Homeless Female Offenders Returning to the Community: Improving Hopeful Futures

在过去的十年中，被监禁的女性人数增加了两倍，使女性成为美国增长最快的罪犯群体。与被监禁的男性相比，女性罪犯因毒品犯罪而被判刑的比例较高;此外，她们往往是注射毒品使用者，其性伴侣也是注射毒品使用者，而且往往被迫从事性交易以求生存。多达50%的女性罪犯报告遭受过身体和/或性虐待;此外，创伤性虐待、长期的情绪困扰以及因重罪犯和吸毒者而产生的内在耻辱感对妇女的自尊心产生了深刻的影响，导致绝望和抑郁的感觉，延迟康复和重返社会，增加危险行为，以及健康问题。毫不奇怪，被监禁的妇女患精神疾病的可能性几乎是非犯罪妇女的两倍;此外，44%的人在一年内因持有受管制物质而复发。特别是，在无家可归的女罪犯中，假释犯和缓刑犯都报告说，成功重返社会面临持续的挑战。这些问题包括住房不稳定、生活无组织、失业以及获得保健和社会服务的机会有限。虽然洛杉矶县缓刑部在其《加州女性罪犯蓝图总计划》中为成功的方案提供了指导，但所建议的增强权能、积极应对和工作技能以及提供同伴指导方法的战略尚未得到实施或评估。 在R34的第一阶段，我们的加州大学洛杉矶、旧金山弗朗西斯科和欧文分校的研究人员计划利用我们成功的社区参与方法来完善一个对性别敏感的、以犯罪需求为重点的干预计划，即女性前罪犯在护理中的指导（FEM-CARE），并得到一个社区咨询委员会的帮助，该委员会由HFO和戒毒工作人员组成;并最终确定战略，这些战略将在与氢氟碳化物的重点小组会议上得到验证。在第二阶段，我们将随机抽取130名参与两个住院药物治疗计划之一的HFO，以评估FEM-CARE或健康促进控制计划对减少药物和酒精使用和累犯的影响。这项研究是基于我们的团队的历史，促进理论为基础的，文化敏感的护士领导的干预措施， 这些项目丰富了刑事司法理论观点，并导致无家可归者中吸毒和酗酒的人数大幅减少，其中许多人有过被监禁的历史。我们最近成功地让男性假释犯参与护士支持的同伴指导，我们的团队在加强弱势妇女减少耻辱方面的专业知识，以及我们的刑事司法专家为这项研究提供了信息。最后，最近对HFO的形成性研究揭示了对同伴榜样的渴望，以支持和增强对医疗保健的了解和获得，促进积极应对，稳定的住房和工作技能，并减少耻辱和抑郁情绪;所有这些因素都可以导致旨在预防药物和酒精使用并减少累犯的新计划。这一基础和强大的社区支持，导致我们提出的干预计划的设计。

DESCRIPTION (provided by applicant): In the last decade, the numbers of incarcerated females has tripled, making women the most rapidly growing group of offenders in the United States. When compared to incarcerated males, female offenders have a higher rate of being sentenced for drug crimes; moreover, they are often injection drug users (IDUs), have sexual partners who are IDUs, and are often forced into the sex trade for survival. As many as 50 percent of female offenders report physical and/or sexual abuse; further, traumatic abuse, chronic emotional distress, and internalized stigma resulting from being a felon and a drug-user, have a profound effect on the women's self-esteem, leading to feelings of hopelessness and depression, delayed recovery and reintegration, increased risky behaviors, and health concerns. Not surprisingly, women who have been incarcerated are nearly twice as likely to experience mental illness compared with non-offending women; further, 44 percent recidivate within a year due to possession of a controlled substance. In particular, among homeless female offenders (HFOs), both parolees and probationers report ongoing challenges for successful re-entry. These include unstable housing, disorganized lives, unemployment, and limited access to health and social services. While the Los Angeles County Department of Probation has provided guidance for successful programs in its California Blueprint Master Plan for Female Offenders, the suggested strategies of enhancing empowerment, positive coping, and job skills, and providing peer-mentored approaches have not yet been implemented or evaluated. In Phase I of this R34, our team of University of California Los Angeles, San Francisco, and Irvine researchers plan to utilize our successful community participatory approaches to refine a gender-sensitive criminogenic needs - focused intervention program, Female Ex-Offender Mentoring in Care (FEM-CARE), with the help of a community advisory board, composed of HFOs and addiction staff; and finalize strategies which will be validated by focus group sessions with HFOs. In Phase II, we will randomize 130 HFOs participating in one of two residential drug treatment programs to assess the impact of the FEM-CARE or a Health Promotion control program on reduction of drug and alcohol use and recidivism. This study is based upon our team's history of promoting theoretically-based, culturally- sensitive nurse-led interventions that are enriched with criminal justice theoretical perspectives, and have resulted in significant reductions in drug and alcohol use among homeless persons, many of whom have had a history of incarceration. Our most recent successes in engaging male parolees in nurse-supported peer mentorship, our team's expertise in enhancing stigma reduction among vulnerable women, and our criminal justice experts have informed this study. Finally, recent formative research with HFOs has revealed a desire for peer role models to support and enhance knowledge of and access to healthcare, promote positive coping, stable housing, and job skills, and to reduce stigma and depressed mood; all of these factors can result in novel programs designed to prevent drug and alcohol use and reduce recidivism. This foundation and strong community support garnered has led to the design of our proposed intervention program.