify the root mean-square error of 
approximation (RMSEA) as an index of misfit. Well-fitting models will have fit indices of.90 or higher and <.06 for 
RMSEA.