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，她们很有可能再次吸毒、再次犯罪、感染或传播艾滋病毒，并作为观察员、受害者和/或肇事者卷入暴力。虽然这是重新进入社区的最大女性罪犯群体，但这是一个相对研究较少的群体，是改变她们状况的慢性和周期性的关键时间点。这项拟议的研究旨在测试对出狱的女性罪犯进行康复管理检查的有效性，以便在获释后立即提供持续的护理，并帮助她们管理长期的康复。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，关于药物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(当需要时)，现场艾滋病毒促进会议(当需要时)，以及治疗参与和保留支持。激励性访谈将提供治疗方法，将妇女从改变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结合在一起，提供了立即与社区治疗和艾滋病毒预防相联系的机会，以及对复发的持续监测和对药物使用和艾滋病毒危险行为的早期再干预(这两个公共卫生优先事项)。研究小组将招募425名有药物使用问题的女性罪犯，从连续入院到基于监狱的药物滥用治疗计划。在监狱期间，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，并在释放转诊到社区治疗之前接受。在基线评估之后，大约一半的妇女将被随机分配到康复管理检查-女性罪犯(RMCWO)条件下，另一半被分配到控制条件下。所有妇女将在3年内完成12次季度评估(总计5525条意见)。所有RMC-WO干预措施将在释放后进行，并为立即和持续监测药物使用和艾滋病毒危险行为、早期再干预、获得和保留基于社区的治疗提供工具。这项实验的具体目的是考察：1)RMC-WO对出狱后头90天和3年期间获得和停留在社区治疗的影响；2)RMC-WO和药物滥用治疗3年对药物使用和艾滋病毒危险行为的影响；3)RMC-WO药物滥用治疗，以及减少药物使用和HIV危险行为对精神疾病共患病率、人际暴力、非法活动、以及3年以上逮捕和重新监禁的影响。

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.