Clinical trial NCT03051997: Increasing Caregiver Engagement in Juvenile Drug Courts
Official title: Behavioral Incentives to Increase Caregiver Engagement in Juvenile Drug Courts
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Substance Abuse
Lead sponsor: Medical University of South Carolina
Sponsor class: OTHER
Collaborators: name: National Institute on Minority Health and Health Disparities (NIMHD)
name: Wayne State University
name: Alliant International University
name: Baylor University
First posted: 2017-02-14
Enrollment: 180
Sex: ALL
Minimum age (years): 13
Maximum age (years): 89
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The purpose of this study is to test a prize-based contingency management intervention for increasing caregiver engagement in juvenile drug court and adolescent drug treatment, and for achieving the ultimate outcomes of reduced substance use and delinquent behavior among drug court-involved youth.

Detailed description: Juvenile offenders with substance abuse problems represent a large and underserved population that is at high risk of deleterious outcomes and long-term costs for themselves, their families, communities, and society. Moreover, a high percentage of substance abusing adolescents continue to abuse substances and engage in criminal activity into adulthood. Although one juvenile justice intervention, Juvenile Drug Court (JDC), has emerged as a promising model for reducing drug use and delinquency among youth, its effectiveness is variable. Drug court outcomes may be compromised by the lack of caregiver engagement in JDC processes and adolescent drug treatment. Incorporating easily implemented evidence-based incentive programs in JDCs might improve their effectiveness in reducing youth drug use and re-offending. An extensive body of research supports the critical role that families play in the etiology, maintenance, and treatment of adolescent substance abuse. Although family-based interventions for adolescent substance abuse have been shown to be superior to other treatment modalities, parents must attend treatment and participate in meaningful ways for these superior outcomes to be realized. This randomized clinical trial will examine the efficacy of a prize-based contingency management intervention for increasing caregiver engagement (attendance and participation) in JDC and adolescent drug treatment. This caregiver contingency management intervention (CCM) will be compared with drug court treatment as usual (TAU). Increased caregiver participation is predicted to improve adolescent outcomes (decreased drug use and delinquent behavior). One hundred and eighty youth enrolled in JDC will be randomly assigned along with a parent/caregiver to TAU or CCM. Analyses will examine measures of caregiver engagement in JDC as well as youth substance use (urine drug screens) and delinquent activity. Results from this study will demonstrate the effectiveness of CCM procedures for increasing caregiver attendance and participation in JDC and adolescent drug treatment above and beyond drug court and usual care. If effective, the CCM approach may ultimately be used to enhance JDC outcomes, thereby reducing substance use and recidivism in juvenile offenders served by this promising juvenile justice intervention.

Eligibility criteria: Inclusion Criteria for youth:

* Involved in juvenile drug court
* Aged 13-17 years
* Youth is willing to participate
* At least one caregiver is willing to participate in the youth's treatment
* Fluent in English or Spanish

Exclusion Criteria for youth:

* Diagnosed with intellectual disability or autism spectrum disorder

Inclusion Criteria for caregivers:

* Caregiver of youth involved in juvenile drug court
* Caregiver is willing to participate
* Fluent in English or Spanish

Exclusion Criteria for caregivers:

* Diagnosed with intellectual disability or autism spectrum disorder

Inclusion Criteria for therapists:

* Providing substance abuse treatment to a youth in juvenile drug court

Exclusion Criteria for therapists:

* None

Inclusion Criteria for Juvenile Drug Court Personnel:

* Personnel working in juvenile drug court

Exclusion Criteria for Juvenile Drug Court Personnel:

* None

Primary outcomes:
measure: Changes from baseline to 18 months post-baseline in Youth Urine Drug Screens (measured at 0, 3, 5, 6, 9, 12, and 18 months).
timeFrame: Baseline to 18 months
measure: Changes from baseline to 18 months post-baseline in Youth Substance Use Frequency and Problems (measured at 0, 1, 2, 3, 4, 5, 6, 9, 12, and 18 months).
timeFrame: Baseline to 18 months
Secondary outcomes:
measure: Changes from baseline to 18 months post-baseline in Youth Arrests, Charges, and Convictions.
timeFrame: Baseline to 18 months
measure: Changes from baseline to 18 months post-baseline in Youth Delinquent Behaviors (measured at 0, 3, 5, 6, 9, 12, and 18 months).
timeFrame: Baseline to 18 months
measure: Changes from Baseline to 18 months post-baseline in caregiver reports on Youth Internalizing Symptoms and Externalizing Behaviors (measured at 0, 1, 2, 3, 4, 5, 6, 9, 12, and 18 months).
timeFrame: Baseline to 18 months
measure: Changes from Baseline to 18 months post-baseline in youth reports on Youth Internalizing Symptoms and Externalizing Behaviors (measured at 0, 1, 2, 3, 4, 5, 6, 9, 12, and 18 months).
timeFrame: Baseline to 18 months
measure: Changes from baseline to post-treatment in Caregiver Substance Use Problems.
timeFrame: Baseline through treatment completion, an average of 4 months
measure: Changes from baseline to post-treatment in Caregiver Depressive Symptoms.
timeFrame: Baseline through treatment completion, an average of 4 months
measure: Changes from baseline to post-treatment in Therapist-Family Working Alliance (measured at 1, 2, 3, and 4 months, as well as post-treatment).
timeFrame: Baseline through treatment completion, an average of 4 months
measure: Changes from baseline to post-treatment in Caregiver Treatment Attendance and Activity Completion (measured at 1, 2, 3, and 4 months, as well as post-treatment).
timeFrame: Baseline through treatment completion, an average of 4 months
measure: Changes from baseline to the end of JDC involvement in Caregiver Attendance at JDC Sessions.
timeFrame: Baseline through the end of JDC involvement, an average of 12 months
measure: Rates of Treatment Completion.
timeFrame: Up to 4 months on average
measure: Levels of Satisfaction with Treatment and JDC.
timeFrame: Up to 4 months on average
measure: Changes from baseline to post-treatment in Caregiver Perceptions of Incentive Programs.
timeFrame: Baseline through treatment completion, an average of 4 months
measure: Changes from baseline to 36 months post-baseline in Therapist and JDC Personnel Perceptions of Incentive Programs (measured at 0, 12, 24, and 36 months).
timeFrame: Baseline to 36 months
measure: Reports at post-treatment on Youth and Caregiver Attitudes Toward Incentive Programs.
timeFrame: Up to 4 months on average
measure: Changes from baseline to 36 months post-baseline in Therapist and JDC Personnel Attitudes Toward Incentive Programs (measured at 0, 12, 24, and 36 months).
timeFrame: Baseline to 36 months
Other outcomes:
Locations:
city: Dayton
country: United States
facility: Montgomer County Juvenile Court, 380 West Second Street
state: Ohio
city: Corpus Christi
country: United States
facility: Nueces County Juvenile Court/Juvenile Treatment Court
state: Texas
Study officials:
affiliation: Medical University of South Carolina
name: Phillippe Cunningham, Ph.D.
role: PRINCIPAL_INVESTIGATOR
affiliation: Wayne State University
name: David Ledgerwood, Ph.D.
role: PRINCIPAL_INVESTIGATOR
affiliation: The University of Texas Health Science Center at San Antonio
name: Stacy Ryan, Ph.D.
role: STUDY_DIRECTOR
References:
citation: Ledgerwood DM, Cunningham PB. Juvenile Drug Treatment Court. Pediatr Clin North Am. 2019 Dec;66(6):1193-1202. doi: 10.1016/j.pcl.2019.08.011.