JCOIN 2.0 TCU Hub: Building Resilient Initiatives for Deflection through Greater Engagement (BRIDGE)

Abstract Background: Collaborative initiatives between public safety and health sectors have been implemented to reduce arrests, overdose deaths, and with emergency medical services (EMS) encounters. These efforts include community-based Deflection initiatives designed to "deflect" individuals away from initial or continued involvement with the criminal legal system (CLS) and toward substance use (SU) treatment services. Although Deflection is widely regarded as a promising practice, barriers to adopting Deflection are well documented. More research is needed to identify the implementation strategies most likely to overcome barriers to produce and sustain positive outcomes. The JCOIN 2.0 TCU Hub study, called the TCU BRIDGE to Deflection Project, addresses this clinical practice and research gap by testing strategies that integrate community engagement as a core component of generalizable Deflection models designed to meet the complex needs of individuals with SU problems, particularly those at high risk of overdose. Methods: The study uses a Hybrid Type 3 design to test two community engagement strategy bundles to promote Deflection. The CORE bundle includes facilitated public health-public safety interagency collaboration, best practices on building community engagement, and cross-system, data-driven learning. The ENHANCED bundle includes the CORE components, plus strategic role development and coaching for a known and trusted community member within each community to strengthen community support for Deflection efforts and promote meaningful engagement in Deflection leadership decisions. The study uses a staggered, parallel cluster randomized trial and will include up to 20 communities across six states. Each community includes law enforcement agencies engaged in existing Deflection efforts, along with community-based SU providers who serve Deflection participants. Discussion: Guided by the Exploration, Preparation, Implementation, and Sustainment (EPIS) Implementation Science Framework, this initiative is positioned to create a lasting contribution to the SU and CLS research fields by advancing knowledge of effective implementation strategies involving community engagement in Deflection in an effort to improve public safety and health outcomes. Trials registration number (TRN): NCT07528846; date of registration: 3/30/2026