Exploration of the effects of incarceration on the health of Latina women and their children using the life course theory

OBJECTIVE

Use the Life Course Theory (LCT) to explore the effects of involvement with the justice system on the health of Latina women and their children.

DESIGN

A supplementary analysis was conducted using data collected from the original study to answer a new research question.

SETTING

South Central Texas.

PARTICIPANTS

A primary qualitative data set from 12 Latina women involved with the justice system.

METHODS

We applied LCT principles and used thematic content analysis as such we employed categoric distinction: lifespan development, time and place in individuals' lives, the timing of lives, human agency, and linked lives to analyze participants' narratives.

RESULTS

Five themes emerged that aligned with LCT principles: (1) It feels like I'm living in my own prison; (2) What do I have to live for now; (3) It is like double punishment; (4) They made my choices; and (5) People didn't really understand. Participants felt helpless with few options to overcome their prior adversities, which affected their ability to make positive future choices.

CONCLUSIONS

Findings highlight the potential, long-term, negative health consequences that may result from incarceration. Considering that justice system involvement can lead to more profound maternal and child health disparities, our findings suggest that greater advocacy from the nursing profession would increase accessibility to equitable and respectful maternity and women's health care services. Key points Involvement with the justice system can result in negative health consequences for women and their children. Maternal and child health disparities are often more profound after involvement with the justice system. Greater advocacy is needed from the nursing profession to ensure access to equitable and respectful maternity and women's health care services.

Documenting Competing Needs to Well-Being Among Those on Community Supervision in the South

Although the harms of incarceration on health are well known, little is known about individuals' competing priorities to maintaining their health while on probation and parole after release from incarceration. We explored individuals' competing needs on probation and parole (lack of health insurance/access, hazardous alcohol use, substance use, food insecurity, un/underemployment, housing insecurity, lack of social support, length of recent incarceration, prohibitive monthly fees, criminal legal discrimination) to achieving well-being. We explored overlap between competing needs and overall well-being. This descriptive, cross-sectional analysis assesses the relationship between competing needs and current well-being of participants in The Southern Pre-Exposure Prophylaxis Study. Of 364 enrolled participants, 48% were thriving. The most common competing need was substance use (73%). Of the 10 competing needs, participants experienced a median 4 (interquartile range [IQR] 3-6). Those considered to be thriving experienced a median 4 (IQR 3-5) competing needs while those not thriving experienced a median 5 (IQR 4-6; p < .001). People on probation and parole experience competing needs to achieving health and well-being. To improve well-being among this population, programs and policies must focus on not only the health of those exiting incarceration but also the multiple competing needs that they face.

Examining Correlates of Substance Use Treatment Needs for Adults Under Community Supervision

Substance use among criminal justice-involved adults is a significant concern for the rehabilitation and reintegration into their communities. Few have examined broader associations with substance use among those in probation or parole (community supervision) using an assessment of risks and needs with a representative sample. Using an assessment based on risk-need-responsivity principles, this research applies negative binomial analyses to examine sociodemographic, criminal, and other problem-area correlates of substance use risks and needs among a statewide dataset of adults in community supervision. Results indicated that mental health risk/need was the strongest predictor of substance use risk/need. Other risk areas, including criminal thinking, employment/education, and the presence of delinquent associates (peers/family) were associated with substance use. Implications highlight the ongoing call to develop integrated models of care that treat co-occurring disorders among adults in supervision. Additionally, diversion-oriented efforts that prevent adults with complex treatment needs from reentering the justice system are discussed.

Traumatic Life Events and Stressors: Associations With Substance Use Problems of Men Under Community Supervision

This study aims to determine associations between sources of stress and substance use problems among men under community supervision programs. We used ordinary least squares regression models to test the hypotheses that the traumatic life events and stressors of men under community supervision and their partners, respectively, were associated with the substance use problems of men under community supervision. The sample included 230 men involved in community supervision programs in New York City and 230 women who were their intimate partners. We found that the traumatic events and the depression and anxiety of men under community supervision and partner's substance use problems were associated with the substance use problems of the men. These findings underscore the importance of addressing trauma in substance use treatment for men under community supervision. Future research can explore how stressful events impact substance use, sources of coping for couples, and the association between racism, traumatic events, stress, and substance use. Clinical Trial Registration: NCT01690494.

Decision-Making Styles as a Moderator on the Efficacy of the StaySafe Tablet Intervention

Background: People with substance use disorders often differ in their decision-making styles. The present study addressed the impact of two decision-making styles (rational and dependent) on outcomes from a StaySafe tablet computer app intervention designed to improve decision-making around health risk behaviors and previously found to be effective for justice-involved people receiving treatment for a substance use disorder and under community supervision. Objectives: Participants were justice-involved residents in residential treatment. After completing a baseline survey, participants were randomly assigned to either complete the StaySafe app or to a standard procedure condition; and then asked to complete a post-intervention survey three months after baseline (this protocol has been registered with clinicaltrials.gov NCT02777086): 348 participants completed a baseline survey and 238 completed the post-test survey. Outcomes included measures of confidence and motivation around HIV knowledge and risks and getting tested. Multilevel analyses addressed the hypothesis that outcomes were related to decision-making style. Multiple imputation (MI) was used to address the effects of missing data. Results: StaySafe was more effective for those in the lower half of the decision-making dependent scale for HIV risks (HIV-Knowledge, Hepatitis testing, HIV Services testing, and Sex Risk, as well as motivation for treatment. The decision-making rational scale was less consistently related to HIV risk. Conclusions: The present study showed individuals with substance use disorders who differed in their decision-making styles reacted differently to the StaySafe intervention. Two scales, rational decision making, and dependent decision making are relevant to consider with respect to interventions targeting improving decision making among drug users.

Surveillance and the experience of the COVID-19 pandemic for formerly incarcerated individuals

To date, most criminal justice research on COVID-19 has examined the rapid spread within prisons. We shift the focus to reentry via in-depth interviews with formerly incarcerated individuals in central Ohio, specifically focusing on how criminal justice contact affected the pandemic experience. In doing so, we use the experience of the pandemic to build upon criminological theories regarding surveillance, including both classic theories on surveillance during incarceration as well as more recent scholarship on community surveillance, carceral citizenship, and institutional avoidance. Three findings emerged. First, participants felt that the total institution of prison "prepared" them for similar experiences such as pandemic-related isolation. Second, shifts in community supervision formatting, such as those forced by the pandemic, lessened the coercive nature of community supervision, expressed by participants as an increase in autonomy. Third, establishment of institutional connections while incarcerated alleviated institutional avoidance resulting from hyper-surveillance, specifically in the domain of healthcare, which is critical when a public health crisis strikes. While the COVID-19 pandemic affected all, this article highlights how theories of surveillance inform unique aspects of the pandemic for formerly incarcerated individuals, while providing pathways forward for reducing the impact of surveillance.

Mobile Health Applications Addressing Health Disparities for Women on Community Supervision: A Scoping Review

BACKGROUND

Mobile health applications have gained popularity in assisting high-risk, hard-to-reach groups in self-management of health conditions. One such population with high rates of health disparities comprises women under community supervision. In this review, we examine the literature on mHealth applications to address health disparities among women under community supervision.

METHODS

We searched CINAHL, PubMed, and PsycInfo for peer-reviewed research articles conducted in the U.S. After removal of duplicates, review of 231 article titles and abstracts and 36 articles for full-text review yielded five articles for analysis. Extracted data include author, year, design, sample, objectives, conclusions, measures, interventions and analytic approach.

RESULTS

Of the five studies that addressed health disparities of individuals under community supervision, one was done with participants on probation, four with participants on medication therapy for substance use disorder, and one with participants in a drug court program. Only one article was specific to women or controlled for ethnicity. No studies were done with those on parole. None done with populations outside the U.S.

CONCLUSION

Few studies focused on health disparities of women under community supervision. mHealth applications that address substance use, reproductive and sexual health, and safety issues specific to women under community supervision are warranted.

Individual Characteristics and Organizational Attributes: An Assessment of Probation Officer Burnout and Turnover Intent

In recent years, Western and non-Western countries have experience increased reliance on probation services. However, prior research indicates that high job demands and ambiguous role responsibilities invoke feelings of stress and suggest the importance of understanding the relationship between stress and burnout and turnover. While past efforts largely focused on correctional officers (COs), less is known about how probation officers (POs) experience burnout and how organizational attributes may influence this relationship. Using survey data of federal POs (N = 80) across eight offices in a southern state, the current study examines the influence of individual characteristics and organizational attributes in predicting burnout and turnover intent. To answer our research questions, we perform a series of linear regression models. Findings suggest the importance of affective commitment for reducing POs' feelings of burnout and turnover intent. Implications of these findings and directions of future research are discussed.

Using Strength and Risk Factors to Inform Treatment Typologies Over Time for Men on Community Supervision

This study examines treatment typologies over time and their relationship to reoffending outcomes. Latent transition analysis was conducted with 6,675 men on community supervision in Alberta, Canada using risk and strength factors measured by the Service Planning Instrument (Orbis Partners, 2003). Three timepoints were assessed: Time 1 = first assessment within 90 days of start of supervision, Time 2 = 3 to 8 months post initial assessment, and Time 3 = 9 to 14 months post initial assessment. Five profiles consistently emerged: Low risk/Low strength profile, Aggressive, complex need/Low strength profile, Moderate risk/Moderate strength profile, Low risk/High strength profile, and Non-aggressive, complex need/Low strength profile. At Time 3, a sixth profile emerged labeled Moderate complex need/Low strength. Profiles characterized as aggressive and those with complex needs had highest rates of reoffending. Results demonstrate the utility of incorporating strengths, mental health needs, and adverse childhood experiences in risk assessment protocols.

REDESIGNING JUVENILE PROBATION TO ALIGN WITH BEHAVIORAL HEALTH AND POSITIVE DEVELOPMENT PRINCIPLEs: A Quasi-Experimental study

Science advisory boards and policy organizations have called for adolescent brain science to be incorporated into juvenile probation operations. To achieve this, Opportunity-Based Probation (OBP), a probation model that integrates knowledge of adolescent development and behavior change principles, was developed in collaboration with a local juvenile probation department. The current study compares outcomes (recidivism and probation violations) for youth in the OBP condition versus probation as usual. Inverse probability weighting (IPW) and coarsened exact matching (CEM) were used to estimate causal effects of OBP's average treatment effect (ATE). Results indicated clear effects of OBP on reducing criminal legal referrals, but no significant effects were observed for probation violations. Overall, results provide promising recidivism-reduction effects in support of developmentally grounded redesigns of juvenile probation.

Are Supervision Violations Filling Prisons? The Role of Probation, Parole, and New Offenses in Driving Mass Incarceration

Advocates for reform have highlighted violations of probation and parole conditions as a key driver of mass incarceration. As a 2019 Council of State Governments report declared, supervision violations are "filling prisons and burdening budgets." Yet few scholarly accounts estimate the precise role of technical violations in fueling prison populations during the prison boom. Using national surveys of state prison populations from 1979 to 2016, the authors document that most incarcerated persons are behind bars for new sentences. On average, just one in eight people in state prisons on any given day has been locked up for a technical violation of community supervision alone. Thus, strategies to substantially reduce prison populations must look to new criminal offenses and sentence length.

COVID-19 and Juvenile Probation: A Qualitative Examination of Emergent Challenges and Useful Strategies

The emergence of COVID-19 placed immediate pressure on the juvenile justice system to adapt to changes in case processing and decision-making practices. Juvenile probation agencies were tasked with quickly altering their policies and practice to abide by local public health measures. As probation supervision is the most common disposition in the juvenile justice system, there is both an empirical and practical need to understand the impact that COVID-19 has on a variety of issues surrounding the supervision and provision of services for juveniles. Using self-report survey data from juvenile probation directors across the United States, the current study examines (a) the biggest challenges faced by juvenile probation agencies during the pandemic, (b) the strategies implemented in response to these challenges, and (c) the most pressing issues currently facing the field of juvenile community corrections. Results have the potential to inform future agency decision-making when adjusting juvenile probation policy and practice.

Evidence of Help-Seeking Behaviors Among Black Women Under Community Supervision in New York City: A Plea for Culturally Tailored Intimate Partner Violence Interventions

BACKGROUND

Black women involved in the legal system disproportionately experience intimate partner violence (IPV); however, current research does not satisfactorily describe the risk and protective factors associated with IPV among Black women under community supervision.

METHODS

We conducted a subgroup analysis of Black women (N = 128) using data from a randomized controlled trial that evaluated the feasibility and efficacy of two IPV screening and prevention programs for women under community supervision. Participants in the original study were randomized into two IPV prevention conditions-computerized or case manager Women Initiating New Goals of Safety (WINGS). In this study, we examine the effects of that study's two conditions on linkage to IPV services and secondary outcomes, specifically among Black participants who experienced physical, sexual, and psychological IPV.

RESULTS

Both conditions showed significant reductions in days of substance use abstinence over the 3-month period among Black women who experienced sexual or verbal IPV. Participants in the case manager arm were 14 times more likely to receive IPV services in the past 90 days-from baseline to the 3-month follow-up (adjusted odds ratio = 14.45, 95% confidence interval [CI] = 1.25 to 166.51, p = 0.032). Participants in the computerized arm were significantly more likely to report receiving social support from baseline to the 3-month follow-up assessment (regression coefficient [b] = 2.27, 95% CI = 0.43 to 4.11, p = 0.015).

CONCLUSIONS

Although both conditions showed significant reductions in the number of days of abstinence from substance use among this subgroup of Black women, the findings showed differential effectiveness between the computerized WINGS arm and the case manager WINGS arm in improving social support and linkage to services. These findings may indicate that different modalities of WINGS may work better for specific activities and point to the need for a hybrid format that optimizes the use of distinct modalities for delivering activities.

Typologies of Stressful Life Events and Their Association With Sexual Risk Behaviors and Communication Among Justice-Involved Males and Their Female Sex Partners

Stressful life events are prevalent among justice-involved populations and are associated with sexual risk behaviors and partner communication regarding safe-sex practices. We describe patterns of stress exposure for heterosexual couples (where males are under community supervision) and how stress patterns are associated with sexual risk behaviors and communication (460 individuals; 230 couples). Latent class analysis identified patterns of stress. Multinominal logistic regression models identified associations between sex, race, ethnicity, and stress classes. Multilevel Poisson regression models described relationships between sexual risk behaviors and frequency of communication about condoms/HIV, and stress classes. We found four classes that differed by sex, race, and ethnicity and were associated with the number of sexual partners, condom use self-efficacy, discussing condoms with partner, and discussing HIV prevention with partner. Partner class was associated with the number of sexual partners. Findings inform future assessment/interventions for sexual health that consider patterns of stress and demographics.

COVID-19's Impact on Probation Professionals' Views About Their Roles and the Future of Probation

In 2020, the COVID-19 global pandemic forced probation departments to change their practices overnight. The phenomenon presented many challenges for probation departments but also opened avenues for innovation and changes in attitudes toward supervision practices. We surveyed adult and juvenile probation departments in the entire state of Texas, specifically targeting management and supervisory personnel, officers with caseloads, including court officers, and information technology personnel (N = 1,353). Our goals of this research included not only obtaining information about operational changes made because of the pandemic but also gauging attitudes toward these changes and the future of probation. We understood operational changes were inevitable, thus findings of significant operational changes were not surprising. We found that probation personnel were open to changes in operational procedures and that the pandemic spurred innovation and widespread acceptance in the use of technology for a variety of activities going forward that may not have been accepted prior to the pandemic.

Can novel 'swift-certain-fair' programs work outside of pioneering jurisdictions? An analysis of 24/7 Sobriety in Montana, USA

BACKGROUND AND AIMS

The US state of South Dakota's 24/7 Sobriety Program (24/7) requires individuals charged or convicted of alcohol-involved offenses to avoid alcohol and submit to twice-daily or continuous alcohol testing. We evaluated the impact of the 24/7 program in the US state of Montana.

METHODS

Using data from everyone in Montana who was convicted of their second driving under the influence (DUI) offense from 2009 to August 2013, we described program violations among 24/7 participants and then estimated the effect of 24/7 participation on the probability of DUI re-arrest. To address potential selection issues related to individual-level 24/7 participation, we used an instrumental variables approach that exploits county-level variation in program adoption.

RESULTS

Among 2768 people convicted of a second DUI in our analytical sample, 356 participated in 24/7 and were monitored for an average of 173 days (median = 112 days). Among the 332 participants monitored by breath test, 95.5% of scheduled alcohol breath tests were completed and did not lead to a program violation. After controlling for individual- and community-level covariates as well as year and county fixed effects, our instrumental variable models suggested that participation in 24/7 reduced the 1-year DUI re-arrest probability by at least 80% (preferred model: 86% decrease; 8.9 percentage points) compared with a counterfactual group of people convicted of a second DUI over the same period but not assigned to the program.

CONCLUSIONS

South Dakota USA's 24/7 Sobriety Program appears to work in Montana as well. Certain delivery of immediate but modest sanctions for repeat driving under the influence (DUI) arrestees who violate alcohol abstinence orders appears to be able to reduce future DUI arrests.

Does Reassessment Improve Prediction? A Prospective Study of the Sexual Offender Treatment Intervention and Progress Scale (SOTIPS)

This prospective study examined the predictive validity of the Sex Offender Treatment Intervention and Progress Scale (SOTIPS; McGrath et al., 2012), a sexual recidivism risk/need tool designed to identify dynamic (changeable) risk factors relevant to supervision and treatment. The SOTIPS risk tool was scored by probation officers at two sites (n = 565) for three time points: near the start of community supervision, at 6 months, and then at 12 months. Given that conventions for analyzing dynamic prediction studies have yet to be established, one of the goals of the current paper was to demonstrate promising statistical approaches for the analysis of longitudinal studies in corrections. In most analyses, static SOTIPS scores predicted all types of recidivism (sexual, violent, and general [any]). Dynamic SOTIPS scores, however, only improved the prediction of general recidivism, and only when the analyses with the greatest statistical power were used (Cox regression with time dependent covariates).

Modeling Repeat DUI Offender Probation Outcomes Using the Wisconsin Risk Need Assessment

This multiyear study of felony driving while intoxicated (DWI) probationers explores the efficacy of the Wisconsin Risk Need Assessment tool along with sociodemographic factors as measures of probation outcomes. To date, few studies have explored the relationship between risk assessment data and technical violations as well as subsequent arrests of individuals on probation. The sample for this study consists of 596 chronic DWI offenders on community supervision in one county who either had been rearrested for a new offense, violated a technical condition of their probation, or committed no violations within the first 5 years of community supervision. The findings are that older defendants and those who had more dependents were more likely to have committed a technical violation compared with the other two groups. Those rearrested for a new offense were slightly younger compared with the other two groups, less likely to be employed and younger at the age of first adjudication of guilt. This study highlights the limited overall utility of the Wisconsin tool in determining probation outcomes and that static factors may be as important as dynamic factors when developing a supervision strategy for chronic DWI offenders.

Does Reassessment Enhance the Prediction of Imminent Criminal Recidivism? Replicating Lloyd et al. (2020) With High-Risk Parolees

Lloyd et al. (2020) proposed and tested a novel three-step framework for examining the extent to which reassessment of dynamic risk and protective factors enhances the prediction of imminent criminal recidivism. We conducted a conceptual replication of Lloyd et al.'s study. We used the same dynamic risk assessment measure in the same jurisdiction but, unlike Lloyd et al., our sample comprised solely high-risk men on parole in New Zealand (N = 966), the individuals who are most frequently reassessed in the community and most likely to imminently reoffend. The results of the previous study were largely reproduced: reassessment consistently enhanced prediction, with the most pronounced effects observed for a scale derived from theoretically acute dynamic risk factors. These findings indicate reassessment effects are robust to sample selection based on a narrower range of risk levels and remain robust across years of practice in applied contexts, despite potential organizational drift from initial training and reassessment fatigue. The findings also provide further support for the practice of ongoing risk reassessment in community supervision and suggest that the method proposed by Lloyd et al. is a replicable approach for testing the essential criteria for defining dynamic risk and protective factors.

Barriers to the Adoption of Technological Innovations in Corrections: A Review and Case Study

Over 600,000 criminal justice involved individuals are released from state and federal prisons each year, and close to 5,000,000 former offenders are placed under some form of community-based supervision. Access to services that may facilitate the reentry process is complicated and more often than not, returning citizens have significant and wide-ranging needs left unaddressed that require a comprehensive approach. In the current paper, we discuss the adoption and implementation processes of technological innovations noted in the criminal justice and correctional literature, as well as other disciplines, while using examples and lessons learned from a pilot project evaluating a new technology known as Pokket, which is a cloud-based service aimed at improving the re-entry process for returning citizens, service providers, and criminal justice agencies.

THE EFFECT OF HOUSING CIRCUMSTANCES ON RECIDIVISM: Evidence From a Sample of People on Probation in San Francisco

The relationships between housing circumstances and recidivism are well established among people released from prison. Despite probation being far more common than prison or parole, we know little about living situations, homelessness, and residential instability among people on probation, and we know even less regarding how these housing circumstances may affect their risk of recidivism. Using a unique dataset of 2,453 people on probation and longitudinal analyses, this study finds that housing insecurity is common and is associated with an increased risk of recidivism among people on probation, above and beyond an array of other recidivism risk factors. Furthermore, we find housing effects are particularly strong for relatively low risk people and for relatively low-severity offenses (i.e., property crimes, minor crimes, and revocations). Interventions that increase housing access for people on probation may reduce recidivism, especially for those who are relatively low risk and low-level reoffending.

Predictors of Change of Working Alliance Over the Course of Probation Supervision: A Prospective Cohort Study

The body of evidence that the working alliance is associated with positive outcomes for mandated clients is growing. The aim of this research was to investigate the influence of several characteristics of probation officers (POs) and offenders on the course of the working alliance during probation supervision. This study examined the patterns on the four alliance subscales: Trust, Bond, Goals-Restrictions, and Reactance of the Working Alliance With Mandated Clients Inventory (WAMCI) in 201 offenders and their 137 POs. Three patterns on each alliance subscale were found: deteriorating, improving, and stable. Multinomial logistic analysis revealed that change of POs and the preference of the PO to maintain rules were associated with a deteriorating Trust pattern. From the perspective of the offenders, being motivated to take part in supervision was associated with a stable pattern on every alliance subscale, but having problems with substance use increased the likelihood of a deteriorating pattern on every alliance subscale.

Adults Recently on Community Supervision

Estimates of chronic conditions and disability among individuals on community supervision in the United States are lacking. We used 2015-2016 data from the National Survey on Drug Use and Health (N = 78,761) to examine the prevalence of chronic conditions and disability among nonelderly adults who had been on probation or parole in the past year, compared to adults without community supervision in the past year. The weighted sample was representative of 4,594,412 adults on community supervision and 191,156,710 adults without community supervision in the past year. Compared to the general population, adults recently on community supervision were significantly more likely to report fair or poor health, chronic obstructive pulmonary disease, hepatitis B or C, one or more chronic conditions, and any disability. Collaboration between health and criminal justice systems is needed to accommodate the health needs and supervision requirements for individuals with community supervision.

National Survey of Juvenile Community Supervision Agency Practices and Caregiver Involvement in Behavioral Health Treatment

OBJECTIVES

This study sought to expand the sparse literature examining the extent to which family engagement interventions and the structural characteristics of juvenile community supervision agencies influence caregiver participation in youths' behavioral health (i.e., mental health and substance use) treatment.

METHODS

We analyzed data from a national survey of juvenile community supervision agencies, conducted as a part of a Juvenile Justice Translational Research on Interventions for Adolescents in the Legal System (JJTRIALS) Cooperative Agreement funded by NIH/NIDA.

RESULTS

Findings indicated agencies employ a variety of family engagement strategies, with passive strategies like services referrals and flexible schedules being more common than active strategies like provision of family therapy. Multivariate prediction of caregiver involvement in behavioral health care showed the most consistent effects for rural-urban location of the agency; rural agencies more successfully engaged families in their youth's behavioral healthcare. Relatedly, the more family engagement services, the greater the involvement of families in behavioral health treatment. Agencies with a juvenile drug treatment court also showed greater involvement.

CONCLUSIONS

Our findings that juvenile justice agencies are using multiple techniques to engage families, and that there is a relationship between use of these techniques and actual family engagement, would benefit from replication over time and in other jurisdictions. Analysis of data from a second wave of the national survey, recently completed, is expected to test the reliability of our findings over time, as well as identify whether and what kind of changes occurred in the two years following the first survey.

Persons With Severe Mental Illnesses and Sex Offenses: Recidivism After Prison Release

Individuals who have committed sex offenses (ISOs) with severe mental illnesses are a complex population to serve and more research is needed to guide practice and policy, especially around community supervision, enrollment in Medicaid, housing, employment, criminal justice contacts, and reincarceration after prison reentry. To further the literature in this area, we used logistic regression to model recidivism and admissions to violator or prison facilities among 127 ISOs with severe mental illnesses and 2,935 people with severe mental illnesses who were incarcerated in prison for other crimes. Compared to prison releasees with severe mental illnesses who committed crimes other than sex offenses, prison releasees with severe mental illnesses who committed sex offenses were admitted to violator facilities at higher rates, when controlling for substance use, Medicaid enrollment, homelessness, and unemployment. Implications for practice, policy and research are discussed.

Health trainer-led motivational intervention plus usual care for people under community supervision compared with usual care alone: a study protocol for a parallel-group pilot randomised controlled trial (STRENGTHEN)

INTRODUCTION

People with experience of the criminal justice system typically have worse physical and mental health, lower levels of mental well-being and have less healthy lifestyles than the general population. Health trainers have worked with offenders in the community to provide support for lifestyle change, enhance mental well-being and signpost to appropriate services. There has been no rigorous evaluation of the effectiveness and cost-effectiveness of providing such community support. This study aims to determine the feasibility and acceptability of conducting a randomised trial and delivering a health trainer intervention to people receiving community supervision in the UK.

METHODS AND ANALYSIS

A multicentre, parallel, two-group randomised controlled trial recruiting 120 participants with 1:1 individual allocation to receive support from a health trainer and usual care or usual care alone, with mixed methods process evaluation. Participants receive community supervision from an offender manager in either a Community Rehabilitation Company or the National Probation Service. If they have served a custodial sentence, then they have to have been released for at least 2 months. The supervision period must have at least 7 months left at recruitment. Participants are interested in receiving support to change diet, physical activity, alcohol use and smoking and/or improve mental well-being. The primary outcome is mental well-being with secondary outcomes related to smoking, physical activity, alcohol consumption and diet. The primary outcome will inform sample size calculations for a definitive trial.

ETHICS AND DISSEMINATION

The study has been approved by the Health and Care Research Wales Ethics Committee (REC reference 16/WA/0171). Dissemination will include publication of the intervention development process and findings for the stated outcomes, parallel process evaluation and economic evaluation in peer-reviewed journals. Results will also be disseminated to stakeholders and trial participants.

TRIAL REGISTRATION NUMBERS

ISRCTN80475744; Pre-results.

Organizational Factors and Probation Officer Use of Evidence-Based Practices: A Multilevel Examination

Growing evidence pointing to the ineffectiveness of control-oriented supervision practices has led to an emphasis on evidence-based practices (EBPs), or practices that are empirically tied to recidivism reduction. Research on EBPs in probation highlights the importance of case management-oriented supervision and provision of proactive, appropriate program referrals. Despite research support, challenges exist regarding implementing EBPs in real-world practice. Utilizing survey data from 813 adult probation officers across 43 agencies, the current study examined variation in use of case management and proactive referral practices. Findings highlight the important role organizational commitment plays in supporting implementation efforts. Implications suggest a need for probation agencies to promote and sustain staff commitment to their agency before embarking on significant reform efforts.

vaginalis Screening

BACKGROUND

The United States has a large community supervision population, a growing number of whom are women. Trichomonas vaginalis infection is strongly associated with an increased risk of human immunodeficiency virus (HIV) acquisition and transmission, particularly among women, but there is a paucity of research on HIV and T. vaginalis co-infection among women under community supervision.

METHODS

This article examines the prevalence of T. vaginalis infection and T. vaginalis and HIV coinfection at baseline among women under community supervision in New York City. It also examines the 12-month outcomes of women treated for T. vaginalis. Women received biological tests for HIV and T. vaginalis at baseline and 12 months follow-up.

RESULTS

Of the 333 women tested for sexually transmitted infections, 77 women (23.1%) tested positive for T. vaginalis at baseline and 44 (13.3%) were HIV positive. Human immunodeficiency virus-positive women had significantly higher rates of T. vaginalis infection than HIV-negative women (36.4% vs 21.3%, P ≤ 0.05). Sixteen women (4.8%) were coinfected with T. vaginalis and HIV. Of the 77 women who were positive for T. vaginalis infection at baseline, 58 (75.3%) received treatment by a health care provider. Of those who received treatment, 17 (29.3%) tested positive for T. vaginalis at the 12-month follow-up.

CONCLUSIONS

Given the high prevalence of T. vaginalis among this sample of women, particularly among HIV-positive women, and high levels of reinfection or persistent infection, screening for T. vaginalis among women under community supervision may have a substantial impact on reducing HIV acquisition and transmission among this high-risk population.

Women in community corrections in New York City: HIV infection and risks

Although the incidence of HIV among women on probation, parole and alternatives to incarceration programs is significant to public health, drivers of this concentrated epidemic among women under community corrections remain understudied. This study examined prevalence of HIV and sexually transmitted infections and the associations between substance use, socio-demographic factors and the prevalence of biologically-confirmed HIV and other sexually transmitted infections among a sample of 337 substance-using women recruited from community correction sites in New York City. Prevalence of HIV was 13% and sexually transmitted infections was 26% ( Chlamydia, trachomatis and Neisseria gonorrhea). After adjusting for covariates, HIV-positive women were 1.42 times more likely to use crack/cocaine than HIV-negative women (95% CI = 1.05-1.92). HIV-positive women were 25% less likely than HIV-negative women to report any unprotected vaginal and anal sex with their main partner (95% CI = 0.57-0.99). They were 70% less likely than HIV-negative women to report unprotected vaginal sex with a non-paying casual partner (95% CI = 0.1-0.9) and 22% less likely to report unprotected vaginal sex across all partners (95% CI = 0.61-0.99). Community corrections settings may be optimal venues to launch HIV/sexually transmitted infections prevention that have potential to reach and engage an ever-growing number of substance-using women.

Implementation of a Contingency Management-Based Intervention in a Community Supervision Setting: Clinical Issues and Recommendations

A cognitive-behaviorally based substance abuse treatment program was implemented within a Community Supervision setting. This program included a goals group that included a contingency management component and included the probation agent as a part of treatment. This paper describes the contingency management component of the treatment and discusses, in detail, issues that arose throughout the course of the study. Possible causes and solutions to the issues are discussed from a contingency management perspective that can result in improved reinforcements to achieve better probationer outcomes.

Collaborative behavioral management: integration and intensification of parole and outpatient addiction treatment services in the Step'n Out study

Integration of community parole and addiction treatment holds promise for optimizing the participation of drug-involved parolees in re-entry services, but intensification of services might yield greater rates of technical violations. Collaborative behavioral management (CBM) integrates the roles of parole officers and treatment counselors to provide role induction counseling, contract for pro-social behavior, and to deliver contingent reinforcement of behaviors consistent with contracted objectives. Attendance at both parole and addiction treatment are specifically reinforced. The Step'n Out study of the Criminal Justice-Drug Abuse Treatment Studies (CJ-DATS) randomly allocated 486 drug-involved parolees to either collaborative behavioral management or traditional parole with 3-month and 9-month follow-up. Bivariate and multivariate regression models found that, in the first 3 months, the CBM group had more parole sessions, face-to-face parole sessions, days on which parole and treatment occurred on the same day, treatment utilization and individual counseling, without an increase in parole violations. We conclude that CBM integrated parole and treatment as planned, and intensified parolees' utilization of these services, without increasing violations.