College of Social Work, The Ohio State University, 208 Stillman Hall, 1947 College Road, Columbus, OH, 43210, USA.
School of Social Work, University of Michigan, Ann Arbor, MI, USA.
BMC Public Health. 2021 Apr 23;21(1):780. doi: 10.1186/s12889-021-10668-1.
Across Ohio, parental substance abuse has contributed to a marked increase in the number of children in foster care. Children exposed to parental substance use have a higher likelihood of physical abuse and neglect, and consequently a variety of physical, psychological and cognitive problems. 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.
EPIC is a quasi-experimental study. Under the program, child welfare-involved adults who screen positive for substances are matched with a peer recovery supporter. Participants are also incentivized to participate in family treatment drug court, medications for opioid use disorders and home-based parenting supports. Participating adults (N = 250) are matched with comparison groups from counties participating in a separate intervention (Ohio START) and to those receiving treatment as usual, resulting in a final sample of 750 adults. Primary outcomes including addiction severity, child trauma symptoms, resilience, and attachment are assessed at baseline and at program completion. Additional outcomes include timely access to treatment services, length of placement in out-of-home care and recidivism into the child welfare system.
This intervention formalizes cross-system collaboration between child welfare, behavioral health and juvenile courts to support families affected by addiction. The use of three evidence-based or evidence-informed strategies presents the opportunity to determine specific strategies that are most effective for reducing addiction severity. Lastly, the intervention combines several sources of funding to bolster sustainability beyond the life of the Regional Partnership Grant (RPG).
NCT04700696 . Registered January 7, 2021-retrospectively registered.
在俄亥俄州，父母的药物滥用导致寄养儿童的数量显著增加。接触过父母药物使用的儿童更有可能遭受身体虐待和忽视，因此会出现各种身体、心理和认知问题。增强儿童和家庭的永久性（EPIC）计划是俄亥俄州立大学社会工作学院、俄亥俄州就业和家庭服务部的两个县办公室、两个少年法庭和当地行为健康机构之间的合作努力。EPIC 的目标是使用三种基于证据和循证的实践来减少虐待和忽视父母的行为，减少父母的成瘾严重程度，并改善因药物滥用而涉及儿童福利系统的家庭的永久性结果。
EPIC 是一项准实验研究。根据该计划，对药物筛查呈阳性的涉及儿童福利的成年人与同伴康复支持者相匹配。参与者还被激励参加家庭治疗毒品法庭、治疗阿片类药物使用障碍的药物和基于家庭的育儿支持。参与的成年人（N=250）与参与单独干预（俄亥俄州 START）的县的对照组以及接受常规治疗的成年人相匹配，最终样本为 750 名成年人。主要结果包括成瘾严重程度、儿童创伤症状、恢复力和依恋，在基线和项目完成时进行评估。其他结果包括及时获得治疗服务、在家庭外照料中的安置时间和重新进入儿童福利系统的累犯率。
这种干预措施正式建立了儿童福利、行为健康和少年法庭之间的跨系统合作，以支持受成瘾影响的家庭。使用三种基于证据或循证的策略为确定最有效地降低成瘾严重程度的具体策略提供了机会。最后，该干预措施结合了几种资金来源，以增强区域伙伴关系赠款（RPG）之外的可持续性。
NCT04700696。2021 年 1 月 7 日注册——回顾性注册。
