Re-entry Alcohol Services for Rural Offenders

描述（由申请人提供）：拟议项目的总体目标是研究使用创新的远程医疗技术的可行性，以提供基于证据的酒精干预（MET），从监狱重新进入社区的农村罪犯。危险使用酒精在农村地区是一个相当大的问题。农村地区危险饮酒问题的一个主要相关因素是获得保健和行为服务的机会有限。在缺乏可用和可获得的重返社会酒精干预措施的情况下，有危险饮酒史的农村罪犯在返回社区时，酒精复发和累犯的风险更高。该研究将包括筛选和招募农村罪犯与监禁前的危险饮酒史使用审计。符合危险饮酒标准（AUDIT评分为8+）的参与者（N=142）将在出狱后一周内接受采访，并随机分配至两种研究条件之一：1）动机增强远程医疗（ME Telemedicine）结合常规重返服务（n=71）和2）照常重返服务（n=71）。在这两种研究条件下，参与者将由其假释官转介给社区个案管理员（社会服务临床医生- SSC），表明他们需要酒精服务，并将符合门诊护理水平的标准。在METelemedicine条件下，参与者还将在一所城市大学治疗诊所通过远程医疗视频会议与一名治疗师进行四次MET。将在释放后3个月收集结局数据，以检查再入组时的戒酒天数。该研究的具体目标包括：（1）采用创新的远程医疗技术，向有危险饮酒监禁前历史的重新进入农村的罪犯提供动机增强疗法（METelemedicine），以及（2）审查使用METelemedicine使有危险饮酒监禁前历史的重新进入农村的罪犯重新进入的可行性。如果本研究的结果确定远程医疗作为提供循证实践的方法的可行性，则将开发R 01应用程序以在更大规模的试验中测试该方法。这一研究议程的长期目标是增加农村重新犯罪者获得有效治疗方法的机会，以促进戒酒和减少累犯。 公共卫生相关性：拟议项目的总体目标是审查利用创新的远程医疗技术向从监狱重新进入社区的农村罪犯提供循证酒精干预的可行性。这项研究对公共卫生的重要性包括有机会利用远程医疗其他用途取得的进展，包括为农村地区的个人和被监禁的个人提供健康和心理健康服务。这项研究是创新的，重点是罪犯在社区重新进入，以及使用远程医疗作为一种新技术，以增加获得基于证据的酒精服务在现实世界中的设置。

DESCRIPTION (provided by applicant): The overall aim of the proposed project is to examine the feasibility of using innovative telemedicine technology to deliver an evidence-based alcohol intervention (MET) to rural offenders re-entering the community from prison. Hazardous use of alcohol is a considerable problem in rural areas. A primary correlate of the problem of hazardous alcohol use in rural areas is the limited access to and availability of health and behavioral services. In the absence of available and accessible re-entry alcohol interventions, rural offenders with a history of hazardous drinking are at heightened risk for alcohol relapse and recidivism when they return to the community. The study will include screening and recruiting rural offenders with a pre- incarceration history of hazardous drinking using the AUDIT. Participants (N=142) who meet criteria for hazardous drinking (AUDIT score of 8+) will be interviewed within one week of their release from prison and randomized to one of two study conditions: 1) Motivational Enhancement Telemedicine (METelemedicine) combined with usual re-entry services (n=71) and 2) Re-entry services as usual (n=71). In both study conditions, participants will have a referral to a community case manager (Social Service Clinician - SSC) by their parole officer, indicating that they are in need of alcohol services, and will meet criteria for outpatient level of care. In the METelemedicine condition, participants will also be provided with four sessions of MET with a therapist in an urban-based university treatment clinic using telemedicine videoconferencing. Outcome data will be collected at 3-months post release to examine number of days of alcohol abstinence at re-entry. The specific aims of the study include: (1) Implement innovative telemedicine technology to deliver Motivational Enhancement Therapy (METelemedicine) to re-entering rural offenders with a pre-incarceration history of hazardous drinking, and (2) Examine the feasibility of using METelemedicine by re-entering rural offenders with a pre-incarceration history of hazardous drinking. If findings from this study establish feasibility of telemedicine as an approach for delivering an evidence-based practice, an R01 application will be developed to test the approach in a larger scale trial. The long-term objective of this research agenda is to increase access to effective treatment approaches for rural re-entering offenders in order to promote alcohol abstinence and reduce recidivism. PUBLIC HEALTH RELEVANCE: The overall aim of the proposed project is to examine the feasibility of using innovative telemedicine technology to deliver an evidence-based alcohol intervention (MET) to rural offenders re-entering the community from prison. The significance of this study for public health includes the opportunity to build on advances made by other uses of telemedicine that have included providing health and mental health services to individuals in rural areas and to incarcerated individuals. This study is innovative with the focus on offenders at community re-entry, as well as the use of telemedicine as a new technology to increase access to evidence- based alcohol services in real-world settings.