Impact of implementation interventions to improve substance use service delivery on recidivism among justice-involved youth

Abstract

Substance use disorders (SUD) are prevalent among justice-involved youth (JIY) and are a robust predictor of re-offending. Only a fraction of JIY with substance use problems receive treatment. This paper describes the impacts of system-level efforts to improve identification and referral to treatment on recidivism of JIY. A cluster randomized trial involving 20 county juvenile justice agency sites across 5 states was used to implement an organizational intervention (Core vs Enhanced) to juvenile justice staff and community-based treatment providers, working with 18,698 JIY from March 2014 to August 2017. Recidivism rates over four study time periods were examined. Logistic regression was used to predict recidivism as a function of site, need for SUD services, level of supervision, time, organizational intervention, and time x intervention interaction terms. Results indicated that Enhanced sites showed decreased levels of recidivism compared to Core-only sites, where it increased over time. Additionally, need for SU services, level of supervision, and site were significant predictors of reoffending. Findings suggest the potential value of facilitation of juvenile justice agency efforts to increasing identification of and referral to SUD services of JIY in need of such services for reducing further contact with the legal system.

Using implementation science to improve evidence-based policing: An introduction for researchers and practitioners

“…The study utilized EPIS, a framework discussed below, to ensure the intended cascade of care was acceptable to practitioners, had goals set by a collaborative JJ-SUD process, and used a data-driven approach (Leukefeld et al, 2017) to assess if different approaches to implementation were met with different results (Becan et al, 2018). The results showed that careful strategic planning and preparation for institutional change produced improvements in the number of youth receiving substance use treatment in the juvenile justice setting Knight et al, 2022;Robertson et al, 2023), yielding promising techniques for implementation going forward (Becan et al, 2020).…”