Screening, Brief Intervention, and Referral to Treatment (SBIRT) with Offenders

描述（由申请人提供）：筛查短暂干预和转诊治疗（SBIRT）是一种循证实践，已被发现可有效减少酒精和非法药物的使用，主要是在医疗中心，初级保健办公室，急诊室和学院和大学招募的人员中。但是SBIRT有可能适用于其他有物质使用问题或有物质使用风险的人群。特别是，犯罪者在不同严重程度上吸毒和酗酒的流行率很高，而且往往得不到充分的干预，这要么是因为方案的可用性有限，要么是因为动机低，要么是因为缺乏对其物质使用后果的认识。 该研究旨在测试SBIRT干预监狱囚犯的有效性，目的是改善公共安全和公共卫生。基于以前和目前对药物滥用罪犯治疗的研究，以及由SAMHSA资助的SBIRT研究在洛杉矶监狱被拘留者建立的基础设施，加州大学洛杉矶分校综合药物滥用计划（ISAP）提出了一项为期四年的随机实地研究，以检查SBIRT对已被定罪并即将从监狱释放的罪犯的有效性。我们将在洛杉矶县的两个监狱招募囚犯，一个为男性，一个为女性，并将他们随机分配到治疗组（SBIRT）（N = 400）或对照组（无干预）（N = 400）。 将收集基线人口统计学数据。研究入组后12个月，将联系所有研究参与者进行随访。实验性研究将使用人工干预的组成部分，将在社区环境（监狱和当地社区治疗系统）内实施，因此将试图适当考虑内部和外部有效性的问题。据我们所知，这将是SBIRT对罪犯群体的第一次严格测试。 本研究的科学目的是：（1）评估SBIRT对监狱囚犯参与一系列渐进式干预（短期干预，短期治疗和转介到长期治疗）的有效性。 根据风险水平进行治疗。(2)在研究入院后12个月，确定SBIRT对监狱囚犯的公共卫生和公共安全结果的有效性，即药物使用，酒精使用，犯罪活动，逮捕，重新监禁，HIV风险行为和生活质量。(3)确定为监狱囚犯提供SBIRT干预的成本。 公共卫生相关性：使用筛查，简短的干预和转诊治疗（SBIRT）的方法，本研究旨在通过为低风险，中风险和高风险罪犯提供一系列渐进的干预措施来影响毒品和酒精的使用以及罪犯人群的HIV风险行为。如果成功，该研究将证明SBIRT可以对吸毒行为和相关的健康和心理社会行为以及犯罪活动和刑事司法参与产生积极影响。

DESCRIPTION (provided by applicant): Screening Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based practice that has been found to be effective in reducing alcohol and illicit drug use, mainly among persons recruited in medical centers, primary care offices, emergency rooms, and colleges and universities. But SBIRT has the potential to be applicable to other populations that have, or that are at risk for, substance use problems. In particular, offenders have high prevalence of drug and alcohol use at varying levels of severity and often do not receive adequate intervention, either because of limited availability of programs, low motivation, or lack of awareness of the consequences of their substance use. The study proposes to test the effectiveness of an SBIRT intervention with jail inmates, with the goal of improving public safety and public health. Building on previous and current research on treatment for substance-abusing offenders and on the infrastructure established by a SAMHSA-funded SBIRT study with jail detainees in Los Angeles, the UCLA Integrated Substance Abuse Programs (ISAP) is proposing a four-year randomized field study to examine the effectiveness of SBIRT with offenders who have been convicted and are about to be released from jail. We will recruit inmates at two jail facilities in Los Angeles County, one for men and one for women, and randomly assign them to the treatment (SBIRT) group (N= 400) or to the control (no intervention) group (N = 400). Baseline demographic data will be collected. Twelve months after study admission, all study participants will be contacted for a follow-up interview. The experimental study will use manualized intervention components, will be implemented within a community setting (jails and a local community treatment system), and will thus attempt to give due consideration to issues of both internal and external validity. To our knowledge, this would be the first rigorous test of SBIRT with an offender population. The scientific aims of the study are: (1) Assess the effectiveness of SBIRT with jail inmates in terms of participation in a graduated series of interventions (brief intervention, brief treatment, and referral to longer-term treatment) depending on risk level. (2) At 12 months after study admission, determine the effectiveness of SBIRT with jail inmates on public health and public safety outcomes, namely, drug use, alcohol use, criminal activity, arrest, reincarceration, HIV risk behaviors, and quality f life.(3) Determine the cost of providing an SBIRT intervention to jail inmates. PUBLIC HEALTH RELEVANCE: Using a screening, brief intervention, and referral to treatment (SBIRT) approach, this study is intended to impact the drug and alcohol use and the HIV risk behavior of an offender population by providing a graduated series of interventions for low-risk, medium-risk, and high-risk offenders. If successful, the study would demonstrate that SBIRT can have a positive effect on the drug use behavior and related health and psychosocial behaviors, as well as on criminal activity and criminal justice involvement.