Skip to main content
OpenTrials
Completed

NCT Number: NCT04700696

Enhancing Permanency in Children and Families

The Enhancing Permanency in Children and Families (EPIC) program is a collaborative effort between the Ohio State University College of Social Work, two county offices of the Ohio Department of Job and Family Services, two juvenile courts and local behavioral health agencies. The goal of EPIC is to use three evidence-based and evidence-informed practices to reduce abusive and neglectful parenting, reduce addiction severity in parents, and improve permanency outcomes for families involved with the child welfare system due to substance abuse.

Completed

Looking for future studies?

Notify Me

Key information

Conditions

Substance Abuse Chemically-Induced Disorders Child Abuse Mental Disorders Neglect, Child Substance Use Substance-Related Disorders

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

The Ohio State University

Columbus, Ohio, 43210, United States

About this study

Funded by the federal Regional Partnership Grant (RPG) Program, the Enhancing Permanency in Children and Families (EPIC) is a partnership between child welfare, juvenile count and behavioral health to holistically address substance misuse and associated parenting needs of child welfare-involved families. The overall goals and objectives of the intervention are to 1) Increase timely access to services among substances abusing parents involved in the child welfare system in Fairfield and Pickaway counties, 2.Enhance child safety and improve permanency and 3. increase child, parent, and caregiver well-being.

Eligible participants are matched with peer recovery supporters who mentor parents through the process. Parents are also referred to Family Treatment Drug Court (FTDC) with the option to receive Medications for Opioid Use Disorders (MOUD), and lastly when children are placed at home with parents or with kinship caregivers, relational skill building services that include financial assistance for child care, respite and transportation services. EPIC participants receive substance abuse and behavioral health treatment services through local providers including from two partner agencies: Integrated Services for Behavioral Health and Ohio Guidestone.

Data collection: Participating parents complete a pretest at baseline and up to 5 post-tests at 6 month intervals. Parents complete questions related to themselves (e.g. Addiction Severity Index, CES-D) and for one focal child (e.g. CBCL).

To evaluate EPIC, a quasi-experimental design will be employed through a two-stage sampling procedure. This design provides the ability to assess (1) the effects of EPIC on access to services for the families in the two intervention counties, and (2) the independent effects of additional services provided under EPIC that may be over and above Ohio START (an intervention administered through the Public Children Services Association of Ohio) and treatment as usual (TAU). In the first stage, two comparison counties will be identified for each of the two intervention counties. One comparison county will be part of the Ohio START program while the second will be a county that has no major interventions to address substance use among child welfare families. Counties are matched based on child population size, rate of child protective services referrals, percent of naloxone administrations per adult population, percent white, percent poverty, child welfare tax levy, and to the extent possible, behavioral health service availability. During the second stage, EPIC families are matched with substance using families in each of the comparison counties.

Parents may consent to one or all three components of EPIC based on the specific needs of each family, however all parents receive intensive case management services, including frequent home visits from caseworkers and peer recovery supporters.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Child welfare involvement
  • Substance use is primary reason for child welfare involvement (a score or 3 or more on UNCOPE assessment or a positive drug screen)

Exclusion criteria

  • Possible substance use, though not primary reason for child welfare involvement
  • incarcerated parents (may enroll after release)

Treatment and study plan

Peer Recovery Support

Behavioral

Weekly visits with peer who has lived experience related to child welfare and addiction

Family Treatment Drug Court with Medications for Opioid Use Disorders (MOUD)

Behavioral

Incentivized to participate in Family Treatment Drug Court with option for Medications for Opioid Use Disorders (MOUD)

Relational Skill Building based on the Nurturing Parenting Program (NPP)

Behavioral

Home-based parenting support

Primary outcomes

  1. Time from opening of child welfare case to SUD screening

    Time frame: Within 30 days of program entry

    Measures: 1) Child welfare case open date; 2) UNCOPE assessment screening date Analyses: We will use T-tests to estimate mean differences in the length of time from entry into child welfare and SUD screening for EPIC participants in comparison to Ohio START and treatment as usual.

  2. Time from opening of child welfare case to trauma screening

    Time frame: Within 30 days of program entry

    Measures: Time from opening of child welfare case to trauma screening will be estimated using 1) child welfare case open date; 2) ACEs assessment date for adults or 3) CTAC assessment dates for children.

    Analyses: We will use t-tests to estimate mean differences in the length of time from entry into child welfare and trauma screening for EPIC participants in comparison to Ohio START and treatment as usual.

  3. Change in wait time between referral to addiction treatment services and initiation of services.

    Time frame: Within 30 days of entering child welfare system

    Measures: Change in wait time will be estimated using service referral and service initiation dates.

    Analyses: We will use t-tests to estimate mean differences in the length of time between SUD treatment service referral and service initiation for EPIC participants in comparison to Ohio START and treatment as usual.

  4. Change in addiction severity among participating parents

    Time frame: At program entry and again at program completion. An average of I year

    Measures: Addiction Severity Index-Self Report (ASI-SR) Analyses: A paired sample t-test will be conducted to examine the change in mean scores on the ASI-SR pre and post participation.

  5. Change in resilience in children

    Time frame: At program entry and again at program completion. An average of I year

    Measures: Resilience in children is measured using the Protective Factors Survey (PFS) Analyses: A paired sample t-test will be conducted to examine change in mean scores on the PFS pre and post participation.

  6. Change in child behavior

    Time frame: At program entry and again at program completion. An average of I year

    Measures: The Child Behavior Checklist (CBCL) is used to screen for emotional, behavioral and social problems among children.

    Analyses: A paired sample t-test will be conducted to examine change in mean scores on the CBCL pre and post participation.

  7. Change length of stay in out-of-home placement for children in EPIC program compared to substance-affected families not receiving EPIC.

    Time frame: Through program completion, an average of 1 year.

    Data source: Statewide Automated Child Welfare Information System (SACWIS), obtained twice a year through study completion.

    Measures: Length of stay in out-of-home placement will be operationalized using placement dates obtained in SACWIS.

    Analyses: Survival analysis will be utilized to study outcome measures (e.g., length of stay in out-of-home placement) Due to the likelihood of censored measures when we have families who are still involved in the child welfare system, particularly for families who enter the system near the end of the study period, we will use survival analysis to estimate treatment effects on length of stay in out of home placement in comparison to Ohio START and treatment as usual families.

  8. Change in reunification among families involved in EPIC compared to substance-affected families not receiving EPIC.

    Time frame: Through program completion, an average of 1 year.

    Data source: Statewide Automated Child Welfare Information System (SACWIS), obtained twice a year through study completion.

    Analyses: Logistic regression will be used to estimate treatment effects on in comparison to Ohio START and treatment as usual.

  9. Change in subsequent child welfare involvement among parents receiving EPIC compared to substance-affected families not receiving EPIC

    Time frame: Through completion of 5 year study. For participants, up to 4 years following program participation, depending on time of enrollment

    Data source: Statewide Automated Child Welfare Information System (SACWIS), obtained twice a year through study completion.

    Measures: Subsequent child welfare entry (yes/no) is measured using re-entry dates in SACWIS.

    Analyses: Logistic regressions will be used to estimate treatment effects on subsequent child welfare involvement in comparison to Ohio START and treatment as usual.

Sponsors and collaborators

Lead sponsor

Ohio State University

Other

Collaborators

  • Children's Bureau - Administration for Children and Families
  • Fairfield County Job and Family Services
  • Fairfield County Juvenile Court
  • Integrated Services for Behavioral Health (ISBH)
  • Ohio Guidestone
  • Pickaway County Job and Family Services
  • Pickaway County Juvenile Court

Registry information

Acronym: EPIC

Important dates

Study start
2017
Primary completion
2023
Study completion
2023
First posted
Jan 8, 2021
Registry last updated
Jan 23, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Related clinical trials

Published trials that share one or more normalized conditions with this study.