Teen Success Project (JPO-CM)

Improving Access to Substance Abuse Evidence-Based Practices for Youth in the Justice System: Strategies Used by JPOs

The purpose of this study is to examine the effectiveness of Juvenile Probation Officers (JPOs) delivering Contingency Management (CM) to teens on their caseload who have problems with drug use. CM has already been shown to be effective at helping teens with drug problems but CM has never been delivered by JPOs. This study will test how well it works to have JPOs deliver CM during their regular meetings with teens.

Study Overview

• Status: Completed
• Conditions: Substance Abuse
• Intervention / Treatment: Behavioral: Contingency Management; Behavioral: Probation as Usual

Detailed Description

Alcohol and other drug (AOD) use issues among adolescents are a major public health problem resulting in significant negative outcomes and extraordinary long-term costs. The rates of AOD use issues among youth in the justice system are twice the rates among youth without justice involvement. Further, youth with AOD issues engage in more severe delinquency and continue offending as adults, and their rate of engagement in HIV/STI sexual risk behaviors is alarming. Therefore, widespread access and delivery of effective AOD interventions to juvenile offenders is of considerable importance. Unfortunately, significant challenges exist for meeting the treatment needs of justice-involved youth. Although these youth are routinely referred to community-based providers for treatment, less than 1 in 5 are able to obtain such treatment. Further, for youth and families who are able to overcome barriers and engage with service providers, it is unlikely that they will receive an intervention that is evidence-based. In light of this context, innovative strategies clearly are needed to improve access to evidence-based practices for AOD abuse among youth in the juvenile justice system. Thus, the overriding purpose of the proposed study is to increase the access to such an evidence-based practice (Contingency Management [CM]) among youth in the juvenile justice system. This study leverages and extends the investigative team's work in CM efficacy, delivery, and technology transfer in juvenile justice settings, as well as 30+ years of collaboration with juvenile justice. We posit that juvenile probation officers (JPOs) are in an ideal position to deliver an AOD evidence-based practice to youth because of their intensive involvement and frequent contact with the youth offenders under their supervision. Further, CM is ideal for JPOs to learn and implement because it is highly specified and low in complexity relative to other AOD evidence-based practices for youth. Also, JPOs regularly monitor their probationers' substance use via frequent biological screens and implement consequences based on results, making CM consistent with JPOs' work. The proposed research randomizes JPOs to 2 conditions: CM versus control (usual JPO services), and then randomizes adolescent probationers with AOD disorders across those 2 conditions. This research would provide (1) evidence for the feasibility of JPOs to deliver an AOD abuse intervention, (2) initial evidence of clinical efficacy for JPOs as service delivery providers [to address clinical public health outcomes of AOD use, criminal activity, and HIV/STI sexual risk behaviors], and (3) identify any barriers that would need to be addressed for JPOs to deliver such services. The primary motivation for this application is the clear public health need for improving and expanding delivery of AOD interventions in the juvenile justice system. The ultimate outcome would be decreased AOD use and other public health-related behaviors (i.e., criminal behaviors, HIV/STI sexual risk behaviors) among these high-risk adolescents.

• Study Type: Interventional
• Enrollment (Actual): 310
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Idaho
    • Burley, Idaho, United States, 83318
      • Cassia County Juvenile Probation
    • Caldwell, Idaho, United States, 83605
      • Canyon County Juvenile Probation
    • Gooding, Idaho, United States, 83330
      • Gooding County Juvenile Probation
    • Hailey, Idaho, United States, 83333
      • Blaine County Juvenile Probation
    • Jerome, Idaho, United States, 83338
      • Jerome County Juvenile Probation
    • Rupert, Idaho, United States, 83350
      • Minidoka Juvenile Probation
    • Shoshone, Idaho, United States, 83352
      • Lincoln County Juvenile Probation
    • Twin Falls, Idaho, United States, 83301
      • Twin Falls County Juvenile Probation
  • Nevada
    • Carson City, Nevada, United States, 89701
      • Carson City Juvenile Probation
    • Reno, Nevada, United States, 89512
      • Washoe County Juvenile Probation
  • Oregon
    • Bend, Oregon, United States, 97701
      • Deschutes County Juvenile Probation
    • Pendleton, Oregon, United States, 97801
      • Umatilla County Juvenile Probation
    • Salem, Oregon, United States, 97301
      • Marion County Juvenile Probation
    • The Dalles, Oregon, United States, 97058
      • Wasco County Juvenile Probation

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 12 years to 17 years (Child, Adult)
• Accepts Healthy Volunteers: No

Description

There are 2 types of participants in this study: juvenile probation officers and youth.

Inclusion Criteria for juvenile probation officers:

• Employed as a juvenile probation officer within one of the participating counties
• Serving clients aged 12-18 years old with a substance abuse problem

Exclusion Criteria for juvenile probation officers:

• Not employed as a juvenile probation officer within one of the participating counties
• Not serving clients aged 12-18 years old with a substance abuse problem
• Juvenile probation officers solely assigned to a specialized caseload (e.g., sexual offense or gang unit) were excluded if they were the only one in their county with that assignment because randomization would be precluded

Inclusion Criteria for youth:

• Newly opened probation case (can have previous cases)
• 12-18 years old
• Diagnostic and Statistical Manual-5 (DSM-5) substance use disorder

Exclusion Criteria for youth:

• Pervasive intellectual or developmental disorder
• Active psychotic disorder
• Youth actively involved in a Drug Court Program at time of study recruitment

Ages Eligible for Study

• Youth: 12 Years to 18 Years
• JPOs: Any age

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Contingency Management; This group will receive regular probation services but will also receive the Contingency Management program for substance abuse from their juvenile probation officer during regular meetings.	Behavioral: Contingency Management; Contingency Management (CM) utilizes behavior modification & cognitive behavioral strategies to target adolescent alcohol or other drug (AOD) use. Protocol components are as follows: (a) The provider introduces CM to the family and engages them in the intervention; (b) The provider conducts Antecedent-Behavior-Consequence (ABC) assessments of the youth's AOD use with the youth and caregiver; (c) Based on the results of the ABC assessments, self-management planning and drug refusal skills training are implemented by the provider in collaboration with the caregiver; (d) Concurrently, a point and level system contract is filled in by the family, which provides rewards/privileges for negative drug and alcohol tests and disincentives (e.g., extra chores) for positive tests. Until continued abstinence is achieved, components "b" through "d" are repeated; (e) The provider collaborates with the family to develop plans for sustaining long-term abstinence. Typical duration of CM is 12-16 weeks.
Active Comparator: Probation as Usual; This group will receive regular services that are usually provided by juvenile probation officers.	Behavioral: Probation as Usual; Standard services that a young person would receive while under probation supervision in the state.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Changes from Baseline scores compared to 9 months post-Baseline Urine Drug Screens (measured at 0, 3, 6 and 9 months).	The number of positive drug screens from toxicology testing for tetrahydrocannabinol (THC), synthetic THC, amphetamines, methamphetamines, opiates, phencyclidine (PCP), cocaine, benzodiazepines and alcohol metabolites (Ethyl glucuronide, Ethyl sulfate ).	Baseline to 9 months
Changes from Baseline scores compared to 9 months post-Baseline Substance Use and Problems (measured at 0, 3, 6 and 9 months).	Frequency of substance use and substance-related problems self-reported on the Global Appraisal of Individual Needs.	Baseline to 9 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Changes in number and severity of criminal charges in official records in the 18 months pre-Baseline compared with 18 months post-Baseline.	Changes from 18 months pre-Baseline in offending, measured in the number and severity of offenses in official arrest records compared to 18 months post-Baseline.	18 months pre-Baseline to 18 months post-Baseline.
Changes from Baseline scores compared to 9 months post-Baseline Delinquent Behaviors (measured at 0, 3, 6 and 9 months).	Delinquent behaviors self-reported using the Self-Report Delinquency Scale.	Baseline to 9 months.
Changes from Baseline scores compared to 9 months post-Baseline Sexual Risk Behaviors (measured at 0, 3, 6 and 9 months).	Sexual risk behaviors self-reported using the HIV Sexual Risk Behavior Scale.	Baseline to 9 months.
Changes from Baseline scores compared to 9 months post-BaselineTreatment Usage (measured at 0, 3, 6 and 9 months).	The number of courses of in-patient and out-patient treatment obtained by youth for substance abuse as measured by the Structured Adolescent Interview (conducted with youth and caregiver together).	Baseline to 9 months.
Changes from Baseline scores compared to 9 months post-Baseline Internalizing and Externalizing Behaviors (measured at 0, 3, 6 and 9 months).	The frequency of youth's internalizing and externalizing behaviors as measured using the Brief Problem Checklist (self- and parent-report).	Baseline to 9 months.
Changes from Baseline scores compared to 31 months post-Baseline Contingency Management (CM) Adherence (measured monthly for 31 months).	Adherence to CM practices by juvenile probation officers as measured using the CM-Therapist Adherence Measure (CM-TAM) (Self-report version, Tape Coding version and Youth/Caregiver versions).	Baseline to 31 months.
Changes from Baseline in Training Needs and Training Satisfaction scores compared to 31 months post-Baseline (measured at 0,16 and 31 months).	Scores in training needs and training satisfaction as measured by the Organizational Readiness for Change-Criminal Justice Version (completed by participating juvenile probation officers).	Baseline to 31 months.
Changes from Baseline in attitudes towards using rewards in substance abuse treatment compared to 31 months post-Baseline (measured at 0,16 and 31 months).	Ratings on attitudes towards using rewards in substance use treatment as measured by the Provider Survey of Incentives (completed by participating juvenile probation officers).	Baseline to 31 months.
Changes from Baseline in attitudes towards Contingency Management (CM) compared to 31 months post-Baseline (measured at 0,16 and 31 months).	Ratings on attitudes towards Contingency Management as measured by qualitative ratings of audio-taped and transcribed focus groups (focus groups involve participating juvenile probation officers).	Baseline to 31 months.

Collaborators and Investigators

• Sponsor: Chestnut Health Systems
• Collaborators: Oregon Social Learning Center; George Mason University

Study record dates

Study Major Dates

• Study Start (Actual): October 1, 2017
• Primary Completion (Actual): September 14, 2022
• Study Completion (Actual): June 5, 2023

Study Registration Dates

• First Submitted: January 6, 2017
• First Submitted That Met QC Criteria: January 6, 2017
• First Posted (Estimated): January 10, 2017

Study Record Updates

• Last Update Posted (Estimated): October 21, 2025
• Last Update Submitted That Met QC Criteria: October 17, 2025
• Last Verified: May 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Mental Disorders; Chemically-Induced Disorders; Substance-Related Disorders
• Other Study ID Numbers: R01DA041434-01 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No