Women offenders released from jail are a growing and vulnerable population who are at high risk of relapsing to substance use, recidivating to the criminal justice system, contracting or spreading HIV, and becoming involved in violence as observers, victims, and/or perpetrators. While this is the largest group of women offenders re-entering the community, it is a relatively under studied population and represents a critical point in time for changing the course of the chronic and cyclical nature of their condition. The proposed study is designed to test the effectiveness of recovery management checkups for women offenders (RMC-WO) released from jail to provide continuity of care immediately upon release and to help them manage their long-term recovery. The components of the checkup will include: on-going monitoring via a re-entry meeting and quarterly assessments for 3 years, personalized feedback on substance use and high risk behaviors, linkage to community-based substance abuse treatment (when needed), on-site HIV booster sessions (when needed), and treatment engagement and retention support. Motivational interviewing will provide the therapeutic approach to transition women from one step of the change process to another. Combined, these components and therapeutic milieu afford an opportunity for immediate linkage to community-based treatment and HIV prevention as well as ongoing monitoring for relapse and early re-intervention for both substance use and HIV risk behaviors (both public health priorities). The research team will recruit 425 women offenders with substance use problems from sequential admissions to a jail-based substance abuse treatment program. While in jail, all women will receive a baseline assessment, substance abuse treatment, HIV testing, counseling and education, and prior to release referrals to community-based treatment. Following the baseline assessment, approximately half of the women will be randomly assigned to the Recovery Management Checkups-Women Offenders (RMCWO) condition and the other half to a control condition. All women will complete 12 quarterly assessments over 3 years (5525 total observations). All RMC-WO interventions will occur post release and provide the vehicle for immediate and ongoing monitoring of substance use and HIV risk behaviors, early re-intervention, access and retention in community-based treatment.
The specific aims of this experiment are to examine the impact of: 1) RMC-WO on accessing and staying in community-based treatment during the first 90 days after release from jail and over the course of 3 years;2) RMC-WO and substance abuse treatment on substance use and HIV risk behaviors over 3 years;and 3) RMC-WO, substance abuse treatment, and reductions in substance use and HIV risk behaviors on psychiatric co-morbidity, interpersonal violence, illegal activity, and arrest and re-incarceration over 3 years.
