This study will explore how to expand the Just Care for Families (JCFF) program beyond its current sites in Oregon, while addressing two main challenges: the developer team cannot provide ongoing support to every new program, and rural counties face limits on caseloads and reimbursement because of long travel distances. To overcome these barriers, the trial will test two strategies-using a JCFF mobile app to improve outcomes and efficiency, and relying on trained Experts (instead of the developer team) to guide new counties. With five active counties and four new ones, researchers will study whether parents receiving JCFF with digital support show reduced opioid and stimulant use, better child welfare outcomes like reunification, and more efficient treatment. This study will also compare how well new counties implement JCFF compared to existing ones, and use modeling to see if digital tools help programs sustain themselves by balancing caseloads and reimbursement. This study is supported by and included in the Helping to End Addiction Long-term Initiative (https://heal.nih.gov/).
Misuse of opioids and/or stimulants in the last year, including misuse of prescriptions
parent of a child aged 0-18 with the child living in the home or a reunification plan in place
residing in one of the nine participating counties
insured by Medicaid
None
Sequential
Just Care for Families (JCFF)
BehavioralJust Care for Families is a behavioral intervention to address the needs of families involved in or at-risk for involvement with the child welfare system. Just Care involves treatment components, supported by ongoing purposeful engagement: (1) Substance use treatment including contingency management and positive reinforcement, day planning, healthy environments and peer choices, and refusal skills; (2) Mental health treatment including cognitive behavioral therapy, developing healthy coping skills, emotion regulation skills, exposure therapy, and referral for medication management; (3) Parent management training including parenting skills, nurturing and attachment, reinforcement, emotion regulation, supervision, structure, non-harsh discipline, and nutrition; (4) Community building including indigenous and external social supports; (5) Systems navigation; and (6) provision of assistance with basic needs including assistance with housing and employment.
Just Care for Families (JCFF) App
BehavioralParticipants will use a Just Care for Families digital support application (App). App features will include interactive tools modeled after those used for in-person interventions and practice exercises. Parent data will be stored within the App, including entered self-report and usage data.
Just Care for Families (JCFF) App Feedback
BehavioralCoaches will receive feedback on parent's use of the App. Parent-reported current needs, clinical status (e.g., substance use and mental health symptoms), progress, and goals will be programmed into dashboards accessible to assigned Coaches (i.e., Feedback).
Change in Opioid and/or Stimulant Use from Baseline to 18 months
Any opioid or stimulant use in the past 30 days as measured by the Addiction Severity Index.
Treatment Engagement
Number of sessions attended as reported by coaches in the Just Portal software used as part of the JCFF delivery and fidelity monitoring.
Treatment Retention
Retained in treatment through completion (i.e. mutual decision between client and coach for how to end treatment). Measured only for the first treatment episode.
Child Welfare Re-Report
Any new referrals for parent or child as reported in Oregon Department of Human Services Administrative Data.
Child Reunification
Any record of child being reunified with parent as reported in Oregon Department of Human Services Administrative Data.
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Chestnut Health Systems
Lead sponsor
National Institute on Drug Abuse (NIDA)
Collaborator
