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Rázuri EB, Yang Y, Tinius E, Knight DK. Adaptation of a trauma-informed intervention to prevent opioid use among youth in the legal system. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 163:209294. [PMID: 38272116 DOI: 10.1016/j.josat.2024.209294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/24/2023] [Accepted: 01/11/2024] [Indexed: 01/27/2024]
Abstract
INTRODUCTION Youth in the legal system are at high risk for opioid and other substance use problems and exhibit high rates of trauma exposure. Trauma-focused therapeutic approaches to prevent substance use show promise, but few evidence-based interventions are designed with justice-involved youth in mind. Consequently, implementing trauma-informed, evidence-based interventions within juvenile justice systems is challenging. The current paper describes the systematic adaptation of Trust-Based Relational Intervention (TBRI) as a family-centered substance use prevention program for youth transitioning from secure residential facilities. METHODS The study utilized the ADAPT-ITT methodological framework to adapt TBRI Caregiver Training, an evidence-based, trauma-informed intervention designed to help caregivers support children and youth with histories of trauma. Phases of adaptation included (1) Assessment, (2) Decision, (3) Prototype Development, and (4) Testing and Integration. The adaptation process explored contextual factors (e.g., systems, facilities, and staff) and the needs of the new target population (i.e., youth in the legal system and their caregivers). Adaptations were made to both content (e.g., terminology and activities) and structure (e.g., session duration and delivery setting) with input from participants from the target population, key stakeholders, and content experts. RESULTS The systematic adaptation of the intervention model resulted in a two-phase, four-component intervention package that can be implemented in juvenile justice settings as part of youth reentry services. The primary intervention, delivered while youth are in residential facilities, includes the TBRI Caregiver Curriculum, TBRI Youth & Young Adult Curriculum, and TBRI Nurture Groups. The secondary intervention, delivered after youth transition home, includes the TBRI Family Coaching Curriculum. CONCLUSIONS Utilizing a systematic methodological framework to guide adaptation has implications for developing accessible, culturally relevant, and contextually appropriate interventions. Accounting for contextual factors and population needs can improve the fit of evidence-based interventions for youth in the legal system, facilitating uptake and ultimately improving outcomes for youth at risk for substance use problems. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04678960.
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Affiliation(s)
- Erin Becker Rázuri
- Karyn Purvis Institute of Child Development, Texas Christian University, United States.
| | - Yang Yang
- Institute of Behavioral Research, Texas Christian University, United States
| | - Elaine Tinius
- Institute of Behavioral Research, Texas Christian University, United States
| | - Danica Kalling Knight
- Karyn Purvis Institute of Child Development, Texas Christian University, United States; Institute of Behavioral Research, Texas Christian University, United States
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Zielinski MJ, Jahangir T, Praseuth A, Wilson S, McLaughlan CL. Mental Health, Drug Use, and Programming: Applying a Needs Assessment Framework in Arkansas' Largest Jail. JOURNAL OF CORRECTIONAL HEALTH CARE 2024; 30:206-215. [PMID: 38842733 DOI: 10.1089/jchc.23.12.0098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
Jail programming is rarely informed by site-specific health needs, diagnostic-specific screening tools that are validated, or the input of incarcerated individuals. Using the community needs assessment (CNA) framework, we aimed to fill these gaps among people incarcerated in the Pulaski County Regional Detention Facility (PCRDF), Arkansas' largest jail. Participants were 179 adults at the PCRDF who completed surveys and open-ended questions focused on (a) their mental and behavioral health and (b) programming needs at the facility. Using a concurrent transformative mixed-methods design, we descriptively analyzed surveys and conducted content analysis of the open-ended questions. Over half of participants reported clinically significant anxiety (62.6%), post-traumatic stress disorder (53.1%), and/or depression (50.3%) symptoms; positive substance use disorder screening was especially common (91.7%). Nearly all (97%) individuals queried desired more programming, with the most desired being mental health and substance use programs. Other desired programs included physical health, education, community reintegration, family support, recreation, nutrition, religious/spiritual services, and meditation. Our CNA ensured the input of those directly impacted during program-focused decision making and identified strategies to effectively implement and sustain jail-based programs. Such assessments can be a potential mechanism for addressing the burden of mental and behavioral health problems in jail populations.
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Affiliation(s)
- Melissa J Zielinski
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Tasfia Jahangir
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Amanda Praseuth
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Stephanie Wilson
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Cassandra L McLaughlan
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
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Matheson FI, McLuhan A, Riccardi JS, Kirby A, McMillan TM. Implementing Interventions for Women and Youth with Traumatic Brain Injury at Transition from Custodial Settings: A Call to Action. Neuropsychiatr Dis Treat 2024; 20:1169-1177. [PMID: 38831936 PMCID: PMC11144573 DOI: 10.2147/ndt.s409794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 05/20/2024] [Indexed: 06/05/2024] Open
Abstract
Traumatic brain injury (TBI) is a serious public health concern and overrepresented among justice-involved populations. An emerging area of research focuses on the complex, interrelated and unmet health and social needs of justice-involved women and youth with TBI. Evidence of these needs continues to grow, yet the health and justice systems continue to underperform in supporting the health and social care of justice-involved women and youth. This commentary is a call to action to begin to redress these gaps. We first provide an overview of the needs of women and youth with TBI that affect their transition from custody to community, including those related to victimization, trauma, mental health, substance use, and homelessness. We then highlight the current gaps in knowledge and practice with respect to interventions for women and youth with TBI at transition from custody. The available evidence for the impact of interventions on people with head injury who are justice-involved is sparse, especially studies of interventions focused on women and youth. We conclude with a call for implementation science studies to support translation from research to practice, emphasizing that researchers, practitioners, policy makers, and women and youth at transition should collaborate to develop, implement, and evaluate accommodations and interventions for TBI. To have meaningful, positive impacts on the systems that serve these women and youth, interdisciplinary service delivery approaches should aim to prevent, raise awareness, identify, and provide timely support and services for the varied needs of women and youth with TBI in transition.
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Affiliation(s)
- Flora I Matheson
- MAP Centre for Urban Health Solutions, St. Michael’s Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Arthur McLuhan
- MAP Centre for Urban Health Solutions, St. Michael’s Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | | | - Amanda Kirby
- School of Education, University of South Wales, Wales, UK
| | - Tom M McMillan
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Scanlon F, Morgan RD, Aceves D. Implementing a Treatment for People with Serious Mental Illness in Jail: A Mixed-Methods Study of Stakeholder Perspectives on Feasibility and Acceptability. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024:10.1007/s10488-024-01380-4. [PMID: 38662179 DOI: 10.1007/s10488-024-01380-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2024] [Indexed: 04/26/2024]
Abstract
People with mental illness are over-represented in the U.S. criminal legal system. Jail presents an optimal opportunity to provide needed mental health care as the entry point to corrections. However, there is a lack of programming available in jails, which may be partly due to limited understanding of how to successfully implement interventions in this complex setting. We implemented a nine-session psychotherapeutic intervention for people with serious mental illness in a county jail. As part of a larger implementation-effectiveness hybrid study, we gathered mixed-methods data from stakeholders (treatment recipients and jail administrators) on the feasibility and acceptability of the intervention's implementation. In focus group discussions and qualitative interviews, treatment recipients (n = 29) provided qualitative and quantitative data on their perceptions of the implementation's feasibility and acceptability. Jail administrators (n = 6) completed two quantitative self-report measures on their perceptions of the treatment's feasibility and acceptability. Qualitative analyses were conducted by two coders using inductive thematic template analysis; seven global themes relating to treatment recipients' perceptions of the assets and hindrances to feasibility and acceptability were developed and are presented with supporting quotations. Quantitatively, all treatment recipients endorsed the intervention's feasibility (100%), and nearly all (97%) endorsed its acceptability. On both self-report measures, jail administrators' mean scores fell above a-priori thresholds indicating feasibility and acceptability. We found qualitative and quantitative support for the use of this intervention in jail from both sets of stakeholders. These results have implications for clinical service and policy in jail, where service providers struggle to meet the considerable demand for mental health services.
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Hailemariam M, Bustos TE, Montgomery BW, Brown G, Tefera G, Adaji R, Taylor B, Eshetu H, Barajas C, Barajas R, Najjar V, Dennis D, Hudson J, Felton JW, Johnson JE. Mental health interventions for individuals with serious mental illness in the criminal legal system: a systematic review. BMC Psychiatry 2024; 24:199. [PMID: 38475800 PMCID: PMC10935949 DOI: 10.1186/s12888-024-05612-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 02/14/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Globally, individuals with mental illness get in contact with the law at a greater rate than the general population. The goal of this review was to identify and describe: (1) effectiveness of mental health interventions for individuals with serious mental illness (SMI) who have criminal legal involvement; (2) additional outcomes targeted by these interventions; (3) settings/contexts where interventions were delivered; and (4) barriers and facilitating factors for implementing these interventions. METHODS A systematic review was conducted to summarize the mental health treatment literature for individuals with serious mental illness with criminal legal involvement (i.e., bipolar disorder, schizophrenia, major depressive disorder). Searches were conducted using PsychINFO, Embase, ProQuest, PubMed, and Web of Science. Articles were eligible if they were intervention studies among criminal legal involved populations with a mental health primary outcome and provided description of the intervention. RESULTS A total of 13 eligible studies were identified. Tested interventions were categorized as cognitive/behavioral, community-based, interpersonal (IPT), psychoeducational, or court-based. Studies that used IPT-based interventions reported clinically significant improvements in mental health symptoms and were also feasible and acceptable. Other interventions demonstrated positive trends favoring the mental health outcomes but did not show statistically and clinically significant changes. All studies reported treatment outcomes, with only 8 studies reporting both treatment and implementation outcomes. CONCLUSION Our findings highlight a need for more mental health research in this population. Studies with randomized design, larger sample size and studies that utilize non-clinicians are needed.
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Affiliation(s)
- Maji Hailemariam
- Charles Stewart Mott Department of Public Health, College of Human Medicine, Michigan State University, Flint, MI, USA.
| | | | | | - Garrett Brown
- Charles Stewart Mott Department of Public Health, College of Human Medicine, Michigan State University, Flint, MI, USA
| | - Gashaye Tefera
- College of Social Work, Florida State University, Tallahassee, USA
| | - Rosemary Adaji
- Department of Epidemiology and Biostatistics, Michigan State University, Flint, MI, USA
| | - Brandon Taylor
- Charles Stewart Mott Department of Public Health, College of Human Medicine, Michigan State University, Flint, MI, USA
| | - Hiywote Eshetu
- Charles Stewart Mott Department of Public Health, College of Human Medicine, Michigan State University, Flint, MI, USA
| | - Clara Barajas
- Dornsife School of Public Health, Health Management and Policy Department, Drexel University, Philadelphia, USA
| | - Rolando Barajas
- Georgetown University School of Medicine, Washington, DC, USA
| | - Vanessa Najjar
- College of Osteopathic Medicine, Michigan State University, Flint, MI, USA
| | - Donovan Dennis
- College of Human Medicine, Michigan State University, Flint, MI, USA
| | - Jasmiyne Hudson
- College of Human Medicine, Michigan State University, Flint, MI, USA
| | - Julia W Felton
- Center for Health Policy & Health Services Research, Henry Ford Health, Detroit, MI, USA
| | - Jennifer E Johnson
- Charles Stewart Mott Department of Public Health, College of Human Medicine, Michigan State University, Flint, MI, USA
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Van Deinse TB, Zielinski MJ, Holliday SB, Rudd BN, Crable EL. The application of implementation science methods in correctional health intervention research: a systematic review. Implement Sci Commun 2023; 4:149. [PMID: 38001546 PMCID: PMC10675852 DOI: 10.1186/s43058-023-00521-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/28/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Improving access to high-quality healthcare for individuals in correctional settings is critical to advancing health equity in the United States. Compared to the general population, criminal-legal involved individuals experience higher rates of chronic health conditions and poorer health outcomes. Implementation science frameworks and strategies offer useful tools to integrate health interventions into criminal-legal settings and to improve care. A review of implementation science in criminal-legal settings to date is necessary to advance future applications. This systematic review summarizes research that has harnessed implementation science to promote the uptake of effective health interventions in adult criminal-legal settings. METHODS A systematic review of seven databases (Academic Search Premier, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Social Work Abstracts, ProQuest Criminal Justice Database, ProQuest Sociological Abstracts, MEDLINE/PubMed) was conducted. Eligible studies used an implementation science framework to assess implementation outcomes, determinants, and/or implementation strategies in adult criminal-legal settings. Qualitative synthesis was used to extract and summarize settings, study designs, sample characteristics, methods, and application of implementation science methods. Implementation strategies were further analyzed using the Pragmatic Implementation Reporting Tool. RESULTS Twenty-four studies met inclusion criteria. Studies implemented interventions to address infectious diseases (n=9), substance use (n=6), mental health (n=5), co-occurring substance use and mental health (n=2), or other health conditions (n=2). Studies varied in their operationalization and description of guiding implementation frameworks/taxonomies. Sixteen studies reported implementation determinants and 12 studies measured implementation outcomes, with acceptability (n=5), feasibility (n=3), and reach (n=2) commonly assessed. Six studies tested implementation strategies. Systematic review results were used to generate recommendations for improving implementation success in criminal-legal contexts. CONCLUSIONS The focus on implementation determinants in correctional health studies reflects the need to tailor implementation efforts to complex organizational and inter-agency contexts. Future studies should investigate policy factors that influence implementation success, design, and test implementation strategies tailored to determinants, and investigate a wider array of implementation outcomes relevant to criminal-legal settings, health interventions relevant to adult and juvenile populations, and health equity outcomes. TRIAL REGISTRATION A study protocol (CRD42020114111) was registered with Prospero.
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Affiliation(s)
- Tonya B Van Deinse
- University of North Carolina at Chapel Hill School of Social Work, Chapel Hill, USA.
| | - Melissa J Zielinski
- University of Arkansas for Medical Sciences Psychiatric Research Institute, Little Rock, USA
| | | | | | - Erika L Crable
- Department of Psychiatry, University of California San Diego, San Diego, USA
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Proctor EK, Bunger AC, Lengnick-Hall R, Gerke DR, Martin JK, Phillips RJ, Swanson JC. Ten years of implementation outcomes research: a scoping review. Implement Sci 2023; 18:31. [PMID: 37491242 PMCID: PMC10367273 DOI: 10.1186/s13012-023-01286-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 07/14/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Proctor and colleagues' 2011 paper proposed a taxonomy of eight implementation outcomes and challenged the field to address a research agenda focused on conceptualization, measurement, and theory building. Ten years later, this paper maps the field's progress in implementation outcomes research. This scoping review describes how each implementation outcome has been studied, research designs and methods used, and the contexts and settings represented in the current literature. We also describe the role of implementation outcomes in relation to implementation strategies and other outcomes. METHODS Arksey and O'Malley's framework for conducting scoping reviews guided our methods. Using forward citation tracing, we identified all literature citing the 2011 paper. We conducted our search in the Web of Science (WOS) database and added citation alerts sent to the first author from the publisher for a 6-month period coinciding with the WOS citation search. This produced 1346 titles and abstracts. Initial abstract screening yielded 480 manuscripts, and full-text review yielded 400 manuscripts that met inclusion criteria (empirical assessment of at least one implementation outcome). RESULTS Slightly more than half (52.1%) of included manuscripts examined acceptability. Fidelity (39.3%), feasibility (38.6%), adoption (26.5%), and appropriateness (21.8%) were also commonly examined. Penetration (16.0%), sustainability (15.8%), and cost (7.8%) were less frequently examined. Thirty-two manuscripts examined implementation outcomes not included in the original taxonomy. Most studies took place in healthcare (45.8%) or behavioral health (22.5%) organizations. Two-thirds used observational designs. We found little evidence of progress in testing the relationships between implementation strategies and implementation outcomes, leaving us ill-prepared to know how to achieve implementation success. Moreover, few studies tested the impact of implementation outcomes on other important outcome types, such as service systems and improved individual or population health. CONCLUSIONS Our review presents a comprehensive snapshot of the research questions being addressed by existing implementation outcomes literature and reveals the need for rigorous, analytic research and tests of strategies for attaining implementation outcomes in the next 10 years of outcomes research.
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Affiliation(s)
- Enola K Proctor
- The Brown School, Shanti Khinduka Distinguished Professor Emerita, Washington University in St. Louis, St. Louis, USA.
| | - Alicia C Bunger
- College of Social Work, The Ohio State University, Columbus, OH, USA
| | | | - Donald R Gerke
- Department of Social Work, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, USA
| | - Jared K Martin
- College of Education & Human Ecology, The Ohio State University, Columbus, OH, USA
| | - Rebecca J Phillips
- College of Liberal Arts & Sciences, Western Oregon University, Monmouth, OR, USA
| | - Julia C Swanson
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
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Moore KE, Johnson JE, Luoma JB, Taxman F, Pack R, Corrigan P, Hart J, Slone JD. A multi-level intervention to reduce the stigma of substance use and criminal involvement: a pilot feasibility trial protocol. HEALTH & JUSTICE 2023; 11:24. [PMID: 37184615 PMCID: PMC10184076 DOI: 10.1186/s40352-023-00224-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 04/11/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Stigma associated with substance use and criminal involvement is pervasive and creates a barrier to evidence-based addiction care within the criminal legal system. Research has yet to examine a multi-level stigma intervention which targets the intersection of these stigmas among both criminal legal staff and legally-involved clients. METHODS This paper presents the protocol for a non-randomized trial of a multi-level stigma intervention called Combatting Stigma to Aid Reentry and Recovery (CSTARR) that involves two interventions: (1) training for criminal legal staff to address public stigma and (2) group-based acceptance and commitment therapy to address self-stigma among legally-involved adults enrolled in substance use treatment. Staff and client participants are engaged with a program called the Tennessee Recovery Oriented Compliance Strategy in 6 East Tennessee counties. This study examines the feasibility, acceptability, and preliminary effectiveness of CSTARR using a type 1 hybrid implementation/effectiveness trial with pre to post follow-up. DISCUSSION Stigma must be addressed in the criminal legal system to facilitate the uptake of evidence-based addiction care. This study is the first to evaluate a stigma intervention designed for the criminal legal setting and results will be used to inform a larger, randomized controlled trial. The rationale for this study, research design and measures, as well as potential implications for the field are described. TRIAL REGISTRATION This clinical trial is registered at clinicaltrials.gov with the identifier NCT05152342. Registered 11/5/2021 at https://register. CLINICALTRIALS gov/prs/app/action/SelectProtocol?sid=S000BIN8&selectaction=Edit&uid=U0005X4C&ts=2&cx=-u3wsbx .
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Affiliation(s)
- Kelly E Moore
- Department of Psychology, East Tennessee State University, 420 Rogers-Stout Hall, P.O. Box 70649, Johnson City, TN, 37614, USA.
| | - Jennifer E Johnson
- College of Human Medicine, Division of Public Health, Michigan State University, 200 E. 1St Street, Flint, MI, 48502, USA
| | - Jason B Luoma
- Portland Psychotherapy Institute, 3700 N Williams Ave., Portland, OR, 97227, USA
| | - Faye Taxman
- Schar School of Policy and Government, George Mason University, 3351 Fairfax Drive Van Metre Hall, Arlington, VA, 22201, USA
| | - Robert Pack
- College of Public Health, East Tennessee State University, 277 Lamb Hall, P.O. Box 70623, Johnson City, TN, 37614, USA
| | - Patrick Corrigan
- Department of Psychology, Llinois Institute of Technology, 3424 S State St., Chicago, IL, 60616, USA
| | - Jim Hart
- Tennessee Institute for Public Service, 1610 University Avenue, Knoxville, TN, 37921, USA
| | - Judge Duane Slone
- Fourth Judicial District of Tennessee, 854 South Hwy. 92, P.O. Box 858, Dandridge, TN, 37725, USA
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Reichert J, Adams S, Taylor J, del Pozo B. Guiding officers to deflect citizens to treatment: an examination of police department policies in Illinois. HEALTH & JUSTICE 2023; 11:7. [PMID: 36750519 PMCID: PMC9906953 DOI: 10.1186/s40352-023-00207-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 01/17/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND The U.S. overdose crisis has motivated police departments to enact policies allowing officers to directly deflect individuals to substance use disorder treatment and other services shown to reduce recidivism and subsequent overdose risk, as well as refer people who voluntarily present at police facilities with a desire for treatment. As a new way of operating, and one that relies on an officer's use of discretion for successful implementation, the practice benefits from guidance through written directives, training, and supervisory support. However, there is little information on the establishment, content, and execution of police department deflection policies, which hampers the implementation and dissemination of this promising practice. We analyzed 16 policies of Illinois police department deflection programs. Using content analysis methodology, we coded the policies for language and terminology, as well as program components and procedures. We aimed to examine how the policies were written, as well as the content intending to guide officers in their work. RESULTS We found the policies and programs had notable differences in length, detail, terminology, and reading level. Only one policy mentioned the use of any type of addiction treatment medication, many used stigmatizing language (e.g., "abuse" and "addict"), and few mentioned "harm reduction" or training in the practice of deflection. Many policies restricted participation in deflection (i.e., no minors, outstanding warrants, current withdrawal symptoms), and critically, a majority of policies allowed police officers to exclude people from participation based on their own judgment. CONCLUSIONS We recommend police departments consider the readability of their policies and reduce barriers to deflection program participation to engage a larger pool of citizens in need of substance use disorder treatment. Since there is limited research on police policies generally, and the field of deflection is relatively new, this study offers insight into the content of different department policies and more specifically, how officers are directed to operate deflection programs.
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Affiliation(s)
- Jessica Reichert
- Center for Justice Research and Evaluation, Illinois Criminal Justice Information Authority, 60 E. Van Buren St., Suite 650, Chicago, IL 60605 USA
| | - Sharyn Adams
- Center for Justice Research and Evaluation, Illinois Criminal Justice Information Authority, 60 E. Van Buren St., Suite 650, Chicago, IL 60605 USA
| | - Jirka Taylor
- RAND Corporation, 1200 S Hayes St, Arlington, VA 22202 USA
| | - Brandon del Pozo
- The Warren Alpert Medical School of Brown University, 593 Eddy Street, Providence, RI 02903 USA
- Rhode Island Hospital, 593 Eddy Street, 02903 Providence, USA
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Pivovarova E, Evans EA, Stopka TJ, Santelices C, Ferguson WJ, Friedmann PD. Legislatively mandated implementation of medications for opioid use disorders in jails: A qualitative study of clinical, correctional, and jail administrator perspectives. Drug Alcohol Depend 2022; 234:109394. [PMID: 35349918 PMCID: PMC9169252 DOI: 10.1016/j.drugalcdep.2022.109394] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 02/20/2022] [Accepted: 03/02/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Individuals with legal involvement and opioid use disorders (OUD) are at an increased risk of overdose and premature death. Yet, few correctional systems provide all FDA approved medications for OUD (MOUD) to all qualifying incarcerated individuals. We report on the implementation of MOUD in seven Massachusetts' jails following a state legislative mandate to provide access to all FDA-approved MOUD and to connect with treatment upon release. METHODS/PARTICIPANTS Based on the Exploration, Preparation, Implementation, and Sustainment framework, 61 clinical, corrections, and senior jail administrators participated in semi-structured interviews and focus groups between December 2019 and January 2020. Qualitative analyses focused on external and internal contexts and bridging factors. FINDINGS Participants detailed how the outer context (i.e., legislative mandate) drove acceptance of MOUD and assisted with continuity of care. Salient inner context factors included decision-making around administration of agonist medications, staff perceptions and training, and changes to infrastructure and daily routines. Leadership was critical in flattening standard hierarchies and advocating for flexibility. System-based characteristics of incarcerated individuals, specifically those who were pre-sentenced, presented challenges with treatment initiation. Inter- and intra-agency bridging factors reduced duplication of effort and led to quick, innovative solutions. CONCLUSIONS Implementation of MOUD in jails requires collaboration with and reliance on external agencies. Preparation for implementation should involve systematic reviews of available resources and connections. Implementation requires flexibility from institutional systems that are inherently rigid. Accordingly, leaders and policymakers must recognize the cultural shift inherent in such programs and allow for resources and education to assure program success.
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Affiliation(s)
- Ekaterina Pivovarova
- Department of Family Medicine and Community Health, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.
| | - Elizabeth A Evans
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, 312 Arnold House, 715 North Pleasant Street, Amherst, MA 01003, USA
| | - Thomas J Stopka
- Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, USA
| | - Claudia Santelices
- Claudia Santelices, Institute for Health Equity and Social Justice Research, Northeastern University, 360 Huntington Ave, Boston MA, 02115, USA
| | - Warren J Ferguson
- Department of Family Medicine and Community Health, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
| | - Peter D Friedmann
- University of Massachusetts Chan Medical School (UMCMS) - Baystate and Baystate Health, 3601 Main Street, Springfield, MA 01107, USA
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Snow-Hill NL, Donenberg G, Feil EG, Smith DR, Floyd BR, Leve C. A Technology-Based Training Tool for a Health Promotion and Sex Education Program for Justice-Involved Youth: Development and Usability Study. JMIR Form Res 2021; 5:e31185. [PMID: 34591028 PMCID: PMC8517818 DOI: 10.2196/31185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 08/12/2021] [Accepted: 08/24/2021] [Indexed: 11/23/2022] Open
Abstract
Background Justice-involved youth are especially vulnerable to mental health distress, substance misuse, and risky sexual activity, amplifying the need for evidence-based programs (EBPs). Yet, uptake of EBPs in the justice system is challenging because staff training is costly in time and effort. Hence, justice-involved youth experience increasing health disparities despite the availability of EBPs. Objective To counter these challenges, this study develops and pilot-tests a prototype of a technology-based training tool that teaches juvenile justice staff to deliver a uniquely tailored EBP for justice-involved youth—PHAT (Preventing HIV/AIDS Among Teens) Life. PHAT Life is a comprehensive sex education, mental health, and substance use EBP collaboratively designed and tested with guidance from key stakeholders and community members. The training tool addresses implementation barriers that impede uptake and sustainment of EBPs, including staff training and support and implementation costs. Methods Staff (n=11) from two juvenile justice settings pilot-tested the technology-based training tool, which included five modules. Participants completed measures of HIV and sexually transmitted infection (STI) knowledge, sex education confidence, and implementation outcomes such as training satisfaction, adoption, implementation, acceptability, appropriateness, and sustainability. PHAT Life trainers assessed fidelity through two activity role plays participants submitted upon completing the training modules. Results Participants demonstrated increases in HIV and STI knowledge (t10=3.07; P=.01), and were very satisfied (mean 4.42, SD 0.36) with the training tool and the PHAT Life curriculum. They believed that the training tool and curriculum could be adopted, implemented, and sustained within their settings as an appropriate and acceptable intervention and training. Conclusions Overall, the results from this pilot test demonstrate feasibility and support continuing efforts toward completing the training tool and evaluating it within a fully powered randomized controlled trial. Ultimately, this study will provide a scalable option for disseminating an EBP and offers a more cost-effective and sustainable way to train staff in an EBP.
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Affiliation(s)
- Nyssa L Snow-Hill
- Center for Dissemination and Implementation Science, Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Geri Donenberg
- Center for Dissemination and Implementation Science, Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | | | | | - Brenikki R Floyd
- School of Public Health, University of Illinois at Chicago, Chicago, IL, United States
| | - Craig Leve
- Influents Innovations, Eugene, OR, United States
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Joudrey PJ, Howell BA, Nyhan K, Moravej A, Doernberg M, Ross JS, Wang EA. Reporting of substance use treatment quality in United States adult drug courts. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 90:103050. [PMID: 33310636 DOI: 10.1016/j.drugpo.2020.103050] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 11/06/2020] [Accepted: 11/18/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Adult drug courts are growing in popularity within the Unites States, but the quality of substance use treatment within drug court programs and the impact of drug courts on health and substance use treatment outcomes is largely unknown. We appraised the quality of United States adult drug court process evaluations and the inclusion of measures of substance use treatment quality. METHODS We systematically reviewed the adult drug court evaluations between 2008 and 2018 in accordance with recommended strategies for systematic gray literature search. We appraised evaluation quality using the Evidence for Policy and Practice Information and Coordination Center tool for process evaluations. We extracted recommended measures of substance use treatment quality, including measures related to screening and monitoring, diagnosis, service availability, service utilization, and outcomes. RESULTS Our search identified 112 evaluations. Process measures were included within 68 evaluations, 45% of which had poor data reliability. We found that less than 10% of evaluations reported substance use treatment quality measures related to service utilization, overdose, and mortality, while more than 75% contained criminal justice measures, including program graduation (completion of criminal justice proceedings) and participant recidivism. CONCLUSIONS We found low uptake of measures of substance use treatment quality. The absence of data call into question the ability of drug courts to stem harmful substance use related health outcomes.
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Affiliation(s)
- Paul J Joudrey
- Section of General Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States.
| | - Benjamin A Howell
- Section of General Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States; VA Connecticut Healthcare System, West Haven, CT. United States; National Clinician Scholars Program, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States; SEICHE Center, Yale School of Medicine, New Haven, CT, United States
| | - Kate Nyhan
- Center for Biomedical Data Science, Cushing/Whitney Medical Library, Yale School of Medicine
| | - Ali Moravej
- Yale School of Public Health, New Haven, CT, United States
| | | | - Joseph S Ross
- Section of General Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States; National Clinician Scholars Program, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States; Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, United States; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT, United States
| | - Emily A Wang
- Section of General Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States; SEICHE Center, Yale School of Medicine, New Haven, CT, United States
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