Improving Substance Use Services for Juvenile Justice-Involved Youth: Complexity of Process Improvement Plans in a Large Scale Multi-site Study

  • Jennifer E. BecanEmail author
  • Jacqueline Horan Fisher
  • Ingrid D. Johnson
  • John P. Bartkowski
  • Robert Seaver
  • Sheena K. Gardner
  • Gregory A. Aarons
  • Tiffaney L. Renfro
  • Roxanne Muiruri
  • Lindrell Blackwell
  • Kaitlin N. Piper
  • Tisha A. Wiley
  • Danica K. Knight
Original Article


Despite the high prevalence of substance use disorders among juvenile offenders, most do not receive services. System-level process improvement plans to address unmet service needs can be optimized by combining data-driven decisions and facilitated meetings with behavioral health stakeholders. This paper operationalizes and analyzes the level of specified complexity among process improvement plans evident within 36 juvenile probation and drug courts across 7 states. To inform more effective implementation strategies, this analysis identifies and prioritizes promising courses of agency enhancement toward addressing unmet substance use needs.


Quality improvement planning Consolidated framework for advancing implementation research The Exploration, Preparation, Implementation, and Sustainment Framework Substance use services Juvenile justice 



The authors would like to thank the following members of the Study Design Workgroup for their assistance and participation in curriculum and methodological development activities: Barbara Estrada, Kate Elkington, Leah Hamilton, Philip Harris, Kevin Knight, James Maccarone, Larkin McReynolds, Alexis Nager, Traci Rieckmann, Eve Rose, Anne Spaulding, Gail Wasserman, and Matt Webster.


This study was funded under the JJ-TRIALS cooperative agreement, funded at the National Institute on Drug Abuse (NIDA) by the National Institutes of Health (NIH). The authors gratefully acknowledge the collaborative contributions of NIDA and support from the following grant awards: Chestnut Health Systems (U01DA036221); Columbia University (U01DA036226); Emory University (U01DA036233); Mississippi State University (U01DA036176); Temple University (U01DA036225); Texas Christian University (U01DA036224); University of Kentucky (U01DA036158), and University of Miami (R21DA044378). NIDA Science Officer on this project is Tisha Wiley. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the NIDA, NIH, or the participating universities or JJ systems.

Compliance with Ethical Standards

Conflict of interest

GAA serves on the Editorial Board for Administration and Policy in Mental Health and Mental Health Services Research; all decisions on this paper were made by another editor. The authors declare that they have no other competing interests.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional review boards for each of the seven research institutions and the coordinating center and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2020

Authors and Affiliations

  • Jennifer E. Becan
    • 1
    Email author
  • Jacqueline Horan Fisher
    • 2
  • Ingrid D. Johnson
    • 3
  • John P. Bartkowski
    • 4
  • Robert Seaver
    • 5
  • Sheena K. Gardner
    • 6
  • Gregory A. Aarons
    • 7
  • Tiffaney L. Renfro
    • 8
  • Roxanne Muiruri
    • 1
  • Lindrell Blackwell
    • 9
  • Kaitlin N. Piper
    • 8
  • Tisha A. Wiley
    • 10
  • Danica K. Knight
    • 1
  1. 1.Institute of Behavioral ResearchTexas Christian UniversityFort WorthUSA
  2. 2.State University of New YorkNew YorkUSA
  3. 3.Justice Center, University of Alaska AnchorageAnchorageUSA
  4. 4.Department of SociologyUniversity of Texas at San AntonioSan AntonioUSA
  5. 5.Center on Drug & Alcohol ResearchUniversity of KentuckyLexingtonUSA
  6. 6.Social Science Research CenterMississippi State UniversityStarkvilleUSA
  7. 7.Department of Psychiatry, and Child and Adolescent Services Research CenterUniversity of CaliforniaSan DiegoUSA
  8. 8.Rollins School of Public HealthEmory UniversityAtlantaUSA
  9. 9.Kentucky Department of Juvenile JusticeFrankfortUSA
  10. 10.National Institute on Drug AbuseBethesdaUSA

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