Using Incentives to Improve Parolee Participation and Attendance in Community Tx

描述（由申请人提供）：尽管相当多的研究表明，以监狱为基础的治疗，然后在社区继续治疗，可以有效地减少吸毒罪犯的吸毒和犯罪，但提供治疗的效果并不理想，因为罪犯往往不能坚持治疗，提前离开治疗，或者对治疗活动的参与程度较差。特别是，除非随后参加社区治疗，否则单独参加监狱治疗很少能有效地减少吸毒或再犯。对于提供从监狱到社区的连续护理模式的惩教系统来说，低入学率和保留率导致结果不佳和资源利用率低下。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，主要以应急管理（CM）的形式，对于一般的药物滥用人群，CM尚未被测试或适应用于犯罪者群体的社区项目，特别是鼓励治疗出席。加州大学洛杉矶分校药物滥用综合项目（ISAP）与瓦尔登之家和加州惩教与康复部合作，提出了一项为期五年的健康服务研究计划，该研究将涉及一项随机试验，对社区TC中的假假释者使用激励措施，以增加接受治疗和治疗保留，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对参与瓦尔登之家项目的粉丝激励（代金券）的影响。出席阶段评估激励措施对出席治疗和治疗后吸毒、犯罪和心理社会行为的影响。干预将持续6个月。研究参与者将在基线和干预后12个月接受访谈。将获得治疗和刑事司法数据。关于可接受性、满意度和可持续性的数据将从员工和客户的焦点小组中收集。该研究有四个具体目标：(1)确定提供奖励（代金券）是否会增加参加过监狱治疗的假释犯接受社区治疗的可能性。(2)对于进入社区治疗的假释犯，确定提供出席奖励是否会导致更大的治疗保留。(3)在六个月干预结束后的12个月内，评估激励措施对吸毒、犯罪和心理社会结果的长期影响。(4)评估激励措施的可接受性、满意度和可持续性，以增加员工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.