Juvenile Justice Translational Research on Interventions for Adolescents in the Legal System

Background: The Juvenile Justice—Translational Research on Interventions for Adolescents in
the Legal System (JJ-TRIALS) study is a cooperative implementation science initiative
involving the National Institute on Drug Abuse, six Research Centers, a Coordinating Center,
and Juvenile Justice Partners representing seven U.S. states. The pooling of resources across
Centers enables a robust implementation study design involving 36 juvenile justice agencies
and their behavioral health partner agencies, coproducing a study protocol that has potential
to advance implementation science, meets the needs of all constituencies (funding agency,
researchers, partners, study sites), and can be implemented with fidelity across the
cooperative can be challenging.

Methods/design: The JJ-TRIALS primary study uses a head-to-head cluster randomized trial with
a phased rollout to evaluate the differential effectiveness of two conditions (Core and
Enhanced) in 36 sites located in 7 states. Core strategies for promoting change are compared
to an Enhanced strategy that incorporate all core strategies plus active facilitation. Target
outcomes include improvements in evidence-based screening, assessment, and linkage to
substance use treatment.

Primary Research Questions:

1. Does the Core and/or Enhanced Intervention reduce unmet need by increasing Cascade
retention related to screening, assessment, treatment initiation, engagement and
continuing care?

2. Does the addition of the Enhanced Intervention components further increase the
percentage of youth retained in the Cascade relative to the Core components?

3. Does the addition of the Enhanced Intervention components improve service quality
relative to Core sites?

4. Do staff perceptions of the value of best practices increase over time, and are
increases more pronounced in Enhanced sites?

Specific site inclusion criteria include: (a) ability to provide youth service records, (b)
service to youth under community supervision, (c) access to treatment provider(s) if
treatment is not provided directly by the JJ agency, (d) participation in requisite
intervention training/activities,(e) minimum average case flow of 10 youth per month, (f)
minimum of 10 staff per site, and (g) a senior JJ staff member who agrees to serve as site
leader/liaison during the study. Study sites are geographically dispersed and were
identified by state JJ agencies (and not selected for particular substance use or related
BH service needs).

Youth inclusion criteria include: all youth entering the juvenile justice system during the
period within the exception of those who are already in treatment at the time that they are
referred to the juvenile justice agency.

Staff inclusion criteria include: all staff actively working with the youth under community
supervision in the site with exclusion only of higher level administrative or regional
staff over multiple units..