Sustainable HIV Risk Reduction Strategies for CJ Systems

说明(由申请人提供)：由于刑事司法、卫生和社会服务机构之间缺乏政策制定和整合，大多数刑事司法治疗系统中不存在包括连续性护理在内的艾滋病毒/乙肝/丙型肝炎风险降低预防/干预计划的良好和一致的使用。针对社区监督的风险降低干预措施至关重要，因为社区监督过程中存在危险行为。在美国，大约有500万罪犯处于社区监督之下(司法部统计局，2004年)，其中41%的人将药物治疗作为一种特殊情况，33%的人需要进行药物测试(Bonczar，1997)。社区矫正人群需要有能力解决动机、社会和认知缺陷的降低风险的方法。此应用程序建议 调整监狱内和高度互动的课程，以改善关于健康危险行为的决策，以便在社区监督下与罪犯一起使用。这个拟议的延续项目的第一阶段开发并测试了一种名为WaySafe的监狱内小组课程，旨在帮助罪犯在释放回社区后就危害健康的行为做出更好的决定。我们研究的下一步是将创新的WaySafe干预应用于社区矫正人群。调整后的干预措施，StaySafe，将包括12次30分钟的自我管理会议，基于基于证据的认知原则，旨在提高在社区监督下的关键前六个月有关健康危险行为的决策技能。StaySafe将适用于最近完成住院、重症门诊或监狱药物滥用治疗计划的缓刑人员。它将在他们等待与缓刑监督官定期预约的时间内交付。这种方法的一个优点是，可以对缓刑人员进行干预，而工作人员只需接受最少的培训和投入最少的时间，而且它利用了缓刑人员在等待预约时的休息时间。它将利用平板电脑，允许根据每个参与者的需求和目标进行个性化干预，并为试用者提供一个易于使用的界面，以完成指导图和回忆以前课程中完成的作业。这项干预将在德克萨斯州的哈里斯县和塔兰特县实施，采用随机干预方法。参与者(N=1,200)将被随机分配到实验(StaySafe)或标准实践(SP)研究臂。6个月和12个月的结果测量将包括关于降低风险行为的知识和态度，参与性行为和毒品风险行为，以及接受艾滋病毒/乙肝病毒/丙型肝炎病毒检测。

DESCRIPTION (provided by applicant): Well established and consistent use of HIV/HBV/HCV risk reduction prevention/intervention programs that include continuity of care do not exist in most criminal justice treatment systems because of lack of policy development and integration among criminal justice, health, and social service agencies. Risk reduction interventions targeting community-based supervision are crucial because of the risk behaviors that exist during community supervision. In the U.S., there are approximately 5 million offenders under community supervision (Bureau of Justice Statistics, 2004) with 41% having drug treatment as a special condition and 33% having a drug-testing requirement (Bonczar, 1997). Risk reduction approaches for community corrections populations are needed that have the capability of addressing motivational, social, and cognitive deficits. This application proposes to adapt an in-prison and highly interactive curriculum for improving decision making regarding health risk behaviors for use with offenders under community supervision. The first phase of this proposed continuation project developed and tested an in-prison, group-based curriculum, titled WaySafe, that was designed to help offenders make better decisions regarding health risk behaviors after release back to the community. The next step in our research is to adapt the innovative WaySafe intervention for use with community-corrections populations. The adapted intervention, StaySafe, will include twelve 30 minute self-administered sessions based on evidence-based cognitive principles designed to improve decision-making skills regarding health risk behaviors during the critical first six months under community supervision. StaySafe will be administered to probationers who recently completed a residential, intensive outpatient, or prison-based substance abuse treatment program. It will be delivered during the time they are waiting for their regularly scheduled appointments with their probation officer. An advantage of this approach is that the intervention can be administered to probationers with minimal training and time commitment by staff and that it utilizes probationer down time when they are waiting for appointments. It will utilize tablet computers that allow the intervention to be individualizedto the needs and goals of each participant, and provide an easy to use interface for probationers to complete guide maps and to recall completed assignments from previous sessions. This intervention will be implemented in Harris and Tarrant Counties in Texas utilizing a randomized intervention approach. Participating probationers (N=1,200) will be randomly assigned to an experimental (StaySafe) or standard practice (SP) study arm. Outcome measures at 6 and 12 months will include knowledge and attitudes regarding risk reduction behaviors, engagement in sex and drug risk behaviors, and getting tested for HIV/HBV/HCV.