Wraparound for High-risk Families with Substance Use Disorders: Examining Family, Child, and Parent Outcomes

Completed · Not applicable

Conditions studied: Substance-Related Disorders, Depression, Stress Disorders, Post-Traumatic, Child Abuse, Child Neglect

In brief

The investigators propose a Hybrid Type 1 effectiveness-implementation quasi-experimental trial. Participants are drawn from two different communities contemporaneously. The intervention participants in one community receive a Wraparound intervention. Comparison group participants drawn from a second matched community receive treatment as usual. With this design, the investigators aim to study outcomes associated with the intervention as well as explore important facilitators and barriers associated with the implementation and other factors associated with reach / participation, engagement and acceptability. Wraparound is a structured 12-month family-driven "process" that is guided by family goals, includes a team of supports to wrap around families, and coordinates care for families. Wraparound has been primarily delivered and tested with families of older-age children with severe emotional and behavioral needs in an attempt to prevent residential placement. The investigators are interested in testing the model in a sample of families (n=160) affected by substance use disorders who have children placed outside the home or are at risk of such placement. The investigators hypothesize that families receiving Wraparound will obtain better parenting and family functioning outcomes (primary outcome); child safety, permanency, and well-being; and parental recovery than families receiving treatment as usual. The investigators will also explore factors associated with higher levels of engagement and outcomes, including family characteristics, referral sources and hand-off, and similarly, explore barriers and facilitators associated with engagement and/or outcomes.

Key facts

Study ID

NCT04637581

Run by

Dartmouth-Hitchcock Medical Center

People needed

73

Starts

2020-11-16

Expected to finish

2024-09-30

Last updated by the study team

2024-11-12

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: accepted.

You may qualify if…

• Expecting parent or parent/guardian of children birth to age 17 where one or both parents report or screen positively for a substance use disorder (SUD) within the past year, excluding tobacco or cannabis/marijuana as the primary substance.
• For court guardianship cases and cases where children are in foster care, where one or both birth parents have a substance use disorder, a birth parent is willing to consent to make a good faith effort to be part of the Wraparound process and complete recovery measures.
• Child(ren) in out-of-home placement or at risk for out of home placement; "at risk" means: 1) strongly considered or have made reports to the New Hampshire Division of Children Youth and Families or the child would be at high risk of removal if not for the intervention. In addition, for guardianship cases, the child's placement with the guardian needs to be at risk for disruption.
• Parent/guardian is age 18 or older.
• Parent/guardian has cognitive capacity to consent to research.
• For intervention: Parent/guardian lives in Sullivan or Lower Grafton counties in New Hampshire (Division of Children Youth and Families Claremont District Office catchment area) or Windsor, upper Windham, and lower Orange County, VT (Hartford and Springfield VT Department of Children and Families district office catchment areas). For the comparison group, parents live within the catchment area of the Keene, NH DCYF district office (Cheshire County, NH and surrounding towns). Parents do not have plans to move outside of these towns within the next 12 mo. *If the parent lives within the catchment area, and the child is placed outside of the catchment area, the foster parent (outside of catchment area) must be willing to make a good faith effort to be involved with the Wraparound process and complete the child well-being measures.

You may not qualify if…

• Exclude if at time of eligibility assessment into the study, the Termination of Parental Rights (TPR) hearing is scheduled. *If the termination hearing is scheduled later, during the course of the intervention, the investigators will continue working with the child(ren) or family if the new guardian with legal authority to consent to the study consents.
• Exclude if the child is in residential care and there is no plan for the child to return home within 2 months.
• Exclude if the parent/guardian is in residential treatment and there is no plan for the parent/guardian to return home within 2 months.
• Exclude if the parent/guardian lacks the cognitive capacity to provide informed consent to research.

Where it is running

• Dept of Children Youth and Families — Claremont, New Hampshire, United States
• NH Claremont District Family Courts — Claremont, New Hampshire, United States
• TLC Family Resource Center — Claremont, New Hampshire, United States
• Dartmouth-Hithcock — Lebanon, New Hampshire, United States

Full record on ClinicalTrials.gov

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