Clinical trial NCT04700696: Enhancing Permanency in Children and Families
Official title: Enhancing Permanency in Children and Families
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Substance Abuse
Substance Use
Child Abuse
Neglect, Child
Keywords: Substance Abuse
Child welfare
Child abuse and neglect
Lead sponsor: Ohio State University
Sponsor class: OTHER
Collaborators: name: Children's Bureau - Administration for Children and Families
name: Pickaway County Job and Family Services
name: Fairfield County Job and Family Services
name: Integrated Services for Behavioral Health (ISBH)
name: Ohio Guidestone
name: Fairfield County Juvenile Court
name: Pickaway County Juvenile Court
First posted: 2021-01-08
Enrollment: 117
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The Enhancing Permanency in Children and Families (EPIC) program is a collaborative effort between the Ohio State University College of Social Work, two county offices of the Ohio Department of Job and Family Services, two juvenile courts and local behavioral health agencies. The goal of EPIC is to use three evidence-based and evidence-informed practices to reduce abusive and neglectful parenting, reduce addiction severity in parents, and improve permanency outcomes for families involved with the child welfare system due to substance abuse.

Detailed description: Funded by the federal Regional Partnership Grant (RPG) Program, the Enhancing Permanency in Children and Families (EPIC) is a partnership between child welfare, juvenile count and behavioral health to holistically address substance misuse and associated parenting needs of child welfare-involved families. The overall goals and objectives of the intervention are to 1) Increase timely access to services among substances abusing parents involved in the child welfare system in Fairfield and Pickaway counties, 2.Enhance child safety and improve permanency and 3. increase child, parent, and caregiver well-being.

Eligible participants are matched with peer recovery supporters who mentor parents through the process. Parents are also referred to Family Treatment Drug Court (FTDC) with the option to receive Medications for Opioid Use Disorders (MOUD), and lastly when children are placed at home with parents or with kinship caregivers, relational skill building services that include financial assistance for child care, respite and transportation services. EPIC participants receive substance abuse and behavioral health treatment services through local providers including from two partner agencies: Integrated Services for Behavioral Health and Ohio Guidestone.

Data collection: Participating parents complete a pretest at baseline and up to 5 post-tests at 6 month intervals. Parents complete questions related to themselves (e.g. Addiction Severity Index, CES-D) and for one focal child (e.g. CBCL).

To evaluate EPIC, a quasi-experimental design will be employed through a two-stage sampling procedure. This design provides the ability to assess (1) the effects of EPIC on access to services for the families in the two intervention counties, and (2) the independent effects of additional services provided under EPIC that may be over and above Ohio START (an intervention administered through the Public Children Services Association of Ohio) and treatment as usual (TAU). In the first stage, two comparison counties will be identified for each of the two intervention counties. One comparison county will be part of the Ohio START program while the second will be a county that has no major interventions to address substance use among child welfare families. Counties are matched based on child population size, rate of child protective services referrals, percent of naloxone administrations per adult population, percent white, percent poverty, child welfare tax levy, and to the extent possible, behavioral health service availability. During the second stage, EPIC families are matched with substance using families in each of the comparison counties.

Parents may consent to one or all three components of EPIC based on the specific needs of each family, however all parents receive intensive case management services, including frequent home visits from caseworkers and peer recovery supporters.

Eligibility criteria: Inclusion Criteria:

* Child welfare involvement
* Substance use is primary reason for child welfare involvement (a score or 3 or more on UNCOPE assessment or a positive drug screen)

Exclusion Criteria:

* Possible substance use, though not primary reason for child welfare involvement
* incarcerated parents (may enroll after release)

Primary outcomes:
measure: Time from opening of child welfare case to SUD screening
timeFrame: Within 30 days of program entry
measure: Time from opening of child welfare case to trauma screening
timeFrame: Within 30 days of program entry
measure: Change in wait time between referral to addiction treatment services and initiation of services.
timeFrame: Within 30 days of entering child welfare system
measure: Change in addiction severity among participating parents
timeFrame: At program entry and again at program completion. An average of I year
measure: Change in resilience in children
timeFrame: At program entry and again at program completion. An average of I year
measure: Change in child behavior
timeFrame: At program entry and again at program completion. An average of I year
measure: Change length of stay in out-of-home placement for children in EPIC program compared to substance-affected families not receiving EPIC.
timeFrame: Through program completion, an average of 1 year.
measure: Change in reunification among families involved in EPIC compared to substance-affected families not receiving EPIC.
timeFrame: Through program completion, an average of 1 year.
measure: Change in subsequent child welfare involvement among parents receiving EPIC compared to substance-affected families not receiving EPIC
timeFrame: Through completion of 5 year study. For participants, up to 4 years following program participation, depending on time of enrollment
Secondary outcomes:
Other outcomes:
Locations:
city: Columbus
country: United States
facility: The Ohio State University
state: Ohio
Study officials:
affiliation: Ohio State University
name: Bridget Freisthler
role: PRINCIPAL_INVESTIGATOR
References:
citation: Freisthler B, Maguire-Jack K, Yoon S, Dellor E, Wolf JP. Enhancing Permanency in Children and Families (EPIC): a child welfare intervention for parental substance abuse. BMC Public Health. 2021 Apr 23;21(1):780. doi: 10.1186/s12889-021-10668-1.