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利用创新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。危险使用酒精在农村地区是一个相当大的问题。农村地区有害饮酒问题的一个主要相关因素是保健和行为服务的获取和提供有限。在缺乏现有和可获得的再入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再次酗酒和再犯的风险较高。这项研究将包括筛选和招募有危险饮酒史的农村罪犯。符合危险饮酒标准（审计评分为8+）的参与者（N=142）将在他们出狱后一周内接受采访，并随机分配到两种研究条件之一：1)动机增强远程医疗（METelemedicine）结合常规再入服务（N= 71）和2)常规再入服务（N= 71）。在这两种研究条件下，参与者将由假释官转介给社区个案经理（社会服务临床医生- SSC），表明他们需要酒精服务，并将符合门诊护理标准。在城市远程医疗条件下，参与者还将通过远程医疗视频会议与城市大学治疗诊所的治疗师进行四次MET治疗。结果数据将在释放后3个月收集，以检查重新进入时戒酒的天数。本研究的具体目的包括：(1)实施创新的远程医疗技术，为入狱前有危险饮酒史的再入狱农村罪犯提供动机增强治疗（METelemedicine）；(2)对入狱前有危险饮酒史的再入狱农村罪犯使用METelemedicine的可行性进行研究。如果本研究的结果确定远程医疗作为一种提供循证实践的方法的可行性，将开发R01应用程序，以在更大规模的试验中测试该方法。这项研究议程的长期目标是增加农村重新进入监狱的罪犯获得有效治疗方法的机会，以促进戒酒和减少再犯。

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.