Learning Health System Intervention for Substance Use Disorders

(ADAPT Trial)

Age: < 65

Sex: Any

Trial Phase: Academic

Sponsor: Indiana University

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to improve addiction treatment for young people involved in the juvenile justice system. It will test a Learning Health System approach, a method to continuously improve healthcare delivery, to connect these youth with local mental health centers for better substance use care. Participants will either continue with usual probation practices or join the new system designed to enhance treatment access. Good candidates for this trial are young people aged 11 to 22 who live in participating counties and have used local mental health services. As an unphased trial, this study offers a unique opportunity to contribute to innovative approaches in addiction treatment for youth.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications. It's best to discuss this with the trial coordinators or your healthcare provider.

What prior data suggests that this Learning Health System is safe for youth involved in the juvenile justice system?

Research has shown that the Learning Health System (LHS) model has been safely used in various settings, including those focused on treating substance use disorders (SUD). For instance, a study in an urban health system in Denver used this model and found it well-received. The goal was to enhance collaboration among organizations to improve addiction treatment. No major safety issues emerged in these settings.

In another instance, the Veterans Affairs (VA) applied this model to mental health and substance use programs. They found it effective in assessing and improving national programs without any major negative events.

Although limited safety data exists for youth in juvenile justice settings, the successful use of LHS in other health systems suggests it is likely safe for this new group as well. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Learning Health System intervention for substance use disorders because it offers a fresh approach to connecting young people with the treatment they need. Unlike standard probation practices that focus primarily on monitoring, this system-level intervention actively promotes better integration and communication between healthcare providers and the justice system. This could lead to more personalized and effective treatment plans for youth struggling with substance use. By creating a feedback loop that continuously improves based on real-time data, the Learning Health System has the potential to significantly enhance outcomes and reduce relapse rates.

What evidence suggests that the Learning Health System is effective for improving substance use disorder care for youth in the juvenile justice system?

Research has shown that Learning Health Systems (LHS) can enhance treatments for substance use. For example, a study in Denver found that an LHS increased the number of patients tracked in substance use disorder programs, leading to better care. Additionally, using LHS in healthcare settings has been linked to more effective treatments for mental health and substance use issues. In this trial, one arm will implement the Learning Health System intervention, designed to improve youth connection to substance use treatment. These systems foster partnerships between health and justice organizations, ensuring more young people receive the care they need. This approach can reduce substance use and lower repeat offenses among young people involved with the justice system. ^{1 5 6 7 8}

Are You a Good Fit for This Trial?

The ADAPT trial is for youth aged 11-22 involved in the juvenile justice system within certain Indiana counties. Participants must have used local community mental health center services during a specific 24-month period.

Inclusion Criteria

Reside in a participating county assigned to receive the LHS intervention

I am between 11 and 22 years old.

Utilized any local CMHC service during the 24-month intervention period

Exclusion Criteria

N/A

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Implementation of LHS Alliances

Establish Learning Health System alliances between juvenile justice agencies and community mental health centers

Ongoing

Quality Improvement Cycles

Continuous quality improvement cycles using local Cascade data to develop tailored solutions

Ongoing

Follow-up

Participants are monitored for long-term outcomes such as substance use and recidivism

10 years

What Are the Treatments Tested in This Trial?

Interventions

• Learning Health System

Trial Overview ADAPT aims to create alliances between juvenile justice agencies and community mental health centers using a Learning Health System approach. It will use data to develop localized solutions for substance use disorder care among these youths.

How Is the Trial Designed?

Group I: Learning Health System Experimental Treatment 1 Intervention

Participating counties receive a system-level intervention, a Learning Health System, designed to improve youth connection to substance use treatment.

Group II: Probation Referral Practice as Usual Active Control 1 Intervention

Data are collected regarding standard probation practice and outcomes before implementation of the Learning Health System.

Who Is Running the Clinical Trial?

Indiana University

Lead Sponsor

Trials

1,063

Recruited

1,182,000+

National Institute on Drug Abuse (NIDA)

Collaborator

Trials

2,658

Recruited

3,409,000+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12264389/

A learning health system model for addressing substance use This paper describes the implementation of a learning health systems model of SUD care at an urban, safety‐net, integrated health system in Denver, Colorado.

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12180564/

Substance Use Disorder Treatment Outcomes The heterogeneous metrics and criteria used to assess the effectiveness of substance use disorders treatment hinders cross‐study comparisons.

3. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0740547221000945

Alliances to disseminate addiction prevention and ... Alliances to disseminate addiction prevention and treatment (ADAPT): A statewide learning health system to reduce substance use among justice-involved youth in ...

4. researchgate.net researchgate.net/publication/390267826_A_learning_health_system_model_for_addressing_substance_use_Denver_Health_Center_for_Addiction_Medicine

A learning health system model for addressing substance ... Results After integration, three more SUD treatment programs were represented in the EHR. This increased the number of patients that could be tracked as ...

5. faseb.onlinelibrary.wiley.com faseb.onlinelibrary.wiley.com/doi/full/10.1096/fba.2020-00124

Learning health systems: Driving real‐world impact in mental ... We describe current VA research initiatives in mental health and substance use disorders that rigorously evaluate national programs and policies.

6. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/40677601/

Denver Health Center for Addiction Medicine This paper describes the implementation of a learning health systems model of SUD care at an urban, safety-net, integrated health system in ...

7. samhsa.gov samhsa.gov/data/

SAMHSA Data SAMHSA collects data through multiple sources and surveys and provides access to public-use data files and documentation to support a better understanding of ...

8. jcoinctc.org jcoinctc.org/testing-a-learning-health-system-in-juvenile-justice-settings-036/

Testing a Learning Health System in Juvenile Justice Settings ... The goal of this study is to identify mechanisms to improve interagency collaboration; enhance prevention and treatment service delivery along the opioid care ...