Using Incentives to Improve Parolee Participation and Attendance in Community Tx

描述（由申请人提供）：虽然相当多的研究表明，监狱为基础的治疗，然后在社区继续治疗是有效的减少药物滥用和犯罪的药物滥用罪犯，提供治疗的影响是不太理想的，因为罪犯往往不跟进治疗转诊，提前离开治疗，或有不良的参与治疗活动。特别是，仅参与监狱治疗很少能有效减少吸毒或累犯，除非随后参与社区治疗。对于提供从监狱到社区的连续照料模式的惩教系统而言，收监率和保留率低导致成果差和资源利用率低。解决这一问题的一种方法是为假释犯提供参与社区治疗的奖励。虽然研究支持行为强化的有效性，主要是在应急管理（CM）的形式，一般药物滥用人群，CM尚未进行测试或调整，用于以社区为基础的方案，罪犯人群，特别是鼓励治疗出席。加州大学洛杉矶分校综合药物滥用项目（ISAP）与瓦尔登之家和加州矫正与康复部合作，提出了一项为期五年的卫生服务研究，该研究将涉及在社区为基础的TC中使用假释人员的激励措施的随机测试，以增加治疗入院率和治疗保留率，从而增加改善结果的可能性。研究参与者将从监狱治疗项目的客户中招募，这些客户被转介到瓦尔登之家社区项目。本研究的入学阶段评估了粉丝激励（代金券）对瓦尔登之家计划入学的影响。出勤阶段评估激励措施对治疗出勤率和治疗后药物使用，犯罪和心理社会行为的影响。干预将持续六个月。研究参与者将在基线和干预后12个月接受采访。将获得治疗和刑事司法数据。将从工作人员和客户的重点小组收集关于可接受性、满意度和可持续性的数据。该研究有四个具体目标：（1）确定提供奖励（代金券）是否会增加参与监狱治疗的假释犯接受社区治疗的机会。(2)对于进入社区治疗的假释犯，确定是否提供激励措施，使其在治疗中有更大的保留。(3)在6个月干预结束后的12个月，评估使用激励措施对药物使用、犯罪和心理社会结果的长期影响。(4)评估可接受性、满意度和使用激励措施的可持续性问题，以增加工作人员和客户的接纳和保留。

DESCRIPTION (provided by applicant): Although a considerable body of research indicates that prison-based treatment followed by continuing treatment in the community is effective in reducing drug abuse and crime among drug-abusing offenders, the impact of providing treatment is less than optimal because offenders often fail to follow through on treatment referrals, leave treatment early, or have poor engagement in treatment activities. In particular, participation in prison-based treatment alone is seldom effective in reducing drug use or recidivism unless it is followed by participation in community treatment. For correctional systems that provide a continuum of care model from prison to community, low rates of admission and retention result in poor outcomes and poor resource utilization. One way to address this problem is to provide incentives to parolees for community treatment participation. Although research supports the effectiveness of behavioral reinforcement, mainly in the form of contingency management (CM), for general substance abuse populations, CM has not yet been tested or adapted for use in community-based programs for offender populations, particularly to encourage treatment attendance. The UCLA Integrated Substance Abuse Programs (ISAP), in collaboration with Walden House and the California Department of Corrections and Rehabilitation, is proposing a five-year health services research study that will involve a randomized test of the use of incentives with parolees in a community-based TC to increase treatment admission and treatment retention, and thereby increase the likelihood of improved outcomes. Study participants will be recruited from clients in a prison-based treatment program who have a referral to the Walden House community program. The Admission Phase of the study assesses the effect to fan incentive (voucher) on enrolling in the Walden House program. The Attendance Phase assesses the effect of incentives on treatment attendance and on post-treatment drug use, crime, and psychosocial behaviors. The intervention will last for six months. Study participants will be interviewed at baseline and at 12 months following the intervention. Treatment and criminal justice data will be obtained. Data on acceptability, satisfaction, and sustainability will be collected from focus groups with staff and clients. The study has four specific aims: (1) Determine whether offering an incentive (voucher) increases admission to community treatment by parolees who have participated in prison treatment. (2) For parolees who enter community treatment, determine whether providing incentives for attendance results in greater retention in treatment. (3) Assess the long-term impact of the use of incentives on drug use, crime, and psychosocial outcomes at 12 months following the end of the six-month intervention. (4) Assess issues of acceptability, satisfaction, and sustainability of the use of incentives to increase admission and retention among staff and clients.