In-person vs. Computer Interventions to Increase Probation Compliance

描述（由申请人提供）：在刑事司法系统中，药物滥用治疗在减少药物使用和相关犯罪行为方面是有效的，这是众所周知的。虽然毒品和酒精治疗是刑事司法项目的共同任务，但只有少数客户真正开始治疗。这个应用程序将比较两种干预形式，目标动机发起和参与药物滥用治疗的一组缓刑犯谁有药物或酒精治疗条件。在两个缓刑地点（马里兰州的巴尔的摩和德克萨斯州的达拉斯），600名毒品和酒精犯罪者将随机接受：1)面对面的动机性访谈（MI）， 2)动机性计算机程序（MC），或3)正常的摄入和监测监督（SAU）。MI条件将按照有希望的检查格式进行构建，其中包括以MI风格提供的评估和个性化反馈；MC条件的内容将从以前关于有效激励计算机程序的文献中提取。此外，由于刑事司法人员中传染病的发病率要高得多，而且吸毒与传染病之间存在联系，因此，MI和MC条件将包括向符合条件的参与者转诊艾滋病毒/艾滋病检测和治疗。这两种干预措施都将在试用期开始时提供，并在1个月、6个月和12个月进行后续评估。主要成果包括参与药物滥用治疗；次要结果包括药物和酒精使用、缓刑进展、艾滋病毒检测和治疗以及犯罪行为。该项目将是第一个开发和测试两项干预措施的项目，旨在鼓励刑事司法部门的案主遵循治疗建议，其目标是增加开始治疗的人数，减少随后的吸毒和相关危险行为。它还与两家大型缓刑机构——达拉斯县监督和惩戒部门以及马里兰州假释和缓刑部门——建立了持续的合作关系。

DESCRIPTION (provided by applicant): It is well established that substance abuse treatment in the criminal justice system is effective at reducing drug use and related criminal behavior. Although drug and alcohol treatment are common mandates in criminal justice programs, only a minority of clients actually initiate treatment. This application will compare two intervention formats that target motivation to initiate and engage in substance abuse treatment among a group of probationers who have drug or alcohol treatment conditions. Six hundred drug and alcohol offenders in two probation sites (Baltimore, Maryland, and Dallas, Texas) will be randomized to receive: 1) an in-person motivational interviewing session (MI), 2) a motivational computer program (MC), or 3) intake and monitoring supervision as usual (SAU). The MI condition will be structured along the lines of the promising Check-Up format, which consists of an assessment and personalized feedback delivered in an MI style; the content of the MC condition will be drawn from previous literature on effective motivational computer programs. In addition, because of the much higher rates of infectious disease among criminal justice populations and the link between drug use and infectious disease, the MI and MC conditions would include a referral to HIV/AIDS testing and treatment for those participants who qualify. Both interventions will be delivered at the start of the probation process, with follow-up assessments at one, six, and twelve months. Primary outcomes include engagement and participation in substance abuse treatment; secondary outcomes include drug and alcohol use, probation progress, HIV testing and treatment, and criminal behavior. This project will be the first to develop and test two interventions for encouraging criminal justice clients to follow through with treatment recommendations, with the goal of increasing treatment initiation and reducing subsequent drug use and related risky behavior. It also contributes to ongoing partnerships with two large probation agencies -- the Dallas County Supervision and Corrections Department and the Maryland Division of Parole and Probation. PUBLIC HEALTH RELEVANCE: Despite being a common mandate of criminal justice sentencing, only a minority of probationers with drug treatment orders actually complete substance abuse treatment. Substance abusers also have higher rates of incidence of HIV/AIDS, yet few seek testing or care. This project will compare an in-person motivational interview, a motivational computer program, or supervision as usual, in order to increase the number of probationers who follow through with substance abuse treatment mandates and/or receive HIV testing and treatment.