Skip to main content

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

Abstract

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.

This is a preview of subscription content, access via your institution.

Fig. 1

Copyright from Knight et al. (2016)

Fig. 2

References

  1. Aarons, G. A., Fettes, D. L., Hurlburt, M. S., Palinkas, L. A., Gunderson, L., Willging, C. E., & Chaffin, M. J. (2014). Collaboration, negotiation, and coalescence for interagency-collaborative teams to scale-up evident-based practice. Journal of Clinical Child and Adolescent Psychology,43(6), 915–928. https://doi.org/10.1080/15374416.2013.876642.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Aarons, G. A., Green, A. E., Palinkas, L. A., Self-Brown, S., Whitaker, D. J., Lutzker, J. R., … Chaffin, M. J. (2012). Dynamic adaptation process to implement an evidence-based child maltreatment intervention. Implementation Science,7(32). https://doi.org/10.1186/1748-5908-7-32.

    Article  PubMed  Google Scholar 

  3. Aarons, G. A., Hurlburt, M., & Horwitz, S. M. (2011). Advancing a conceptual model of evidence-based practice implementation in public service sectors. Administration and Policy in Mental Health and Mental Health Services Research,38(1), 4–23. https://doi.org/10.1007/s10488-010-0327-7.

    Article  PubMed  Google Scholar 

  4. American Society of Addiction Medicine. (2013). The ASAM criteria: Treatment criteria for addictive, substance-related, and co-occurring conditions. Chevy Chase, MD: Author.

    Google Scholar 

  5. Atkins, M. S., Frazier, S. L., Leathers, S. J., Graczyk, P. A., Talbott, E., Jakobsons, L., … Bell, C. C. (2008). Teacher key opinion leaders and mental health consultation in low-income urban schools. Journal of Consulting and Clinical Psychology,76(5), 905–908. https://doi.org/10.1037/a0013036.

    Article  PubMed  Google Scholar 

  6. Barwick, M. A., Peters, J., & Boydell, K. (2009). Getting to uptake: Do communities of practice support the implementation of evidence-based practice? Journal of the Canadian Academy of Child and Adolescent Psychiatry,18(1), 16–29. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2651208/.

  7. Becan, J. E., Bartkowski, J., Knight, D. K., Wiley, T., DiClemente, R., Ducharme, L., … Aarons, G. A. (2018). A Model for Rigorously Applying the Exploration, Preparation, Implementation, and Sustainment (EPIS) Framework in the Design and Measurement of a Large Scale Collaborative Multi-site Study. Health and Justice. https://doi.org/10.1186/s40352-018-0068-3.

    Article  PubMed  Google Scholar 

  8. Belenko, S., & Dembo, R. (2003). Treating adolescent substance abuse problems in the juvenile drug court. International Journal of Law and Psychiatry,26(1), 87–110. https://doi.org/10.1016/s0160-2527(02)00205-4.

    Article  PubMed  Google Scholar 

  9. Belenko, S., Knight, D., Wasserman, G. A., Dennis, M. L., Wiley, T., Taxman, F. S., … Sales, J. (2017). The Juvenile Justice Behavioral Health Services Cascade: A new framework for measuring unmet substance use treatment services needs among adolescent offenders. Journal of Substance Abuse Treatment,74, 80–91. https://doi.org/10.1016/j.jsat.2016.12.012.

    Article  PubMed  Google Scholar 

  10. Belenko, S., Sprott, J. B., & Peterson, C. (2004). Drug and alcohol involvement among minority and female juvenile offenders: Treatment and policy issues. Criminal Justice Policy Review,15(1), 3–36. https://doi.org/10.1177/0887403403255068.

    Article  Google Scholar 

  11. Bowser, D., Henry, B., Wasserman, G., Knight, D., Gardner, S., Krupka, K., … Robertson, A. (2018). Comparison of the overlap between juvenile justice case processing and screening & referral to Behavioral Health Services. Journal of Applied Juvenile Justice Services,5(1), 96–125. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6342497/.

  12. Brooks, J. M., Titler, M. G., Ardery, G., & Herr, K. (2008). The effect of evidence-based acute pain management practices on inpatient costs. Health Services Research,44(1), 245–263. https://doi.org/10.1111/j.1475-6773.2008.00912.x.

    Article  Google Scholar 

  13. Chamberlain, P., Hendricks Brown, C. H., & Saldana, L. (2011). Observational measure of implementation progress in community based settings: The Stages of Implementation Completion (SIC). Implementation Science,6, 116. https://doi.org/10.1186/1748-5908-6-116.

    Article  PubMed  Google Scholar 

  14. Chamberlain, P., Roberts, R., Jones, H., Marsenich, L., Sosna, T., & Price, J. M. (2012). Three Collaborative models for scaling up evidence-based practices. Administration and Policy in Mental Health and Mental Health Services Research,39(4), 278–290. https://doi.org/10.1007/s10488-011-0349-9.

    Article  PubMed  Google Scholar 

  15. Chambers, D. A., Glasgow, R. E., & Stange, K. C. (2013). The dynamic sustainability framework: Addressing the paradox of sustainment amid ongoing change. Implementation Science,8, 117. https://doi.org/10.1186/1748-5908-8-117.

    Article  PubMed  Google Scholar 

  16. Chandler, R. K., Fletcher, B. W., & Volkow, N. D. (2009). Treating drug abuse and addiction in the criminal justice system: Improving public health and safety. Journal of the American Medical Association,301(2), 183–190. https://doi.org/10.1001/jama.2008.976.

    CAS  Article  PubMed  Google Scholar 

  17. Chorpita, B. F., Bernstein, A., Daleiden, E. L., & Research Network on Youth Mental Health. (2008). Driving with roadmaps and dashboards: Using information resources to structure the decision models in service organizations. Administration and Policy in Mental Health and Mental Health Services Research,35(1–2), 114–123. https://doi.org/10.1007/s10488-007-0151-x.

    Article  PubMed  Google Scholar 

  18. Committee on Substance Abuse. (2011). Substance use screening, brief intervention, and referral to treatment for pediatricians. American Academy of Pediatrics,128(5), e1330–e1340. https://doi.org/10.1542/peds.2011-1754.

    Article  Google Scholar 

  19. Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A., & Lowery, J. C. (2009). Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science. Implementation Science,4, 50. https://doi.org/10.1186/1748-5908-4-50.

    Article  PubMed  Google Scholar 

  20. Dansereau, D. F., & Simpson, D. D. (2009). A picture is worth a thousand words: The case for graphic representations. Professional Psychology: Research and Practice,40(1), 104–110. https://doi.org/10.1037/a0011827.

    Article  Google Scholar 

  21. Dennis, M., Smith, C., Knight, D., Belenko, S., Dembo, R., DiClemente, R., … Wiley, T. (2018). Demonstrating the need for and feasibility of applying a behavioral health services cascade framework in juvenile justice. Presentation at the College on Problems of Drug Dependence 80th Annual Scientific Meeting, San Diego, CA.

  22. Gardner, S. K., Elkington, K. S., Knight, D. K., Huang, S., DiClemente, R. D., Spaulding, A. C., & Baird-Thomas, C. (2018). Juvenile justice staff attitudes about HIV/STI prevention, testing, and treatment linkage. Unpublished manuscript, Mississippi State: Social Science Research Center. https://doi.org/10.1186/s40352-019-0096-7.

  23. Gardner, E. M., McLees, M. P., Steiner, J. F., del Rio, C., & Burman, W. J. (2011). The spectrum of engagement in HIV care and its relevance to test-and-treat strategies for prevention of HIV infection. Clinical Infectious Diseases,52(6), 793–800. https://doi.org/10.1093/cid/ciq243.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Glisson, C., Schoenwald, S. K., Hemmelgarn, A., Green, P., Dukes, D., Armstrong, K. S., & Chapman, J. E. (2010). Randomized trial of MST and ARC in a two-level evidence based treatment implementation strategy. Journal of Consulting and Clinical Psychology,78(4), 537–550. https://doi.org/10.1037/a0019160.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Greenhalgh, T., Robert, G., MacFarlane, F., Bate, P., & Kryriakidou, O. (2004). Diffusion of innovations in service organizations: Systematic review and recommendations. The Milbank Quarterly,82(4), 581–629. https://doi.org/10.1111/j.0887-378x.2004.00325.x.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Grol, R. P. T. M., Bosch, M. C., Hulscher, M. E. J. L., Eccles, M. P., & Wensing, M. (2007). Planning and studying improvement in patient care: The use of theoretical perspectives. The Milbank Quarterly,85(1), 93–138. https://doi.org/10.1111/j.1468-0009.2007.00478.x.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Gustafson, D. H., Quanbeck, A. R., Robinson, J. M., Ford II, J. H., Pulvermacher, A., French, M. T., … McCarty, D. (2013). Which elements of improvement collaboratives are most effective? A cluster-randomized trial. Addiction,108(6), 1145–1157. https://doi.org/10.1111/add.12117.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Henderson, C. E., & Taxman, F. S. (2009). Competing values among criminal justice administrators: The importance of substance abuse treatment. Drug and Alcohol Dependence,103(Suppl 1), S7–S16. https://doi.org/10.1016/j.drugalcdep.2008.10.001.

    Article  PubMed  Google Scholar 

  29. Horan Fisher, J., Becan, J. E., Harris, P. W., Nager, A., Baird-Thomas, C., Hogue, A., … The JJ-TRIALS Cooperative. (2018). Using goal achievement training in juvenile justice settings to improve substance use services for youth on community supervision. Health and Justice,6(1), 10. https://doi.org/10.1186/s40352-018-0067-4.

    Article  Google Scholar 

  30. Hurlburt, M., Aarons, G. A., Fettes, D., Willging, C., Gunderson, L., & Chaffin, M. J. (2014). Interagency Collaborative Team model for capacity building to scale-up evidence-based practice. Children and Youth Services Review,39, 160–168. https://doi.org/10.1016/j.childyouth.2013.10.005.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Keith, R. E., Crosson, J. C., O’Malley, A. S., Cromp, D., & Taylor, E. F. (2017). Using the Consolidated Framework for Implementation Research (CFIR) to produce actionable findings: A rapid-cycle evaluation approach to improving implementation. Implementation Science,12(1), 15. https://doi.org/10.1186/s13012-017-0550-7.

    Article  PubMed  Google Scholar 

  32. Kieffer, M. P., Mattingly, M., Giphart, A., van de Ven, R., Chouraya, C., Walakira, M., … the EGPAF Technical Directors Forum. (2014). Lessons learned from early implementation of Option B+: The Elizabeth Glaser Pediatric AIDS Foundation Experience in 11 African countries. Journal of Acquired Immune Deficiency Syndromes,67(Suppl 4), S188–S194. https://doi.org/10.1097/qai.0000000000000372.

    Article  PubMed  Google Scholar 

  33. King-Sears, M. E. (2001). Institutionalizing peer-mediated instruction and interventions in schools: Beyond “Train and Hope”. Remedial and Special Education,22(2), 89–101. https://doi.org/10.1177/074193250102200203.

    Article  Google Scholar 

  34. Knight, D. K., Belenko, S., Wiley, T., Robertson, A. A., Arrigona, N., Dennis, M., … The JJ-TRIALS Cooperative. (2016). Juvenile Justice—Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS): A cluster randomized trial targeting system-wide improvement in substance use services. Implementation Science,11, 57. https://doi.org/10.1186/s13012-016-0423-5.

    Article  PubMed  Google Scholar 

  35. Knight, D. K., Joe, G. W., Morse, D. T., Smith, C., Knudsen, H., Johnson, I., … Wiley, T. R. A. (2019). Organizational context and individual adaptability in promoting perceived importance and use of best practices for substance use. Journal of Behavioral Health Services & Research,46(2), 192–216. https://doi.org/10.1007/s11414-018-9618-7.

    Article  Google Scholar 

  36. Kochevar, L. K., & Yano, E. M. (2006). Understanding health care organization needs and context: Beyond performance gaps. Journal of General Internal Medicine,21(Suppl 2), S25–S29. https://doi.org/10.1111/j.1525-1497.2006.00359.x.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Kötter, T., Blozik, E., & Scherer, M. (2012). Methods for the guideline-based development of quality indicators—A systematic review. Implementation Science,7, 21. https://doi.org/10.1186/1748-5908-7-21.

    Article  PubMed  Google Scholar 

  38. Lawlor, K. B., & Hornyak, M. J. (2012). Smart goals: How the application of smart goals can contribute to achievement of student learning outcomes. Developments in Business Simulation and Experiential Learning,39, 259–267. https://absel-ojs-ttu.tdl.org/absel/index.php/absel/article/view/90/86.

  39. Leukefeld, C. G., Cawood, M., Wiley, T., Robertson, A., Horan Fisher, J., Arrigona, N., … The JJ-TRIALS Cooperative. (2017). The benefits of community and juvenile justice involvement in organizational research. Journal of Juvenile Justice,6(1), 112–124. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5562037/.

  40. Locke, E. A., & Latham, G. P. (1990). A theory of goal setting & task performance. Englewood Cliffs, NJ: Prentice-Hall, Inc. https://doi.org/10.5860/choice.28-0608.

    Book  Google Scholar 

  41. Morrison, M. (2010). History of SMART objectives. Retrieved from https://rapidbi.com/history-of-smart-objectives.

  42. Mugavero, M. J., Amico, K. R., Horn, T., & Thompson, M. A. (2013). The state of engagement in HIV care in the United States: From cascade to continuum to control. Clinical Infectious Diseases,57(8), 1164–1171. https://doi.org/10.1093/cid/cit420.

    Article  PubMed  Google Scholar 

  43. National Institute on Alcohol Abuse and Alcoholism. (2015). Alcohol screening and brief intervention for youth: A practitioner’s guide (NIH Publication No. 11-7805, revised). Retrieved from https://www.niaaa.nih.gov/alcohol-screening-and-brief-intervention-youth-practitioners-guide.

  44. New York State Department of Health. (1999, April). Disease screening—Statistics teaching tools. Retrieved from https://www.health.ny.gov/diseases/chronic/discreen.htm.

  45. Orwin, R. G., Edwards, J. M., Buchanan, R. M., Flewelling, R. L., & Landy, A. L. (2012). Data-driven decision making in the prevention of substance-related harm: Results from the Strategic Prevention Framework State Incentive Grant Program. Contemporary Drug Problems,39(1), 73–106. https://doi.org/10.1177/009145091203900105.

    Article  Google Scholar 

  46. Pearson, F. S., Shafer, M. S., Dembo, R., del Mar Vega-Debién, G., Pankow, J., Duvall, J. L., … Patterson, Y. (2014). Efficacy of a process improvement intervention on delivery of HIV services to offenders: A multisite trial. American Journal of Public Health, 104(12), 2385–2391. https://doi.org/10.2105/ajph.2014.302035.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Prendergast, M., Welsh, W. N., Stein, L., Lehman, W., Melnick, G., Warda, U., … Duvall, J. (2017). Influence of organizational characteristics on success in implementing process improvement goals in correctional treatment settings. Journal of Behavioral Health Services & Research,44(4), 625–646. https://doi.org/10.1007/s11414-016-9531-x.

    Article  Google Scholar 

  48. Proctor, E. K., Powell, B. J., & McMillen, J. C. (2013). Implementation strategies: Recommendations for specifying and reporting. Implementation Science,8, 139. https://doi.org/10.1186/1748-5908-8-139.

    Article  PubMed  Google Scholar 

  49. Schneider, S., & Simpson, L. (2011). Getting on board with juvenile justice information technologies. In F. T. Sherman & F. H. Jacobs (Eds.), Juvenile justice: Advancing research, policy, and practice. Hoboken, NJ: Wiley. https://doi.org/10.1002/9781118093375.ch22.

    Chapter  Google Scholar 

  50. Taxman, F. S., Henderson, C. E., & Belenko, S. (2009). Organizational context, systems change, and adopting treatment delivery systems in the criminal justice system. Drug and Alcohol Dependence,103(Suppl 1), S1–S6. https://doi.org/10.1016/j.drugalcdep.2009.03.003.

    Article  PubMed  Google Scholar 

  51. Taylor, M. J., McNicholas, C., Nicolay, C., Darzi, A., Bell, D., & Reed, J. E. (2014). Systematic review of the application of the plan-do-study-act method to improve quality in healthcare. BMJ Quality & Safety,23(4), 290–298. https://doi.org/10.1136/bmjqs-2013-001862.

    Article  Google Scholar 

  52. Young, D. W., Dembo, R., & Henderson, C. E. (2007). A national survey of substance abuse treatment for juvenile offenders. Journal of Substance Abuse Treatment,32(3), 255–266. https://doi.org/10.1016/j.jsat.2006.12.018.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Young, D., Moline, K., Farrell, J., & Bierie, J. (2006). Best implementation practices: Disseminating new assessment technologies in a juvenile justice agency. Crime & Delinquency,52(1), 135–158. https://doi.org/10.1177/0011128705281752.

    Article  Google Scholar 

Download references

Acknowledgements

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.

Funding

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.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Jennifer E. Becan.

Ethics declarations

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.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Becan, J.E., Fisher, J.H., Johnson, I.D. et al. Improving Substance Use Services for Juvenile Justice-Involved Youth: Complexity of Process Improvement Plans in a Large Scale Multi-site Study. Adm Policy Ment Health 47, 501–514 (2020). https://doi.org/10.1007/s10488-019-01007-z

Download citation

Keywords

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