A Pilot Trial of a Network Intervention for Youth After Incarceration

NCT03556618 | Terminated Results DMC

• 1 other identifier: K23DA045747-01
• Study Type: interventional
• Target: 19
• Locations: 1 country
• Sites: 1

Brief Summary

A vicious cycle exists between adolescent substance use disorders and youth incarceration. Re-wiring adolescent social networks during community reentry after incarceration can potentially break the cycle of adolescent substance use and youth incarceration. Social networks influence adolescent substance use and delinquent behavior, yet little is known about how to intervene on social networks to improve health. Community reentry is a key opportunity to re-set youths' social networks and re-direct high-risk youth toward a healthier, more supportive network that can foster drug abstinence and reduce recidivism. The investigators hypothesize that an adult who has successfully navigated reentry can guide youth to rewire their social network by encouraging pro-social relationships, troubleshooting basic barriers to healthcare and social services, and helping create linkages to substance use and mental health treatment services. The goal of this study is to measure the impact of a pilot intervention to address two key barriers to accessing behavioral health treatment among recently incarcerated youth: poor care coordination and need for more positive support from the social network. The proposed study intervention, the Whole Person Care (WPC) Reentry Program, is based on the successful adult Transitions Clinic model, and is being adapted for delivery to transition age youth (TAY) by community partners in the Los Angeles County justice system. WPC community health workers (coaches) will provide recently released inmates a formerly incarcerated adult role model who provides care coordination and social support to facilitate access to needed health services, and who actively intervenes to guide TAY youth toward pro-social peers and adults. The investigators propose a pilot longitudinal study of WPC, using a community-partnered participatory research approach. The primary outcome will be reductions in adolescent substance use in response to the intervention (Aim 1). Secondary outcomes will test whether the intervention increases receipt of behavioral health services, decreases recidivism and mental health symptoms, and improves school and work engagement (Aim 2). Finally, the investigators will examine social networks as a potential mechanism by measuring whether youth receiving the intervention report healthier social networks (lower proportion of peers engaging in risky behaviors and a higher number of supportive adults) than control youth (Aim 3).

Conditions

Youth Incarceration; Health Care Utilization

Outcome Measures

Primary Outcomes (2)

• Frequency of Past-month (30-day) Marijuana Use

  Self-reported frequency of past-month (30-day) marijuana use

  3 months post-release

• Frequency of Past-month (30-day) Alcohol Use

  Self-reported frequency of past-month (30-day) alcohol use

  3 months post-release

Secondary Outcomes (18)

• Frequency of Past-month (30-day) Marijuana Use

  9 months post release

• Frequency of Past-month (30-day) Alcohol Use

  9 months post release

• Recidivism

  3 months post-release

• Recidivism

  9 months post release

• Receipt of Behavioral Health Services

  3 months post-release

Study Arms (2)

Whole Person Care (WPC) Reentry Program - Post-Release

EXPERIMENTAL

In partnership with LA County Health Agency, Dr. Barnert is adapting the successful Transitions Clinic model developed for reentry adults, to assist recently incarcerated transition age youth link to needed health services and reduce substance use disorder relapse and recidivism. This adaption is informed by Dr. Barnert's prior research on the needs of incarcerated adolescents. The intervention, called the "Whole Person Care (WPC) Reentry Program" will consist of community health workers (i.e. network coaches) who are formerly incarcerated and formally trained in care coordination and social network coaching, who interact with justice-involved transition age youth pre- and post-release to increase youths' engagement in community SUD and mental health services. Participants in this branch will include youth exiting the adult justice system (ages 18-24) who receive PRE- and POST-release WPC services.

Behavioral: Whole Person Care (WPC) Reentry Program - Pre & Post Release services

Control

NO INTERVENTION

Participants in the control arm will receive PRE-release services only from Whole Person Care. They will not receive the POST-release WPC community health worker intervention. Participants in this branch will include youth exiting the adult jail system (ages 18-24).

Interventions

Whole Person Care (WPC) Reentry Program - Pre & Post Release services BEHAVIORAL

Social network intervention to provide care coordination and social support during youth reentry before release and post-release from jail.

Whole Person Care (WPC) Reentry Program - Post-Release

Eligibility Criteria

• Age: 18 Years - 24 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Recipient of WPC pre-release reentry intervention (determined by Los Angeles County)
• Ages 18-24
• Fluent in English or Spanish

You may not qualify if:

• Not receiving WPC pre-release reentry intervention (determined by Los Angeles County)
• Severe cognitive delay
• Unable to complete surveys in English or Spanish

Sponsors & Collaborators

• University of California, Los Angeles: lead

Study Sites (1)

Los Angeles County Jails

Los Angeles, California, 90012, United States

Location

MeSH Terms

Conditions

Patient Acceptance of Health Care

Condition Hierarchy (Ancestors)

Treatment Adherence and Compliance; Health Behavior; Behavior

Results Point of Contact

• Title: Dr. Elizabeth Barnert, Principal Investigator, Associate Professor
• Organization: University of California, Los Angeles

ebarnert@mednet.ucla.edu

(310) 206-1483

Study Officials

• Elizabeth S Barnert, MD, MPH

  University of California, Los Angeles

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: May 18, 2018
• First Posted: June 14, 2018
• Study Start: March 2, 2020
• Primary Completion: December 16, 2021
• Study Completion: October 31, 2023
• Last Updated: March 27, 2024
• Results First Posted: March 27, 2024

Record last verified: 2024-02

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)