Substance Use DisorderCOSTARSNCT07439783
Testing the CrOss Systems Technical Assistance for Retaining Staff (COSTARS) Model for Improving Staff Retention Among Child Welfare Workers and Peer Supporters, and Implementation of Evidence Based Interventions.
A study testing COSTARS and Implementation As Usual in people with Substance Use Disorder and Opioid Use Disorder, run by Alicia Bunger at 1 site in United States.
Trial summary
The goal of this study is to test whether the CrOss System Technical Assistance for Retaining Staff (COSTARS) supervision leadership institute can promote workforce stability and improved implementation outcomes within the Ohio START child welfare program. Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- Substance Use Disorder, Opioid Use Disorder, Child Maltreatment
- What is being tested?
- COSTARS and Implementation As Usual
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 200 participants
- Where
- 1 siteUnited States
- Study dates
- 28 Jul 2026to 31 Aug 2030
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Adults employed as supervisors in child welfare agencies who are leading teams of case workers and family peer mentors as part of Ohio START implementation.
Who cannot join
- Not involved in Ohio START
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
About this study
Official title: Staffing and Supports for Implementing Cross-System Interventions With Peer Mentors
The goal of this study is to test whether the CrOss System Technical Assistance for Retaining Staff (COSTARS) supervision leadership institute can promote workforce stability and improved implementation outcomes within the Ohio START child welfare program. The main questions it aims to answer are:
- Among supervisors, caseworkers, and family peer mentors, what is the effect of COSTARS on staff retention and perceptions of the work environment?
- What is the effect of COSTARS on service timeliness, implementation fidelity, and parent outcomes within Ohio START?
Read more
Researchers will compare public children services agencies implementing COSTARS to those implementing supervision practices as usual to see if there are differences between groups in the outcomes described above.
Participating supervisors will:
- Complete a 6-hour training workshop in the FOCUS model of supervision.
- Participate in monthly group coaching sessions with other supervisors, for approximately one year.
- Receive individualized feedback from coaches about their supervision performance.
- Conditions
- Substance Use Disorder, Opioid Use Disorder, Child Maltreatment, Implementation, Peer Recovery Supporters
- Being tested
- COSTARS, Implementation As Usual
- Medical subject headings
- Substance-Related Disorders, Opioid-Related Disorders
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
COSTARSOther
CrOss System Technical Assistance for Retaining Staff (COSTARS) is designed to help child welfare supervisors support the case workers and family peer mentors on their teams so that they can deliver programs like Ohio START to families affected by substance use disorder. COSTARS will deliver personalized coaching support to child welfare supervisors by a pair of coaches: one with child welfare expertise and one with lived recovery/child welfare experience. Supervisors will participate in a group training that emphasizes supportive supervision practices, and then receive up to two years of ongoing coaching support that involves monthly calls, and written feedback based on recorded supervision sessions.
Implementation As UsualOther
Implementation as Usual includes training on the model, monthly technical assistance calls focused on model fidelity, regular audits of programmatic data, and monthly group calls with implementers from across the state.
| Study group | Role | What they receive |
|---|---|---|
| COSTARS | Experimental | To receive the COSTARS intervention Receives: Other: COSTARS; Other: Implementation As Usual |
| Implementation As Usual | Active comparator | Implementation As Usual Receives: Other: Implementation As Usual |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change Over Time in Employee Intention to Leave Position, as Assessed by the Turnover Intention Scale (TIS-6)
The Turnover Intention Scale (TIS-6) measures the degree to which an employee intends to leave their job.
Measured: Collected at Baseline, Year 2, Year 3, Year 4, and Year 5
Change Over Time in Staff Retention
Number of months family peer mentors and caseworkers serve in their position.
Measured: Collected at Baseline, Year 2, Year 3, Year 4, Year 5
Secondary outcomes (9)
Change Over Time in Service Timeliness
Count of days to receive:
- Family peer mentor visit
- Substance use disorder assessment
- First substance use disorder treatment
Measured: Collected from administrative records at Baseline, Year 2, Year 3, Year 4, and Year 5.
Change Over Time in Implementation Fidelity
Delivery of START model components.
- Family peer mentor visit, any substance use disorder treatment, medically assisted treatment (binary)
- Total number of substance use disorder treatment sessions received (count)
Measured: Collected from administrative records at Baseline, Year 2, Year 3, Year 4, and Year 5.
Change Over Time in Program Completion Rate
Administrative records indicate parent discharge reason as "completed the family case plan" (binary)
Measured: Collected from administrative records at Baseline, Year 2, Year 3, Year 4, and Year 5.
Change Over Time in Family Reunification Rates
At the time of child welfare case close, proportion of child(ren) who are living with family.
Measured: Collected from administrative records at Baseline, Year 2, Year 3, Year 4, and Year 5.
Change Over Time in Perceived Stigma as assessed by the Child Welfare Worker Attitudes about Addiction Scale
This scale contains 13 items rated along a 6-point scale from 0 = strongly disagree to 6 = strongly agree
Measured: Collected at Baseline, Year 2, Year 3, Year 4, and Year 5
Change Over Time in Role Clarity as Assessed by the Role Conflict-Role Ambiguity Scale
This scale contains 14 items that measure the degree to which respondents perceive that there is conflict or incongruence (8 items; role conflict) and uncertainty in what is expected of them in their role (6-items, role ambiguity). Participants rate each statement on a 7-point scale (1=Very false, 7=Very true)
Measured: Collected at Baseline, Year 2, Year 3, Year 4, and Year 5
Change Over Time in Implementation Leadership as Assessed by the Implementation Leadership Scale (ILS)
The Implementation Leadership Scale (ILS) measures the degree to which those in leadership positions support or hinder the process of implementation. This scale contains four subscales (proactive, knowledgeable, supportive, and perseverant leadership) measured using 12 items that are rated on a 5-point scale from 0=not at all to 4=very great extent.
Measured: Collected at Baseline, Year 2, Year 3, Year 4, and Year 5
Change Over Time in Implementation Climate as assessed using a 9-item scale
The degree to which START is perceived to be expected, supported, and rewarded within the systems will be assessed using a 9-item scale that assesses innovation supports, expectations, and rewards. Items are rated on a 5-point scale from 1=disagree to 5=agree.
Measured: Collected at Baseline, Year 2, Year 3, Year 4, and Year 5
Change Over Time in Job Satisfaction as Assessed by the Job Satisfaction Survey (JSS)
This survey was developed for use in human service and public organizations and contains 36 items that reflect satisfaction with 9 job dimensions: pay, benefits, contingent rewards, promotion opportunities, supervision, nature of the work, communication, coworkers, and work conditions. Items are rated on a 6-point scale from 1=disagree very much to 6=agree very much. The JSS is one of the few job satisfaction scales with evidence of validity and reliability.
Measured: Collected at Baseline, Year 2, Year 3, Year 4, and Year 5
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Feb 2026
- Study start28 Jul 2026 (estimated)
- Primary completion31 Aug 2030 (estimated)
- Study completion31 Aug 2030 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Substance Use DisorderStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- None (open label)
- Enrolment
- 200 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Alicia Bunger
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor-investigator, Alicia Bunger, Ohio State University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07439783
- Sponsor's protocol ID
- R33DA059893
- Acronym
- COSTARS
- Status last verified
- Jul 2026
- First submitted
- 17 Sep 2025
- Last updated
- 13 Jul 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes
Study at a glance
From the registry record, last updated by the sponsor on 13 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Staffing and Supports for Implementing Cross-System Interventions With Peer Mentors
- ClinicalTrials.gov ID
- NCT07439783
- Acronym / sponsor ID
- COSTARS / R33DA059893
- Conditions
- Substance Use Disorder, Opioid Use Disorder, Child Maltreatment, Implementation, Peer Recovery Supporters
- Study type
- Interventional
- Recruitment status
- Enrolling by invitation
- Enrolment
- 200 participants (estimated)
- Lead sponsor
- Alicia BungerUniversity, hospital or other
- Study start
- 28 Jul 2026 (estimated)
- Primary completion
- 31 Aug 2030 (estimated)
- Study completion
- 31 Aug 2030 (estimated)
- First posted
- 27 Feb 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this study is to test whether the CrOss System Technical Assistance for Retaining Staff (COSTARS) supervision leadership institute can promote workforce stability and improved implementation outcomes within the Ohio START child welfare program. The main questions it aims to answer are:
- Among supervisors, caseworkers, and family peer mentors, what is the effect of COSTARS on staff retention and perceptions of the work environment?
- What is the effect of COSTARS on service timeliness, implementation fidelity, and parent outcomes within Ohio START?
Researchers will compare public children services agencies implementing COSTARS to those implementing supervision practices as usual to see if there are differences between groups in the outcomes described above.
Participating supervisors will:
- Complete a 6-hour training workshop in the FOCUS model of supervision.
- Participate in monthly group coaching sessions with other supervisors, for approximately one year.
- Receive individualized feedback from coaches about their supervision performance.
Study design
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| COSTARS | Experimental | Other: COSTARS, Other: Implementation As UsualTo receive the COSTARS intervention |
| Implementation As Usual | Active comparator | Other: Implementation As UsualImplementation As Usual |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (1 listed)
- Adults employed as supervisors in child welfare agencies who are leading teams of case workers and family peer mentors as part of Ohio START implementation.
Key exclusion criteria (1 listed)
- Not involved in Ohio START
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| COSTARSCrOss System Technical Assistance for Retaining Staff (COSTARS) is designed to help child welfare supervisors support the case workers and family peer mentors on their teams so that they can deliver programs like Ohio START to families affected by substance use disorder. COSTARS will deliver personalized coaching support to child welfare supervisors by a pair of coaches: one with child welfare expertise and one with lived recovery/child welfare experience. Supervisors will participate in a group training that emphasizes supportive supervision practices, and then receive up to two years of ongoing coaching support that involves monthly calls, and written feedback based on recorded supervision sessions. | Other | COSTARS |
| Implementation As UsualImplementation as Usual includes training on the model, monthly technical assistance calls focused on model fidelity, regular audits of programmatic data, and monthly group calls with implementers from across the state. | Other | COSTARS, Implementation As Usual |
Primary outcome
Change Over Time in Employee Intention to Leave Position, as Assessed by the Turnover Intention Scale (TIS-6)
Time frame: Collected at Baseline, Year 2, Year 3, Year 4, and Year 5
The Turnover Intention Scale (TIS-6) measures the degree to which an employee intends to leave their job.
Change Over Time in Staff Retention
Time frame: Collected at Baseline, Year 2, Year 3, Year 4, Year 5
Number of months family peer mentors and caseworkers serve in their position.
9 secondary outcomes
Change Over Time in Service Timeliness
Time frame: Collected from administrative records at Baseline, Year 2, Year 3, Year 4, and Year 5.
Change Over Time in Implementation Fidelity
Time frame: Collected from administrative records at Baseline, Year 2, Year 3, Year 4, and Year 5.
Change Over Time in Program Completion Rate
Time frame: Collected from administrative records at Baseline, Year 2, Year 3, Year 4, and Year 5.
Change Over Time in Family Reunification Rates
Time frame: Collected from administrative records at Baseline, Year 2, Year 3, Year 4, and Year 5.
Change Over Time in Perceived Stigma as assessed by the Child Welfare Worker Attitudes about Addiction Scale
Time frame: Collected at Baseline, Year 2, Year 3, Year 4, and Year 5
Change Over Time in Role Clarity as Assessed by the Role Conflict-Role Ambiguity Scale
Time frame: Collected at Baseline, Year 2, Year 3, Year 4, and Year 5
Change Over Time in Implementation Leadership as Assessed by the Implementation Leadership Scale (ILS)
Time frame: Collected at Baseline, Year 2, Year 3, Year 4, and Year 5
Change Over Time in Implementation Climate as assessed using a 9-item scale
Time frame: Collected at Baseline, Year 2, Year 3, Year 4, and Year 5
Change Over Time in Job Satisfaction as Assessed by the Job Satisfaction Survey (JSS)
Time frame: Collected at Baseline, Year 2, Year 3, Year 4, and Year 5
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 13 Jul 2026.
- Individual participant dataSharing planned: Yes
Related trials for Substance Use Disorder
Not yet recruitingEarly Phase 1
Pain Sensitivity, Alcohol-Induced Analgesia, and Heavy Drinking in Individuals With Opioid Use Disorder
Opioid Use Disorder, Alcohol Intoxication
Active, not recruiting
Closed-loop TBS Targeting rPO for the Core Clinical Features of Methamphetamine Use Disorder
Methamphetamine Use Disorder, Substance Use Disorder
RecruitingObservational study
SMART-r: Substance Monitoring and Active Relapse Tracking Repository
Alcoholism, Substance-Related Disorders
Enrolling by invitationObservational study
Development of an Interview-Informed Timeline Follow-Back (TLFB) for Opioid Use in the Era of Fentanyl
Substance Use Disorders (SUDs)
RecruitingObservational study
Olfactory Function and Model-Based Behavior in People Living With HIV and SUD
HIV, Substance Use Disorder
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing COSTARS and Implementation As Usual in people with Substance Use Disorder and Opioid Use Disorder, run by Alicia Bunger at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: enrolling by invitation, as of the sponsor's last update on 13 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change Over Time in Employee Intention to Leave Position, as Assessed by the Turnover Intention Scale (TIS-6) (time frame: Collected at Baseline, Year 2, Year 3, Year 4, and Year 5). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Jul 2026.