# Linking a Pediatric Healthcare Advance with a Task-Shifting Approach to Optimize Juvenile Justice Outcomes

> **NIH NIH R01** · OREGON SOCIAL LEARNING CENTER, INC. · 2021 · $701,897

## Abstract

PROJECT SUMMARY/ABSTRACT
 Juvenile justice (JJ) is the public service system most impacted by alcohol and other drug (AOD) use in
youth, and outcomes for these youth, their families, and society are grave. Thus, delivery of effective
interventions with JJ youth is of considerable importance. The evidence-based practices (EBPs) with the
strongest outcomes for JJ youth are family-based, but many communities do not have the resources to support
their delivery. This is particularly true in rural areas where AOD treatment resources are scarce. Further, even
when communities can support a family-based EBP, JJ youth face barriers to treatment participation. Indeed, JJ
youth are routinely referred for treatment, but data indicate less than 1 in 5 actually receive treatment. Juvenile
probation/parole officers (JPOs) are on the front line of this crisis. This workforce is in every community across
the nation and routinely interfaces with JJ youth to try to achieve positive outcomes. However, JPOs often face
limited options for treatment referrals; further, they do not have the time or training to deliver one of the full-scale,
family-based EBPs. As a consequence, JPOs try to manage the behavior of their probationers with a small menu
of youth-based interventions that have limited success (e.g., structured sanctions). One strategy for achieving
better outcomes in low-resourced, rural settings that cannot deploy a full-scale EBP, called task-shifting, involves
redistribution of tasks downstream to an indigenous workforce that has less training. Importantly, reviews indicate
that the leading EBPs for JJ youth share a common change mechanism: activation of parents. Thus, while the
family-based EBPs cannot be task-shifted, perhaps the central change mechanism of these EBPs (parent
activation) can be shifted downstream to enhance JPO practice. JJ leaders already cite improved parent
engagement as a top priority, but it is also one of the most challenging problems facing the JJ system.
Fortuitously, within pediatric healthcare services, there is an effective intervention called parent activation (PA)
comprised of concrete tasks by healthcare service providers to better engage and motivate parents of at-risk
youth. PA has been delivered by clinicians and also by paraprofessionals. Thus, this healthcare service advance
might be primed for use by JPOs to activate parents and achieve more positive JJ youth outcomes. The proposed
stepped-wedge cluster randomized trial investigates the use and impact of PA by JPOs across 32 rural counties.
Aims are to: (1) determine the capacity of JPOs to deliver PA within JJ services, (2) examine impact of PA
delivery on de-identified family outcomes, and (3) examine implementation outcomes, assessed via the Stages
of Implementation Completion, for PA in the JJ service system, including JPO inner context variables that might
impact implementation. In a context where the nation’s behavioral healthcare service system is struggling to
m...

## Key facts

- **NIH application ID:** 10116355
- **Project number:** 5R01DA050669-02
- **Recipient organization:** OREGON SOCIAL LEARNING CENTER, INC.
- **Principal Investigator:** Michael R McCart
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $701,897
- **Award type:** 5
- **Project period:** 2020-04-01 → 2025-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10116355

## Citation

> US National Institutes of Health, RePORTER application 10116355, Linking a Pediatric Healthcare Advance with a Task-Shifting Approach to Optimize Juvenile Justice Outcomes (5R01DA050669-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10116355. Licensed CC0.

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