The current study proposes to use a Hybrid Type 3 implementation research strategy to: 1) Significantly enhance our understanding of public health outcomes \[e.g., overdose incidents and substance-use (SU)-related Emergency Medical Service (EMS) contacts\] and public safety outcomes (e.g., drug-related arrests) associated with Deflection and Pre-Arrest Diversion initiatives (DPAD, hereafter referred to as Deflection); and 2) Create a lasting contribution to the fields of research focused on SU and the criminal legal system (CLS) by advancing knowledge of effective implementation strategies involving the critical role of community engagement in Deflection. The highly experienced team of Multiple PIs, senior-level collaborators from both Deflection and Community Behavioral Health (CBH), state-level evaluation partners, a national stakeholder advisory group, and CLS and behavioral health partners within each community have teamed up to carry out the proposed project. The study approach uses a hybrid implementation-effectiveness design to examine strategies to improve opioid and stimulant relevant outcomes, and specifically proposes to test the implementation-effectiveness of 2 strategy bundles to promote Deflection models through a CORE community engagement bundle (designed to facilitate community stakeholder engagement) and ENHANCED community engagement bundle (CORE plus a component to systematically involve community advocates) on improving implementation as well as public safety and health outcomes. The proposed randomized control trial includes a total of 20 geographically distinct clinical research performance sites (i.e., 20 communities spanning 5 states; New Mexico, Illinois, Wisconsin, Colorado, and Pennsylvania), with 3-5 communities per state and the inclusion of key CLS and CBH stakeholders within each site. The large scope of the project will maximize potential generalizability of study results and sustainability of implementation strategies.
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public health and safety collaboration
Timeframe: Month 10, 26, and 38 for Wave1; Month 14, 30, and 42 forWave 2
citizen awareness and perceived utility of Deflection
Timeframe: Month 10, 26, and 38 for Wave1; Month 14, 30, and 42 forWave 2
deflection workforce referrals and citizen enrollments in Deflection
Timeframe: Month 10, 26, and 38 for Wave1; Month 14, 30, and 42 for Wave 2
overdose and SU related mortality
Timeframe: Month 4-38 for Wave 1; Month8-42 for Wave 2
service access along the full substance use cascade
Timeframe: Month 4-38 for Wave 1; Month8-42 for Wave 2