Ignite Creation Date:
2024-05-06 @ 6:59 PM
Last Modification Date:
2024-10-26 @ 2:58 PM
Study NCT ID:
NCT05853289
Status:
RECRUITING
Last Update Posted:
2024-05-16
First Post:
2023-05-02
Brief Title:
Piloting a Web Resource for Pregnancy OUD in Jail
Sponsor:
Johns Hopkins University
Organization:
Johns Hopkins University
Study Overview
Official Title:
Piloting a Web-Based Implementation Resource for Pregnancy Opioid Use Disorder Care in Jail
Status:
RECRUITING
Status Verified Date:
2024-05
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
The goal of this clinical trial is to pilot an adaptable user-friendly web-accessible toolkit and implementation strategy for jails to be able to provide access to pregnancy-specific opioid use disorder OUD care The main question it aims to answer is
- What support and tools do jails that vary in size resources and health care delivery systems need for pregnancy care that can be tailored to the environment
Jail staff will use the implementation resource to provide care to pregnant people in and leaving custody through facilitated guidance While using the resource jail staff will
Complete 6-month and 12-month surveys assessing the participants use of the tool
Complete baseline 6-month and 12-month qualitative interviews assessing the participants perspectives on using the tool
Report de-identified jail outcomes data monthly on the pregnant people in the jails care
Report jail policy and financial data as it pertains to pregnant people with OUD at baseline Pregnant people with OUD in custody at pilot jails will be asked to participate in qualitative interviews as baseline and 1- and 6 months after release to assess the participants perspectives on the care received in jail and continuity of care
- What support and tools do jails that vary in size resources and health care delivery systems need for pregnancy care that can be tailored to the environment
Jail staff will use the implementation resource to provide care to pregnant people in and leaving custody through facilitated guidance While using the resource jail staff will
Complete 6-month and 12-month surveys assessing the participants use of the tool
Complete baseline 6-month and 12-month qualitative interviews assessing the participants perspectives on using the tool
Report de-identified jail outcomes data monthly on the pregnant people in the jails care
Report jail policy and financial data as it pertains to pregnant people with OUD at baseline Pregnant people with OUD in custody at pilot jails will be asked to participate in qualitative interviews as baseline and 1- and 6 months after release to assess the participants perspectives on the care received in jail and continuity of care
Detailed Description:
Ensuring jails provide access to medications for opioid use disorder MOUD and in ways that are tailored to the distinctive medical mental health and social structural aspects of care for pregnant people with OUD is essential for improving short and long-term pregnancy recovery and intergenerational outcomes This project will engage multiple stakeholders including directly impacted people to design then pilot a patient-centered and jail-feasible implementation strategy that will facilitate and enhance jails implementation of MOUD for pregnant people The strategy will contain a menu of tools to assist jails with immediate needs to provide MOUD to pregnant people entering jails with pregnancy-tailored counseling and with other support services and linkages to care that center the obstetrical psychosocial and structural needs of this population The implementation strategy will also be adaptable to a variety of types and geographies of jails The strategies will then be piloted at four jails with different baseline capacities and services for MOUD for pregnant people
Study Design The investigators will conduct this pilot study to assess feasibility of facilitation of use of a web-based resource bundle to help jail workers be able to implement programs and provide care for pregnant people with OUD PPwOUD The investigators will design the bundle and then the research team will train jail staff clinicians and administrators at 4 pilot sites on how to use each element of the website-- where things are and how to adapt it to the local environment The investigators will then measure implementation outcomes at the jail with staff and with implementing care practices as well as patient level outcomes
The investigators will do the pilot sequentially starting with two jails in cohort A and then six months later the two jails in cohort BThe investigators will follow the same procedures at each pair of sites
Pilot sites and champions The investigators will pilot the resource package at jails with combinations of different geography and availability of MOUD for pregnant people These strata allows for testing and refinement of the bundle tools to be useful to jails with differing local resources differing frequencies of encountering pregnant people and differing stages of providing MOUD for pregnant people While 3 sites provide MOUD in some capacity in pregnancy all have self-identified needs for enhancements due to lack of pregnancy specificity and numerous challenges in the care for pregnant people with opioid use disorder PPwOUD Pilot site 4 with no MOUD will be recruited through existing networks and as outlined in support letters with assistance of Sheriffs from confirmed pilot sites Each jail will identify 1-2 champions for the implementation effort eg nurse clinician social worker health admin
Facilitated delivery of the bundle The implementation strategy of facilitation provides human support to promote self-efficacy persistence and problem solving it is rooted in the notion that implementation is a social activity that reflects interpersonal relationships learning and peoples decisions in a relational context The team will adapt the integrated Promoting Action on Research Implementation in Health Services i-PARIHS facilitation checklist with a blended approach that includes external and internal facilitation At baseline the team will conduct in-person or video conference sessions dependent on jail location to orient pilot site champions jail staff and key community partners to the implementation strategy and bundle followed by monthly video-conference check-ins Modeling after the Network for the Improvement of Addiction Treatment NIATx process improvement model currently being tested at 48 jails The investigators will deliver well-structured mentoring and technical assistance to jails as to use the bundle to improve care and coordination for pregnant people with OUD NIATx is an organizational change approach that aims to gauge performance and improve processes by pairing a coach with a site to identify ways to implement change and monitor performance The investigators will incorporate regularly scheduled outreach to assist and assess competency of community partners eg probation parole child welfare services community opioid treatment providers with justice-involved pregnant populations The coaching will assist jail leaders and staff to identify local resources services agencies and tools that are relevant for that geographic setting This focus underlines that toolkits alone have limited impact on implementation outcomes and successful toolkits benefit from natural internal facilitation
The intervention is exposing jail staff to a web-based resource that the investigators will design for this study that contains practical evidence based information on clinical best practices adapted to jail settings for providing medications for OUD for pregnant women in custody AND that contains an implementation strategy for leaders to be able to implement programs
Study Design The investigators will conduct this pilot study to assess feasibility of facilitation of use of a web-based resource bundle to help jail workers be able to implement programs and provide care for pregnant people with OUD PPwOUD The investigators will design the bundle and then the research team will train jail staff clinicians and administrators at 4 pilot sites on how to use each element of the website-- where things are and how to adapt it to the local environment The investigators will then measure implementation outcomes at the jail with staff and with implementing care practices as well as patient level outcomes
The investigators will do the pilot sequentially starting with two jails in cohort A and then six months later the two jails in cohort BThe investigators will follow the same procedures at each pair of sites
Pilot sites and champions The investigators will pilot the resource package at jails with combinations of different geography and availability of MOUD for pregnant people These strata allows for testing and refinement of the bundle tools to be useful to jails with differing local resources differing frequencies of encountering pregnant people and differing stages of providing MOUD for pregnant people While 3 sites provide MOUD in some capacity in pregnancy all have self-identified needs for enhancements due to lack of pregnancy specificity and numerous challenges in the care for pregnant people with opioid use disorder PPwOUD Pilot site 4 with no MOUD will be recruited through existing networks and as outlined in support letters with assistance of Sheriffs from confirmed pilot sites Each jail will identify 1-2 champions for the implementation effort eg nurse clinician social worker health admin
Facilitated delivery of the bundle The implementation strategy of facilitation provides human support to promote self-efficacy persistence and problem solving it is rooted in the notion that implementation is a social activity that reflects interpersonal relationships learning and peoples decisions in a relational context The team will adapt the integrated Promoting Action on Research Implementation in Health Services i-PARIHS facilitation checklist with a blended approach that includes external and internal facilitation At baseline the team will conduct in-person or video conference sessions dependent on jail location to orient pilot site champions jail staff and key community partners to the implementation strategy and bundle followed by monthly video-conference check-ins Modeling after the Network for the Improvement of Addiction Treatment NIATx process improvement model currently being tested at 48 jails The investigators will deliver well-structured mentoring and technical assistance to jails as to use the bundle to improve care and coordination for pregnant people with OUD NIATx is an organizational change approach that aims to gauge performance and improve processes by pairing a coach with a site to identify ways to implement change and monitor performance The investigators will incorporate regularly scheduled outreach to assist and assess competency of community partners eg probation parole child welfare services community opioid treatment providers with justice-involved pregnant populations The coaching will assist jail leaders and staff to identify local resources services agencies and tools that are relevant for that geographic setting This focus underlines that toolkits alone have limited impact on implementation outcomes and successful toolkits benefit from natural internal facilitation
The intervention is exposing jail staff to a web-based resource that the investigators will design for this study that contains practical evidence based information on clinical best practices adapted to jail settings for providing medications for OUD for pregnant women in custody AND that contains an implementation strategy for leaders to be able to implement programs
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None
Secondary IDs
| Secondary ID | Type | Domain | Link |
|---|---|---|---|
| 1R34DA056014-01A1 | NIH | None | httpsreporternihgovquickSearch1R34DA056014-01A1 |