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，他们有很高的风险重新使用药物，重新进入刑事司法系统，感染或传播艾滋病毒，并作为观察者，受害者和/或肇事者参与暴力。虽然这是重新进入社区的最大的女罪犯群体，但这是一个相对而言研究较少的群体，是改变其状况的慢性和周期性的关键时刻。拟议的研究旨在测试对从监狱释放的女罪犯进行康复管理检查的有效性，以便在释放后立即提供连续的护理，并帮助她们管理长期康复。检查的组成部分将包括：通过重新进入会议和季度评估进行持续监测3年，对物质使用和高风险行为的个性化反馈，与社区药物滥用治疗的联系（需要时），现场艾滋病毒助推器会议（需要时），以及治疗参与和保留支持。动机访谈将为妇女从变革过程的一个步骤过渡到另一个步骤提供治疗方法。这些组成部分和治疗环境相结合，提供了一个机会，立即联系到社区为基础的治疗和艾滋病毒预防，以及不断监测复发和早期再干预药物使用和艾滋病毒风险行为（两者都是公共卫生优先事项）。该研究小组将招募425名有药物使用问题的女性罪犯，这些女性罪犯将从监狱药物滥用治疗计划中连续入院。在监狱中，所有妇女都将接受基线评估、药物滥用治疗、艾滋病毒检测、咨询和教育，并在释放前转介到社区治疗。在基线评估之后，大约一半的妇女将被随机分配到恢复管理检查-妇女罪犯（RMCWO）条件下，另一半则被分配到对照条件下。所有女性将在3年内完成12次季度评估（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、早期再干预、获得和保留社区治疗提供工具。这项实验的具体目的是审查：（1）RMC-WO在出狱后的头90天内和3年内对获得和留在社区治疗的影响;（2）RMC-WO和药物滥用治疗对3年内药物使用和艾滋病毒风险行为的影响;和3）RMC-WO，物质滥用治疗，减少物质使用和HIV危险行为对精神病共病，人际暴力，非法活动，逮捕和重新监禁超过3年。

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.