Ohio START: An adaption of the National Sobriety Treatment and Recovery Teams model

Background: The Sobriety Treatment and Recovery Teams (START) model is an evidence-supported intervention for families with at least one child under age 6 involved in the child welfare system due to substance misuse. The hallmark of the START model is early identification and linkage to addiction treatment services. To address the dual problem of heightened need for addiction treatment services and limited treatment availability in the wake of the opioid epidemic, Ohio's adaptation extended the model to serve all eligible families regardless of the age of children in the household. Objective: To investigate the delivery of the START model for parents and caregivers of older youth (age 6-18) only as compared to the population for which it was originally intended. Methods: We used data from 40 counties and with parents as the unit of analysis (N = 714). We used multilevel models to estimate the relationship between the age of children in the home and 1) meeting fidelity for timely access to treatment services and 2) successful completion of the model. Results: There was no statistically significant difference in the likelihood of meeting fidelity requirement for timely access to treatment services, nor in successful completion for families with older children as compared to those with at least one child aged 0-5. Conclusions: These results lend support to the use of the START model for all eligible families, regardless of the children's ages. Future studies can examine more nuanced relationships to include the role of specific substances, child placement, and the role of family peer mentors.