Julie Bobitt, PhD
Principal Investigator: Julie Bobitt
Project Dates: June 1, 2020 – May 31, 2021
Veterans often struggle with disabling conditions, such as chronic pain and PTSD, that tend to worsen as they age. Common treatments for these conditions include the use of opioids and benzodiazepines, yet these medications tend to have unwanted side effects and can even result in addiction. Meanwhile cannabis use in the US has increased significantly over the past decade and a growing number of research studies have highlighted the benefits derived from taking cannabis for medical purposes. Previous studies with older adults have found that individuals are reportedly using cannabis to replace or reduce reliance on opioids and benzodiazepines, however, no research has looked at cannabis relative to opioids and benzodiazepine use in older Veterans. The goal of this study is to develop a deeper understanding of cannabis use in older Veterans who are using it as a substitute or complement for opioids and/or benzodiazepines. Using data collected from older Veterans enrolled in the Illinois Medical Cannabis Program we will identify individual level variables and compare self-reported outcomes associated with using cannabis as a complement or substitute for opioids and/or benzodiazepines. We will also conduct 30 interviews with a sub-set of Veterans who respond to our surveys to discuss cannabis use as a complement or substitute for opioids and/or benzodiazepines.
Principal Investigator: Julie Bobitt
Project Dates: July 1, 2018 – September 30, 2020
Data from the National Survey of Drug Use and Health (NSDUH) showed past-year cannabis use climbed from nearly 3% in 2003 to just over 9% by 2014 in adults age 50-64 and from .2% – 2.1%—a tenfold increase—in adults over age 65. While the number of older adults who use cannabis has been increasing, little is known about the reasons why older adults use cannabis and the outcomes for when they do. We sent surveys to the 16,000+ individuals age 60 and older enrolled in the Illinois Medical Cannabis program to learn about what motivates cannabis use (i.e. chronic pain), describe how cannabis is used, and identify both positive and negative outcomes of cannabis use (i.e. ability to stay active or increased falls risk).
Sponsor: Midwest Roybal Center for Health Promotion and Translation
Principal Investigator: Julie Bobitt
Co Investigators: Laura Payne, Chelsey Byers, Neha Gothe
Project Dates: June 1, 2021 – May 30, 2022
Research has shown that lifestyle changes such as participating in regular physical activity, staying socially engaged, and managing stress and diet make a positive difference that can delay or reduce cognitive decline. Wits Wellness is a holistic, 12-session (60-minute per session), multi-modal workshop series that offers adults ages 50 and older facilitated, interactive dialogue and activities about healthy behaviors that promote health including, stress management, the importance of physical activity, healthy diet, good sleep, and socialization. We will deliver Wits Wellness to 240 participants in locations throughout Illinois, and conduct a mixed-method evaluation of Wits Wellness using a two-arm randomized controlled trial to determine the feasibility and acceptability of Wits Wellness and examine the preliminary efficacy of Wits Wellness on changes in cognitive function, self-efficacy, socialization, sleep, stress and physical activity levels at 3 and 6 months.
Geri Donenberg, PhD
SYNC - Technology-based Training Tool for an Empirically-Supported Group-Based HIV and STI Prevention Intervention for Juvenile Offenders
Sponsor: National Institute on Minority Health and Health Disparities (R43 MD014113/R44 MD014113)
Principal Investigators: Geri Donenberg, David Smith, Edward Feil
Project Dates: September 24, 2019 – May 31, 2024
Youth under age 18 involved in the criminal justice system are disproportionately minorities and affected by substance abuse, mental illness, and HIV/STI. Most young offenders are released on community supervision without the STI, mental health, or substance use screening, diagnosis, and treatment afforded detained youth, despite similar rates of risk behavior. Their long-term trajectory is poor, the costs to society are high, and lasting effects on community well-being and individual employment prospects are profound. Altering this trajectory is a public health priority. SYNC (formerly PHAT Life) is an evidence-based program that meets the need in juvenile justice to address youths’ co-morbid health problems. The next––and perhaps most critical–– step in ensuring that this decade-long line of research produces actual, real-world improvements in the lives of probation youth is to develop a SYNC training strategy that is effective, cost-effective, and sustainable within juvenile justice settings. This private/public collaboration between Oregon Research Behavioral Intervention Strategies and the University of Illinois at Chicago will leverage existing resources and competencies to create a commercially viable technology-based training tool for SYNC with great potential for sustainability and cost-effectiveness. Building on SBIR Phase I research, in this Phase II application proposes to use a formative process to refine, enhance and complete the technology-based training tool to include: (a) an interactive multimedia web browser and mobile application, (b) dynamic multimedia presentations and interactive queries, (c) video examples of mock intervention delivery, (d) audio narration along with scripted language, (e) brief quizzes to ensure comprehension and knowledge acquisition, (f) opportunities to “learn more” by clicking on tabs for supplemental information, (g) targeted referrals to appendix materials, (h) games to promote engagement, and (i) other adaptations based on Phase I feedback. The proposed technology-based training tool should be highly sustainable, because it (a) relies on “indigenous” personnel to deliver the intervention, (b) is likely to prove cost-effective since we will utilize a technology that can deliver training at scale, and (c) will improve fidelity by leveraging technology to provide consistent training experiences to para-professionals. We will evaluate the training tool via a 2-arm RCT with 130 individuals who work with justice-involved youth. All trainees will receive the technology-based training tool and half will be randomized to receive supervision prior to real-life delivery. We will evaluate facilitator knowledge and satisfaction, and fidelity to SYNC following real-time intervention delivery. We will assess key implementation outcomes, including cost, feasibility, acceptability and sustainability. The proposed study is highly significant with strong commercialization opportunities for a scalable training solution that supports implementation fidelity and program sustainment addressing a key public health imperative.
Principal Investigator: Geri Donenberg
Project Dates: September 30, 2016 – September 29, 2022
The purpose of this project is to increase the capacity of the Community Outreach Intervention Projects (COIP) to serve 13-24 year-old African-American (AA) women residing in Chicago’s West, South, and Southeast sides. Through collaboration with partner agencies and input from community members, the activities of this project will build a solid foundation for delivering and sustaining high quality and accessible state-of-the-science HIV prevention and substance abuse services within COIP. IMARA (Informed, Motivated, Aware, and Responsible about AIDS) is a culturally relevant, multi-level, integrated, family-based, HIV and mental health prevention program that simultaneously targets African American women and their daughters. This proposal will increase the availability and accessibility of IMARA and other education and awareness programs, HIV testing and counseling, and evidence-based practices for behavioral and substance use risk reduction, thereby increasing the number of young AA women who are screened, tested, linked to care, and offered brief substance use and sexual risk reduction programs. Increased testing will indicate AA women at high-risk for these health conditions, identify newly discovered positives, and offer on-site HIV primary care. Co-location of behavioral and medical services will create a seamless continuum of primary prevention to active treatment, leading to earlier diagnosis and improved health-related outcomes. The expansion of resources proposed in this application will increase COIP’s capacity to serve 13-24 year old AA women. COIP’s close collaboration with the HIV Community Care Network (HCCN), the Hepatitis C Community Alliance to Test and Treat (HepCCATT), and New Age Services Corporation (NASC) will facilitate referrals for treatment of HIV, viral hepatitis, and serious substance abuse, respectively.
The IMARA program was developed with support (R01 MD006198) from the National Institute of Minority Health and Health Disparities.
Principal Investigator: Judith Levy
Role: Project Co-Director
Project Dates: April 27, 2018 – January 31, 2023
Unlike many parts of the world where HIV rates are decreasing, Indonesia is experiencing an accelerating AIDS epidemic that affects multiple vulnerable populations across a geographic span of approximately 18,000 inhabited islands. Research and research training is desperately needed to identify and test the best policies and methods to reverse this trend. To help address this challenge, we propose to develop and implement the “UIC/AJCU Training Program in Advanced Research Methods and Translational Science.” The program will entail a collaborative effort between Atma Jaya Catholic University (AJCU) in Jakarta and the School of Public Health, University of Illinois at Chicago. The program is designed to build AIDS research capacity at AJCU, train a cadre of highly prepared Indonesian investigators to conduct innovative HIV/AIDS research using advanced research methods and translational science, and contribute to AJCU’s further development toward becoming a Center of Research Excellence for Indonesia. Its underlying goal is to train a next generation of HIV research investigators who can provide the innovative research needed to guide the country’s policies and programming in successfully addressing HIV. The program will meet 3 aims: (1) To train a cadre of highly prepared Indonesian Investigators with the research skills needed to conduct innovative research that will advise HIV social policy, intervention programming, and social/medical services; (2) To further build the institutional HIV research capacity at AJCU and its AIDS Research Center (ARC); and (3) To contribute through research training to AJCU’s development toward becoming a Center of Excellence in HIV research and research training for Indonesia. A mix of AIDS research training and research opportunities will be offered that is designed to produce a next generation of Indonesian HIV/AIDS research investigators. Over the five- year period, we will recruit and train in HIV research: 2 doctoral students in public health who will undertake and complete all requirements for a PhD, 3 post-docs, 2 Informatics Certificate Program trainees, and 4 short- term (3-4 month) trainees. All program trainees will be required to select an area of methodological competence for which they will be required to develop or strengthen their research skills. They also will be required to conduct their studies in Indonesia. Program-sponsored workshops in advanced research methods and translational science held at both universities and also a lecture series at AJCU will inform and/or update faculty/research investigators’ and students’ methodological skills. Seven program strategies will build AIDS research capacity at AJCU and also enhance its development in becoming a Center of Excellence in HIV research and training for the archipelago. The program meets the NIH-identified overarching priority of providing the workforce research training required to conduct High Priority HIV/AIDS or HIV/AIDS-related research. The long-term benefits of the program lie in its impact on improving HIV prevention, treatment, care, and services for Indonesia.
Experimental evaluation of a multi-site suicide intervention for youth during and after residential placement
Principal Investigators: Shabnam Javdani, Erin Godfrey
Project Period: August 23, 2018 – May 31, 2023
In response to the public health threat that suicide poses to American youth in general and incarcerated youth in particular, we propose a multi-year, multi-site, setting-level intervention in the New York City Juvenile Justice system. In partnership with the NYC Administration for Children’s Services (ACS), we will experimentally evaluate an evidence-based staff-level training (S4L) to address youth suicidality during two critical points of contact for juvenile-justice involved youth: placement and post-release Aftercare. S4L combines training in Shield of Care (SOC), an evidence-based model for acute suicide detection training for juvenile justice staff, with evidence-based suicide prevention skill-building training informed by dialectical-behavior therapy for adolescents at risk for suicide ideation, behavior, and non-suicidal self-injury (NSSI). We will compare the effectiveness of S4L to a training as usual control condition (control), and to a condition in which we provide monthly on-site coaching to staff to support the acquisition and implementation of S4L skills (S4L+). The intervention will be implemented as part of ACS’s usual staff-training procedures. The need for intervention is urgent at this time due to recent state-level policy shifts that will increase the number youth in these sites and heighten their suicide risk. S4L and S4L+ will be evaluated using a 3-arm cluster-randomized design with the full population of non-secure placement (NSP)/Aftercare sites (N=30 sites; N=1800 youth, 30% girls). These sites are sole infrastructure for long-term confinement in NYC. NSP/Aftercare sites will be randomized to control (N=10 sites; 600 youth), S4L (N=10 sites; 600 youth), and S4L+ (N=10 sites; 600 youth) conditions. We test the effectiveness of S4L compared to S4L+ and control on improving suicidal behavior, suicidal ideation, and NSSI; mental health outcomes (internalizing, externalizing and substance use); and correlates of suicide/mental health (impulsivity, mood, and coping). In addition, we test the extent to which site-level implementation characteristics (e.g., proportion of staff trained; average amount of detection and prevention activities); site and staff-level structural characteristics (e.g., prior training, burnout); and individual youth characteristics (e.g., demographics; trauma history) moderate S4L and S4L+ effectiveness. Youth outcome data on suicidal behavior, suicidal ideation, NSSI, and mental health problems and their correlates will be tracked longitudinally for 1 year. In response to the FOA, outcomes will be assessed via evidence-based measures that capture dimensional facets of disorder in line with NIH’s common data elements and recommendations by the National Action Alliance for Suicide Prevention. Site-level intervention moderators will be measured by staff survey and administrative data. This project aims to expand the scientific knowledge base on suicide prevention and intervention in high-stakes youth settings and provide empirically-based guidance regarding the feasibility and scalability of staff training and coaching into different juvenile justice systems and jurisdictions. This project leverages an existing collaboration and has the full support of ACS.
Principal Investigators: Erin Meek and Sean Arayasiikul
Project Dates: August 1, 2020 – July 31, 2023
Our proposed study will test a task shifting, mHealth peer navigation intervention for trans women living with HIV in a SFDPH trans health clinic to increase initiation and engagement in mental health and substance use services. We will deploy a trusted peer patient navigator to ensure initiation and engagement with mental health and substance use services. The peer will navigate and provide support in-person and via mobile phone with HIPAA-compliant text messaging. Ecological momentary assessments will be conducted to enhance self-monitoring of mental health stress and coping-related substance use. We will engage community, providers, trans women, and SFDPH leadership in a pre-implementation assessment of the acceptability and appropriateness of our proposed intervention and use CFIR validated measures of the inner clinic setting to identify systems barriers. We will use data to refine and pilot our intervention with 40 trans women living with HIV. Our proposed study will employ an effectiveness-implementation hybrid design in recognition of the urgency of efforts to address the needs of trans women most affected by HIV in our city. The following are the specific aims: Aim 1: To engage community, providers and SFDPH leadership to determine the acceptability and appropriateness of a task shifting, peer navigation mHealth mental health and substance use intervention for trans women living with HIV. Aim 2: To measure the reach, effectiveness and potential for adoption of our intervention for increasing initiation and engagement in mental health and substance use services among trans women living with HIV.
Principal Investigator: Phoenix Matthews
Role: Co-Investigator and Implementation Scientist
Project Dates: September 10, 2020 – August 31, 2023
Demonstrating the feasibility, effectiveness, and cost-effectiveness of electronically delivered smoking cessation interventions via patient portals in Federally Qualified Health Care (FQHC) settings has the potential for wide-spread dissemination and significant public health impact. on patient populations with demonstrated high rates of smoking. The specific aims of are to: UG3: Aim 1. Examine the burden of tobacco use and its influence on pulmonary health disparities (lung cancer, COPD, and asthma) in the patient population and the economically disadvantaged and racially segregated catchment areas of Mile Square Health Centers. Aim 2: Evaluate knowledge, attitudes, barriers and facilitators to: smoking cessation, engagement with the tobacco quit line, linkage to the tobacco quit line via a patient health portal and receipt of patient navigation to facilitate access to the tobacco quit line among MSHC patients and health care providers. Aim 3: Evaluate the use of community engagement strategies to increase uptake of the UI Health Patient Portal among low-income patients receiving care at Mile Square Health Center. Aim 4: Test the acceptability, feasibility, and capacity of Mile Square Health to deliver Mi Quit CARE, an evidence-based and multi-level intervention to increase engagement with the quit line via the UI Health Portal. UH3: Aim 1: Determine the effectiveness Mi Quit CARE compared to standard of care in increasing patient engagement with the Illinois tobacco quitline and subsequent smoking cessation outcomes. Aim 2: Evaluate the scalability of Mi Quit CARE to multiple sites within the UI Health FQHC Mile Square clinic network and by translating the intervention to Spanish. Aim 3: Examine the cost effectiveness of Mi Quit CARE on smoking cessation outcomes compared to standard of care among a high risk FQHC population.
Sponsor: National Institute of Child Health and Human Development (UG3 HD096875/UH3 HD096875)
Principal Investigators: Geri Donenberg and Linda-Gail Bekker
Project Dates: September 1, 2018 – August 31, 2023
This project will adapt and evaluate the effectiveness and cost-effectiveness of IMARA, a family-based HIV prevention package for South African adolescent girls and young women and female caregivers. Reducing new HIV and STI infections among South African adolescent girls and young women (AGYW) is global public health priority. South Africa has world’s largest HIV epidemic, and South African adolescent girls and young women acquire HIV at twice the rate of and seroconvert on average 5 – 7 years earlier than male peers. 15-19 year-old females account for over two thirds of new HIV infections in sub-Saharan Africa, but only 15% know their HIV status. HIV mortality is rising among adolescents while decreasing for every other age group. As new infections continue to outpace access to and availability of PrEP and ART, primary prevention remains the most viable strategy to stem new transmissions. South African efforts to prevent HIV transmission in youth focus mostly on individual-level behavior change, but adolescent girls and young women’s persistent HIV disparities are explained by broad social and structural inequities that shape and constrain HIV-risk behaviors. Comprehensive HIV prevention packages that are integrated, synergistic, and tailored to the local epidemiology and cultural context are likely to achieve and sustain maximum reductions in HIV-risk. Female caregivers are an untapped resource in the HIV prevention toolbox and offer a novel opportunity to strengthen AGYW prevention efforts, particularly for uptake of new biomedical technologies like PrEP and HIV testing and counseling. Adolescent girls and young women may also be change agents for female caregivers who want to be positive role models for AGYW and thus, change their own behavior to practice HIV prevention. Establishing the cost- effectiveness of comprehensive HIV prevention packages will inform sustainment over time. This proposal answers a compelling need to reduce incident HIV and STI infections among South African women and AGYW to achieve an AIDS-free generation.
The IMARA program was developed with support (R01 MD006198) from the National Institute of Minority Health and Health Disparities.
Principal Investigator: Niranjan Karnik
Role: site PI
Project Dates: June 15, 2019 – February 29, 2024
This project seeks to establish the Great Lakes Node (GLN) of the NIDA-supported Drug Abuse Clinical Trials Network (CTN). This node will draw on an experienced set of investigators who have active collaborations and represent all of the major academic medical centers in the Greater Chicago and Wisconsin areas. The node will serve as a vital Midwestern hub for the CTN and will expand on the success of the CTN approach. In addition, the GLN will bring substantial experience in adolescent/young adult research, seniors/aging research, digital & mobile technologies, opioid misuse, collaborative care/population health, telehealth, and electronic health record and systems-driven interventions and research methodologies. The GLN will support engagement with CTN protocols and also add the following: Aim 1: GLN will identify and recommend substance misuse research and intervention protocols focused on systems-based practice using hospital-based screening, collaborative care, and population approaches. Aim 2: We will establish a digital and computation health core that will leverage our expertise in these domains and serve as a conduit for studies in mHealth, eHealth, artificial intelligence, natural language processing, and telehealth interventions. Aim 3: Our node will bring substantial expertise with youth/adolescent health and seniors/aging that will enable us to recommend studies to the CTN that examine the genesis of substance misuse and the potential for prevention strategies to mitigate these life-course pathways. Aim 4: In alignment with our team’s expertise, we plan to support work on substance and opioid misuse that focuses on health disparities including socioeconomic, geographic, sexual orientation, and gender identity. Aim 5: Leveraging our experience in professional education and practice-based learning, our node will rigorously test the impact of professional education on opioid and substance treatment. We have built on the ECHO model to develop methods to conduct high-quality distance education and supported training that are currently being trialed in Illinois with plans to expand these programs nationally. Aim 6: GLN will expand the pipeline of early investigators interested in substance misuse research. We will align this part of our program with our very successful CTSA-supported programs and build specific subprogramming that supports addiction and substance misuse research, training, and mentorship.
IMPAACT 2016: Evaluating a Group-Based Intervention to Improve Mental Health and ART Adherence Among Youth Living with HIV in Low Resource Settings
Sponsor: International Maternal Pediatric And Adolescent Clinical Trials network (IMPAACT) (UM1 AI068632)
Co-chairs: Geri Donenberg, PhD and Dorothy Dow, MD
Project Dates: February 1, 2017 – November 30th, 2027
IMPAACT 2016 is a multi-site, two-arm, randomized, controlled study preceded by a feasibility and acceptability pilot to examine if an Indigenous Leader Outreach Model (ILOM) of trauma-informed cognitive behavioral therapy (TI-CBT) intervention demonstrates improved mental health outcomes and ART adherence for youth living with HIV. The study will proceed in two stages over approximately three and one-half years. In Stage, 1 the feasibility and acceptability of the ILOM of TI-CBT program, consisting of 6 two-hour sessions, will be evaluated for 15-19 year-olds living with HIV and their caregivers using the ADAPT-ITT Model. In Stage 2, the efficacy of an ILOM of TI-CBT intervention using a 2-arm randomized controlled trial design will be evaluated for 15-19 year-olds living with HIV and their caregivers. This study will prioritize implementation in countries with high volumes of 15 – 19 year-olds living with HIV, and sites with minimal mental health care infrastructure in order to achieve the biggest impact and deliver the program in areas of greatest need.
Overall support for the International Maternal Pediatric Adolescent AIDS Clinical Trials Network (IMPAACT) was provided by the National Institute of Allergy and Infectious Diseases (NIAID) with co-funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the National Institute of Mental Health (NIMH), all components of the National Institutes of Health (NIH), under Award Numbers UM1AI068632 (IMPAACT LOC), UM1AI068616 (IMPAACT SDMC) and UM1AI106716 (IMPAACT LC), and by NICHD contract number HHSN275201800001I.
Ashley Kendall, PhD
Project AIM (Action In Mindfulness): Adapting and Implementing a Meditation App for Justice-Involved Youth Placed on Probation
Sponsor: National Institute on Drug Abuse (K99 DA047890/R00 DA047890)
Principal Investigator: Ashley Kendall
Project Dates: March 1, 2019 – February 28, 2024
Young people placed in the justice system experience important health disparities compared with non-justice-involved peers. Meditation may promote mental and physical health, and can be delivered by smartphone app, reaching youth in their daily lives. In the K99 phase of this study, we partnered with justice-involved youth and a range of community stakeholders–including a Youth Advisory Board, meditation experts, juvenile justice officers, and professional app programmers–to guide the adaptation and implementation of a meditation app for use by youth placed on probation. In the R00 phase, currently underway, we are conducting a longitudinal randomized controlled trial with youth currently placed on probation in the Chicago area to evaluate both clinical and implementation outcomes associated with the adapted meditation app.
Feasibility Trial of a Mindfulness-based mHealth Intervention to Mitigate the Effects of Chronic Workplace Stress among Juvenile Justice Officers
Sponsor: National Center for Complementary and Integrative Health (R34AT012078)
Principal Investigator: Ashley Kendall
Project Dates: August 10 2022 – April 30 2025
Juvenile justice officers (JJOs) face high chronic workplace stress. This stress is implicated in a constellation of adverse outcomes underpinned by emotion dysregulation: depression, anxiety, and workplace burnout. Mindfulness-based interventions (MBIs) target emotion dysregulation and show reductions in depression, anxiety, and burnout. Mobile health (mHealth) technology can be harnessed to deliver and tailor MBI content to JJOs during their workdays, presenting a platform that is both scalable on the macro level and responsive to the variability in each JJO’s schedule on the micro level. For the present study, our team is adapting an existing MBI app, Bodhi, according to empirically-supported adaptation targets and conducting a feasibility clinical trial in the Chicago Cook County juvenile justice system.
Kate Merrill, PhD
Sponsor: Eunice Kennedy Shriver National Institute of Child Health & Human Development (K99 HD105490)
Principal Investigator: Katherine G. Merrill
Project Dates: August 11, 2021 – July 31, 2023
Latina adolescents in the U.S. are disproportionately affected by HIV/AIDS/sexually-transmitted infections (STIs) and other adverse consequences of risky sexual behavior. The home environment is recognized to shape adolescents’ health outcomes, but only one Latina mother-daughter sexual health program was identified in the literature. IMARA (Informed, Motivated, Aware, and Responsible Adolescents and Adults) is an evidence-based intervention for African American adolescent girls and their mothers, which is well-suited to be adapted for Latinas. In a randomized controlled trial (RCT) in Chicago, the program reduced the risk of new STIs by 45% compared to the control group among 14-18-year-olds. In this study, we will adapt IMARA to a Latina audience and pilot an optimization trial within community-based organizations (CBOs) in Chicago, using the multiphase optimization strategy (MOST). MOST is a methodological framework for developing an optimal intervention package by assessing the effectiveness of an intervention’s components prior to subjecting the intervention to an RCT. This study focuses on the preparation phase of MOST, using an implementation science approach and drawing on community-based participatory research principles. Findings will form the basis for a fully-powered optimization trial to test intervention component impacts on STI incidence among Latina adolescents. The long-term goal is to generate an efficient, sustainable adapted intervention with potential for scale-up with CBOs serving Latinas.
Geri Donenberg, PhD
Sponsor: National Institute on Minority Health and Health Disparities (R01 MD010433)
Principal Investigator: Geri Donenberg
Project Dates: September 23, 2015 – June 30, 2021
PHAT Life: Preventing HIV/AIDS Among Teens is an intervention designed to help youth on juvenile probation make healthy choices regarding sexual health and substance use. The intervention content provides youth with health knowledge and emotional management skills which help them make healthy decisions. The program is comprised of 8 sessions that are delivered over a 2-week period to small groups of youth.
We deliver the program in partnership with the Cook County Juvenile Probation Department at probation programming throughout the Chicagoland area.
Juvenile offenders are disproportionately minorities and affected by HIV, sexually transmitted infections (STI), mental illness, and substance use. Evidence-based programs (EBP) are sorely needed in juvenile justice settings, yet few exist, and for those that do, implementation has been slow, challenging, and rarely sustained. Yet without intervention, young offenders continue to engage in risk behaviors while on probation, amplifying their own and worsening already serious health disparities. Altering this trajectory is public health priority. This study builds on a 10-year collaboration between the investigative team and Cook County Juvenile Probation and Court Services (the second largest juvenile probation system in the U.S.) to develop and deliver PHAT Life, a uniquely-tailored comprehensive risk reduction EBP for young offenders. Findings from PHAT Life’s recent efficacy trial reveal sustained reductions in sexual risk taking and substance use at 12-month follow up. The next step is to identify an implementation strategy that is both sustainable and cost-effective within juvenile probation. Few previous studies have compared peer- vs. adult- led behavior change programs and existing studies suffer from significant methodological deficiencies. This study will compare the effectiveness, cost-effectiveness, and sustainability of two implementation strategies, peer-led vs. probation staff-led PHAT Life, in juvenile probation’s Evening Reporting Centers. Peers will be young adults formerly involved in juvenile justice who serve on the Juvenile Advisory Council (Youth Representatives). Both Youth Representatives and probation staff will receive extensive training, supervision, and fidelity monitoring. We will compare the impact, costs, and cost-effectiveness of PHAT Life on 300 13-17 year-old male and female offenders’ risky sex, STI, substance use, and theoretical mediators when delivered by Youth Representatives vs. probation staff. Using qualitative methods, we will elicit the views of Youth Representatives, probation staff, and probation administrators regarding strategies to enhance PHAT Life’s sustainability within juvenile justice, and we will explore the impact delivering PHAT Life on Youth Representatives’ sexual risk, substance use, and other important outcomes. This proposal answers a compelling need for EBP in juvenile justice settings by addressing the interrelated issues of HIV/STI risk, substance use, and mental illness among probation youth, and their negative long-term trajectories. Comparing two implementation strategies–peers vs. probation staff–to determine the more effective and cost-effective approach will expedite uptake, delivery, and sustainability of much-needed EBP for teens who are at greatly elevated risk for HIV and other STIs.
Monte Staton, PhD
Sponsor: SAMHSA MAT-PDOA through IU Health West
Principal Investigators: Monte Staton
Project Dates: September 2019 to September 2021
Evaluation of implementation and patient outcomes of a new clinical program aiming to expand treatment services to persons with opioid use disorder, including Medication Assisted Treatment (MAT) and Intensive Outpatient Programming (IOP).
Principal Investigator: Antonio D. Jimenez
Project Dates: September 1, 2020 – August 30, 2022
The study aims to gather and analyze qualitative data from persons using opioids, family members of persons using opioids, and providers of treatment to persons using opioids, to help increase public health officials’ understanding of opioid use and overdose risks in suburban Cook County, how it impacts opioid users and their family members, and how local health/social service providers are responding to the needs of community members impacted by opioid use and overdose.