Justice Community Overdose Innovation Network II TCU Hub

NCT07528846 | Not Yet Recruiting DMC

• 1 other identifier: 1RM1DA064502
• Study Type: interventional
• Target: 1,620
• Locations: 1 country
• Sites: 1

Brief Summary

The current study proposes to use a Hybrid Type 3 implementation research strategy to: 1) Significantly enhance our understanding of public health outcomes \[e.g., overdose incidents and substance-use (SU)-related Emergency Medical Service (EMS) contacts\] and public safety outcomes (e.g., drug-related arrests) associated with Deflection and Pre-Arrest Diversion initiatives (DPAD, hereafter referred to as Deflection); and 2) Create a lasting contribution to the fields of research focused on SU and the criminal legal system (CLS) by advancing knowledge of effective implementation strategies involving the critical role of community engagement in Deflection. The highly experienced team of Multiple PIs, senior-level collaborators from both Deflection and Community Behavioral Health (CBH), state-level evaluation partners, a national stakeholder advisory group, and CLS and behavioral health partners within each community have teamed up to carry out the proposed project. The study approach uses a hybrid implementation-effectiveness design to examine strategies to improve opioid and stimulant relevant outcomes, and specifically proposes to test the implementation-effectiveness of 2 strategy bundles to promote Deflection models through a CORE community engagement bundle (designed to facilitate community stakeholder engagement) and ENHANCED community engagement bundle (CORE plus a component to systematically involve community advocates) on improving implementation as well as public safety and health outcomes. The proposed randomized control trial includes a total of 20 geographically distinct clinical research performance sites (i.e., 20 communities spanning 5 states; New Mexico, Illinois, Wisconsin, Colorado, and Pennsylvania), with 3-5 communities per state and the inclusion of key CLS and CBH stakeholders within each site. The large scope of the project will maximize potential generalizability of study results and sustainability of implementation strategies.

Conditions

Substance Use Disorder (SUD); Drug Overdose; Criminal Behavior

Keywords

deflection; pre-arrest diversion

Outcome Measures

Primary Outcomes (5)

• public health and safety collaboration

  Is there a change in public health and safety collaboration? Measured using the Brewer et al., 2018 survey on aligning strategy (e.g., work together to identify unmet needs in the community) and coordinating current work (e.g., share information that helps the system of care work better). The Brewer et al. (2018) Aligning Strategy and Coordinating Work Survey is measured on a 5-point Likert scale, and scores are computed by averaging all items within each scale to yield a mean. Higher scores = stronger collaboration / alignment / coordination

  Month 10, 26, and 38 for Wave1; Month 14, 30, and 42 forWave 2

• citizen awareness and perceived utility of Deflection

  Is there a change in citizen awareness and perceived utility of Deflection? Measured using several survey measures on attitudes toward deflection efforts and law enforcement within their community, including awareness, acceptability, appropriateness, and feasibility. Survey measures are scored via averaging scale items together to yield a mean, with higher scores indicating higher levels of awareness, acceptability, appropriateness, and feasibility.

  Month 10, 26, and 38 for Wave1; Month 14, 30, and 42 forWave 2

• deflection workforce referrals and citizen enrollments in Deflection

  Is there a change in workforce referrals and citizen enrollments in Deflection? Measured using existing data collected by the deflection program on referral and enrollments to deflection services including adoption (e.g., proportion of workforce and agencies referring clients to deflection), penetration (e.g., count of deflection referrals and enrollments), equity (e.g., proportion of referrals and enrollments of minority representation), and sustainment (e.g., continued adoption and penetration). Scores for each will be represented by a count/number.

  Month 10, 26, and 38 for Wave1; Month 14, 30, and 42 for Wave 2

• overdose and SU related mortality

  Is there a change in overdose and SU related mortality rates? Measured using the National Association of State EMS Officials (NAEMSSO) harmonized data as collected from EMS agencies within the 5 participating states, as well as through coroner/vital statistics records on cause of death information for the communities. Rates are represented by a count/number of overdoses and SU related mortality rates, before and after implementation.

  Month 4-38 for Wave 1; Month8-42 for Wave 2

• service access along the full substance use cascade

  Is there a change in service access along the full substance use cascade and complex needs? Measured through data sharing of existing records from deflection programs. Numbers/counts will be used to measure each step of the substance use cascade.

  Month 4-38 for Wave 1; Month8-42 for Wave 2

Secondary Outcomes (2)

• deflection workforce attitudes toward deflection

  Month 10, 26, and 38 for Wave1; Month 14, 30, and 42 forWave 2

• citizen ratings of community law enforcement trust

  Month 10, 26, and 38 for Wave1; Month 14, 30, and 42 forWave 2

Study Arms (2)

Core-interagency community engagement approach

OTHER

facilitated public health-public safety interagency collaboration, best practices on building community engagement, and cross-system data driven learning

Other: Core-interagency community engagement approach

Enhanced-Core plus community engagement specialist

OTHER

core plus strategic role development and coaching of known and trusted citizens to serve as Community Advocates in promoting community support of deflection efforts and fully engage in deflection leadership decisions

Other: Enhanced-Core plus community engagement specialist

Interventions

Core-interagency community engagement approach OTHER

community engagement approaches that including building interagency collaboration, strategic planning, advocacy

Core-interagency community engagement approach

Enhanced-Core plus community engagement specialist OTHER

community engagement approaches that include the core, plus promoting identification and full integration of community citizens in community engagement practices

Enhanced-Core plus community engagement specialist

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Directly involved in Deflection services, including:
• Making referrals (e.g., law enforcement, first responders, community agencies) \& Providing services to participants (e.g., case managers, peer specialists, coordinators);
• Aged 18 years or older;
• Able to complete surveys in English;
• Willing to provide informed consent

You may not qualify if:

• Not affiliated with a participating Deflection agency;
• No role in Deflection referral or service delivery;
• Under age 18;
• Unable or unwilling to provide informed consent
• Clients
• Aged 18 years or older;
• Enrolled in a Deflection program within a participating community;
• Between 1 and 12 months post-enrollment at time of recruitment;
• Documented history of substance use disorder (SUD) or risk for SUD;
• Priority for individuals reporting opioid and/or stimulant use within the past year;
• Able to complete survey and/or interview; Willing to provide informed consent
• Under age 18;
• Not enrolled in a Deflection program;
• Insufficient exposure to Deflection (\<1 month);
• Unable or unwilling to provide informed consent

Sponsors & Collaborators

• Texas Christian University: lead
• National Institute on Drug Abuse (NIDA): collaborator

Study Sites (1)

Texas Christian University

Fort Worth, Texas, 76109, United States

Location

Related Publications (92)

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  BACKGROUND

MeSH Terms

Conditions

Substance-Related Disorders; Drug Overdose; Criminal Behavior

Condition Hierarchy (Ancestors)

Chemically-Induced Disorders; Mental Disorders; Prescription Drug Misuse; Drug Misuse; Behavior

Study Officials

• Jennifer E Becan, Ph.D.

  Texas Christian University

  PRINCIPAL INVESTIGATOR

• Kevin Knight, Ph.D.

  Texas Christian University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Amanda W Sease, Ph.D.

CONTACT

817-257-5841; a.wiese@tcu.edu

Study Design

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

Study Record Dates

• First Submitted: March 30, 2026
• First Posted: April 14, 2026
• Study Start (Estimated): July 1, 2026
• Primary Completion (Estimated): March 1, 2029
• Study Completion (Estimated): May 1, 2029
• Last Updated: April 14, 2026

Record last verified: 2026-04

Locations

US (1)