e-Connect: A Service System Intervention for Justice Youth at Risk for Suicide
Study Details
Study Description
Brief Summary
The investigators propose to create e-Connect: a new service delivery model that will enable real time identification and targeted, county-specific referral and linkage of participants with suicidal behavior (SB) and related behavioral health (BH) problems. e-Connect will: (i) establish and formalize interagency referral decisions based on clinical need, jointly derived by JJ (juvenile justice) and BH agencies; (ii) train probation staff to increase BH/SB understanding; (iii) utilize an existing evidence-based (EB) BH/SB screen; and (iv) develop a mobile application to seamlessly integrate screening, classification of clinical need and development of a related referral plan. There are 4 project phases: Development, Baseline, Implementation, and Sustainment/Evaluation. After development, activities take place in 10 NY (New York) counties, 9 of which will be randomized to one of 3 Waves, to begin implementation of e-Connect at 4m intervals in a Stepped-Wedge design (Hemming, Haines, Chilton, Girling, & Lilford, 2015). The 10th county will serve as a pilot site. The investigators will examine changes in outcomes (e.g., service use) relative to baseline in (i) identification of participants service need (SB and BH correlates) in juvenile probationers; (ii) cross-system (probation-BH agency) referral; and (iii) participants BH service use (access and engagement). Analyses will further consider contributions of multi-level factors (e.g., staff, organizational, family, and community) that influence implementation (feasibility, acceptability, sustainability) of e-Connect across various probation department processing categories (e.g. status offenders, diversion cases). The investigators will consider the role of mediating elements (e.g., probation practices) in explaining the association between e-Connect and identification, referral, and service use.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
While youth at all juvenile justice (JJ) processing points are at increased risk for suicidal behavior (SB) and associated behavioral health (BH) issues, those supervised in community settings (e.g., probation), may be at greatest risk: (a) protocols for identification and service referral are far more common in secure settings, (b) national policy increasingly favors community supervision/diversion over incarceration, (c) participants supervised in the community have far more access to means and opportunity than do those in secure settings, and (d) the multi- system coordination challenges to accessing BH care for community JJ participants are far greater than for those secure care. The investigators propose to adapt and test the utility of a multi-level service delivery model that increases identification of SB and related BH problems, guides targeted referral, trains staff and structures interagency collaboration to increase uptake of BH services by participants on probation; and document the organizational elements required to widely-implement this model in juvenile probation and community treatment settings. The model is based on our earlier, evidence-based linkage protocols from Project Connect, and capitalizes on technological advances unavailable at Connect's 2007 development, so as to address earlier implementation issues. Working in 9 NYS counties, project specific aims are (1) to develop technologically advanced cross-system identification/linkage service model that trains staff, formalizes interagency collaboration and referral decision-making and uses a mobile application to seamlessly combine (a) screening for SB and related BH problems, (b) classification of clinical need and (c) county-specific streamlined referral plans for BH services; (2) to examine the degree to which, compared to Baseline, e- Connect improves (a) intermediary PO practice outcomes (service need identification, cross-system referral) and increasing (b) participants BH service use (access, engagement); and (3) to elucidate multi-level factors (e.g., staff, organizational, participants/family, community,) that influence implementation (feasibility, acceptability, sustainability) of e-Connect across various probation department processing categories (e.g. status offenders, diversion cases) to inform comprehensive scale-up. The theoretically based mechanisms (e.g., changes in staff knowledge and self-efficacy; agency structural characteristics) by which PO practice change affects BH service use will also be examined. Guided by the GPM and CFIR framework, this 5-year study will comprise 4 project phases: (1) Development, (2) Baseline data collection, (3) Implementation, and (4) Sustainment. After development, counties are randomized to one of 4 Waves to begin implementation of e-Connect at 4-month intervals in a stepped-wedge design. Implementation activities continue for 18m and sites' use of e-Connect protocols after 18m will be an indication of sustainability. This initiative is one of the first to address SB and advance JJ participants enrollment in BH treatment. Because the investigators propose addressing risk and acute SB, this study has the likelihood of identifying and linking to services high-risk, high need participants that are often overlooked.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: e-Connect County receives training and materials and subsequently begins the e-Connect intervention |
Behavioral: e-Connect
e-Connect
|
Outcome Measures
Primary Outcome Measures
- Youth screened for risk of suicide [Day one of probation]
Evidence-based screening tool self administered by youth
Secondary Outcome Measures
- Behavioral health referral [Day one of probation]
Clinically appropriate referral made by probation officer to behavioral health provider based on screening results
Other Outcome Measures
- Behavioral health treatment service usage [Monthly in years 2- 5]
Number of weeks of treatment service
Eligibility Criteria
Criteria
Inclusion Criteria:
Probation Officers in 10 site counties
Exclusion Criteria:
- under 18
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | New York State Psychiatric Institute | New York | New York | United States | 10032 |
Sponsors and Collaborators
- New York State Psychiatric Institute
- George Mason University
- Columbia University
Investigators
- Principal Investigator: Katherine Elkington, PhD, Columbia University/New York State Psychiatric Institute
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- #7588