Juvenile Justice Girls Randomized Control Trial: Young Adult Follow-up

Study Overview
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Brief Summary
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This study is a young adult follow-up of 166 females who originally participated in an RCT during adolescence due to their involvement in the juvenile justice system.

Detailed Description
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Females under age 18 years old are the fastest-growing segment of the juvenile justice population and are at risk for negative co-occurring outcomes including drug abuse, HIV/STI risk, criminal behavior, and educational failure. As they enter young adulthood, this constellation of behaviors puts them at heightened risk for early parenthood and subsequent involvement in the child welfare system (for their parenting behaviors) and the adult corrections system (for criminal behaviors). Such system involvement is costly, and its prevention would be of great significance to public health; however, very little is known about factors leading to females' success/failure in young adulthood and factors that might prevent involvement in these two public systems. This study aims to further our understanding of the pathways to and the prevention of HIV/STI risk, drug use, and child welfare and adult corrections involvement by following-up 166 women who participated in two randomized intervention trials aimed at reducing delinquency during adolescence. In the original studies, juvenile justice girls who had been referred for out-of-home placement due to chronic delinquency were randomly assigned to services as usual or to Treatment Foster Care Oregon (TFCO, formerly known as MTFC). Efficacy of the intervention with this sample has been shown at 12- and 24-month follow-ups on criminal referral rates, days spent in locked settings, deviant peer associations, educational engagement, and pregnancy prevention. The investigators propose to examine the developmental pathways for these juvenile justice girls into young adulthood (ages 21-28 years) using innovative data collection and data analytic techniques, with foci on the long-term effects of TFCO, the mediators of young adult adjustment and child welfare/corrections involvement, and the cost effectiveness and cost avoidance of TFCO on these outcomes. The overarching aim is to identify potential targets for subsequent intervention. One in-person assessment is proposed with each female and her current romantic partner (if she has one); in addition, telephone interviews will be conducted every 6 months for the duration of the study, and system data from child welfare and adult corrections will be collected.

Official Title
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Juvenile Justice Girls: Pathways to Adjustment and System Use in Young Adulthood

Conditions
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Delinquency, Drug Use

Intervention / Treatment
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* Behavioral: Treatment Foster Care (TFCO)
* Behavioral: Group Care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: female 13-17 years old at least one criminal referral in the prior year court-mandated placement in out-of-home care Exclusion Criteria: Currently pregnant

Ages Eligible for Study
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Minimum Age: 13 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Treatment Foster Care Oregon (TFCO)<br>Youth are placed individually in well-trained and supervised foster homes. Basic components include: (a) daily telephone contact with TFCO parents using the Parent Daily Report; (b) weekly foster parent group meetings focused on supervision, training in parenting practices, and support; (c) an individualized behavior management program implemented daily in the home by foster parent; (d) individualized skills training for the youth; (e) family therapy for aftercare family focused on parent management strategies; (f) close monitoring of school attendance, performance, and homework completion; (g) case management to coordinate TFCO, family, peer, and school settings; (h) 24-hour on-call staff availability to TFCO and biological parents; and (i) psychiatric consultation. | Behavioral: Treatment Foster Care (TFCO)<br>* Youth placed individually in well-trained and supervised foster homes. Basic components: (a) daily telephone contact with TFCO parents; (b) weekly foster parent group meetings focused on supervision, training in parenting practices, and support; (c) an individualized behavior management program implemented daily in the home by foster parent; (d) individualized skills training for the youth; (e) family therapy for aftercare family focused on parent management strategies; (f) close monitoring of school attendance, performance, and homework completion; (g) case management to coordinate TFCO, family, peer, and school settings; (h) 24-hour on-call staff availability to TFCO and biological parents; and (i) psychiatric consultation. Services typically last approximately 6 months.<br>* Other names: Multidimensional Treatment Foster Care;|
| Active Comparator: Group Care<br>Group Care is the usual service for youth placed in out-of-home care for chronic delinquency in Oregon. These programs represented typical services for girls being referred to out-of-home care by the juvenile justice system and had 2-51 youth in residence (M = 21) and 1-50 staff members (Mdn = 2); most also had onsite schooling. Although the programs differed somewhat in theoretical orientations, 86% reported that they endorsed a specific treatment model, of which the primary philosophy was a behavioral (70%), eclectic (26%), or family-style therapeutic approach (4%). | Behavioral: Group Care<br>* Group Care is the usual service for youth placed in out-of-home care for chronic delinquency in Oregon. These programs represented typical services for girls being referred to out-of-home care by the juvenile justice system and had 2-51 youth in residence (M = 21) and 1-50 staff members (Mdn = 2); most also had onsite schooling. Although the programs differed somewhat in theoretical orientations, 86% reported that they endorsed a specific treatment model, of which the primary philosophy was a behavioral (70%), eclectic (26%), or family-style therapeutic approach (4%). Services typically last approximately 6 months.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Delinquency | Measured as self-reported criminal activity and count of official arrests and criminal referrals | Months 12, 24, 36, and young adulthood (ave. of 7 year follow-up + 10 year follow-up) | 
| substance use | Measured via self-reported use and diagnostic interview assessment | Months 12, 24, 36 and young adulthood (ave. of 7-year follow-up + 10 year follow-up) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| HIV risk behavior | Measured as self-reported engagement in sexual behaviors | Months 12, 24, 36 and young adulthood (ave. of 7-year follow-up) | 
| economic costs | Measured by comparing the costs of intervention delivery relative to the two intervention programs relative to costs incurred through time in detention, jail, and prison; relative to costs incurred due to child welfare involvement; and relative to symptom counts on self-report inventories. | young adulthood (age 18-28; average of 7-year follow-up) | 
| Depression | Measured on the CESD depression inventory and the Brief Symptom Inventory, and via diagnostic interview | Months 6, 12, 18, 24 and Young Adult (average 7 year follow-up) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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delinquency, drug use, HIV risk behavior, economic costs