Click here for comprehensive list of completed projects.

Current Research Projects (by Expiration Date in Descending Order)

Title Recovery Management Checkups for Primary Care (RMC-PC) Experiment
Principal Investigator Christy K. Scott, Ph.D.
Funded By National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Grant Number R01 AA24440
Project Period January 27, 2017 – December 31, 2022
Abstract Screening and Brief Intervention (SBI) in primary care for risky adult alcohol use has been demonstrated effective in reducing use among heavy alcohol users. While the process also identifies 5-10% of the patients who have substance use disorders (SUD) that require referral to alcohol and other drug (AOD) treatment, the most recent meta-analysis indicates that the procedures had little to no effect on actual treatment linkage and utilization. Patient and system level barriers present challenges and new linkage models are needed that can successfully overcome the barriers. Results from three clinical trials conducted by the applicant team have demonstrated the effectiveness of Recovery Management Checkups (RMC) as a linkage model for individuals needing AOD treatment. Moreover, RMC participants were significantly more likely to enter treatment, enter sooner, and stay longer, having fewer days of use and fewer SUD symptoms. Outcomes were also associated with lower health care utilization, decreased criminal activity, and substantial savings to society, thereby offsetting the costs of additional treatment. RMC was modified for primary care (RMC-PC) and pilot resultsindicated RMC-PC significantly increased linkage rates to treatment relative to a baseline cohort (12% vs. 75%, OR=22.0, p<.0001). In the proposed trial, we will: a) recruit 300 adult patients with SUD through SBIRT programs operating in five sites operated by three FQHC organizations, b) randomly assign half to a referral as usual control and half to RMC-PC, and c) conduct quarterly follow-ups for 12-months post enrollment. Hypotheses include: H1 Relative to the control patients, RMC-PC patients will be more likely to initiate AOD treatment sooner, receive any AOD treatment, and receive more days of AOD treatment; H2 Relative to the control patients, RMC-PC patients and those who receive more AOD treatment will report fewer days of heavy alcohol use, other drug use, any AOD use and SUD problems; H3 The days of treatment will mediate the relationship between RMC-PC and changes in the pre and post measures of these AOD related behaviors; H4 Relative to the control patients, RMC-PC patients and those with fewer days of AOD use will have significantly less total health care utilization costs after factoring in increases in AOD treatment; and H5 The days of AOD use will mediate the relationship between RMC-PC and the cost of health care utilization.

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 State Targeted Response (STR) to the Opioid Crisis
Principal Investigator Christy K. Scott, Ph.D.
Contracted From Illinois Department of Human Services (IDHS)
Funded By Center for Substance Abuse Treatment (CSAT)
Grant Number 1H79TI080231-01
Project Period July 1, 2017 – June 30, 2019
Abstract In 2011, the Chicago Metropolitan Area ranked first nationally for both emergency department (ED) mentions (24,627) for heroin (Drug Abuse Warning Network) and percentage (18.6%) of individuals who were arrested and tested positive for heroin (Arrestee Drug Abuse Monitoring Program). In Chicago and nationally, there is an emerging consensus on the need to address this epidemic and a particular focus on broad dissemination of over-the-counter Naloxone to prevention opioid overdose and death. Efforts are currently underway (and supported by federal and state funds) to distribute Naloxone and train individuals in its use. There is no one place to find all or even most of the people at risk of overdose. This project seeks to address this gap by combining two well established protocols: 1) Peer Outreach Workers (POW) to identify and recruit opioid users and 2) Recovery Management Checkups (RMC) to link and engage people in substance use disorder (SUD) treatment. The general efficacy of POW has been well established in over 3 dozen studies with injection drug users and crack users, but has not yet been applied to prescription opioid users. The general efficacy of RMC has been established in 3 clinical trials with opioid users (both injection and other) recruited from SUD treatment and jail, as well as 1 quasi experiment study (referral from primary care).  

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 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 4,700 licensed GAIN entities in all 50 U.S. states and all 10 provinces of Canada, as well as 10 other countries (Australia, Belgium, Brazil, China, Mexico, Japan, Great Britain, India, South Africa, Spain). As of 12/31/16, the 14,559 users of the GAIN software have entered 711,621 interviews. In collaboration with these programs and staff, norms, psychometrics, and 438 publications have been publicly provided on over 100,000 adolescents, young adults and adults.
Website http://www.gaincc.org