Journal of consulting and clinical psychology · 2026
Legal outcomes of task-shifting contingency management for youth substance use to rural probation officers: Secondary results from a randomized clinical trial.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
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Sheidow Ashli J, Drazdowski Tess K, Chapman Jason E, McCart Michael R
Аннотация
OBJECTIVE: Youth substance use disorder is a significant problem in rural communities, yet treatment access is negligible. Task-shifting evidence-based treatments to juvenile probation officers (JPOs) may help, but could increase surveillance and thus be iatrogenic for legal outcomes. Task-shifting contingency management (CM) to JPOs was examined for increased youth legal system consequences.
METHOD: Data were from a randomized clinical trial that randomized 32 JPOs in Idaho to probation as usual (PAU) or family-based CM integrated into probation. Then, 160 youth with substance use disorder on probation were randomized to JPOs delivering PAU or JPO-delivered CM. Legal system records (charges and detentions) spanning 18 months before and after randomization were obtained for each youth from the state database.
RESULTS: For CM and PAU groups, respectively, 32.6% versus 51.4% had at least one charge postrandomization, 22.1% versus 20.3% had at least one detention, and median charge count was 0.0 (interquartile range, 0.0-1.0) versus 1.0 (interquartile range, 0.0-2.0). Intent-to-treat generalized linear mixed effects models nested youth within JPOs. Groups did not differ on charge count (event rates = 1.12; 95% CI [0.29, 4.36]) or likelihood of detention (OR = 1.54; 95% CI [0.65, 3.65]). However, CM youth had a significantly lower likelihood of receiving a charge (OR = 0.42; 95% CI [0.21, 0.83]), with a predicted probability of 31% (95% CI [21%, 42%]) versus 52% for PAU (95% CI [40%, 63%]).
CONCLUSIONS: Youth legal system consequences do not worsen when JPOs deliver CM. The likelihood of a new charge actually decreases when JPOs deliver CM. Task-shifting CM for youth substance use to JPOs could increase treatment access in rural communities. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
METHOD: Data were from a randomized clinical trial that randomized 32 JPOs in Idaho to probation as usual (PAU) or family-based CM integrated into probation. Then, 160 youth with substance use disorder on probation were randomized to JPOs delivering PAU or JPO-delivered CM. Legal system records (charges and detentions) spanning 18 months before and after randomization were obtained for each youth from the state database.
RESULTS: For CM and PAU groups, respectively, 32.6% versus 51.4% had at least one charge postrandomization, 22.1% versus 20.3% had at least one detention, and median charge count was 0.0 (interquartile range, 0.0-1.0) versus 1.0 (interquartile range, 0.0-2.0). Intent-to-treat generalized linear mixed effects models nested youth within JPOs. Groups did not differ on charge count (event rates = 1.12; 95% CI [0.29, 4.36]) or likelihood of detention (OR = 1.54; 95% CI [0.65, 3.65]). However, CM youth had a significantly lower likelihood of receiving a charge (OR = 0.42; 95% CI [0.21, 0.83]), with a predicted probability of 31% (95% CI [21%, 42%]) versus 52% for PAU (95% CI [40%, 63%]).
CONCLUSIONS: Youth legal system consequences do not worsen when JPOs deliver CM. The likelihood of a new charge actually decreases when JPOs deliver CM. Task-shifting CM for youth substance use to JPOs could increase treatment access in rural communities. (PsycInfo Database Record (c) 2026 APA, all rights reserved).