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Current Research Projects (by Expiration Date in Descending Order)

Title Treating Rural Adult Clients with Technology (TRACT)
Principal Investigator Lora L. Passetti, M.S. 
Funded By Center for Substance Abuse Treatment (CSAT)
Grant Number 1H79TI026425-01
Project Period September 30, 2016 - September 29, 2019
Abstract Research shows that rural residents with substance use disorders have more barriers to accessing outpatient and continuing care treatment than those who live in urban areas. Chestnut Health Systems proposes to enhance its capacity to provide evidence-based substance use treatment for rural adults through the use of a combination of tele-health and web-based treatment services to deliver the Community Reinforcement Approach. The population of focus for the proposed “Technology-Based Treatment” project is rural adults who reside in underserved areas within 11 counties located in central Illinois who are: 1) admitted to outpatient treatment for substance use disorders; OR 2) discharged from residential treatment for substance use disorders and admitted to continuing care. Based on existing data, we anticipate that rural participants in this project will have the following characteristics: 45% female, 3% African American, 4% Hispanic, and 3% Other. Average age will be 32 years old. Sixty-five percent will be involved with the criminal justice system, 31% employed, 51% using alcohol weekly, 31% using marijuana weekly, 25% using cocaine weekly, 11% using heroin weekly, 70% presenting with symptoms of Major Depressive Disorder, and 50% presenting with symptoms of generalized anxiety disorder. The four primary goals of this project are to: 1) share effective treatment models and results among providers; 2) increase engagement of persons in treatment in their health care; 3) increase monitoring and tracking of the health status of individuals; and 4) improve recovery and resiliency rates. These goals will be achieved by implementing the project’s measurable objectives as defined by the Washington Circle Group: increase continuity of care after assessment; increase continuity of care after residential discharge; increase treatment initiation; and increase treatment engagement. We plan to serve 76 unduplicated individuals in year 1, 98 unduplicated individuals in year 2, and 87 unduplicated individuals in year 3. Thus, over the course of the three-year project, we plan to serve a total of 261 unduplicated adults living in rural areas of central Illinois. In addition to improving the availability, accessibility, and acceptability of and rates of retention in treatment for rural populations with substance use disorders in central Illinois, this project is significant in that it seeks to substantially improve compliance with national Washington Circle performance standards, as well as improve dissemination of technology-based treatment to other rural areas of the United States.

Title Using Smartphones to provide Recovery Support Services
Principal Investigator Christy K. Scott, Ph.D.
Funded By National Institute on Drug Abuse (NIDA)
Grant Number R01 DA035879
Project Period May 1, 2014 - February 28, 2019
Abstract The primary goal of the proposed trial is to examine the effect of combining more frequent self-monitoring via EMAs and automated interventions via Ecological Momentary Interventions (EMIs) provided by A-CHESS, on days of abstinence from drugs and alcohol and HIV risk behaviors over 6 months following treatment discharge. We will recruit 400 participants at discharge (both planned or unplanned) from Illinois’ largest treatment organization and randomly assign them in a 2 x 2 factorial design to receive EMA only, EMI only, combined EMA+EMI, or neither (control). Participants in the 3 EMA and EMI groups will receive a smartphone and training after discharge. To help them self-monitor, individuals in the EMA groups will be randomly signaled 6 times daily for 6 months and asked to record their recent substance use, HIV risk behaviors (e.g., needle use, unprotected sex) and exposure to internal and external protective and risk factors, then to rate the extent to which these factors support their recovery or make them want to use drugs or alcohol. Individuals in the EMI groups will have 24/7 access to A-CHESS. In the combined EMA+EMI group, participants will receive feedback directly following completion of each 2-3 minute EMA, and EMA responses will be used to encourage EMI utilization. The AIMS of this experiment are to: Aim 1. Test the effect of EMA, EMI and EMA+EMI on days of abstinence; Aim 2. Test the effect of EMA, EMI and EMA+EMI on HIV risk behaviors; and Aim 3. Evaluate the extent to which changes in days of abstinence mediate the effect of EMA, EMI, and EMA+EMI on HIV risk behaviors.
Title Illinois Access to Recovery - IV (ATR IV)
Contracted From Illinois Department of Human Services (IDHS)
Evaluator Christy K. Scott, Ph.D.
Evaluator Site Lighthouse Institute, Inc. - Chicago
Funded By Center for Substance Abuse Treatment (CSAT)
Grant Number TI023111
Project Period October 1, 2014 - September 30, 2018
Abstract The Access to Recovery (ATR) Program is designed to provide client choice among substance abuse clinical treatment and recovery support service providers, expand access to a comprehensive array of clinical treatment and recovery support options (including faith-based programmatic options), and increase substance abuse treatment capacity. The Care Coordination services includes: establishing a relationship with the participant beginning at enrollment, 30- and 90-day calls to check in with the participant about whether the participant needs additional services or referrals and then making the referrals and/or re-linking them to ATR enrolling site, tracking the participant for 6 months; and completing the 6-month GPRA and client satisfaction interview with the participant.
Title Juvenile Justice - Translational Research on Interventions for Adolescents in the Legal Systems (JJ-TRIALS) Coordinating Center to Reduce Substance use, HIV Risk Behaviors, & Crime
Principal Investigator Michael L. Dennis, Ph.D., Christy K. Scott, Ph.D.
Funded By National Institute on Drug Abuse (NIDA)
Grant Number U01 DA036221
Project Period July 1, 2013 - June 30, 2018
Abstract Through the Coordinating Center (CC) and six Research Centers (RCs), the cooperative will seek to improve the continuum of evidence-based services available to youth within the juvenile justice system. The Coordinating Center’s aims are to 1) conduct a national survey of juvenile justice agencies that provides a context and comparison standard for the TRIALS pre-implementation needs assessment and subsequent implementation studies; 2) coordinate each Research Center’s pre-implementation needs assessment; 3) develop and manage a common data base infrastructure for cross-site research implementation studies, and 4) provide communications and logistical support. To examine the needs and services provided to youth on community supervision, the CC was responsible for conducting a national survey of juvenile justice agencies, behavioral health agencies, and judges. The survey was conducted with a sample of 20 states and 192 counties, which were randomly selected based on the size of their adolescent population. The survey objectives were to a) Identify screening and assessment tools and procedures currently being used; b) Identify what services are available and to whom; c) Identify evidence-based practices being used; d) Determine the extent to which services are integrated; e) Determine the extent to which youth and families utilize the different types of services; f) Assess the availability and efficacy of linkage/referral services; g) Inquire about the presence of administrative data systems to monitor service implementation and outcomes. The CC will conduct the survey again in 2017 using the same sample of states and counties to measure outcomes.
Title Effectiveness of Volunteer Telephone Continuing Care (VTCC) for Adolescents with Alcohol and Other Drug Use Disorders
Principal Investigator Mark D. Godley, Ph.D.
Funded By National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Grant Number R01 AA021118-01A1
Project Period December 15, 2012 - November 30, 2017
Abstract The main goal of this study is to evaluate the effectiveness of Volunteer Telephone Continuing Care for adolescents after discharge from residential substance use treatment in terms of reducing relapse to substance use and substance-related problems and increasing involvement with pro-recovery peers and activities.

Title Pathways to Recovery: Older Substance Users
Principal Investigator Christy K. Scott, Ph.D.
Funded By National Institute on Drug Abuse (NIDA)
Grant Number R01 DA 15523
Project Period March 1, 2010 - June 30, 2017
Abstract Historically, the majority of people with substance use disorders in the US has been under age 50. This trend is changing as baby boomers, many of whom are former and current substance users, are entering their 50s and 60s, and their demand for treatment is expected to double for the second time by 2020. Consequences of addiction are expected to interact with vulnerabilities associated with natural aging. While rates of long-term recovery increase with age, many will continue to relapse and interact with treatment systems lacking in age-appropriate services. Chiefly missing is an empirical basis to inform service development and delivery. Few long-term studies of individuals with chronic addiction and treatment histories exist; even fewer elucidate the interface between chronic addiction and aging. This study targets this gap by capitalizing on a previous NIDA-funded longitudinal study that recruited 1,326 people presenting to publicly funded substance abuse treatment between 1996 and 1998 and re-assessed 9 times through 2007 (90%+ retention/wave). The original gender-balanced sample consisted largely of ethnic minority members with chronic histories of polysubstance use including cocaine (64%), alcohol (44%), opioids (41%), or marijuana (14%). At intake, the mean age was 35 years (4% 50+), at 9 years it was 44 (18% 50+), at the start of the proposed study it will be 49 (42% 50+) and at the close 54 (53% 50+). This project will extend the original study by adding annual interviews at 14, 15, 16, 17, and 18 years post intake to establish one of the longest and largest treatment cohort studies of its type to date. The cohort’s comprehensive history, captured in earlier waves, paired with new prospective information, offers a cost-effective and rare opportunity to identify factors to help minimize the burden of aging on the substance use and heath fields. Study aims are to (1) determine if there are age-related changes in the predictive value of factors expected over time to increase (e.g., age of first use, number of sober friends, treatment received) and decrease (e.g., severity, mental distress and legal involvement) the likelihood of initiating abstinence in the next 12 months; (2) determine if there are age-related changes in the predictive value of factors expected over time to increase (e.g., prior abstinence, being female, self-help engagement) and decrease (e.g., number of prior treatment episodes, homelessness, and number of arrests) the likelihood of maintaining abstinence another 12 months; (3) to test whether there are age-related changes in the predictive value of variables expected over time to decrease (e.g., loss, grief, functioning, disability) and increase (e.g., activity level, quality of life, social support) the time from 3 years of abstinence to late stage relapse; and (4) to evaluate whether there are age-related changes in the impact of the cumulative pattern of recovery on future critical positive and negative health outcomes (e.g., quality of life, functioning, disability, death).
Title Evidence-Based Treatment (EBTx) Center
Director Mark D. Godley, Ph.D.
Funded By Federal and state agencies and local provider organizations throughout the U.S. and Canada
Project Period Variable (12-48 months)
Abstract The primary goal of Chestnut’s Evidence-Based Treatment (EBTx) Center is to improve the quality and outcomes of treatment for substance use disorders by disseminating evidence based treatments to provider organizations. Dissemination strategies are based on recommendations from implementation science research and involve training, competency-based learning (for practice and feedback), coaching, and on-demand technical support. Another goal of the EBTx Center is to help each provider organization develop the capacity to self-sustain evidence based treatment. To date, the EBTx Center has worked with more than 270 provider organizations resulting in over 1,000 EBT-certified clinical supervisors and clinicians. As a result, in excess of 12,000 patients and their families have received one of the following evidence based treatments: 1) the Adolescent Community Reinforcement Approach (A-CRA); 2) Assertive Continuing Care (ACC); and 3) the Community Reinforcement Approach (CRA) for adults.
Website http://ebtx.chestnut.org
Title GAIN Coordinating Center (GCC)
Director Michael L. Dennis, Ph.D.
Funded By Federal and state agencies and local provider organizations throughout the U.S. and Canada
Project Period Variable (dependent upon services requested)
Abstract The primary goal of Chestnut’s GAIN Coordinating Center (GCC) is to bridge the gap between clinical research and the growing movement toward evidence-based practice. Dissemination strategies are based on recommendations from implementation science research and involve training, competency-based learning (for practice and feedback), coaching, technical support, data services, and clinical support. A key goal of the GCC is to help each organization develop the capacity to self-sustain evidence-based assessment utilizing a “train the trainer” model. The Global Appraisal of Individual Needs (GAIN) is a family of instruments which originated in 1993 as a collaborative effort between clinicians, researchers, and policy makers to create comprehensive and standardized screening and bio-psychosocial assessment tools. All of the GAIN instruments are available via web-based interactive administration hosted on a secured network to insure maximum protection of confidential information. The GCC has over 2,500 licensed GAIN entities at the individual, county, state and national levels resulting in an excess of 10,600 certified GAIN certifications throughout the U.S., Australia, Brazil, Canada, China, and South Africa.
Website http://www.gaincc.org