JCOIN 2.0 Collaborative Pilot Projects

Collaborative project submissions can be viewed at this link:
https://gmu1.box.com/s/vus05zcpncjvla2ebmgrfor9u9vxmmtq

JCOIN 2.0 Collaborative Pilot Project Form Submissions

Name Lead/Hub Collaborator Contacts Project Title Other Collaborators Type of Project
Dennis WatsonRMC-SS (Dennis_Chestnut)TCU = Jenny Becan; KYU = Carrie Osser; RTI = Dennis Watson (also representing RMCSS))Moral Injury Among the Behavioral Health Workforce Serving Criminal-Legal-Involved Populations with Substance Use DisorderTCU BRIDGE, RTI, WJCOIN IIMixed Method

Workers who deliver substance use disorder (SUD) services to criminal-legal-system-involved (CLSI) individuals operate at the intersection of public health and public safety. This workforce spans a wide range of roles (e.g., licensed clinicians, case managers, peer recovery specialists, reentry staff, harm reduction workers, and drug court personnel) across community, correctional, court, and reentry settings. These workers routinely face conditions in which institutional mandates, organizational constraints, and system-level policies conflict directly with their professional and personal values. Such conditions are potentially potent sources of moral injury. Moral injury refers to the psychological and spiritual harm resulting from perpetrating, failing to prevent, or witnessing acts that transgress deep moral beliefs. Originally described in military contexts, the construct has been extended to healthcare and human services settings, where it has been associated with depression, burnout, diminished quality of care, and workforce attrition. Despite its theoretical relevance to the SUD workforce serving CLS-involved populations, moral injury in this group has not, to our knowledge, been directly explored. This collaborative proposal supports a phased explanatory mixed methods project. In this first phase, we will conduct in-depth, semi-structured interviews with a minimum of 30 purposively sampled workers (to be expanded based on the number of additional collaborating hubs) to achieve variation across role types and practice settings. Interviews will investigate the sources and experience of moral injury, its perceived impacts, and protective strategies. We will follow a hybrid inductive-deductive thematic analysis where themes will be identified as they pertain to specific interview questions. Findings will be used to develop and refine survey items for Phase 2, to be pursued through a future collaborative project proposal targeting a larger sample of workers.

 

Additional information: https://gmu1.box.com/s/jzzbo5k776i3vmajs5i9wotweply3b0z

Name Lead/Hub Collaborator Contacts Project Title Other Collaborators Type of Project
Joseph Carpenter; Note that Helen Jack, UWashington is co-leadEmory (Carpenter_Emory)OPT-IN: Helen Jack (project co-lead); CTC: Danielle Rudes; Wisconsin: Jessi Vechinski; Kentucky: Martha TillsonNew Psychoactive Substances in US Carceral FacilitiesWisconsin, CTC, OPT-IN, WJCOIN IIMixed Method, Survey, Qualitative Study, Pilot observational study

US carceral residents experience high rates of substance use. Jails/Prisons are reporting increased use of New Psychoactive Substances (NPS) including synthetic cannabinoids (K2), kratom, and other synthetics (e.g., 7-OH). NPS enters facilities on drug-soaked paper that is dissolved or smoked and pose significant health risks, including severe toxicity, psychosis, and death, though effects vary. Staff are unprepared to manage NPS due to evolving substances and limited guidance. Facilities responded by increasing security, including scanning mail rather than providing originals but struggle with supply reduction, detection, and treatment. Prior studies are limited by single-site, cross-sectional designs and lack of contextual depth. Research needs to understand NPS occurrences, use, facility responses, and longitudinal trends across systems.

Aim 1: Understand longitudinal trends in NPS & and management in carceral settings. Add NPS occurrence and management questions to an existing longitudinal survey of staff at 120 prisons (UWi HUB). Align with the MAARC survey of US jail staff. This will characterize use patterns, clinical and security responses, and differences across states and facilities over 24 months.

Aim 2: Understand clinical & security management strategies for NPS.
Conduct 30 interviews with medical and security staff from 15 JCOIN affiliated jails/prisons. Interviews examine NPS transport, use patterns, security/healthcare responses, and training/resources. This will identify best management practices and inform larger-scale research.

Aim 3: Perform longitudinal surveillance of NPS in carceral settings. Build on current partnerships to collect seized NPS from jails/prisons. Samples will be analyzed by Center for Forensic Science Research & Education, which specializes in detecting and characterizing NPS. Quarterly reports will detail NPS trends at regional and national scale. Findings linked to facility-level health effects and overdose rates.

Name Lead/Hub Collaborator Contacts Project Title Other Collaborators Type of Project
Rosemarie MartinECHO (Martin_UMASS)National Survey of the Correctional WorkforceSurvey

A rigorous national survey would provide the first comprehensive picture of correctional workforce capacity, implementation readiness, organizational climate, and staff attitudes affecting the delivery of evidence-based SUD services across U.S. correctional systems. These data would identify modifiable barriers and actionable opportunities to improve treatment access, quality, and outcomes for incarcerated individuals with substance use disorders. There is a gap in understanding implementation barriers nationwide, particularly in regions JCOIN has not yet reached. An independent national sample would allow for comparison of JCOIN sites against a national picture. More detail provided in attached concept proposal, which incorporates feedback from the Jails/Prisons and Workforce interest groups. *Note: While open to any interested study team, this 2-year proposal requires a minimum of two RM1/UM1 hubs contributing collaboration funds to proceed.

Additional information: https://gmu1.box.com/s/y7yuhzip90fvjvvu6s3ej5hoy0gafnx0

Name Lead/Hub Collaborator Contacts Project Title Other Collaborators Type of Project
Lori DucharmeECHO (Martin_UMASS)Rural Geospatial ConceptAcquisition and analysis of geospatial data

Several JCOIN2 projects are working with criminal legal jurisdictions in rural areas, creating both a need and opportunity to better understand addiction and recovery support services available in those areas. In JCOIN 1.0, NIDA invested in the MAARC’s geospatial core to develop the OEPS resource, which brings together multiple data sources to characterize the addiction treatment service environment at various levels (state, county, census tract, etc.). MAARC has limited resources to update these data in JCOIN 2.0, and the addition of other (commercially produced) datasets is beyond their scope. If this concept is approved to move forward, participating hubs would partner with MAARC’s geospatial core team to acquire and analyze additional data with a focus on treatment and recovery support service availability in rural communities. [*Note: there is a possibility that this concept could be merged with the Behavioral Health Services Landscape Analysis concept, but that is still TBD at the July submission deadline. Because this is a potentially broader concept, we are submitting it for consideration. Full details in the attached proposal.]

Additional information: https://gmu1.box.com/s/tknyob5yklpmry9lp1t8t91yezs775jh

Name Lead/Hub Collaborator Contacts Project Title Other Collaborators Type of Project
Lori DucharmeUMass ECHO (Martin)Examine implementation strategy fidelity and its association with implementation outcomesMeasure development followed by (likely quant) data collection

Open to: Any hub that is explicitly testing one or more implementation strategies as part of its study design

Effort: This is a low-lift, low-expense collaboration. Personnel effort equivalent to participating in a workgroup; data collection would be structured and only collected by us, about us (no impact on study participants, no human subjects implications).

Description:
Measurement of implementation strategy fidelity remains a gap area in implementation science, as does its logical extension — whether and how fidelity is associated with implementation outcomes. In JCOIN 1.0, we published a conceptual model for measuring "implementation strategy integrity" (https://doi.org/10.1177/26334895241297278). This was largely done retrospectively across JCOIN hubs. JCOIN 2.0 gives us the opportunity to operationalize that conceptual model, and prospectively collect fidelity/outcome data across multiple hubs who are testing different implementation strategies in different settings.

We'd collectively develop measures to (a) specify our implementation strategies; (b) measure fidelity in their delivery (differentiating planned/positive changes from unplanned/problematic changes); and (c) associate degree/type of fidelity with categories of implementation outcomes (e.g., adoption, acceptability, sustainment).

The ultimate contribution would be a pragmatic measurement approach for implementation strategy fidelity/adaptation that is applicable across strategies and in contexts beyond usual healthcare settings.

Name Lead/Hub Collaborator Contacts Project Title Other Collaborators Type of Project
Lisa SaldanaJCAP (Saldana_Chestnut)Unsure - e-connect, RMC-SS, and JCAP are already on track to contribute definitively; FWIW ADAPT from JCOIN 1.0 could also already contributeCreating an Implementation Blueprint for CLS Contexts: Process and CostsCLEAR, CTC, Friends Research Institute, Johns Hopkins, MassJCOIN, NYU, RMC-SS, Wisconsin, RTIMeasure development and quant data collection and analyses

See attachment for details.

While interventions and strategies are being, and have been, developed to address some of the most intractable challenges for individuals who intersect with the CLS and experience substance use disorder or risk for disorder, the field remains plagued with difficulty in successfully implementing those solutions and sustaining them independent of grant funding.

The Stages of Implementation Completion® (SIC) is a measure of implementation process fidelity that can help to track and monitor implementation process progression and provide feedback about the potential for implementing sites to meet sustainment. The Cost of Implementing New Strategies (COINS) is a tool used alongside the SIC to track the cost of implementation.
The BUILD-IT platform is an emerging tool to support implementers through the implementation process (e.g., providing resources to explain how to complete implementation activities and why it is important, understanding how to prepare for implementation costs). The tool allows users to create their own implementation blueprint (i.e., set of strategies mapped to a timeline) based on recommendations provided for service settings, or to select an EBP-specific Blueprint that has been previously operationalized. The platform currently is focused on substance use prevention programs.

This project aims to:

  • Operationalize the implementation process for JCOIN 2.0 interventions and strategies. The SIC is a web-based tool.
  • Harmonize SICs across participating projects to:
    • Create a CLS Blueprint for implementation.
    • Conduct cross-project analyses of the implementation process in the CLS setting.
  • Harmonize COINS data across participating projects to conduct cross-project analyses of the cost of implementing new programs in CLS settings.
  • Create a module in the BUILD-IT platform that implementing sites can go to for support when implementing a new program. The module will integrate the CLS Blueprint.

Additional information: https://gmu1.box.com/s/yfveef2d6x5m2z3h9bplolyjgwodgmdd

Name Lead/Hub Collaborator Contacts Project Title Other Collaborators Type of Project
Liz EvansMassJCOIN (Evans_UMASS)Harold PollackReentry Demonstrations and Improving Services and Supports in Jails and PrisonsMAARCMixed Method

Reentry waivers authorize Medicaid coverage for services, including substance use disorder (SUD) treatment during the last 30-90 days of incarceration and case management to assist individuals in maintaining access to SUD treatment after release from incarceration. The reentry 1115 waiver was introduced in 2023, and as of April 2025, the Centers for Medicare and Medicaid Services had approved 19 Reentry Section 1115 Demonstrations (hereafter called “reentry demonstrations”), with nine states pending approval. Reentry demonstrations are expected to increase health access and continuity as people transition from living in jails and prisons and return to community-based settings, but studies are needed to assess outcomes and inform implementation.

We propose a staged mixed-methods national study to provide the first comprehensive picture of state-level variation in reentry demonstration program elements and implementation processes. The 2-3 year study will be informed by the EPIS conceptual framework and guided by periodic engagement with the CERRC Community Advisory Board and the JCOIN Practitioner Advisory group.

Stage 1: leverage the JCOIN network to synthesize existing data, conduct an environmental scan, and identify key informants across the 19 states with approved reentry demonstrations and the 22 states that have not received or sought approval for a reentry demonstration.

Stage 2: conduct in-depth interviews about reentry demonstrations with a diverse sample of key informants in jail/prison systems and state Medicaid directors.

Stage 3: conduct a pilot survey to assess facility-specific information about reentry demonstrations and inform future jail surveys. Resulting products will complement and enrich existing surveillance resources and contribute new knowledge by focusing specifically on county jails and state prison systems.

Additional information: https://gmu1.box.com/s/z3x7oq4pod5low6okuv3a1i33ab05tw0

Name Lead/Hub Collaborator Contacts Project Title Other Collaborators Type of Project
Brendan SalonerJohns Hopkins (Bandara_Hopkins)[email protected]Examining Variation in Carceral Health Care ContractsWisconsin, MassJCOIN, JustResearch CERRCLegal policy review

More than half of all jails and prisons contract for the provision of health services to outside vendors. This contracting process is poorly understood, yet it has profound implications for the scope, comprehensiveness, and quality of health services available to incarcerated people. The goal of this collaborative project is to develop a methodology to review contracted health services related to medications for opioid use disorder (MOUD) and to analyze contracts in a large, diverse sample of jail and prison systems. We propose a systematic review of contracts used in carceral facilities, with the goal of developing comparable measures of issues such as services available, staffing levels, oversight processes, and accountability. The first phase will be to develop a coding tool with legal regulatory input, the second will be to collate and review documents from an array of jurisdictions, and the final step will be to systematically compare documents and develop best practices around abstraction of these documents. This process will unfold over 24 months and will culminate with the development of a coding tool that can be parlayed into further work, including a larger grant to study the relationship between the contracts and the outcomes experienced by people receiving care in facilities.

Additional information: https://gmu1.box.com/s/mh57uko4vid4ay4tm1e6fbpwqeil0rmj

Name Lead/Hub Collaborator Contacts Project Title Other Collaborators Type of Project
Michele StatonWJCOIN II (Staton_KY)Examining unique overdose risks for women across intercepts of the criminal legal systemCROSSROADS, MAARC, MassJCOIN, RMC-SSMixed Method

The rate of increase in overdose deaths among women increased in recent years (Van Houten et al., 2019). Women re-entering the community following incarceration are particularly at risk with higher rates of overdose than men (e.g., Binswanger et al., 2013) and women in the general population (Waddell et al., 2020). Incarceration increases overdose risk due to tolerance loss, limited access to medications for opioid use disorder (MOUD) and other treatment, and disruptions in supportive networks (Sinkman et al., 2022). Yet, research to examine the unique overdose risks among women across legal system intercepts remains limited. This study will seek to understand women’s unique risks in a two-phased study: (1) During Year 01, the project will engage in two primary activities: A) Secondary data analysis from JCOIN1 to examine unique differences for women in overdose risk factors including severity of drug use, history of overdose, history of high-risk drug use (injection practices), utilization of SUD treatment at re-entry with a specific focus on MOUD, and mental health. B) Participating sites will work on a supplement for data collection that may integrate optional variables focused on unique factors for women which include sex trafficking, victimization/violence, trauma, parenting and caregiving, history of overdose risk, role of partners in OD experiences, etc which will be further examined in Year 02. (2) During Year 02, building upon findings from the secondary analysis, examine how each of these factors play a unique role in the response to JCOIN2 interventions focused on overdose prevention for women across different intercepts of the criminal legal system. The study will be guided by a scientific and community advisory board of women. Findings will make a significant impact regarding the effectiveness, implementation, and sustainability of innovative overdose prevention strategies among vulnerable, CLS-involved women.

Name Lead/Hub Collaborator Contacts Project Title Other Collaborators Type of Project
Margaret RoachCROSSROADS (Brinkley-Rubinstein_Duke)From Crisis Response to Prevention: Frontline Barriers and Facilitators to Expanding the Diversion and Deflection RoleQualitative Study

Prevention-oriented care is consistently identified as valuable yet consistently fails to become embedded in frontline systems whose main function is to address acute crisis. This CPP is grounded in the need to understand how frontline crisis workers move from merely a crisis-amelioration orientation to integrating preventative care into their scope of work; and what would make that expansion possible.. Throughout the JCOIN and CONNECT networks there are a suite of projects that have a focus on some aspect of crisis response. Therefore, we propose the following research questions: 1) Among crisis teams (broadly defined), what do they perceive as the feasibility, acceptability, and professional-role implications of expanding their scope from acute crisis response to proactive prevention services; 2) What organizational, regulatory, and professional-identity barriers (scope-of-practice constraints, liability concerns, training gaps, workflow incompatibility) do crisis teams identify as limiting this expansion? We will utilize semi-structured qualitative interviews with crisis teams across all partner sites participating in JCOIN and CONNECT network projects that engage in crisis-response, diversion, or deflection work. A shared interview guide will be developed collaboratively across contributing hubs so that questions are comparable across role types and settings, probing perceived feasibility, acceptability, and professional-role-identity implications of expanding into prevention services (RQ1), as well as the organizational, regulatory, and professional-identity barriers that limit that expansion (RQ2). Interviews will be audio-recorded, transcribed, and coded using a hybrid deductive-inductive approach: a shared codebook derived from the RQ1 and RQ2 constructs will guide initial coding, with inductive codes added to capture role- or site-specific facilitators and barriers.

Name Lead/Hub Collaborator Contacts Project Title Other Collaborators Type of Project
Faye TaxmanCTCLori Ducharme, Ginnie Sawyer-Morris, Michele Staton, Liz Evans, Josh Lee, David SmelsonLandscape Analysis of the Substance Use and Mental Health Service Delivery System Across Justice-Health InterceptsChestnut, ECHO, Friends Research Institute, Kentucky, MassJCOIN, NYU, RMC-SS, STAR-RSurvey

JCOIN’s fundamental focus is on improving receipt of evidence-based SUD services for individuals involved in the criminal legal system, both while they are detained and in the community. Fragmentation of services between the SUD treatment and public safety systems is well-documented. Part of that fragmentation stems from a lack of readily available information about local SUD service providers and the array of services available, which is a barrier to organizational partnerships and effective referral relationships.

The proposed study will develop a shared methodology to document the SUD and MH service delivery system in the communities or catchment areas of sites in the participating JCOIN projects. Each participating JCOIN Hub/Center will then apply that methodology to the intercept(s) and geographic areas (e.g., sites) relevant to their own projects. The study will characterize behavioral health infrastructure, organized around the cascade of care. For example, we will identify where SUD and MH assessments can be obtained, referral processes can be made, availability of MOUD and behavioral therapies, availability of other services, and indicators of provider quality (e.g., accreditation, licensure). Depending on data availability, analyses could be expanded to include local recovery support services, telehealth providers, general medical care, and/or services for related co-occurring conditions (e.g., HIV).

Additional information: https://gmu1.box.com/s/9ziqy6bn820g01f76yvjf0fu8am9w2u9
Comorbid Mental Health Faye Taxman 6/15/2026, 4pm ET Link
Stigma Danielle Rudes 6/26/2026, 9am ET Link
Workforce Carrie Pettus 6/26/2026, 10am ET Link
Comorbid Physical Tess Drazdowski 7/1/2026, 1:30pm ET Link
Rural Mike Gordon/ Anabelle Belcher 7/8/2026, 9am ET Link
Recovery Capital Carrie Pettus On hold
Digital Interventions Amy Murphy On hold
Drug Trends Helen Jack/ Joe Carpenter 6/29/2026, 4pm ET Link
Women Michele Staton 6/29/2026, 10am ET Link
Family/Social Support Carrie Oser 6/23/2026, 2pm ET Link
1115 Waivers Liz Evans 6/26/2026, 1pm ET Link
Implementation Science Dennis Watson/ Lisa Saldana 6/30/2026, 3pm ET Link
Practitioner Listening Session Jessica Hulsey 7/13/2026, 4pm ET Link Meeting Notes
Lived Experience Advisory Network DeAnna Hoskins 7/7/2026, 11am ET Link Meeting Notes Survey Link
Stigma Martha Tillson 7/10/26, 10:30am ET Link