Research

JCOIN includes 13 clinical research centers (“Research Hubs”), that are studying evidence-informed approaches to ensure quality care is provided to individuals with opioid use disorder in justice settings, and two resource centers that conduct complementary studies and provide supportive infrastructure: the Coordination and Translation Center (CTC) and the Methodology and Advanced Analytics Resource Center (MAARC).

JCOIN Studies

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Research Translation

Breakdowns of research regarding substance use disorders within health and justice settings.

JCOIN Studies

Each JCOIN study brings researchers together with justice and health stakeholders in five or more communities to address gaps in opioid use disorder treatment and related services. Their work engages a wide range of justice settings, including jails, prisons, community corrections, problem-solving courts, and juvenile justice agencies. The studies evaluate behavioral interventions, digital therapeutics, comprehensive patient-centered treatments, and delivery of medications for opioid use disorder (MOUD) throughout the United States.

In 2018-2020, JCOIN supported 15 accelerator supplement projects, which included short-term studies and surveys.

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Understanding Perceptions, Barriers and Facilitators for COVID-19 Vaccination among Detention-based Healthcare Workers in 8 States (050)

Principal Investigator(s): Bruce Taylor

Correctional medical staff have been on the front lines of the current COVID-19 pandemic. Medical staff working in prisons and jails are responsible for providing healthcare in very challenging correctional environments. As county jails have been among the hotspots for COVID-19 related outbreaks, it is imperative to better understand perceptions of COVID-19 related risk, experiences…

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Teleservices in Judicially Led Diversion Programs: The Impact of COVID-19 on the Adoption of Remote Treatment and Recovery Services (048)

Principal Investigator(s): Tara Kunkel

J-RIG funding supports research into teleservice practices within Judicially Led Diversion Programs (JLDPs) since the pandemic. Judicially led diversion is an umbrella term that encompasses drug courts, opioid courts, and recovery-oriented compliance dockets. While these models differ in design, they share the common features of early intervention, supervision, consistent judicial oversight, and an emphasis on…

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Leveraging Social Networks to Increase COVID-19 Testing Uptake (046)

Principal Investigator(s): Kate Elkington

This study will research the efficacy and sustainability of a community-social network outreach model that partners infectious disease health providers with community-based organizations to successfully implement (reach, uptake, delivery and sustainment) COVID-19 point of service, rapid-testing among a highly vulnerable and often underserved population, those who use opioids and other substances. Two distinct social network…

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Connections Application for Recovery Engagement (CARE): Testing a Mobile App to Increase Recovery Engagement among Individuals Involved in the Criminal Justice System (047)

Principal Investigator(s): Jessica Hulsey

The success of digital therapeutics and telehealth are empirically well documented. What is less understood is what is needed to successfully adopt, sustain, and scale up these efforts in criminal justice settings to maximize both availability and effectiveness. Making evidence-based technology available to particularly vulnerable populations during the pandemic is important and justice-involved substance use…

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A Statewide Evaluation of the Implementation of Medications for Opioid Use Disorder in Vermont Correctional Facilities and the Impact of COVID-19 (049)

Principal Investigator(s): Elias Klemperer

Through the NIH Rapid Acceleration of Diagnostics Underserved Populations (RADx-UP) program, Yale University received a supplement to support a study to increase the reach, access, uptake, and impact of COVID-19 testing and to mitigate the impact of COVID-19 among incarcerated people and corrections staff. The initiative’s multidisciplinary team will be working with jails and prisons across Florida, Rhode Island, Minnesota, and Washington to address the urgent need for the development and implementation of long-term COVID-19 testing and prevention strategies. The long-term goal is to mitigate the impact of  COVID-19 in correctional facilities while considering the ethical issues that must be addressed to optimize implementation and effectiveness.

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COVID-19 Testing and Prevention in Correctional Settings (045)

Principal Investigator(s): Lauren Brinkley-Rubinstein, Emily Wang, Rosemarie Martin

Through the NIH Rapid Acceleration of Diagnostics Underserved Populations (RADx-UP) program, Yale University received a supplement to support a study to increase the reach, access, uptake, and impact of COVID-19 testing and to mitigate the impact of COVID-19 among incarcerated people and corrections staff. The initiative’s multidisciplinary team will be working with jails and prisons across Florida, Rhode Island, Minnesota, and Washington to address the urgent need for the development and implementation of long-term COVID-19 testing and prevention strategies. The long-term goal is to mitigate the impact of  COVID-19 in correctional facilities while considering the ethical issues that must be addressed to optimize implementation and effectiveness.

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Community Network-Driven COVID-19 Testing of Vulnerable Populations in the Central US (044)

Principal Investigator(s): Harold Pollack, John Schneider, Mai Pho

The University of Chicago received a supplement from NIH Rapid Acceleration of Diagnostics Underserved Populations (RADx-UP) program to support the Community Network-Driven COVID-19 Testing of Vulnerable Populations in the Central US (C3) project to evaluate a COVID-19 testing approach that combines Social Network Testing Strategy (SNS) with community-developed public health messages. This study will focus on addressing misinformation, stigma, and distrust about COVID-19 testing and prevention among two populations that have been particularly hard hit by the pandemic: individuals involved in the criminal justice system that are not currently incarcerated and low-income Latinx individuals. The study will be conducted in rural and urban sites across Texas, Louisiana, Arkansas, Indiana, and Illinois. The goal of this study is to address challenges of current COVID-19 testing strategies which are limited by misinformation, stigma, distrust, and limited affirmation of ability to prevent COVID-19.

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COVID-19 Mitigation Policies on Access to MOUD for Justice Involved Populations (043)

Principal Investigator(s): Rosemarie Martin

COVID-19 threatens to exacerbate the ongoing opioid epidemic in the United States, but the pandemic has also provided an opportunity to experiment with changes in how opioid treatment services are delivered around the country. The current pandemic has resulted in a flurry of unprecedented policy measures, and it is crucial to understand the impact that rapid changes in law, regulation, and policy are having on individuals with opioid use disorder (OUD), particularly those involved with the criminal justice system.

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Addressing Risk Through Community Treatment for Infectious Disease and Opioid Use Disorder Now (ACTION) Among Justice-Involved Populations (042)

Principal Investigator(s): Kevin Knight, Sandra Springer, Ank Nijhawan

Improving HIV and Opioid Use Disorder (OUD) management and implementation for criminal justice (CJ)- involved individuals requires effective approaches to screening, linkage and adherence to integrated services across community agencies and service providers. Community reentry represents a critical opportunity to link individuals to HIV prevention and treatment and OUD service providers. In response, Yale University is conducting a effectiveness-implementation random control trial study to compare two models [Patient Navigation (PN) or Mobile Health Unit (MHU) service delivery] of linking individuals recently released from prison and jail to the continuum of community-based HIV and OUD prevention and treatment service cascades of care.

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NIATx vs ECHO as Comparative Implementation Strategies (041)

Principal Investigator(s): Faye Taxman, Todd Molfenter

The trial will test two timely and successful evidence-based implementation practices, NIATx Coaching and Extension for Community Healthcare Outcomes (ECHO), with jail and community-based treatment providers to increase MOUD use with justice populations. NIATx Coaches provide expertise in MOUD implementation and organizational change to help treatment organizations and staff make, sustain, and spread MOUD. The ECHO platform focuses on the provider side by connecting primary care providers with expert MOUD prescribers to promote high-quality MOUD practices. This will be the first trial that assesses the comparative effectiveness of these approaches overall, and in justice settings.

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Reducing Opioid Mortality in Illinois (040)

Principal Investigator(s): Harold Pollack, John Schneider, Mai Pho

This study is conducting a multi-site trial called ROMI (Reducing Opioid Mortality in Illinois) to study the effectiveness of case management approaches to link individuals with community-based treatment services upon release from jail. The ROMI intervention includes peer recovery coaches to improve linkages to medications for opioid use disorder (MOUD), supportive services, naloxone distribution, and harm reduction services for justice-involved individuals with opioid use disorder (OUD).

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Using Implementation Interventions and Peer Recovery Support to Improve Opioid Treatment Outcomes in Community Supervision (039)

Principal Investigator(s): Damaris Rohsenow, Lauren Brinkley-Rubinstein, Rosemarie Martin

This study will rigorously test a systems-change approach for increasing the use of medications for opioid use disorder (MOUD) in seven community supervision sites in Rhode Island, North Carolina, and Pennsylvania. The study uses facilitated local change teams consisting of justice and community service providers to develop and implement interorganizational linkage strategies.

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Evaluation of Enhanced Primary Care and Opioid Use Disorder Treatment for Justice-involved Individuals Transitioning from Jail to Improve Opioid Treatment Cascade (038)

Principal Investigator(s): Emily Wang

The study will assess whether the Transitions Clinic Network (TCN) program, which provides enhanced primary care and OUD treatment for people recently released from incarceration, improves services along the opioid treatment cascade. In TCN, formerly incarcerated community health workers are embedded within primary care teams and address social determinants of OUD, provide social support, help patients build trust in the health system, and advocate in interactions with the criminal justice system.

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Implementation of an Opioid Treatment Linkage Model to Improve Cross-System Coordination in Community Supervision Settings (037)

Principal Investigator(s): Danica Knight, David Olson, Kevin Knight, Noah Painter-Davis

This study is testing two different strategies to implement an Opioid Treatment Linkage Model (O-TLM). The model is designed to link individuals under community supervision with appropriate community-based treatment services. O-TLM seeks to improve interagency collaboration through staff training and cross-system data sharing.

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Effectiveness of Implementing Learning Health Care System in Juvenile Justice Settings to Improve Coordination Among Justice Agencies and Community-based Services (036)

Principal Investigator(s): Matt Aalsma

This study aims to improve treatment linkages and care coordination within the eight juvenile justice systems across Indiana. To address current gaps, the study is implementing a Learning Health System (LHS) to improve collaboration between juvenile justice agencies and community mental health centers, using interagency data-sharing to help identify gaps and opportunities to implement evidence-based interventions.

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Comparison of Long-acting Buprenorphine (Sublocade) and Naltrexone Opioid Treatments Among Justice-involved Individuals Leaving Jails (035)

Principal Investigator(s): David Farabee, Elizabeth Waddell, Josh Lee, Lisa Marsch, Robert Schwartz, Sandra Springer

This study is conducting a large multisite trial to compare the effectiveness of extended-release buprenorphine (Sublocade, XR-B) to extended-release naltrexone (XR-NTX). The trial will enroll individuals prior to release from jail and randomize to either medication option. The first dose of medication will be administered prior to release, with an additional 24 weeks of treatment received in the community.

Participating jails are located in Connecticut, Delaware, New Hampshire, New Jersey and Oregon. The study will measure retention in treatment, and opioid and other substance use outcomes between the two medication conditions, as well as a sample of individuals who opt for other treatment options (“treatment as usual”).

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A Comparative Effectiveness Trial of Extended-release Naltrexone and Extended-release Buprenorphine (Brixadi) with Individuals Leaving Jail (034)

Principal Investigator(s): Mike Gordon, Shannon Mitchell

This study is conducting a comparative effectiveness trial of extended-release naltrexone (XR-NTX) versus a new extended-release formulation of buprenorphine (Brixadi, XR-B) to treat opioid use disorder (OUD) among justice-involved individuals in ten Maryland county jails.

Participants will be randomly assigned to receive either XR-NTX or XR-B prior to release from jail, followed by six monthly injections while in the community. The goal of the study is to evaluate the effectiveness of the two medications, measure medication adherence, and gather data to inform broader scale-up of medications for opioid use disorder (MOUD) in jails and in the community.

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Improving Retention across the Opioid Use Disorder Service Cascade upon Re-entry from Jail using Recovery Management Checkups (033)

Principal Investigator(s): Chris Scott

This study is comparing the effectiveness of the Recovery Management Checkups (RMC) model, an evidence-based intervention that provides regular, fixed schedule check-ups to support treatment retention and recovery, and an adaptive model (RMC-Adapted) that tailors checkup frequency and intensity to individuals’ needs. Each condition offers justice-involved individuals referral or assertive linkage to a designated treatment provider upon release from jail.

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Evaluation of Massachusetts Policy Mandating all Medication for Opioid Use Disorders in Jails (032)

Principal Investigator(s): Liz Evans, Peter Friedmann

A 2018 Massachusetts law (“Chapter 208”) established a 4-year pilot program to expand the use of all FDA-approved forms of medications for opioid use disorder (MOUD) at five county jails; two additional jails voluntarily joined this pilot. The law stipulates that MOUD be maintained in individuals who were already receiving it prior to detention; initiated prior to release from jail when appropriate; and continued in the community via facilitated linkages to local services after release. The Massachusetts Hub will conduct a longitudinal treatment outcome study of individuals in these jails to examine MOUD initiation, engagement and retention, as well as fatal and non-fatal overdose and recidivism. The study will also identify strategies associated with the successful implementation of MOUD and inform the development of future strategies to address opioid use disorder in jails nationwide.

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Facilitating Opioid Care Connections through System Level Strategies to Improve Use of Medications and Linkages to Care Drug Courts across New York (031)

Principal Investigator(s): Kate Elkington, Milton Wainberg, Ned Nunes

This study is evaluating strategies to implement New York’s new opioid court model (OCM) in ten counties across the state. New York’s OCM was developed by the Unified Court System and provides practice guidelines for drug courts to reduce overdose, decrease recidivism, and improve service delivery and linkages to medications for opioid use disorder (MOUD) for justice-involved individuals across the state. The goal of the study is to develop, evaluate, and refine implementation strategies to support the OCM practice guidelines to be scaled up across New York.

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