Substance Use Disorder (SUD)JCOIN II TCUNCT07528846
Justice Community Overdose Innovation Network II TCU Hub
A study testing Core-interagency community engagement approach and Enhanced-Core plus community engagement specialist in people with Substance Use Disorder (SUD) and Drug Overdose, run by Texas Christian University at 1 site in United States.
Trial 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)… Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- Substance Use Disorder (SUD), Drug Overdose, Criminal Behavior
- What is being tested?
- Core-interagency community engagement approach and Enhanced-Core plus community engagement specialist
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 1,620 participants
- Where
- 1 siteUnited States
- Study dates
- Jul 2026to May 2029
- Phase
- Interventional
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- 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
- Aged 18 years or older;
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- 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
- Aged 18 years or older;
- Resident of a participating community;
- Represents general community population (including individuals with or without lived experience of SUD/CLS involvement);
- Able to participate in: Surveys and/or Community Listening Sessions;
- Willing to provide informed consent
- Aged 18 years or older;
- Identified as a community or agency leader/stakeholder involved in Deflection programming;
- Member of a DAG within a participating community;
- Represents one of the required stakeholder roles: Law enforcement leadership or staff, Behavioral health leadership or staff Health professional, Community representative (citizen);
- Able to participate in meetings, surveys, and/or focus groups;
- Willing to provide informed consent
Who cannot join
- 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
- Under age 18;
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- Not enrolled in a Deflection program;
- Insufficient exposure to Deflection (<1 month);
- Unable or unwilling to provide informed consent
- Citizens
- Under age 18;
- Not residing in a participating community;
- Unable or unwilling to provide informed consent
- Workgroup
- Not part of a DAG in a participating community;
- Does not hold a role relevant to Deflection leadership or decision-making;
- Under age 18;
- Unable or unwilling to provide informed consent
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
About this study
Official title: Justice Community Overdose Innovation Network II TCU Hub: TCU Building Resilient Initiatives for Deflection Through Greater Engagement Project (TCU BRIDGE to Deflection Project)
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.
- Being tested
- Core-interagency community engagement approach, Enhanced-Core plus community engagement specialist
- Keywords
- deflection, pre-arrest diversion
- Medical subject headings
- Substance-Related Disorders, Drug Overdose, Criminal Behavior
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Core-interagency community engagement approachOther
community engagement approaches that including building interagency collaboration, strategic planning, advocacy
Enhanced-Core plus community engagement specialistOther
community engagement approaches that include the core, plus promoting identification and full integration of community citizens in community engagement practices
| Study group | Role | What they receive |
|---|---|---|
| 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 Receives: 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 Receives: Other: Enhanced-Core plus community engagement specialist |
What is being measured
The primary outcome is the main question the study is designed to answer.
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
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 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.
Measured: Month 4-38 for Wave 1; Month8-42 for Wave 2
Secondary outcomes (2)
deflection workforce attitudes toward deflection
Is there a change in deflection workforce attitudes toward deflection? Measured using the Donnelly et al. (2024) Tough on Crime Index and the Bailey et al. (2024) Stigma and Policing Attitudes Toward PWUD Scale, items are rated on Likert-type scales and averaged to create composite scores, with higher values indicating stronger endorsement of punitive ("tough on crime") attitudes and greater stigma toward people who use drugs and restrictive policing approaches.
Measured: Month 10, 26, and 38 for Wave1; Month 14, 30, and 42 forWave 2
citizen ratings of community law enforcement trust
Is there a change in community-law enforcement trust? Measured using the Hamm et al. (2018) Community-Law Enforcement Trust Scale, items are rated on Likert-type scales and averaged to create a composite score, with higher values indicating greater perceived trust between community members and law enforcement.
Measured: Month 10, 26, and 38 for Wave1; Month 14, 30, and 42 forWave 2
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted14 Apr 2026
- Study startJul 2026 (estimated)
- Primary completionMar 2029 (estimated)
- Study completionMay 2029 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (92)Papers the sponsor has linked to this study.
- Other trials for Substance Use Disorder (SUD)Studies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 1,620 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Texas Christian University
- Sponsor type
- University, hospital or other
- Collaborators
- National Institute on Drug Abuse (NIDA)
- Responsible party
- Principal investigator, Jennifer Becan, Texas Christian University
- Investigators
- Jennifer E Becan, Ph.D., Principal investigator, Texas Christian UniversityKevin Knight, Ph.D., Principal investigator, Texas Christian University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07528846
- Sponsor's protocol ID
- 1RM1DA064502
- Other IDs
- 1RM1DA064502
- Acronym
- JCOIN II TCU
- Status last verified
- Apr 2026
- First submitted
- 30 Mar 2026
- Last updated
- 14 Apr 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Publications
Yang, Y. and Knight, K., (2024). An AI-Driven Tool for Precisely Identifying Intervention Needs with Ecologically Valid, Multimodal Data (AI-PINNED). https://ibr.tcu.edu/ai-pinned/
Wu E, Villani J, Davis A, Fareed N, Harris DR, Huerta TR, LaRochelle MR, Miller CC, Oga EA. Community dashboards to support data-informed decision-making in the HEALing communities study. Drug Alcohol Depend. 2020 Dec 1;217:108331. doi: 10.1016/j.drugalcdep.2020.108331. Epub 2020 Oct 1.
PubMed 33070058Winkelman TNA, Chang VW, Binswanger IA. Health, Polysubstance Use, and Criminal Justice Involvement Among Adults With Varying Levels of Opioid Use. JAMA Netw Open. 2018 Jul 6;1(3):e180558. doi: 10.1001/jamanetworkopen.2018.0558.
PubMed 30646016Wiese AL, Carey PD, Becan JE, Wood C, Knight K. Policy Changes to Improve Service Access: Best Practices for Researchers Engaging With Criminal Justice Partners. J Correct Health Care. 2025 Feb;31(1):11-16. doi: 10.1089/jchc.24.09.0075. Epub 2024 Nov 28.
PubMed 39607681Weiner BJ, Lewis CC, Stanick C, Powell BJ, Dorsey CN, Clary AS, Boynton MH, Halko H. Psychometric assessment of three newly developed implementation outcome measures. Implement Sci. 2017 Aug 29;12(1):108. doi: 10.1186/s13012-017-0635-3.
PubMed 28851459Walters ST, Drainoni ML, Oga EA, Byard J, Chandler RK. Solving the "last mile" problem in overdose prevention: Lessons from the HEALing Communities Study. Drug Alcohol Depend. 2024 Nov 1;264:112453. doi: 10.1016/j.drugalcdep.2024.112453. Epub 2024 Sep 28.
PubMed 39379270Tsui JI, Barry MP, Austin EJ, Sweek EW, Tung E, Hansen RN, Ninburg M, Scott JD, Glick SN, Williams EC. 'Treat my whole person, not just my condition': qualitative explorations of hepatitis C care delivery preferences among people who inject drugs. Addict Sci Clin Pract. 2021 Aug 12;16(1):52. doi: 10.1186/s13722-021-00260-8.
PubMed 34384494Tang F, Ishwaran H. Random Forest Missing Data Algorithms. Stat Anal Data Min. 2017 Dec;10(6):363-377. doi: 10.1002/sam.11348. Epub 2017 Jun 13.
PubMed 29403567Taffere, G. R., Abebe, H. T., Zerihun, Z., Mallen, C., Price, H. P., & Mulugeta, A. (2024). Systematic review of community engagement approach in research: Describing partnership approaches, challenges and benefits. Journal of Public Health, 32(2), 185-205. https://doi.org/10.1007/s10389-022-01799-9
Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol Bull. 1979 Mar;86(2):420-8. doi: 10.1037//0033-2909.86.2.420.
PubMed 18839484Snijders, T. A. B., & Bosker, R. J. (2012). Multilevel Analysis: An Introduction to Basic and Advanced Multilevel Modeling (2nd ed.). Sage Publications.
Shea CM, Jacobs SR, Esserman DA, Bruce K, Weiner BJ. Organizational readiness for implementing change: a psychometric assessment of a new measure. Implement Sci. 2014 Jan 10;9:7. doi: 10.1186/1748-5908-9-7.
PubMed 24410955SAMHSA. (2024). The Sequential Intercept Model (SIM). https://www.samhsa.gov/criminal-juvenile-justice/sim-overview
SAMHSA (2022). Community Engagement: An Essential Component of an Effective and Equitable Substance Use Prevention System. (n.d.). Retrieved December 9, 2024, from https://store.samhsa.gov/product/community-engagement-essential-component-effective-and-equitable-substance-use-prevention
Rouhani S, Gudlavalleti R, Atzmon D, Park JN, Olson SP, Sherman SG. Police attitudes towards pre-booking diversion in Baltimore, Maryland. Int J Drug Policy. 2019 Mar;65:78-85. doi: 10.1016/j.drugpo.2018.11.012. Epub 2019 Jan 30.
PubMed 30710878