Just Care for Families Program for Substance Use Disorders
Recruiting in Palo Alto (17 mi)
Age: Any Age
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Chestnut Health Systems
Disqualifiers: Non-Oregon resident, Uninsured, others
No Placebo Group
Approved in 1 Jurisdiction
Trial Summary
What is the purpose of this trial?The study will evaluate the effectiveness of the Just Care for Families program in preventing Oregon Department of Human Services (ODHS)-involved parents in rural communities from escalating opioid and/or methamphetamine use and mental health disorders by disrupting the associated social determinants of health (SDOH). In addition, investigators will examine the impacts of SDOH on Just Care treatment and the associated costs from the perspective of provider clinics delivering Just Care. Just Care is a behavioral intervention for the treatment of parental substance abuse and child neglect for families involved in the child welfare system. Just Care involves treatment components, supported by ongoing purposeful engagement: (1) Substance use treatment; (2) Mental health treatment; (3) Parent management training; (4) Community building; (5) Systems Navigation; and (6) Addressing basic needs.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.
What data supports the effectiveness of the Just Care for Families treatment for substance use disorders?
Research shows that involving families in addiction treatment can improve treatment outcomes, such as better treatment entry and completion. Additionally, collaborative efforts between agencies to address family needs related to substance use disorders have shown promising results in improving family well-being and recovery.
12345Is the Just Care for Families Program safe for humans?
The available research does not provide specific safety data for the Just Care for Families Program, but it discusses related programs that focus on harm reduction and coordinated care for families affected by substance use. These programs aim to improve safety and well-being for families, suggesting a focus on safe practices.
678910How is the Just Care for Families treatment different from other treatments for substance use disorders?
The Just Care for Families treatment is unique because it focuses on helping families affected by substance use disorders by combining substance abuse recovery with family preservation. It aims to support parents in their recovery journey while also improving their parenting skills and family involvement, which is not typically emphasized in standard substance use disorder treatments.
1112131415Eligibility Criteria
This trial is for parents in rural areas involved with the Oregon Department of Human Services who are at risk of worsening opioid or methamphetamine use and mental health issues. It aims to help by addressing factors like poverty, education, and access to care that can affect their health.Inclusion Criteria
Clinical Staff must be providing Just Care for Families services to parents in the study at any point during the study
Parents must not have used or misused opioids in the last year, and/or any methamphetamine use in the last year
I am a parent of a child who is 18 years old or younger.
+5 more
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Treatment
Participants receive the Just Care for Families intervention, which includes substance use treatment, mental health treatment, parent management training, community building, systems navigation, and addressing basic needs
9 months
Weekly visits (in-person or virtual)
Follow-up
Participants are monitored for safety and effectiveness after treatment, including assessments of substance use, mental health, and social determinants of health
9 months
Periodic assessments at 9 and 18 months post-baseline
Long-term Follow-up
Data collection on long-term outcomes related to substance use and mental health, including administrative data from ODHS and Medicaid
24 months
Participant Groups
The 'Just Care for Families' program is being tested. It's a behavioral intervention designed to treat substance abuse and child neglect among these parents. The study will look into how well it works, its impact on social challenges, and the costs for clinics providing this service.
1Treatment groups
Experimental Treatment
Group I: Just Care for FamiliesExperimental Treatment1 Intervention
Parents receiving Just Care for Families
Just Care for Families is already approved in United States for the following indications:
🇺🇸 Approved in United States as Just Care for Families for:
- Substance use treatment
- Mental health treatment
- Parent management training
- Community building
- Systems Navigation
- Addressing basic needs
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Chestnut Health SystemsEugene, OR
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Who Is Running the Clinical Trial?
Chestnut Health SystemsLead Sponsor
National Institute on Drug Abuse (NIDA)Collaborator
References
Family-focused practices in addictions: a scoping review protocol. [2018]Families are significantly impacted by addictions and family involvement in treatment can reduce the harms and can also improve treatment entry, treatment completion and treatment outcomes for the individual coping with an addiction. Although the benefits of family-focused practices in addictions have been documented, services continue to have an individual focus and research on this topic is also limited. The objective of this study is to map the extent, range and nature of evidence available examining family interventions in addictions and identify gaps to guide future research, policy and practice.
Participant perception of an integrated program for substance abuse in pregnancy. [2018]To assess participant perception of an integrated model of care for substance abuse in pregnancy.
Promising Results for Cross-Systems Collaborative Efforts to Meet the Needs of Families Impacted by Substance Use. [2016]This study is based on data regarding more than 15,000 families served by 53 federal grantees showing that child safety and permanency, parental recovery, and family well-being improve when agencies work together to address the complex needs of families at the intersection of substance abuse treatment and child welfare. Strategies summarized here offer promising collaborative approaches to mitigate the negative outcomes too often experienced by families impacted by substance use disorders.
Brief family treatment intervention to promote aftercare among male substance abusing patients in inpatient detoxification: A quasi-experimental pilot study. [2019]We developed a brief family treatment (BFT) intervention for substance abusing patients in inpatient detoxification to promote aftercare treatment post-detox. BFT consisted of meeting with the patient and a family member (spouse or parent) with whom the patient lived to review and recommend potential aftercare plans for the patient. A phone conference was used when logistics prevented an in-person family meeting. Results indicated that male substance abusing patients who received BFT (N=14), as compared with a matched treatment as usual (TAU) comparison group (N=14) that did not, showed a trend toward being more likely to enter an aftercare program and to attend more days of aftercare in the 3 months after detoxification. The magnitude of these differences favoring BFT over TAU was midway between a medium and a large effect size. Days using alcohol or drugs in the 3 months after detox were lower for treatment-exposed BFT patients who had an in-person family meeting than TAU counterparts (trend, medium effect), and for patients who entered aftercare regardless of treatment condition (significant large effect).
Does meeting the HEDIS substance abuse treatment engagement criterion predict patient outcomes? [2021]This study examines the patient-level associations between the Health Plan Employer Data and Information Set (HEDIS) substance use disorder (SUD) treatment engagement quality indicator and improvements in clinical outcomes. Administrative and survey data from 2,789 US Department of Veterans Affairs SUD patients were used to estimate the effects of meeting the HEDIS engagement criterion on improvements in Addiction Severity Index Alcohol, Drug, and Legal composite scores. Patients meeting the engagement indicator improved significantly more in all domains than patients who did not engage, and the relationship was stronger for alcohol and legal outcomes for patients seen in outpatient settings. The benefit accrued by those who engaged was statistically significant but clinically modest. These results add to the literature documenting the clinical benefits of treatment entry and engagement. Although these findings only indirectly support the use of the HEDIS engagement measure for its intended purpose-discriminating quality at the facility or system level-they confirm that the processes of care captured by the measure are associated with important patient outcomes.
Facilitating Integrated Perinatal Care for Families Affected by Substance Use. [2023]Families of newborns are frequently referred to child protection systems because of parental substance use, yet many families face barriers to accessing prenatal care and substance use treatment services. Although federal legislation requires states to develop Plans of Safe Care to address families' health and substance use treatment needs, few have developed comprehensive and systematic approaches to provide perinatal support to parents and infants. In this commentary, we describe the development and initial testing of a Plan of Safe Care that engages patients and their providers in perinatal care coordination. Developed out of an in-depth analysis of current care workflows at an urban safety net health system, the Plan of Safe Care facilitates conversations with clients around delivery planning and aligns resources to support families with substance use disorders.
National Partnership for Maternal Safety: Consensus Bundle on Obstetric Care for Women With Opioid Use Disorder. [2021]The opioid epidemic is a public health crisis, and pregnancy-associated morbidity and mortality due to substance use highlights the need to prioritize substance use as a major patient safety issue. To assist health care providers with this process and mitigate the effect of substance use on maternal and fetal safety, the National Partnership for Maternal Safety within the Council on Patient Safety in Women's Health Care has created a patient safety bundle to reduce adverse maternal and neonatal health outcomes associated with substance use. The Consensus Bundle on Obstetric Care for Women with Opioid Use Disorder provides a series of evidence-based recommendations to standardize and improve the quality of health care services for pregnant and postpartum women with opioid use disorder, which should be implemented in every maternity care setting. A series of implementation resources have been created to help providers, hospitals, and health systems translate guidelines into clinical practice, and multiple state-level Perinatal Quality Collaboratives are developing quality improvement initiatives to facilitate the bundle-adoption process. Structure, process, and outcome metrics have also been developed to monitor the adoption of evidence-based practices and ensure consistency in clinical care.
"It's a place that gives me hope": A qualitative evaluation of a buprenorphine-naloxone group visit program in an urban federally qualified health center. [2022]Background: Medication for opioid use disorder (MOUD) with buprenorphine is effective in treating opioid use disorder yet remains underutilized. Scant research has examined the experience of patients, clinic staff, and providers in a "low-threshold" group-based MOUD program. This study evaluates a "low-threshold" MOUD program at a federally qualified health center (FQHC) in Philadelphia, Pennsylvania through the perspectives of its key stakeholders. Methods: This qualitative study involved focus groups of patients, providers, and clinic staff. Focus groups were conducted between October 2017 and June 2018. Grounded theory was used for analysis. Results: There were a total of 10 focus groups, including 20 patient participants and 26 staff members. Program participants noted that a strength of the program is its person-centered harm reduction approach, which is reflected in the program's policies and design. Program participants discussed the programmatic design choices that facilitated their participation and engagement in the program: ease of access, integration into primary care, and group-based visit model. Challenges in program implementation included varying acceptance and understanding of harm reduction among staff, the unpredictability of clinic volume and workflow, and the need to balance access to primary care and MOUD. Conclusion: This group-based MOUD program's philosophy of person-centered harm reduction, low-barrier approach, the structure of group-based visits, and integrated care contributes to increased patient access and retention. Understanding the strengths and challenges of the program may be useful for other safety-net clinics considering a MOUD program.
Implementation of the North Carolina Plan of Safe Care in Wake County, North Carolina. [2022]BACKGROUND The Comprehensive Addiction and Recovery Act (CARA) of 2016 amended the Child Abuse Prevention and Treatment Act (CAPTA), reinforcing and revising the requirement that states develop policies and procedures to address the needs of substance-affected infants and their caregivers. North Carolina's program, the North Carolina Plan of Safe Care (NC POSC), was implemented in August 2017 and involves coordination between multiple agencies.METHODS We conducted a quality improvement project to assess implementation of the North Carolina Plan of Safe Care in Wake County through interviews with key stakeholders involved in program delivery including health care providers (n = 7), child protective services social workers (CPS; n = 14), and care managers at Care Coordination for Children (CC4C; n = 10). We also analyzed data on Plan of Safe Care notifications to Wake County CPS from January 2018 to October 2019.RESULTS Several key themes emerged in stakeholder interviews, including 1) lack of awareness of the program among health care providers; 2) gaps in information sharing and communication between agencies; 3) concerns regarding CPS notifications for all substance exposure types, including prenatal exposure to medication for opioid use disorder (MOUD); 4) common family needs and service referrals; 5) challenges engaging with families; 6) lack of knowledge among health care providers and CPS social workers regarding CC4C; and 7) benefits of the program for infants and families. From January 2018 to October 2019, 91% of notifications for substance-affected infants received by Wake County CPS as part of the NC POSC were screened-in for a maltreatment assessment. Of those screened-in, more than two-thirds (70%) involved prenatal marijuana exposure only.LIMITATIONS This project was limited to one county.CONCLUSIONS As NC POSC implementation continues, further consideration of the infrastructure and guidance available to address the implementation challenges identified by stakeholders will be essential to meeting family needs and promoting infant safety and well-being.
Integrating Harm Reduction into Medical Care: Lessons from Three Models. [2023]Substance use disorders (SUDs) are at a national high, with significant morbidity and mortality. Harm reduction, a public-health strategy aimed at reducing the negative consequences of a risky behavior without necessarily eliminating the behavior, represents a useful approach to engage patients with SUDs in care. The objective of this article is to describe how 3 medical practices operationalized harm reduction as a framework toward patient care and identify the common practices undertaken across these settings to integrate harm reduction and medical care.
In-home continuing care services for substance-affected families: the bridges program. [2019]Addressing substance abuse in families is an important concern for the social work field. This article presents a preliminary view of a continuing care substance abuse recovery services program designed to assist the substance-affected family. The intervention approach is a blended model of substance abuse recovery work and family preservation. Services are directed at helping substance-abusing parents with "recovering" their role with their families, developing support for their recovery work, and helping them gain the education and skills they need for effective parenting, supportive family involvement, and avoidance of drugs and alcohol. The program focuses on helping substance abusers and their families achieve relapse prevention by addressing functioning in four domains: individual actions and cognitions, individual recovery actions, family actions and cognitions, and family recovery actions. The article presents two case examples to highlight the efficacy of the intervention model and the general positive effect continuing care services are having on substance-affected families.
[Family-based drug use prevention: the "Familias que Funcionan" ["Families that Work"] program]. [2019]Family-based drug use prevention: The > program.. >[Families that work] is a family-based drug-use prevention program resulting from the adaptation to the Spanish context of the prestigious North-American >. The program was applied at four secondary schools (N = 380 pupils) in Asturias (northern Spain). This article presents the results of the assessment of this application after a two-year follow-up, regarding its effectiveness in the reduction of drug use among adolescents and its effects on certain family risk factors. Consistent attendance in the > program proved effective for reducing both rates (t= -2.73, p
e-Delphi Study: Expert Consensus on the Needs and Resources Available to Family Caregivers of Individuals with Substance Use Disorder. [2023]Family caregivers of individuals with substance use disorder (SUD) experience a significant burden and have few evidence-based resources available.
Caring for Families Impacted by Opioid Use: A Qualitative Analysis of Integrated Program Designs. [2023]We sought to 1) identify models of integrated care that offer medical care and social services for children and families impacted by opioid use disorder (OUD) in the postpartum year; and 2) describe how each program was developed, designed, and sustained, and explore facilitators and barriers to implementation of a dyadic, two-generation approach to care.
To Improve Substance Use Disorder Prevention, Treatment and Recovery: Engage the Family. [2018]: Approximately 21 million people in the United States have a substance use disorder (SUD); the number of family members impacted by a loved one's SUD is exponentially greater. Affected family members of individuals with SUDs are at high risk for developing chronic medical and psychiatric health conditions, are high utilizers of the health care system, and have high health care expenditures. Family members play a central role in the lives of many individuals with SUDs; information given to family members can have a significant impact on persons with addiction and therefore the SUD treatment that an individual might receive. Evidence-based interventions targeting affected family members have been shown to: improve health outcomes for all family members, result in better addiction treatment outcomes, and prevent adolescent substance use. Despite mounting evidence, the health care system has been hesitant to engage families in a meaningful way. Health care providers should consider how implicit and explicit assumptions about the role of family members in SUD development, treatment, and recovery may contribute to this underlying reluctance. Antiquated policies and procedures that alienate family members should be modified (e.g., limiting phone access). Family members have a right to receive professional treatment and to be educated about the difference between mutual/peer support and evidence-based treatment options. Despite the potential for family members to move the needle on the country's current addiction crisis they remain an underutilized resource. A paradigm shift will be required to get the current SUD care continuum to adopt a family-centric model.