Recovery Management Checkups for Women Offenders (RMC-WO) Experiment

描述（由申请人提供）：从监狱释放的女性罪犯是一个不断增长的弱势​​群体，她们极有可能再次吸毒、重犯刑事司法系统、感染或传播艾滋病毒，以及作为观察者、受害者和/或施暴者参与暴力。虽然这是重新进入社区的最大的女性罪犯群体，但这一群体的研究相对较少，并且是改变其长期和周期性状况的关键时间点。拟议的研究旨在测试出狱女罪犯康复管理检查（RMC-WO）的有效性，以便在释放后立即提供连续性护理，并帮助她们管理长期康复。检查的组成部分将包括：通过重返会议和为期 3 年的季度评估进行持续监测、对药物使用和高风险行为的个性化反馈、与基于社区的药物滥用治疗的联系（需要时）、现场艾滋病毒加强课程（需要时）以及治疗参与和保留支持。动机访谈将提供一种治疗方法，帮助女性从变革过程的一个步骤过渡到另一个步骤。这些组成部分和治疗环境相结合，提供了与基于社区的治疗和艾滋病毒预防立即联系的机会，以及对药物滥用和艾滋病毒危险行为（均为公共卫生优先事项）的复发和早期再干预的持续监测。研究小组将招募 425 名有药物滥用问题的女性罪犯，从连续入狱到监狱药物滥用治疗计划。在监狱期间，所有女性都将接受基线评估、药物滥用治疗、艾滋病毒检测、咨询和教育，并在出狱前转介到社区治疗。基线评估后，大约一半的女性将被随机分配到康复管理检查 - 女性罪犯 (RMCWO) 状态，另一半分配到对照状态。所有女性将在 3 年内完成 12 次季度评估（总共 5525 次观察）。所有 RMC-WO 干预措施都将在释放后进行，并为立即和持续监测药物使用和艾滋病毒风险行为、早期重新干预、获得和保留社区治疗提供工具。本实验的具体目的是检验以下方面的影响： 1) RMC-WO 对出狱后 90 天内以及 3 年内获得和维持社区治疗的影响； 2) 3年以上针对物质使用和HIV危险行为的RMC-WO和物质滥用治疗； 3) RMC-WO、药物滥用治疗，以及在 3 年内减少药物使用和艾滋病毒风险行为，包括精神共病、人际暴力、非法活动、逮捕和再监禁。

DESCRIPTION (provided by applicant): Women offenders released from jail are a growing and vulnerable population who are at high risk of relapsing to substance use, recidivating to the criminal justice system, contracting or spreading HIV, and becoming involved in violence as observers, victims, and/or perpetrators. While this is the largest group of women offenders re-entering the community, it is a relatively under studied population and represents a critical point in time for changing the course of the chronic and cyclical nature of their condition. The proposed study is designed to test the effectiveness of recovery management checkups for women offenders (RMC-WO) released from jail to provide continuity of care immediately upon release and to help them manage their long-term recovery. The components of the checkup will include: on-going monitoring via a re-entry meeting and quarterly assessments for 3 years, personalized feedback on substance use and high risk behaviors, linkage to community-based substance abuse treatment (when needed), on-site HIV booster sessions (when needed), and treatment engagement and retention support. Motivational interviewing will provide the therapeutic approach to transition women from one step of the change process to another. Combined, these components and therapeutic milieu afford an opportunity for immediate linkage to community-based treatment and HIV prevention as well as ongoing monitoring for relapse and early re-intervention for both substance use and HIV risk behaviors (both public health priorities). The research team will recruit 425 women offenders with substance use problems from sequential admissions to a jail-based substance abuse treatment program. While in jail, all women will receive a baseline assessment, substance abuse treatment, HIV testing, counseling and education, and prior to release referrals to community-based treatment. Following the baseline assessment, approximately half of the women will be randomly assigned to the Recovery Management Checkups-Women Offenders (RMCWO) condition and the other half to a control condition. All women will complete 12 quarterly assessments over 3 years (5525 total observations). All RMC-WO interventions will occur post release and provide the vehicle for immediate and ongoing monitoring of substance use and HIV risk behaviors, early re-intervention, access and retention in community-based treatment. The specific aims of this experiment are to examine the impact of: 1) RMC-WO on accessing and staying in community-based treatment during the first 90 days after release from jail and over the course of 3 years; 2) RMC-WO and substance abuse treatment on substance use and HIV risk behaviors over 3 years; and 3) RMC-WO, substance abuse treatment, and reductions in substance use and HIV risk behaviors on psychiatric co-morbidity, interpersonal violence, illegal activity, and arrest and re-incarceration over 3 years.