Enhancing Permanency in Children and Families

Substance Abuse Clinical Trial

— EPIC  

Official title:

Enhancing Permanency in Children and Families

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04700696
• Other study ID #: 90CU0083-01-00
• Status: Completed
• Phase: N/A
• Start date: October 1, 2017
• Est. completion date: September 30, 2023

Study information

• Verified date: September 2022
• Source: Ohio State University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The Enhancing Permanency in Children and Families (EPIC) program is a collaborative effort between the Ohio State University College of Social Work, two county offices of the Ohio Department of Job and Family Services, two juvenile courts and local behavioral health agencies. The goal of EPIC is to use three evidence-based and evidence-informed practices to reduce abusive and neglectful parenting, reduce addiction severity in parents, and improve permanency outcomes for families involved with the child welfare system due to substance abuse.

Description:

Funded by the federal Regional Partnership Grant (RPG) Program, the Enhancing Permanency in Children and Families (EPIC) is a partnership between child welfare, juvenile count and behavioral health to holistically address substance misuse and associated parenting needs of child welfare-involved families. The overall goals and objectives of the intervention are to 1) Increase timely access to services among substances abusing parents involved in the child welfare system in Fairfield and Pickaway counties, 2.Enhance child safety and improve permanency and 3. increase child, parent, and caregiver well-being.

Eligible participants are matched with peer recovery supporters who mentor parents through the process. Parents are also referred to Family Treatment Drug Court (FTDC) with the option to receive Medications for Opioid Use Disorders (MOUD), and lastly when children are placed at home with parents or with kinship caregivers, relational skill building services that include financial assistance for child care, respite and transportation services. EPIC participants receive substance abuse and behavioral health treatment services through local providers including from two partner agencies: Integrated Services for Behavioral Health and Ohio Guidestone.

Data collection: Participating parents complete a pretest at baseline and up to 5 post-tests at 6 month intervals. Parents complete questions related to themselves (e.g. Addiction Severity Index, CES-D) and for one focal child (e.g. CBCL).

To evaluate EPIC, a quasi-experimental design will be employed through a two-stage sampling procedure. This design provides the ability to assess (1) the effects of EPIC on access to services for the families in the two intervention counties, and (2) the independent effects of additional services provided under EPIC that may be over and above Ohio START (an intervention administered through the Public Children Services Association of Ohio) and treatment as usual (TAU). In the first stage, two comparison counties will be identified for each of the two intervention counties. One comparison county will be part of the Ohio START program while the second will be a county that has no major interventions to address substance use among child welfare families. Counties are matched based on child population size, rate of child protective services referrals, percent of naloxone administrations per adult population, percent white, percent poverty, child welfare tax levy, and to the extent possible, behavioral health service availability. During the second stage, EPIC families are matched with substance using families in each of the comparison counties.

Parents may consent to one or all three components of EPIC based on the specific needs of each family, however all parents receive intensive case management services, including frequent home visits from caseworkers and peer recovery supporters.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 117
• Est. completion date: September 30, 2023
• Est. primary completion date: July 1, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: N/A and older

Eligibility

Inclusion Criteria:

• Child welfare involvement

• Substance use is primary reason for child welfare involvement (a score or 3 or more on UNCOPE assessment or a positive drug screen)

Exclusion Criteria:

• Possible substance use, though not primary reason for child welfare involvement

• incarcerated parents (may enroll after release)

Related Conditions & MeSH terms

• Child Abuse
• Neglect, Child
• Substance Abuse
• Substance Use
• Substance-Related Disorders

Intervention

Behavioral:
• Peer Recovery Support
Weekly visits with peer who has lived experience related to child welfare and addiction
• Family Treatment Drug Court with Medications for Opioid Use Disorders (MOUD)
Incentivized to participate in Family Treatment Drug Court with option for Medications for Opioid Use Disorders (MOUD)
• Relational Skill Building based on the Nurturing Parenting Program (NPP)
Home-based parenting support

Locations

Country	Name	City	State
United States	The Ohio State University	Columbus	Ohio

Sponsors (8)

Lead Sponsor	Collaborator
Ohio State University	Children's Bureau - Administration for Children and Families, Fairfield County Job and Family Services, Fairfield County Juvenile Court, Integrated Services for Behavioral Health (ISBH), Ohio Guidestone, Pickaway County Job and Family Services, Pickaway County Juvenile Court

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Time from opening of child welfare case to SUD screening	Measures: 1) Child welfare case open date; 2) UNCOPE assessment screening date Analyses: We will use T-tests to estimate mean differences in the length of time from entry into child welfare and SUD screening for EPIC participants in comparison to Ohio START and treatment as usual.	Within 30 days of program entry
Primary	Time from opening of child welfare case to trauma screening	Measures: Time from opening of child welfare case to trauma screening will be estimated using 1) child welfare case open date; 2) ACEs assessment date for adults or 3) CTAC assessment dates for children.; Analyses: We will use t-tests to estimate mean differences in the length of time from entry into child welfare and trauma screening for EPIC participants in comparison to Ohio START and treatment as usual.	Within 30 days of program entry
Primary	Change in wait time between referral to addiction treatment services and initiation of services.	Measures: Change in wait time will be estimated using service referral and service initiation dates.; Analyses: We will use t-tests to estimate mean differences in the length of time between SUD treatment service referral and service initiation for EPIC participants in comparison to Ohio START and treatment as usual.	Within 30 days of entering child welfare system
Primary	Change in addiction severity among participating parents	Measures: Addiction Severity Index-Self Report (ASI-SR) Analyses: A paired sample t-test will be conducted to examine the change in mean scores on the ASI-SR pre and post participation.	At program entry and again at program completion. An average of I year
Primary	Change in resilience in children	Measures: Resilience in children is measured using the Protective Factors Survey (PFS) Analyses: A paired sample t-test will be conducted to examine change in mean scores on the PFS pre and post participation.	At program entry and again at program completion. An average of I year
Primary	Change in child behavior	Measures: The Child Behavior Checklist (CBCL) is used to screen for emotional, behavioral and social problems among children.; Analyses: A paired sample t-test will be conducted to examine change in mean scores on the CBCL pre and post participation.	At program entry and again at program completion. An average of I year
Primary	Change length of stay in out-of-home placement for children in EPIC program compared to substance-affected families not receiving EPIC.	Data source: Statewide Automated Child Welfare Information System (SACWIS), obtained twice a year through study completion.; Measures: Length of stay in out-of-home placement will be operationalized using placement dates obtained in SACWIS.; Analyses: Survival analysis will be utilized to study outcome measures (e.g., length of stay in out-of-home placement) Due to the likelihood of censored measures when we have families who are still involved in the child welfare system, particularly for families who enter the system near the end of the study period, we will use survival analysis to estimate treatment effects on length of stay in out of home placement in comparison to Ohio START and treatment as usual families.	Through program completion, an average of 1 year.
Primary	Change in reunification among families involved in EPIC compared to substance-affected families not receiving EPIC.	Data source: Statewide Automated Child Welfare Information System (SACWIS), obtained twice a year through study completion.; Analyses: Logistic regression will be used to estimate treatment effects on in comparison to Ohio START and treatment as usual.	Through program completion, an average of 1 year.
Primary	Change in subsequent child welfare involvement among parents receiving EPIC compared to substance-affected families not receiving EPIC	Data source: Statewide Automated Child Welfare Information System (SACWIS), obtained twice a year through study completion.; Measures: Subsequent child welfare entry (yes/no) is measured using re-entry dates in SACWIS.; Analyses: Logistic regressions will be used to estimate treatment effects on subsequent child welfare involvement in comparison to Ohio START and treatment as usual.	Through completion of 5 year study. For participants, up to 4 years following program participation, depending on time of enrollment

External Links

•   Study website