Recovery Opportunities Through Ongoing Treatment Sustainment
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Youth Substance Use Unit.
- Who it may be relevant to
- Registry conditions: Substance Use Disorders (SUDs). Basic parameters: 13 years — 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Center list to be confirmed — check the primary protocol.
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Recovery Opportunities Through Ongoing Treatment Sustainment (ROOTS): A Dynamic Approach to Integrate and Sustain Adolescent Substance Use Services in Rural Schools
Overview
Adolescents in rural communities face limited access to effective substance use services, increasing their risk for opioid and other substance use disorders. This project will use an adaptive, iterative implementation approach to improve the integration of external substance use service providers into rural school settings. Findings will inform strategies to integrate and scale adolescent substance use services in schools. Support for this trial is provided by the HEAL Initiative (https://heal.nih.gov/).
Detailed description
Rural adolescents are more likely than their peers in urban areas to engage in high-risk substance use, including opioid misuse. Rural adolescents also face challenges accessing behavioral care because of limited clinics and providers in rural settings, including substance use care providers. External specialists may fill a critical gap in augmenting existing school-based services; however, challenges in cross-system coordination contribute to poor reach and retention in care. These challenges are particularly urgent given the need to treat opioid use disorder (OUD) and prevent escalation to OUD among high-risk adolescents with other substance use disorder (SUD) or behavioral health challenges. Research is needed to identify implementation strategies that support cross-system coordination without overburdening existing school staff. The proposed K23 will examine the implementation and effectiveness of an innovative community partnership-the Youth Substance Use Unit (YSU), a collaboration between schools and local substance use service providers that delivers services to adolescents with substance use problems at high schools on the rural Eastern Shore of Maryland. Guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, the study has three aims: (1) identify determinants and opportunities to improve implementation of the YSU by conducting semi-structured interviews with constituents (e.g., school personnel, peer recovery specialists); (2) develop and adapt initial implementation strategies to improve reach and implementation of the YSU into rural schools based on constituent feedback using Implementation Mapping, a participatory approach to co-develop and specify implementation strategies; and (3) test the effectiveness and implementation of the YSU in Type 2 hybrid effectiveness-implementation trial using an adaptive-iterative design. Support for this trial is provided by the HEAL Initiative (https://heal.nih.gov/).
Interventions
- Behavioral Youth Substance Use Unit
The YSU provides adolescents access to several evidence-based interventions, including access to an on-site substance use counselor trained in evidence-based practices for adolescent SUD, peer recovery specialists, and, if indicated, virtual access to an OUD treatment provider and/or clinical psychologist for more acute and co-occurring disorder treatment.
Primary outcome measures
- Reach and Engagement [Time frame: From enrollment to 90-day follow-up]
- 90-day Substance Use Self Report [Time frame: Measured from baseline to 90-day follow-up]
- 90-Day Substance Use Urinalysis [Time frame: Measured from baseline to 90-day follow-up.]
- Opioid-related knowledge and likelihood to engage in misuse behaviors [Time frame: Assessed from baseline to 90-day follow-up]
Secondary outcome measures (3)
- Motivation for substance use and problems associated [Time frame: Assessed between the baseline assessment and 90-day follow-up]
- Depressive Symptoms [Time frame: Assessed between the baseline assessment and 90-day follow-up]
- Anxiety Symptoms [Time frame: Assessed from baseline to 90-day follow-up.]
Eligibility criteria
Inclusion criteria
- Are enrolled in one of the participating schools
- Are referred or independently access YSU services;
- Are above age of 13
Exclusion criteria
- Demonstrating active, unstable or untreated psychiatric symptoms, including mania and/or psychosis that would interfere with study participation
- Inability to understand the study and provide informed consent in English
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- N/A
- Model
- Single group
- Masking
- Open label
- Primary purpose
- Treatment
Study locations
Center list to be confirmed — check the primary protocol.
Identifiers
NCT: NCT07746401 · 2342 · 1K23DA065849-01