Sustainable HIV Risk Reduction Strategies for CJ Systems

描述（由申请人提供）：由于缺乏政策制定和刑事司法，卫生和社会服务机构之间的整合，大多数刑事司法治疗系统中不存在包括连续性护理在内的艾滋病毒/乙型肝炎病毒/丙型肝炎病毒风险降低预防/干预计划。由于社区监管过程中存在的风险行为，以社区监管为目标的风险降低干预措施至关重要。在美国，大约有500万名罪犯接受社区监督（司法统计局，2004年），其中41%的人接受药物治疗作为一种特殊情况，33%的人需要进行药物测试（Bonczar，1997年）。社区矫正人群的风险降低方法是必要的，有能力解决动机，社会和认知缺陷。本申请建议 调整监狱内高度互动的课程，以改进有关健康风险行为的决策，供社区监督下的罪犯使用。 这个拟议的延续项目的第一阶段开发和测试了一个在监狱中，以小组为基础的课程，名为WaySafe，旨在帮助罪犯在释放回到社区后对健康风险行为做出更好的决定。我们研究的下一步是将创新的WaySafe干预措施用于社区矫正人群。适应性干预，StaySafe，将包括12个30分钟的自我管理会议，基于循证认知原则，旨在改善社区监督下关键的前六个月期间有关健康风险行为的决策技能。StaySafe将适用于最近完成了住宅，强化门诊或监狱药物滥用治疗计划的缓刑犯。它将在他们等待与他们的缓刑监督官定期预约的时间内交付。这种方法的一个优点是，干预措施可以管理到见习人员与最低限度的培训和时间承诺的工作人员，它利用见习人员的休息时间，当他们等待任命。它将利用平板电脑，使干预措施能够根据每个参与者的需求和目标进行个性化，并为试用者提供一个易于使用的界面，以完成指南地图并回忆以前课程中完成的任务。这项干预措施将在德克萨斯州的哈里斯县和塔兰特县采用随机干预方法实施。参与的缓刑犯（N= 1，200）将被随机分配到实验（StaySafe）或标准实践（SP）研究组。6个月和12个月的结果测量将包括有关风险降低行为的知识和态度，参与性行为和药物风险行为，以及进行HIV/HBV/HCV检测。

DESCRIPTION (provided by applicant): Well established and consistent use of HIV/HBV/HCV risk reduction prevention/intervention programs that include continuity of care do not exist in most criminal justice treatment systems because of lack of policy development and integration among criminal justice, health, and social service agencies. Risk reduction interventions targeting community-based supervision are crucial because of the risk behaviors that exist during community supervision. In the U.S., there are approximately 5 million offenders under community supervision (Bureau of Justice Statistics, 2004) with 41% having drug treatment as a special condition and 33% having a drug-testing requirement (Bonczar, 1997). Risk reduction approaches for community corrections populations are needed that have the capability of addressing motivational, social, and cognitive deficits. This application proposes to adapt an in-prison and highly interactive curriculum for improving decision making regarding health risk behaviors for use with offenders under community supervision. The first phase of this proposed continuation project developed and tested an in-prison, group-based curriculum, titled WaySafe, that was designed to help offenders make better decisions regarding health risk behaviors after release back to the community. The next step in our research is to adapt the innovative WaySafe intervention for use with community-corrections populations. The adapted intervention, StaySafe, will include twelve 30 minute self-administered sessions based on evidence-based cognitive principles designed to improve decision-making skills regarding health risk behaviors during the critical first six months under community supervision. StaySafe will be administered to probationers who recently completed a residential, intensive outpatient, or prison-based substance abuse treatment program. It will be delivered during the time they are waiting for their regularly scheduled appointments with their probation officer. An advantage of this approach is that the intervention can be administered to probationers with minimal training and time commitment by staff and that it utilizes probationer down time when they are waiting for appointments. It will utilize tablet computers that allow the intervention to be individualizedto the needs and goals of each participant, and provide an easy to use interface for probationers to complete guide maps and to recall completed assignments from previous sessions. This intervention will be implemented in Harris and Tarrant Counties in Texas utilizing a randomized intervention approach. Participating probationers (N=1,200) will be randomly assigned to an experimental (StaySafe) or standard practice (SP) study arm. Outcome measures at 6 and 12 months will include knowledge and attitudes regarding risk reduction behaviors, engagement in sex and drug risk behaviors, and getting tested for HIV/HBV/HCV.