Preventing Opioid Use Among Justice-involved Youth as They Transition to Adulthood Leveraging Safe Adults (LeSA)
LeSA
1 other identifier
interventional
250
1 country
11
Brief Summary
Across the US, substance use is a significant public health concern, with juvenile justice (JJ)-involved youth representing a particularly vulnerable population. The current study proposes to adapt and test an intervention Trust-based Relational Intervention® (TBRI®) for preventing initiation and/or escalation of opioid misuse among older adolescents involved in the JJ system. Successful completion of study aims will provide information on TBRI's utility for older JJ adolescents, barriers and facilitators of sustainment, and provide training and implementation support for sustainment in participating facilities.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Feb 2021
Longer than P75 for not_applicable
11 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
Click on a node to explore related trials.
Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
November 11, 2020
CompletedFirst Posted
Study publicly available on registry
December 22, 2020
CompletedStudy Start
First participant enrolled
February 15, 2021
CompletedPrimary Completion
Last participant's last visit for primary outcome
September 30, 2025
CompletedStudy Completion
Last participant's last visit for all outcomes
September 30, 2025
CompletedDecember 12, 2025
December 1, 2025
4.6 years
November 11, 2020
December 10, 2025
Conditions
Keywords
Outcome Measures
Primary Outcomes (3)
Youth days to opioid (and other substance use) initiation
Initiation to opioid and other substance use (e.g., alcohol, marijuana, methamphetamine) over 15 months follow-up in days, measured by the scale of Timeline follow-back, Substance Use Involvement (i.e., during the past 30 days, how many days did you use alcohol or drugs; developed by the HEAL Prevention Cooperative), urinalysis results. Scores: 0-450 days; a higher score indicating a better outcome.
15 months
Youth months to opioid (and other substance use) initiation
Initiation to opioid and other substance use over 15 months follow-up in months, monthly check-ins (any opioid use; any alcohol, other drug use in the past month). Scores: 0-15 months; a higher score indicating a better outcome.
15 months
Youth substance use severity
Opioid use and other substance use (e.g., alcohol, marijuana, methamphetamine) over 15 months; measured by TCU Drug Screen 5 and TCU Drug Screen 5 - Opioid Supplement. Scores: 0-11, a higher score indicating a worse outcome.
15 months
Secondary Outcomes (15)
Self-regulation (youth) - positive and negative urgency
15 months
Self-regulation (youth) - delayed discounting
15 months
Self-regulation (youth) - emotion regulation
15 months
Self-regulation (youth) - executive functioning
15 months
Self-efficacy (youth)
15 months
- +10 more secondary outcomes
Other Outcomes (7)
Frequency of receiving substance use treatment
15 months
Times of hospital visits related to substance use
15 months
Times of treatment referral for substance use
15 months
- +4 more other outcomes
Study Arms (4)
Standard Reentry Practice
NO INTERVENTIONYouth/safe adult participants only receive assessments (baseline assessment while youth are at the facility; 3, 6, 12, 18 months follow-up assessments after youth are released from the facility).
TBRI Training only
EXPERIMENTALYouth/safe adult dyads participate in 9 TBRI caregiver modules (caregivers only), 9 youth modules (youth only), and 4 Nurture Groups (caregiver and youth joint role-play activities) prior to youth's release. After the youth's release, they would receive phone support (only when requested by the caregiver or youth).
TBRI Training + TBRI In-Home Structured Coaching
EXPERIMENTALYouth/safe adult dyads participate in 9 TBRI caregiver modules (caregivers only), 9 youth modules (youth only), and 4 Nurture Groups (caregiver and youth joint role-play activities) prior to youth's release. After youth's release, trained TCU TBRI Practitioners provide coaching sessions to youth/safe adult dyads in which they meet 4 times (once monthly) over the first 4 months following release.
TBRI Training + TBRI In-Home Responsive Coaching
EXPERIMENTALYouth/safe adult dyads participate in 9 TBRI caregiver modules (caregivers only), 9 youth modules (youth only), and 4 Nurture Groups (caregiver and youth joint role-play activities) prior to youth's release. After youth's release, trained TCU TBRI Practitioners provide coaching sessions to youth/safe adult dyads. They meet a minimum of 2 times during the first 2 months after release. Starting from Month 3, TBRI Practitioners would provide additional coaching when requested or when a research assistant (RA) identifies a need for additional coaching sessions.
Interventions
The intervention (Trust-based Relational Intervention® TBRI®) uses a youth-centered, attachment-based, and trauma-informed approach to strengthen youth/safe adult relationships and improve youth self-regulation (thinking, emotions, and behavior). TBRI includes TBRI Group Training and TBRI In-Home Coaching. TBRI Group Training is comprised of three components: TBRI Youth Group Training (youth only), Caregiver Training (caregivers only), and Nurture Groups (youth-caregiver joint roleplay activities), which is conducted prior to youth's release.
The intervention (Trust-based Relational Intervention® TBRI®) uses a youth-centered, attachment-based, and trauma-informed approach to strengthen youth/safe adult relationships and improve youth self-regulation (thinking, emotions, and behavior). TBRI includes TBRI Group Training and TBRI In-Home Coaching. TBRI In-Home Structured Training includes four structured in-home coaching sessions.
The intervention (Trust-based Relational Intervention® TBRI®) uses a youth-centered, attachment-based, and trauma-informed approach to strengthen youth/safe adult relationships and improve youth self-regulation (thinking, emotions, and behavior). TBRI includes TBRI Group Training and TBRI In-Home Coaching. TBRI In-Home Responsive Training includes at least 2 structured in-home coaching sessions plus additional sessions indefinitely as needed.
Eligibility Criteria
You may qualify if:
- For the effectiveness component,
- Youth ages 15-18 at study enrollment
- Being disposed to community supervision (i.e., probation) following a minimum of 2 months in the secure residential JJ facility
- No indication of active suicide risk
- Being able to identify one safe adult that is willing to participate in the study.
- For the implementation component:
- All staff with direct care or supervisory responsibilities within and outside the facilities (i.e., officers supervising youth after release) working with TCU on the LeSA project.
You may not qualify if:
- Youth outside the age range described above
- Active suicide risk at the time of recruitment
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (11)
Illinois Youth Center - Chicago
Chicago, Illinois, 60612, United States
Illinois Youth Center - Pere Marquette
Grafton, Illinois, 62037, United States
Illinois Youth Center- Harrisburg
Harrisburg, Illinois, 62946, United States
Illinois Youth Center- Warrenville
Naperville, Illinois, 60563, United States
Illinois Youth Center - St. Charles
St. Charles, Illinois, 60175, United States
Grayson County Juvenile Center/Boot Camp
Denison, Texas, 75020, United States
Texas Monarch Academy for Girls/Rite of Passage
Denison, Texas, 75020, United States
Williamson County Juvenile Services
Georgetown, Texas, 78626, United States
Lake Granbury Youth Services/Rite of Passage
Granbury, Texas, 76048, United States
Harris County Youth Village
Houston, Texas, 77586, United States
Collin County Juvenile Probation Services
McKinney, Texas, 75071, United States
Related Publications (42)
Biederman J, Faraone SV, Monuteaux MC, Feighner JA. Patterns of alcohol and drug use in adolescents can be predicted by parental substance use disorders. Pediatrics. 2000 Oct;106(4):792-7. doi: 10.1542/peds.106.4.792.
PMID: 11015524BACKGROUNDBaglivio, M. T., & Epps, N. (2016). The interrelatedness of adverse childhood experiences among high-risk juvenile offenders. Youth Violence and Juvenile Justice, 14(3), 179-198.
BACKGROUNDBaglivio, M. T., Wolff, K. T., Piquero, A. R., & Epps, N. (2015). The relationship between Adverse Childhood Experiences (ACE) and juvenile offending trajectories in a juvenile offender sample. Journal of Criminal Justice, 43(3), 229-241.
BACKGROUNDBelenko S, Johnson ID, Taxman FS, Rieckmann T. Probation Staff Attitudes Toward Substance Abuse Treatment and Evidence-Based Practices. Int J Offender Ther Comp Criminol. 2018 Feb;62(2):313-333. doi: 10.1177/0306624X16650679. Epub 2016 May 23.
PMID: 27220361BACKGROUNDBrockie TN, Dana-Sacco G, Wallen GR, Wilcox HC, Campbell JC. The Relationship of Adverse Childhood Experiences to PTSD, Depression, Poly-Drug Use and Suicide Attempt in Reservation-Based Native American Adolescents and Young Adults. Am J Community Psychol. 2015 Jun;55(3-4):411-21. doi: 10.1007/s10464-015-9721-3.
PMID: 25893815BACKGROUNDBrown LK, Tarantino N, Tolou-Shams M, Esposito-Smythers C, Healy MG, Craker L. Mental Health Symptoms and Parenting Stress of Parents of Court-Involved Youth. J Child Fam Stud. 2018 Mar;27(3):843-852. doi: 10.1007/s10826-017-0923-1. Epub 2017 Nov 6.
PMID: 29805245BACKGROUNDColder CR, Shyhalla K, Frndak SE. Early alcohol use with parental permission: Psychosocial characteristics and drinking in late adolescence. Addict Behav. 2018 Jan;76:82-87. doi: 10.1016/j.addbeh.2017.07.030. Epub 2017 Jul 25.
PMID: 28772246BACKGROUNDCouncil of State Governments Justice Center. (2017, September). Dos and don'ts for reducing recidivism among young adults in the justice system. Retrieved February 15, 2019 from https://csgjusticecenter.org/wp-content/uploads/2017/09/Dos-and-Donts-for-Reducing- Recidivism-among-Young-Adults-in-the-Justice-System.pdf
BACKGROUNDDube SR, Miller JW, Brown DW, Giles WH, Felitti VJ, Dong M, Anda RF. Adverse childhood experiences and the association with ever using alcohol and initiating alcohol use during adolescence. J Adolesc Health. 2006 Apr;38(4):444.e1-10. doi: 10.1016/j.jadohealth.2005.06.006.
PMID: 16549308BACKGROUNDEvans-Chase, M. (2014). Addressing trauma and psychosocial development in juvenile justice- involved youth: A synthesis of the developmental neuroscience, juvenile justice and trauma literature. Laws, 3(4), 744-758. DOI: 10.3390/laws3040744
BACKGROUNDFord, J. D., & Hawke, J. (2012). Trauma affect regulation psychoeducation group and milieu intervention outcomes in juvenile detention facilities. Journal of Aggression, Maltreatment & Trauma, 21(4), 365-384. https://doi.org/10.1080/10926771.2012.673538
BACKGROUNDForster M, Grigsby TJ, Rogers CJ, Benjamin SM. The relationship between family-based adverse childhood experiences and substance use behaviors among a diverse sample of college students. Addict Behav. 2018 Jan;76:298-304. doi: 10.1016/j.addbeh.2017.08.037. Epub 2017 Sep 1.
PMID: 28889058BACKGROUNDFosco GM, Frank JL, Stormshak EA, Dishion TJ. Opening the "Black Box": family check-up intervention effects on self-regulation that prevents growth in problem behavior and substance use. J Sch Psychol. 2013 Aug;51(4):455-68. doi: 10.1016/j.jsp.2013.02.001. Epub 2013 Feb 26.
PMID: 23870441BACKGROUNDFrisman, L., Ford, J., Lin, H.-J., Mallon, S., & Chang, R. (2008). Outcomes of trauma treatment using the TARGET Model. https://doi.org/10.1080/15560350802424910
BACKGROUNDHovdestad, W. E., Tonmyr, L., Wekerle, C., & Thornton, T. (2011). Why is childhood maltreatment associated with adolescent substance abuse? A critical review of explanatory models. International Journal of Mental Health Addiction, 9(5), 525-542. DOI: 10.1007/s11469-011-9322-9
BACKGROUNDKumpfer KL, Alvarado R, Whiteside HO. Family-based interventions for substance use and misuse prevention. Subst Use Misuse. 2003 Sep-Nov;38(11-13):1759-87. doi: 10.1081/ja-120024240.
PMID: 14582577BACKGROUNDLaird RD, Pettit GS, Bates JE, Dodge KA. Parents' monitoring-relevant knowledge and adolescents' delinquent behavior: evidence of correlated developmental changes and reciprocal influences. Child Dev. 2003 May-Jun;74(3):752-68. doi: 10.1111/1467-8624.00566.
PMID: 12795388BACKGROUNDMarrow, M. T., Knudsen, K. J., Olafson, E., & Bucher, S. E. (2012). The value of implementing TARGET within a trauma-informed Juvenile Justice Setting. Journal of Child & Adolescent Trauma, 5(3), 257-270. DOI: 10.1080/19361521.2012.697105
BACKGROUNDMurray, D. W., Rosanbalm, K., & Christopoulos, C. (2016, February). Self-Regulation and toxic stress report 3: A comprehensive review of self-regulation interventions from birth through young adulthood (OPRE Report # 2016-34). Washington, DC: Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. Retrieved February 14, 2019 from https://www.acf.hhs.gov/sites/default/files/opre/acf_report_3_approved_fromword_b508. pdf
BACKGROUNDNational Center for Mental Health and Juvenile Justice. (2016, September). Trauma among youth in the Juvenile Justice System. Retrieved March 7, 2019 from https://www.ncmhjj.com/wp-content/uploads/2016/09/Trauma-Among-Youth-in-the- Juvenile-Justice-System-for-WEBSITE.pdf
BACKGROUNDNelis D, Kotsou I, Quoidbach J, Hansenne M, Weytens F, Dupuis P, Mikolajczak M. Increasing emotional competence improves psychological and physical well-being, social relationships, and employability. Emotion. 2011 Apr;11(2):354-66. doi: 10.1037/a0021554.
PMID: 21500904BACKGROUNDNational Research Council (US) and Institute of Medicine (US) Committee on the Prevention of Mental Disorders and Substance Abuse Among Children, Youth, and Young Adults: Research Advances and Promising Interventions; O'Connell ME, Boat T, Warner KE, editors. Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities. Washington (DC): National Academies Press (US); 2009. Available from http://www.ncbi.nlm.nih.gov/books/NBK32775/
PMID: 20662125BACKGROUNDQuinn K, Frueh BC, Scheidell J, Schatz D, Scanlon F, Khan MR. Internalizing and externalizing factors on the pathway from adverse experiences in childhood to non-medical prescription opioid use in adulthood. Drug Alcohol Depend. 2019 Apr 1;197:212-219. doi: 10.1016/j.drugalcdep.2018.12.029. Epub 2019 Feb 14.
PMID: 30849646BACKGROUNDRobertson AA, Xu X, Stripling A. Adverse events and substance use among female adolescent offenders: effects of coping and family support. Subst Use Misuse. 2010 Feb;45(3):451-72. doi: 10.3109/10826080903452512.
PMID: 20141458BACKGROUNDShin SH, McDonald SE, Conley D. Patterns of adverse childhood experiences and substance use among young adults: A latent class analysis. Addict Behav. 2018 Mar;78:187-192. doi: 10.1016/j.addbeh.2017.11.020. Epub 2017 Nov 13.
PMID: 29179155BACKGROUNDStein MD, Conti MT, Kenney S, Anderson BJ, Flori JN, Risi MM, Bailey GL. Adverse childhood experience effects on opioid use initiation, injection drug use, and overdose among persons with opioid use disorder. Drug Alcohol Depend. 2017 Oct 1;179:325-329. doi: 10.1016/j.drugalcdep.2017.07.007. Epub 2017 Aug 5.
PMID: 28841495BACKGROUNDSteinberg L. Risk taking in adolescence: what changes, and why? Ann N Y Acad Sci. 2004 Jun;1021:51-8. doi: 10.1196/annals.1308.005.
PMID: 15251873BACKGROUNDTaxman FS, Young DW, Fletcher BW. The National Criminal Justice Treatment Practices survey: an overview of the special issue. J Subst Abuse Treat. 2007 Apr;32(3):221-3. doi: 10.1016/j.jsat.2006.12.017. Epub 2007 Mar 9. No abstract available.
PMID: 17383547BACKGROUNDTexas Senate Bill 1356. (2013, September 1). About Texas Senate Bill 1356. Retrieved March 8, 2019 from https://www.crisisprevention.com/Blog/August-2013/Texas-Senate-Bill-1356?lang=en-US
BACKGROUNDTolou-Shams M, Brogan L, Esposito-Smythers C, Healy MG, Lowery A, Craker L, Brown LK. The role of family functioning in parenting practices of court-involved youth. J Adolesc. 2018 Feb;63:165-174. doi: 10.1016/j.adolescence.2017.12.016. Epub 2018 Jan 6.
PMID: 29310009BACKGROUNDTolou-Shams M, Hadley W, Conrad SM, Brown LK. The Role of Family Affect in Juvenile Drug Court Offenders' Substance Use and HIV Risk. J Child Fam Stud. 2012 Jun 1;21(3):449-456. doi: 10.1007/s10826-011-9498-4. Epub 2011 May 6.
PMID: 22661883BACKGROUNDWills, T. A., Sandy, J. M., Shinar, O., & Yaeger, A. (1999). Contributions of positive and negative affect to adolescent substance use: Test of a bidimensional model in a longitudinal study. Psychology of Addictive Behaviors, 13(4), 327-338. http://dx.doi.org/10.1037/0893-164X.13.4.327
BACKGROUNDWills TA, Sandy JM, Yaeger AM. Moderators of the relation between substance use level and problems: test of a self-regulation model in middle adolescence. J Abnorm Psychol. 2002 Feb;111(1):3-21.
PMID: 11866177BACKGROUNDWolff KT, Baglivio MT, Piquero AR. The Relationship Between Adverse Childhood Experiences and Recidivism in a Sample of Juvenile Offenders in Community-Based Treatment. Int J Offender Ther Comp Criminol. 2017 Aug;61(11):1210-1242. doi: 10.1177/0306624X15613992. Epub 2015 Nov 12.
PMID: 26567183BACKGROUNDWright, K. N., & Wright, K. E. (1993). Family life and delinquency and crime: A policymakers' guide to the literature (NCJ 140517). Washington, DC: U.S. Department of Justice, Office of Juvenile Justice and Delinquency Prevention, National Institute of Justice. Retrieved March 8, 2019 from https://www.ncjrs.gov/pdffiles1/Digitization/140517NCJRS.pdf
BACKGROUNDZolkoski, S. M., & Bullock, L. M. (2012). Resilience in children and youth: A review. Children and Youth Services Review, 34(12), 2295-2303. http://dx.doi.org/10.1016/j.childyouth.2012.08.009
BACKGROUNDKuklinski MR, Gibbons BJ, Bowser DM, McCollister KE, Smart R, Dunlap LJ, Shenkar E, Bonar EE, Boomer T, Campbell M, Fiellin LE, Hutton DW, Rao V, Saldana L, Su K, Walton MA, Yilmazer T. Investing in Interventions to Prevent Opioid Use Disorder in Adolescents and Young Adults: Start-up Costs from NIDA's HEAL Prevention Initiative. Prev Sci. 2025 Nov;26(7):1045-1055. doi: 10.1007/s11121-025-01835-6. Epub 2025 Oct 14.
PMID: 41085955DERIVEDBowser D, McCollister K, Berchtold G, Ruscitti B, Yang Y, Hines H, Fardone E, Knight D. Start-Up and Implementation Costs for the Trust Based Relational Intervention. J Prev (2022). 2024 Dec;45(6):847-860. doi: 10.1007/s10935-024-00803-0. Epub 2024 Aug 17.
PMID: 39153158DERIVEDRazuri EB, Yang Y, Tinius E, Knight DK. Adaptation of a trauma-informed intervention to prevent opioid use among youth in the legal system. J Subst Use Addict Treat. 2024 Aug;163:209294. doi: 10.1016/j.josat.2024.209294. Epub 2024 Jan 24.
PMID: 38272116DERIVEDAhrens K, Blackburn N, Aalsma M, Haggerty K, Kelleher K, Knight DK, Joseph E, Mulford C, Ryle T, Tolou-Shams M. Prevention of Opioid Use and Disorder Among Youth Involved in the Legal System: Innovation and Implementation of Four Studies Funded by the NIDA HEAL Initiative. Prev Sci. 2023 Oct;24(Suppl 1):99-110. doi: 10.1007/s11121-023-01566-6. Epub 2023 Jul 1.
PMID: 37393415DERIVEDRazuri EB, Yang Y, Tinius E, Knight DK. Adaptation of a trauma-informed intervention for youth involved in the legal system. Res Sq [Preprint]. 2023 Mar 1:rs.3.rs-2596631. doi: 10.21203/rs.3.rs-2596631/v1.
PMID: 36909596DERIVEDKnight DK, Yang Y, Joseph ED, Tinius E, Young S, Shelley LT, Cross DR, Knight K. Preventing opioid use among justice-involved youth as they transition to adulthood: leveraging safe adults (LeSA). BMC Public Health. 2021 Nov 20;21(1):2133. doi: 10.1186/s12889-021-12127-3.
PMID: 34801009DERIVED
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
Danica K Knight, Ph.D.
Texas Christian University
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- NONE
- Purpose
- PREVENTION
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
November 11, 2020
First Posted
December 22, 2020
Study Start
February 15, 2021
Primary Completion
September 30, 2025
Study Completion
September 30, 2025
Last Updated
December 12, 2025
Record last verified: 2025-12
Data Sharing
- IPD Sharing
- Will share
- Time Frame
- The data will be shared with the HEAL Prevention Cooperative between 2021 and 2024. Sharing of underlying primary data for the publications will be made broadly available through an appropriate data repository, such as the NIH HEAL Initiative central data repository, or a non-NIH repository that conforms to the principles articulated in the HEAL Public Access and Data Sharing Policy (referred to in the URL included below).
- Access Criteria
- All research teams that participate in the NIH Helping to End Addiction Long-term (HEAL) Initiative. https://heal.nih.gov/files/2020-01/2020-01-16\ data-sharing-4.pdf
All data will be further de-identified (e.g., by systematically scrambling Study IDs within study sites) before being shared with the HEAL Prevention Coordinating Center. The Coordinating Center will not have access to identifying information, nor will they have access to or knowledge of how participant study identification numbers were scrambled. The data will also be shared publicly, following the HEAL Prevention Guidance for Appropriate Public Access and Data Sharing Plans, including the following aspects: * Electronic copies of publications will be deposited within 4 weeks of acceptance * Publications will be published under the Creative Commons Generic License * Publications will be made publicly available immediately without embargo * Underlying Primary Data for the Publications will be made broadly available * Sharing of Underlying Primary Data must be responsive to protecting confidential and proprietary data and is consistent with applicable laws and regulations.