The goal of this observational study is to learn about the roles played by parental activity spaces and social networks in reducing parental substance use and promoting child and family health outcomes in the context of Ohio START (Sobriety, Treatment, and Reducing Trauma) for families in rural areas. This study will investigate if substance use treatment service referrals and family peer mentoring services provided by Ohio START lead to positive changes in parental activity spaces and social networks, and if these positive changes lead to better child and family outcomes. The main questions it aims to answer are:
* Does having behavioral health services (referred by Ohio START workers) close to where parents spend their time help with substance use recovery and child health? * Does peer mentor support through Ohio START help parents build stronger social connections and family resilience, and does this lead to better long-term family health? * Do these associations differ in rural areas compared to urban areas?
Participants will:
* Answer survey questions about their substance use, parenting, child health, and family well-being across three waves (Wave 1: when they enroll in the study, Wave 2: 6-month follow-up, and Wave 3: 12-month follow-up) * Share information about places they go regularly (such as work, stores, and healthcare visits) * Share information about people in their support network
age 18 or older
who score 3 or higher on the substance use screening tool (UNCOPE)
None
Single group
Ohio START (Ohio Sobriety, Treatment, and Reducing Trauma)
BehavioralOhio START launched in 2017 in response to the opioid epidemic and is led by the Public Children Services Association of Ohio (PASCO). Ohio START integrates child welfare and substance use treatment systems to enhance access to treatment for parents who come into the child welfare system with addictions. Ohio START capitalizes on collaboration between the child welfare system and behavioral health providers in order to reduce parent wait times for treatment for referrals, increase parent engagement and retention in treatment, and enhance coordination of resources and support for parents and children. Another key aspect of START is the use of family peer mentors as a social network intervention. Parents are paired with family peer mentors who, through weekly visits, support participating families and enhance coordination of resources. Family peer mentors are required to have a minimum of a weekly face-to-face visit with parents for 90 days.
Parental substance use severity
Parental substance use problems will be measured using the Simple Screening Instrument for Alcohol and Other Drugs (SSI-AOD), a 16-item screen that assesses respondents' experiences with substances in the past month and measures the severity of alcohol and other drug problems. In addition, weekly urine drug screening data (tests administered randomly each week) collected from all Ohio START participants will be drawn from the Need Portal and used to objectively assess parental substance use.
Child psychosocial and behavioral health
Child psychosocial-behavioral functioning, including emotional symptoms, conduct problems, peer relationships, hyperactivity, prosocial behaviors, and total problems will be assessed using the Strengths and Difficulties Questionnaire (SDQ; 25 items), a well-established brief psychological assessment tool for children 2 to 17 years old. For children ages 2 months to 1 year and 11 months, the Ages \& Stages Questionnaires: Social-Emotional (ASQ:SE) will be used.
Child maltreatment
Using SACWIS data, we will assess the number of reports made to child protective services (CPS) and the type of maltreatment (e.g., physical, sexual, emotional abuse, neglect).
Substance use disorder (SUD) treatment service use
Parents' SUD treatment service utilization (the number of substance use treatment sessions attended) will be measured using the information (e.g., date of the treatment session attended) that behavioral health service providers enter into the Needs Portal.
Family resilience
Family resilience score will be computed using the Family Functioning and Resilience subscale of the Protective Factors Survey (PFS; 5 items). Responses on the five items (e.g., "my family pulls together when things are stressful", "my family is able to solve our problems", "in my family, we talk about problems") will be summed to create the total family resilience score.
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Ohio State University
Lead sponsor
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Collaborator
University of Michigan
Collaborator
