Continuing Care App for Justice-Involved Individuals with Substance Use Disorders

摘要 物质使用障碍（SUD）仍然是美国最严重的公共卫生问题之一。 研究一致证明，在司法管辖下的成年人中，SUD的患病率显著较高 社区中的监督（即，与一般人群相比，缓刑/假释）。2 -4继续护理 针对SUD患者的倡议越来越受到关注，因为人们认识到物质使用 治疗需要长期护理。15，46，47，54-58研究表明，持续的护理干预可以提供 持续支持或扩大初级治疗在减少药物使用、复发和 12，52，55，56，61-63最近在弱势群体中传播互联网和智能手机技术 人口现在为增加获得优质持续护理干预措施提供了前所未有的机会 以及慢性病自我管理工具。受感化者及假释犯复吸风险高 和参与危害健康的行为是一个重要的人群， 持续护理技术。 基于我们团队在犯罪学和药物使用领域的丰富经验，我们建议 通过增强应用程序功能，完成持续护理移动的应用程序（app）的开发， 进行随机对照试验，以评估其在缓刑或假释客户中的有效性， 参加了门诊药物使用治疗。该应用程序旨在满足恢复和个人 支持需要缓刑和假释与SUD谁是在复发，治疗的风险增加 中止，重新逮捕和监禁。它是由跨理论模型的原则， 行为改变，24和应用程序的内容是从你自己的重返社会系统（YOURS）计划，25 一项以药物使用康复、减少犯罪思维和 行为和培养支持系统。如果证明是有效的，CC应用程序可以部署在整个 它将成为全国门诊治疗提供者网络的一部分，并将对公共卫生产生重大的直接影响。

Abstract Substance use disorders (SUDs) continue to be one of the most serious public health problems in the US.1 Studies have consistently documented a substantially higher prevalence of SUDs among adults under justice supervision in the community (i.e., probation/parole) as compared to the general population.2-4 Continuing care initiatives for individuals with SUDs have gained increased attention with the recognition that substance use treatment requires long-term care.15, 46, 47, 54-58 Studies show that continuing care interventions can provide ongoing support or extend primary treatment gains with respect to reductions in substance use, relapse, and criminal activity.12, 52, 55, 56, 61-63 Recent diffusion of Internet and smartphone technologies among disadvantaged populations now offers unprecedented opportunities for increasing access to quality continuing care interventions as well as chronic disease self-management tools. Probationers and parolees at high risk for drug abuse relapse and involvement in health compromising behaviors are an important population that stands to benefit from continuing care technologies. Building on our team’s extensive experience in the fields of criminology and substance use, we propose to finalize the development of a Continuing Care mobile application (app) by enhancing app capabilities and conducting a randomized controlled trial to assess its effectiveness among clients on probation or parole who are enrolled in outpatient substance use treatment. The app is designed to meet the recovery and personal support needs of probationers and parolees with SUDs who are at elevated risk of relapse, treatment discontinuation, re-arrest, and incarceration. It is guided by the principles of the transtheoretical model of behavior change,24 and app content is derived from the Your Own Reintegration System (YOURS) program,25 an empirically-supported26 intervention that focuses on substance use recovery, reducing criminal thinking and behavior, and cultivating support systems. If proven to be effective, the CC app could be deployed across the national network of outpatient treatment providers and be highly significant in its direct impact on public health.