Kentucky Women's Justice Community Opioid Innovation Network (W-JCOIN)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
This study will incorporate random assignment for two study conditions: medication for opioid use disorder (MOUD) PreTreatment Telehealth or MOUD PreTreatment Telehealth with Peer Navigation using a rigorous randomized block design. Women in the experimental conditions will be stratified by sites (6 sites; 3 urban and 3 non-urban) and by offender classification level of felony versus misdemeanor (due to potential differences in community supervision). Three comparison sites with existing jail-based MOUD treatment for women will not be randomized but will be included in analyses within planned, non-randomized comparisons.
- MOUD PreTreatment Telehealth: Participants who screen positive for moderate to high-risk opioid use and complete the baseline interview will be connected via telehealth to the community MOUD provider for a psychosocial assessment. The study data coordinator will assist with linking the participant to the community MOUD provider via telehealth, as well as collecting initial in-person biological specimens for medical evaluation. The psychosocial assessment with the community MOUD provider will involve a more detailed examination of OUD using the Diagnostic and Statistical Manual of Mental Disorders (DSM) 5 criteria. Type of medication (naltrexone, buprenorphine, or methadone) will depend on the psychosocial assessment and medical evaluation. Indications for the most appropriate course of treatment will be determined by the community MOUD provider in conjunction with the study participant. Women in this condition will also receive general education about MOUD options including risks and benefits, and they will be given the opportunity to ask questions about the medication. The community MOUD provider will also use motivational interviewing to assess each woman's readiness to engage in MOUD and to better understand possible barriers to MOUD utilization. At the end of the education session, the study participant and the MOUD community provider will develop a re-entry plan for ongoing care, which will include a plan for insurance coverage of medications in the community.
- MOUD PreTreatment Telehealth + Peer Navigation: In addition to MOUD PreTreatment Telehealth, women in this arm will be connected with a peer, a woman in recovery who is employed by Voices of Hope (VOH) in Lexington, KY. Peer Navigators will be located in Lexington through a partnership with VOH. VOH is a non-profit recovery support organization which provides peer recovery support services. In conjunction with the study data coordinators, the Peer Navigator will schedule an initial session via telehealth with the participant, assist with scheduling a follow-up appointment with the community MOUD provider, and provide recovery support for community MOUD initiation and maintenance. Peer Navigators will be certified Peer Support Specialists trained and supervised by VOH in accordance with state statutory requirements. When a woman returns to the community, Peer Navigators will engage her in weekly telephone recovery services (TRS) for 12 weeks, which may include identifying personal goals and strength-based, practical strategies for success. In addition to MOUD linkages to care, Peer Navigators will suggest strategies to maintain sobriety and improve recovery capital, including safe housing, transportation, financial counseling, continued education, employment skills, and sober social activities.
- Services as Usual: Women in this arm will not be randomized, but will receive substance abuse treatment as usual in three comparison jail sites. Each of these jails has a women's substance abuse program (SAP) managed by the Kentucky Department of Corrections (KY-DOC with the option to initiate MOUD prior to jail release. These programs operate as modified therapeutic communities with transitional support following release.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Michele Staton, MSW, PhD
- Phone Number: 859-257-2483
- Email: mstaton@uky.edu
Study Contact Backup
- Name: Erin Winston, MPA
- Phone Number: 859-257-1720
- Email: ermcne0@uky.edu
Study Locations
-
-
Kentucky
-
Elizabethtown, Kentucky, United States, 42701
- Hardin County Detention Center
-
Harlan, Kentucky, United States, 40828
- Harlan County Detention Center
-
Henderson, Kentucky, United States, 42420
- Henderson County Detention Center
-
Lebanon, Kentucky, United States, 40033
- Marion County Detention Center
-
Leitchfield, Kentucky, United States, 42754
- Grayson County Detention Center
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London, Kentucky, United States, 40741
- Laurel County Correctional Center
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Pikeville, Kentucky, United States, 41501
- Pike County Detention Center
-
Shelbyville, Kentucky, United States, 40065
- Shelby County Detention Center
-
Williamstown, Kentucky, United States, 41097
- Grant County Detention Center
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- ASSIST opioid (prescription or street) score of 4+
- Willingness to participate in MOUD pre-treatment
- Incarceration period of at least 7 days
Exclusion Criteria
• Cognitive impairment
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Services as Usual (SAU)
Substance abuse program (SAP) managed by the Kentucky Department of Corrections, with the option to initiate MOUD prior to jail release.
|
Medications to treat opioid use disorder (MOUD) pre-treatment.
|
|
Experimental: MOUD Pre-Treatment Telehealth
Telehealth connection to a community MOUD provider.
|
Opioid use disorder (OUD) assessment, medical evaluation, and medications to treat opioid use disorder (MOUD) education with a MOUD provider during incarceration via telehealth
|
|
Experimental: MOUD Pre-Treatment Telehealth and Peer Navigator
Telehealth connection to a community MOUD provider, in addition to a peer navigator
|
Opioid use disorder (OUD) assessment, medical evaluation, and medications to treat opioid use disorder (MOUD) education with a MOUD provider during incarceration via telehealth.
Additionally, participants will be connected with a Peer Navigator who will meet with them via telehealth prior to release and provide ongoing support by telephone post-release.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
The number of participants who initiate MOUD
Time Frame: 13 months
|
Any initiation of MOUD post-release over the study period
|
13 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Medication Type
Time Frame: 13 months
|
Percentage of participants on naltrexone, buprenorphine or methadone.
|
13 months
|
|
Opioid Relapse
Time Frame: 13 months
|
Percentage of participants relapsing, measured by self-report or drug screen.
|
13 months
|
|
Treatment Retention
Time Frame: 13 months
|
Length of time in treatment
|
13 months
|
|
Recidivism
Time Frame: 12 months
|
Percent of participants returning to custody
|
12 months
|
|
Overdose Rates
Time Frame: 13 months
|
Percentage of participants who overdose (medical attention needed for revival)
|
13 months
|
|
Criminal Activity
Time Frame: 12 months
|
Percent of participants engaging in criminal activity (self-report or arrest records)
|
12 months
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Total Annual Intervention Cost
Time Frame: 5 years
|
Total annual intervention cost
|
5 years
|
|
Average Participant Cost
Time Frame: 13 months
|
Average intervention cost per participant
|
13 months
|
|
Incremental Cost-Effectiveness Ratio
Time Frame: 5 years
|
Cost per unit outcome of interventions versus services as usual
|
5 years
|
|
Public Health Cost of Opioid Relapse
Time Frame: 5 years
|
Cumulative estimated cost of hospitalizations, treatments, loss of work, child welfare, and other services related to relapse.
|
5 years
|
|
Public Safety Cost of Recidivism and Criminal Activity
Time Frame: 5 years
|
Cumulative estimated cost of return to custody, arrests, and other social costs of recidivism.
|
5 years
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Michele Staton, MSW, PhD, University Of Kentucky
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 51656
- 1UG1DA050069 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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