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.
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. With approximately 5 million offenders under community supervision in the U.S. who have considerably high rates of substance abuse and HIV/HBV/HCV infection and who are likely to increase risk behaviors after release back to the community, the proposed project has potential to significantly impact public health. If successful, this project will help reduce risk behaviors among probationers in the community and subsequently reduce risks of spreading HIV/HBV/HCV infection among probationers and the general population.
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