Reducing Offenders' HIV Risk: MI Enhanced Case Management With Drug-Free Housing

This study is not yet open for participant recruitment. (see Contacts and Locations)
Verified October 2013 by Public Health Institute, California
Sponsor:
Collaborator:
Information provided by (Responsible Party):
Public Health Institute, California
ClinicalTrials.gov Identifier:
NCT01977092
First received: September 25, 2013
Last updated: October 30, 2013
Last verified: October 2013

September 25, 2013
October 30, 2013
Not Provided
March 2018   (final data collection date for primary outcome measure)
  • Change in criminal justice outcomes [ Time Frame: Baseline, 6-mo, 12-mo ] [ Designated as safety issue: No ]
    Measured by number of arrests, convictions, and length of time incarcerated.
  • Change in Alcohol and Drug Use (Alcohol Severity Index & Timeline Follow Back) [ Time Frame: Baseline, 6-mo, 12-mo ] [ Designated as safety issue: No ]
    Measured by number of days of use for specific drugs in last 30 days and last 6 months.
  • Change in needle use and injection, sexual risk behaviors, and HIV status and testing. [ Time Frame: Baseline, 6-mo and 12-mo ] [ Designated as safety issue: No ]
    Measured by how often needles were used, shared and cleaned; frequency of high risk sexual behaviors; how recently HIV testing was completed and level of concern about exposure to HIV.
Same as current
Complete list of historical versions of study NCT01977092 on ClinicalTrials.gov Archive Site
  • Change in Alcohol Severity Index (ASI) Scales [ Time Frame: Baseline, 6-mo and 12-mo ] [ Designated as safety issue: No ]
    Measured utilizing the standard ASI scales.
  • Change in housing stability [ Time Frame: Baseline, 6-mo and 12-mo ] [ Designated as safety issue: No ]
    Measured by recent housing situation, how stable the situation is, ability to pay for housing, and how many days living in controlled environments.
  • Change in work and income history [ Time Frame: Baseline, 6-mo and 12-mo ] [ Designated as safety issue: No ]
    Measured by level of income and how many days worked in the last 30 days and last 6 months.
Same as current
  • Change in social support [ Time Frame: Baseline, 6-mo and 12-mo ] [ Designated as safety issue: No ]
    Measured by how frequently the respondent either received or offered support from/to family and friends in the last 12 months.
  • Changes in Alcoholics Anonymous (AA)/ Narcotics Anonymous (NA) involvement [ Time Frame: Baseline, 6-mo and 12-mo ] [ Designated as safety issue: No ]
    Measured by how many AA/NA meetings were attended in the last 6 months, and measures of identification with AA/NA programs.
  • Changes in services received [ Time Frame: Baseline, 6-mo and 12-mo ] [ Designated as safety issue: No ]
    Measured by how often common services, such as medical and counseling services, were accessed in the prior 2 months.
  • Changes in support and confrontations with family, friends and professionals about drug and alcohol use [ Time Frame: Baseline, 6-mo and 12-mo ] [ Designated as safety issue: No ]
    Measured by how often significant people in their lives confronted the respondents about making changes to alcohol and drug use.
  • Changes in occurrence and impact from trauma, post-traumatic stress disorder (PTSD), and abuse history [ Time Frame: Baseline, 6-mo and 12-mo ] [ Designated as safety issue: No ]
    Measured by how much past traumatic events are causing bothersome feelings and experiences, whether past physical or sexual abuse has occurred and how recently it has happened.
  • Changes in motivation to change based on the Alcohol and Drug Consequences Questionnaire (ADCQ) [ Time Frame: Baseline, 6-mo and 12-mo ] [ Designated as safety issue: No ]
    Measured by two scales that assess motivation to change substance abuse, based on consequences and benefits significant to the respondents.
  • Changes in results from urine screens for drugs [ Time Frame: Baseline, 6-mo and 12-mo ] [ Designated as safety issue: No ]
    Measured by positive or negative drug rest results.
Same as current
 
Reducing Offenders' HIV Risk: MI Enhanced Case Management With Drug-Free Housing
Reducing Offenders' HIV Risk: MI Enhanced Case Management With Drug-Free Housing

The goal of the study is to see if a Motivational Interviewing Case Management (MICM) intervention will improve outcomes for respondents who are on probation or parole, at risk for HIV and have recently entered a Sober Living House. The MICM will help respondents access needed services, adapt to their new living environment, find and maintain work, address HIV risk and treatment, and manage setbacks. The risk for HIV infection among criminal justice offenders is significant, as is the need for stable, drug free housing in this population. Our aim is to see if the MICM intervention in the context of drug free housing will improve health outcomes, reduce recidivism, and increase service utilization for this population.

This application is based on the premise that probationers and parolees must have access to stable, drug free housing to reduce HIV risk, access needed services and avoid rearrests and reincarceration. Drug free housing at the Sober Living Network (SLN) in California will be studied as a way to provide a positive living environment for probationers and parolees. The houses use a sober living house (SLH) model of recovery that includes a communal recovery environment, abstinence from drugs and alcohol, peer support, and encouragement to attend self-help groups such as Alcoholics Anonymous. Preliminary data based on a sample of 300 individuals entering 20 SLHs in California showed resident improvement in a variety of areas, including drug and alcohol use, employment, psychiatric symptoms, and arrests (Polcin et al., 2010). Although residents referred from parole and probation systems had substance use reductions that were comparable to voluntary residents, they had had far more problems maintaining employment, higher rates of arrest and incarceration, and lower attendance at self- help groups (Polcin, et al., 2010). Thirty seven percent had been rearrested at 6 month follow-up and 0ne reason may be that probationers and parolees received only 35% of the services that they felt they needed to succeed. Although over half met DSM IV criteria for methamphetamine dependence during the last year, a very high risk group for HIV, we did not assess HIV outcomes.

The proposed study will improve SLHs for offenders by adding a Motivational Interviewing Case Management (MICM) intervention specifically targeted to the problems presented by each offender. The list of potential problems that MICM can address is extensive: 1) adapting to the SLH environment, 2) complying with parole and probation, 3) finding and maintain work, 4) successfully accessing and maintaining retention in services, 5) addressing HIV risk, testing and treatment, 6) mobilizing personal and informal resources, and 7) managing setbacks (e.g., relapse, loss of housing, loss of work).

Men and women offenders (N=330) entering SLHs will be assigned to a condition consisting of drug free housing and provision of a resources manual where residents can seek help for a variety of problems (a control group) or drug free housing plus the MICM (intervention).

Aim 1: To assess HIV testing rates, HIV risk behaviors, and utilization for HIV services at baseline, 6, and 12 months.

H1.1 Residents receiving MICM in addition to drug free housing will have higher rates of HIV testing, higher utilization of HIV services, and fewer HIV risk behaviors than the drug free housing and resources condition.

Aim 2: To compare baseline substance use within each study condition with 6- and 12-month substance use.

H2.1 Residents in each study condition will show significant reductions in drug and alcohol use between baseline and follow-up time points as measured by the Time Line Follow Back (TLFB).

H2.2 Residents in each study condition will show significant reductions in drug and alcohol problems between baseline and follow-up time points on the Addiction Severity Index alcohol and drug scales.

Aim 3: To compare outcomes between the two study conditions at baseline, 6, and 12 months.

H3.1 Residents receiving MICM in addition to drug free housing will have less substance use (TLFB) and lower ASI alcohol and drug severity than the drug free housing and resources condition.

H3.2 Residents receiving MICM in addition to drug free housing will have fewer arrests, fewer days incarcerated and lower ASI legal severity than the drug free housing and resources condition.

H3.3 Residents receiving MICM in addition to drug free housing will have fewer work problems (ASI Employment scale) and more days worked than the drug free housing and resources condition.

Aim 4: To assess mediators and moderators of the MICM. H4.1 Service utilization (Hser et al., 1999) will mediate the relationship between drug free housing plus MICM and outcome (TLFB, ASI Alcohol and Drug scales and criminal justice recidivism).

Exploratory Aims: 1) To explore additional outcomes (e.g., ASI Family, Medical, and Psychiatric scales, long-term housing status) and covariates (e.g., social support, supportive confrontation, motivation). (2) To conduct 30 qualitative interviews (15 per condition) to identify general and intervention specific factors affecting outcome.

Interventional
Not Provided
Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Alcohol and Drug Abuse
  • Behavioral: Motivational interviewing case management
  • Behavioral: Resource referrals
  • Experimental: Motivational interviewing case management
    MICM intervention combines aspects of motivational interviewing along with case management to influence HIV risk and recovery from alcohol and drug problems. Participants assigned to the MICM condition will receive 3 individual sessions within the first 2 weeks of entering the SLH. Thereafter they will have contact with the MICM therapist monthly throughout the duration of their enrollment in the study (12 months).
    Intervention: Behavioral: Motivational interviewing case management
  • Resource referrals
    Respondents will receive SLH services as usual along with a list of resources that can be used to address a variety of problems.
    Intervention: Behavioral: Resource referrals
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Not yet recruiting
330
March 2018
March 2018   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • Be 18 years or older
  • Speak English
  • Entered the sober living house in the last 7 days
  • Able to provide contact info for followups
  • Willing to attend MICM sessions
  • On probation or parole
  • ONE of the following: tested positive for HIV, injected drugs, sex work history, men who have sex with men (MSM), or women who have had unprotected sex in the last month with multiple partners

Exclusion Criteria:

  • serious mental health disorder that would hinder their ability to provide informed consent or otherwise participate
Both
18 Years and older
Yes
Contact: Doug Polcin, Ed.D 510-597-3440 dpolcin@arg.org
United States
 
NCT01977092
1R01 DA034973-01A1, R01DA034973-01A1
Yes
Public Health Institute, California
Public Health Institute, California
National Institute on Drug Abuse (NIDA)
Principal Investigator: Doug Polcin, Ed.D Alcohol Research Group / Public Health Institute
Public Health Institute, California
October 2013

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP