Methamphetamine use in inmates: risk behaviors, health status and recidivism

囚犯使用甲基苯丙胺：危险行为、健康状况和累犯

• 批准号: 7574424
• 负责人: MARY Castle WHITE
• 金额: $ 7.73万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-03-01 至 2011-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7574424
• 关键词: Adult; Aftercare; Age; Alcohol or Other Drugs use; Anal Sex; Behavior; Behavior Control; California; Caring; Communities; Consent; County; Cross-Sectional Studies; Data; Dependence; Development; Drug usage; Education; Ethnic Origin; Face; Family; Gender; Goals; Health; Health Care Visit; Health Services; Health Services Accessibility; Health Status; Health behavior; Healthcare; Historical Cohort Studies; Imprisonment; Intervention; Interview; Jail; Knowledge; Lead; Length; Life; Measures; Medical Records; Methamphetamine; Outcome; Participant; Patient Self-Report; Persons; Pharmaceutical Preparations; Population; Prevalence; Primary Health Care; Prisoner; Provider; Public Health; Race; Recording of previous events; Records; Research; Risk; Risk Behaviors; Risk Factors; Sampling; Services; Sexual Partners; Source; Stigmata; Substance abuse problem; Target Populations; Testing; Time; Treatment outcome; Violence; Woman; Work; abstracting; base; care seeking; experience; follow-up; health care delivery; high risk; high risk behavior; high risk sexual behavior; improved; insight; men; methamphetamine abuse; programs; public health relevance; recidivism; reincarceration; social; social stigma; therapy development

DESCRIPTION (provided by applicant): Project Summary/Abstract Substance abuse is strongly associated with both high-risk sexual and drug-related behaviors and incarceration. Methamphetamine in particular has been associated with high-risk behavior and violence. Jails provide primary care to the incarcerated and may be a setting for interventions. Those who self-identify as substance users may benefit from interventions in jail, and the description the target population is critical to development of appropriate services. The purpose of this study is to measure methamphetamine use and associated risk behaviors, health status, health service use and recidivism, in a jailed population. This study is an initial step toward the long-term goal of identifying and testing interventions to improve substance abuse treatment and outcomes. The specific aims of this project are to measure the prevalence of self-reported methamphetamine use and correlate its use with sexual and drug-use risk behaviors; describe the health conditions of and health services provided to inmates by methamphetamine use; and compare length of jail stay and recidivism over a one-year period by methamphetamine use. The project will take place at the Santa Clara County, California, Jail and includes two approaches: one is a cross-sectional study, by interview and medical record at jail entry. A random sample of 200 inmates, 100 men and 100 women, will be drawn. Consenting participants will be interviewed for socio-demographic information (age, race/ethnicity, education, living situation before jail, social and family support), information related to substance use, health status, risk factors including sexual practices, healthcare access and use including prior experience with substance abuse treatment services, perceived stigma and barriers to care, and past and perceived needs for services and care after release. Analyses will describe the sample and evaluate the association between methamphetamine use and high-risk sexual and drug behaviors. The second approach is a historical cohort study, by medical record review, of healthcare services provided and recidivism over time. A random sample of 300 inmate records, 150 men and 150 women, of inmates seen by Adult Custody Health Services during a six-month period in 2007 will be drawn. Information for one year following the 2007 healthcare visit will be extracted, including: socio-demographic data, health conditions (including substance use) and services received and outcome of care, and subsequent jail terms. Analyses for each gender will describe, by methamphetamine use: the use of services, number and prevalence of conditions, and will test the hypothesis that methamphetamine users have less time to re-arrest; have more arrests and longer time in jail in the one-year follow-up. PUBLIC HEALTH RELEVANCE: The relevance of this study to public health is in its focus on the incarcerated and on the unanswered questions about methamphetamine use and associated health risks and conditions. Well-known barriers to care that face marginalized persons in the community are removed when persons enter jails, which serve as primary care providers for the incarcerated; thus jails have increasingly become settings for identification of health conditions and initiation of treatment, and sometimes have become the only source of healthcare for this population. Knowledge gained in this setting is likely to provide insight to other jails in the assessment, management, and provision of programs to incarcerated methamphetamine abusers.

描述（由申请人提供）：项目摘要/摘要药物滥用与高风险性行为和毒品相关行为以及监禁密切相关。特别是甲基苯丙胺与高风险行为和暴力有关。监狱为被监禁者提供初级保健，也可作为干预的场所。那些自我认定为药物使用者的人可能会从监狱中的干预措施中受益，对目标人群的描述对于发展适当的服务至关重要。本研究的目的是测量甲基苯丙胺的使用和相关的危险行为，健康状况，卫生服务的使用和累犯，在一个被监禁的人口。这项研究是朝着确定和测试干预措施以改善药物滥用治疗和结果的长期目标迈出的第一步。该项目的具体目标是衡量自我报告的甲基苯丙胺使用的流行程度，并将其使用与性和毒品使用风险行为联系起来;描述使用甲基苯丙胺的囚犯的健康状况和向其提供的保健服务;并比较使用甲基苯丙胺一年期间的监禁时间和累犯率。该项目将在加州圣克拉拉县监狱进行，包括两种方法：一种是横断面研究，通过访谈和入狱时的医疗记录。将随机抽取200名囚犯，100名男性和100名女性。将对参加者进行社会人口信息访谈（年龄、种族/民族、教育、入狱前的生活状况、社会和家庭支持）、与药物使用有关的信息、健康状况、包括性行为在内的风险因素、医疗保健的获得和使用，包括先前的药物滥用治疗服务经验、感知的耻辱和护理障碍，以及释放后对服务和护理的过去和感知需求。分析将描述样本，并评估甲基苯丙胺使用与高风险性行为和毒品行为之间的关联。第二种方法是历史队列研究，通过医疗记录审查，提供医疗服务和累犯随着时间的推移。将在2007年6个月期间随机抽取300名囚犯的记录，其中150名男性和150名女性，由成人拘留保健服务机构提供。将提取2007年医疗保健访问后一年的信息，包括：社会人口数据、健康状况（包括药物使用）和所接受的服务以及护理结果，以及随后的刑期。对每种性别的分析将按甲基苯丙胺用途：使用服务、数量和患病率进行描述，并将检验以下假设：甲基苯丙胺使用者重新被捕的时间较少;在一年的随访中被捕次数较多，入狱时间较长。公共卫生关系：这项研究与公共卫生的相关性在于其重点是被监禁者和关于甲基苯丙胺使用及相关健康风险和状况的未回答问题。当人们进入监狱时，社区中边缘化人群面临的众所周知的护理障碍就会被消除，监狱是被监禁者的初级保健提供者;因此，监狱已越来越多地成为识别健康状况和开始治疗的环境，有时已成为这一人群唯一的医疗保健来源。在这种情况下获得的知识可能会提供洞察力，以其他监狱的评估，管理和提供方案，以监禁甲基苯丙胺滥用者。