Justice Community Overdose Innovation Network II TCU Hub
Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18+
SponsorTexas Christian University
About this trial
The current study proposes to use a Hybrid Type 3 implementation research strategy to: 1) Significantly enhance our understanding of public health outcomes \[e.g., overdose incidents and substance-use (SU)-related Emergency Medical Service (EMS) contacts\] and public safety outcomes (e.g., drug-related arrests) associated with Deflection and Pre-Arrest Diversion initiatives (DPAD, hereafter referred to as Deflection); and 2) Create a lasting contribution to the fields of research focused on SU and the criminal legal system (CLS) by advancing knowledge of effective implementation strategies involving the critical role of community engagement in Deflection. The highly experienced team of Multiple PIs, senior-level collaborators from both Deflection and Community Behavioral Health (CBH), state-level evaluation partners, a national stakeholder advisory group, and CLS and behavioral health partners within each community have teamed up to carry out the proposed project. The study approach uses a hybrid implementation-effectiveness design to examine strategies to improve opioid and stimulant relevant outcomes, and specifically proposes to test the implementation-effectiveness of 2 strategy bundles to promote Deflection models through a CORE community engagement bundle (designed to facilitate community stakeholder engagement) and ENHANCED community engagement bundle (CORE plus a component to systematically involve community advocates) on improving implementation as well as public safety and health outcomes. The proposed randomized control trial includes a total of 20 geographically distinct clinical research performance sites (i.e., 20 communities spanning 5 states; New Mexico, Illinois, Wisconsin, Colorado, and Pennsylvania), with 3-5 communities per state and the inclusion of key CLS and CBH stakeholders within each site. The large scope of the project will maximize potential generalizability of study results and sustainability of implementation strategies.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
Making referrals (e.g., law enforcement, first responders, community agencies) & Providing services to participants (e.g., case managers, peer specialists, coordinators);
Aged 18 years or older;
Able to complete surveys in English;
Willing to provide informed consent
Disqualifiers
Not affiliated with a participating Deflection agency;
No role in Deflection referral or service delivery;
Under age 18;
Unable or unwilling to provide informed consent
Trial design
Design model
Parallel
Treatments tested in this trial
Core-interagency community engagement approach
Other interventioncommunity engagement approaches that including building interagency collaboration, strategic planning, advocacy
Enhanced-Core plus community engagement specialist
Other interventioncommunity engagement approaches that include the core, plus promoting identification and full integration of community citizens in community engagement practices
Treatment groups
1,620 Participants
are divided into 2 treatment groupsGroup A: Core-interagency community engagement approachOther 1 intervention
Group B: Enhanced-Core plus community engagement specialistOther 1 intervention
Trial outcomes
Primary outcomes
1
public health and safety collaboration
Is there a change in public health and safety collaboration? Measured using the Brewer et al., 2018 survey on aligning strategy (e.g., work together to identify unmet needs in the community) and coordinating current work (e.g., share information that helps the system of care work better). The Brewer et al. (2018) Aligning Strategy and Coordinating Work Survey is measured on a 5-point Likert scale, and scores are computed by averaging all items within each scale to yield a mean. Higher scores = stronger collaboration / alignment / coordination
Time frame
Month 10, 26, and 38 for Wave1; Month 14, 30, and 42 forWave 22
citizen awareness and perceived utility of Deflection
Is there a change in citizen awareness and perceived utility of Deflection? Measured using several survey measures on attitudes toward deflection efforts and law enforcement within their community, including awareness, acceptability, appropriateness, and feasibility. Survey measures are scored via averaging scale items together to yield a mean, with higher scores indicating higher levels of awareness, acceptability, appropriateness, and feasibility.
Time frame
Month 10, 26, and 38 for Wave1; Month 14, 30, and 42 forWave 23
deflection workforce referrals and citizen enrollments in Deflection
Is there a change in workforce referrals and citizen enrollments in Deflection? Measured using existing data collected by the deflection program on referral and enrollments to deflection services including adoption (e.g., proportion of workforce and agencies referring clients to deflection), penetration (e.g., count of deflection referrals and enrollments), equity (e.g., proportion of referrals and enrollments of minority representation), and sustainment (e.g., continued adoption and penetration). Scores for each will be represented by a count/number.
Time frame
Month 10, 26, and 38 for Wave1; Month 14, 30, and 42 for Wave 24
overdose and SU related mortality
Is there a change in overdose and SU related mortality rates? Measured using the National Association of State EMS Officials (NAEMSSO) harmonized data as collected from EMS agencies within the 5 participating states, as well as through coroner/vital statistics records on cause of death information for the communities. Rates are represented by a count/number of overdoses and SU related mortality rates, before and after implementation.
Time frame
Month 4-38 for Wave 1; Month8-42 for Wave 2Secondary outcomes
1
deflection workforce attitudes toward deflection
Is there a change in deflection workforce attitudes toward deflection? Measured using the Donnelly et al. (2024) Tough on Crime Index and the Bailey et al. (2024) Stigma and Policing Attitudes Toward PWUD Scale, items are rated on Likert-type scales and averaged to create composite scores, with higher values indicating stronger endorsement of punitive ("tough on crime") attitudes and greater stigma toward people who use drugs and restrictive policing approaches.
Time frame
Month 10, 26, and 38 for Wave1; Month 14, 30, and 42 forWave 22
citizen ratings of community law enforcement trust
Is there a change in community-law enforcement trust? Measured using the Hamm et al. (2018) Community-Law Enforcement Trust Scale, items are rated on Likert-type scales and averaged to create a composite score, with higher values indicating greater perceived trust between community members and law enforcement.
Time frame
Month 10, 26, and 38 for Wave1; Month 14, 30, and 42 forWave 2Sponsors and contacts
Click on the lead sponsor to view all of their trials.
Texas Christian University
Lead sponsor
National Institute on Drug Abuse (NIDA)
Collaborator
Source ClinicalTrials.gov
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