Sustainable HIV Risk Reduction Strategies for CJ Systems

CJ Systems 的可持续艾滋病毒风险降低策略

• 批准号: 7577284
• 负责人: D DWAYNE SIMPSON
• 金额: $ 53.44万
• 依托单位: TEXAS CHRISTIAN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-15 至 2013-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7577284
• 关键词: AIDS education/prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; African American; Arizona; Attitude; Behavior; Behavioral; Caring; Centers for Disease Control and Prevention (U.S.); Climate; Cognitive; Collaborations; Communicable Diseases; Communication; Communities; Contracts; Criminal Justice; Decision Making; Development; Disease; Drug usage; Educational Intervention; Effectiveness; Effectiveness of Interventions; Evaluation; Evaluation Studies; Experimental Designs; General Population; HIV; Health Benefit; Hispanics; Imprisonment; Indium; Infection; Institution; Intervention; Intervention Studies; Life; Manuals; Measures; Mission; Modeling; Motivation; New Mexico; Oklahoma; Outcome; Pamphlets; Perception; Persons; Phase; Phase I Clinical Trials; Population; Prisoner; Prisons; Process; Program Development; Provider; Public Health; Punishment; Randomized; Randomized Controlled Clinical Trials; Rate; Readiness; Recording of previous events; Research; Research Design; Resources; Risk; Risk Behaviors; Risk Reduction; Rural; Series; Services; Sex Behavior; Site; Specific qualifier value; Staging; Standards of Weights and Measures; Substance abuse problem; Supervision; System; Testing; Texas; Time; Training; Use Effectiveness; Visuospatial; Week; addiction; base; community reentry; correctional system; design; disorder risk; fitness; follow-up; improved; innovation; member; offender; parole; pressure; probation; programs; psychosocial; satisfaction; service intervention; tool; urban Native American

DESCRIPTION (provided by applicant): The proposed study covers 5 years and includes 2 major research phases intended to reduce HIV and other addiction-related disease risks in criminal justice (CJ) populations. The first phase is a Disease Risk Reduction (DRR) intervention effectiveness study, and the second addresses its implementation in CJ field settings. A manual-guided DRR planning and decision-making strategy will be based on cognitive tools that focus on an evidence-based, visual-spatial (rather than traditional didactic) communication approach. It will focus on risky sexual and drug use behaviors during re-entry, including problem recognition, commitment to change, and strategies for avoiding behavioral risks of infections. Motivational and planning sessions will be delivered near the end of CJ institution-based substance abuse treatment, and they will also bridge into re- entry care services during community transitional treatment by using a series of self-study toolkits emphasizing applications of DRR principles. Offender-level engagement and functioning will be the key analytical focus of this initial study phase. In the second phase of the project, the process of intervention implementation will be examined in an expanded network of CJ systems in Texas as well as 3 adjoining states (Arizona, New Mexico, and Oklahoma). This phase will employ a naturalistic research design relying on organizational needs and functioning assessments (based on staff evaluations of DRR intervention training and utilization) in the analyses of implementation progress in institution and community-based re-entry divisions of the CJ system. When compared to "standard care" currently used during institution-based treatment, the DRR intervention is expected to significantly improve offender motivation, commitment, and self-confidence in planning their behavioral risk-reduction strategies for use during community re-entry. It also is expected that DRR re-entry self-study guides will further increase the rate of offender use of support networks in the community, reduce their risk levels related to drug use and sexual behaviors, and decrease their likelihood of re-incarceration during follow-up. More favorable offender psychosocial functioning and engagement during institution-based treatment likewise are expected to be positively associated with better outcomes during community re-entry. In the implementation evaluation study (Phase 2), institution and community-based re-entry teams (representing CJ systems across 4 states) are expected to respond to innovation training and make applications of DRR components commensurate with their collective perceptions about program needs, pressures, resources, and organizational fitness. That is, higher (average) ratings by staff members at CJ sites (e.g., in-prison treatment and probation/parole regions) of needs, readiness for HIV intervention services, organizational resources, mission, and operational climate are expected to predict greater participation and responsiveness to subsequent training for the DRR innovation. These indicators, in turn, are expected to predict higher DRR utilization and staff satisfaction at the post-training follow-up. PUBLIC HEALTH RELEVANCE: Effective HIV/AIDS-risk reduction interventions for criminal justice populations can offer significant public health benefits, both to offenders themselves and the public at large. However, there are challenges to "engaging" and convincing offenders with substance abuse histories to adequately plan and apply risk reduction principles during the crucial community re-entry phase after imprisonment. Correctional systems also are often fragmented, representing another challenge to efforts to provide integrated care and supervision to offenders at-risk for infectious diseases. The current proposal addresses both of these highly significant issues.

描述（由申请人提供）：拟议的研究涵盖了5年，其中包括2个主要研究阶段，旨在减少刑事司法（CJ）人口中的艾滋病毒和其他与成瘾有关的疾病风险。第一阶段是降低疾病风险（DRR）干预效率研究，第二阶段涉及其在CJ现场设置中的实施。手动指导的DRR计划和决策策略将基于认知工具，该工具侧重于循证的，视觉空间（而不是传统的教学方法）。它将重点介绍重新进入时风险的性和吸毒行为，包括问题认识，对变革的承诺以及避免感染行为风险的策略。动机和计划会议将在基于CJ机构的药物滥用治疗结束之后进行，并且通过使用一系列强调DRR原则应用的自学工具包，他们还将在社区过渡治疗期间桥接进入社区过渡服务。犯罪者级别的参与和功能将是该初始研究阶段的关键分析重点。在项目的第二阶段中，将在得克萨斯州的CJ系统以及3个相邻国家（亚利桑那州，新墨西哥州和俄克拉荷马州）的CJ系统网络中进行干预实施过程。该阶段将采用自然研究设计，以依靠组织需求和运作评估（基于对DRR干预培训和利用的员工评估）的运作评估），分析了CJ系统的机构和基于社区的重新进入部门的实施进展。与目前基于机构的治疗期间使用的“标准护理”相比，DRR干预措施预计将显着改善罪犯的动机，承诺和自信心，以计划其在社区重入期间使用的行为降低风险降低风险策略。还可以预期，DRR重新进入自学指南将进一步提高社区中罪犯使用支持网络的使用率，降低其与药物使用和性行为相关的风险水平，并减少其在随访期间重新监禁的可能性。在基于机构的治疗期间，更有利的罪犯的社会心理功能和参与也有望与社区重入期间更好的结果成正相关。在实施评估研究（第2阶段）中，预计机构和基于社区的重新进入团队（代表4个州的CJ系统）将对创新培训做出反应，并使DRR组件的应用与他们对计划需求，压力，资源和组织健身的集体看法相称。也就是说，在CJ站点（例如，治疗和缓刑/假释地区）的工作人员的较高（平均）评级），艾滋病毒干预服务的准备，组织资源，使命和运营环境的准备就绪，预计将预测更多的参与以及对DRR创新的后续培训的响应能力。反过来，这些指标有望在培训后随访中预测更高的DRR利用率和员工满意度。 公共卫生相关性：有效的艾滋病毒/艾滋病风险减少刑事司法人口的干预措施可以为罪犯自己和整个公众提供巨大的公共卫生福利。但是，“参与”并说服罪犯滥用毒品历史的罪犯在监禁后，在关键的社区重新进入阶段中充分计划和降低风险原则。惩教系统也经常被分散，这代表了为在感染感染疾病的罪犯提供综合护理和监督的努力。当前的提案解决了这两个非常重要的问题。