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Bormann NL, Weber AN, Miskle B, Arndt S, Lynch AC. Sex Differences in Recovery Capital Gains Post-Incarceration. Subst Use Misuse 2023; 58:1839-1846. [PMID: 37702512 DOI: 10.1080/10826084.2023.2257303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
BACKGROUND People with substance use disorders are highly prevalent in the carceral system. Recovery capital (RC) is the resources available to an individual to initiate or maintain substance use cessation. Sex differences have been identified in RC during both active substance use and recovery in the general population, however, less is known about these sex differences in the post-incarceration population. METHODS Participants (n = 136) were those with an opioid or stimulant use disorder with past year involvement with the Iowa criminal justice system (USA), who completed the Assessment of Recovery Capital (ARC) twice over a six-month cohort study. Participants were involved in an addiction clinic that utilized active case management. Analysis of covariance evaluated changes in ARC during the study. Separate models compared total ARC and individual ARC domains, with sex as the independent variable of interest. Model means were generated for interpretation based on sex, comparing baseline and study endpoint ARC scores. RESULTS There were no baseline sex differences in total ARC. ARC increased significantly for the group, however, males showed disproportionate growth. Females ended the study with a mean ARC of 37.8 (SD= 9.3) and males finished at 41.6 (SD= 9.3), which was a significant difference (p = 0.044); this significant difference was driven by ARC subdomains of 'Psychological Health' and 'Physical Health.' CONCLUSIONS People post-incarceration are at high risk for return to substance use. Treatment that is informed by sex-based differences may have the potential to decrease the differing rates of growth in RC between sexes.
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Affiliation(s)
| | - Andrea N Weber
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
- Department of Internal Medicine, University of Iowa, Iowa City, IA, USA
| | - Benjamin Miskle
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
- Department of Pharmacy, University of Iowa, Iowa City, IA, USA
| | - Stephan Arndt
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
- Department of Biostatistics, University of Iowa, Iowa City, IA, USA
| | - Alison C Lynch
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
- Department of Family Medicine, University of Iowa, Iowa City, IA, USA
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Feasibility of using Facebook for HIV prevention: Implications for translational research among justice-involved women who use drugs in rural Appalachia. J Clin Transl Sci 2023; 6:e127. [PMID: 36590363 PMCID: PMC9794968 DOI: 10.1017/cts.2022.497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 10/20/2022] [Accepted: 10/30/2022] [Indexed: 11/11/2022] Open
Abstract
Background Justice-involved women from rural Appalachia face significant barriers to the utilization of evidence-based HIV prevention interventions in spite of high rates of injection drug use and risky sexual practices. Adapting evidence-based practices to incorporate the cultural uniqueness of the target population is needed in order to advance translational and clinical science in this area. This study provides a descriptive overview of indicators of feasibility and acceptability of an adapted version of the National Institute on Drug Abuse Standard HIV prevention intervention for delivery using Facebook through a small randomized controlled pilot study with rural Appalachian women. Method Study methods include the random selection of rural Appalachian women from two local jails, screening for study eligibility, baseline data collection, random assignment to study interventions, and follow-up in the community three months post-release. Results Results indicate that the feasibility of the approach was supported through study enrollment of the target population who reported regular Facebook use and HIV risk behaviors including drug use and sex. Acceptability of the intervention was demonstrated through enrollment in the study intervention, engagement in the intervention through Facebook, and indicators of HIV/HCV knowledge. Conclusions Study findings contribute to the critical and unmet need to advance translational science on the delivery of evidence-based prevention interventions in real-world rural Appalachian settings to understudied, vulnerable individuals who are often overlooked in targeted prevention efforts.
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Providing peer navigation services to women with a history of opioid misuse pre- and post-release from jail: A program description. J Clin Transl Sci 2022; 6:e106. [PMID: 36128341 PMCID: PMC9453575 DOI: 10.1017/cts.2022.441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 06/10/2022] [Accepted: 08/05/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Justice system-involved women with opioid use disorder (OUD) experience layered health risks and stigma, yet peer navigation services during reentry may support positive outcomes. This manuscript offers a program description of a women’s peer navigation intervention delivered pre- and post-release from jail to remove barriers to women’s access to OUD treatment, including medications for opioid use disorder (MOUD). Methods: All data were collected as part of a NIH/NIDA-funded national cooperative, the Justice Community Opioid Innovation Network (JCOIN) project. Through the larger study’s intervention, women in jail with OUD are connected via videoconference to a peer navigator, who provides an initial reentry recovery assessment and 12+ weeks of recovery support sessions post-release. Qualitative analyses examined peers’ notes from initial sessions with women (N = 50) and in-depth interviews with peers (N = 3). Results: Peers’ notes from initial sessions suggest that women anticipate challenges to successful recovery and community reentry. More than half of women (51.9%) chose OUD treatment as their primary goal, while others selected more basic needs (e.g. housing, transportation). In qualitative interviews, peers described women’s transitions to the community as unpredictable, creating difficulties for reentry planning, particularly for rural women. Peers also described challenges with stigma against MOUD and establishing relationships via telehealth, but ultimately believed their role was valuable in providing resource referrals, support, and hope for recovery. Conclusions: For women with OUD, peer navigation can offer critical linkages to services at release from jail, in addition to hope, encouragement, and solidarity. Findings provide important insights for future peer-based interventions.
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Transitioning into the Community: Perceptions of Barriers and Facilitators Experienced By Formerly Incarcerated, Homeless Women During Reentry-A Qualitative Study. Community Ment Health J 2021; 57:609-621. [PMID: 33387178 PMCID: PMC8514107 DOI: 10.1007/s10597-020-00748-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 11/17/2020] [Indexed: 10/22/2022]
Abstract
Formerly incarcerated, homeless women on parole or probation experience individual-and structural-level barriers and facilitators as they prepare to transition into the community during reentry. A qualitative study was undertaken using focus group methods with formerly incarcerated, currently homeless women (N = 18, Mage = 37.67, SD 10.68, 23-53 years of age) exiting jail or prison. Major themes which emerged included the following: (1) access to resources-barriers and facilitators during community transition, (2) familial reconciliation and parenting during community transition, and (3) trauma and self-care support during community transition. These findings suggest a need to develop multi-level interventions at the individual, program and institutional/societal level with a gender-sensitive lens for women who are transitioning to community reentry. It is hoped that providing such resources will reduce the likelihood of homelessness and reincarceration.
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Staton M, Webster JM, Leukefeld C, Tillson M, Marks K, Oser C, Bush HM, Fanucchi L, Fallin-Bennett A, Garner BR, McCollister K, Johnson S, Winston E. Kentucky Women's Justice Community Opioid Innovation Network (JCOIN): A type 1 effectiveness-implementation hybrid trial to increase utilization of medications for opioid use disorder among justice-involved women. J Subst Abuse Treat 2021; 128:108284. [PMID: 33455828 DOI: 10.1016/j.jsat.2021.108284] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 12/03/2020] [Accepted: 01/05/2021] [Indexed: 01/20/2023]
Abstract
The opioid crisis has disproportionately affected women, but research on approaches to increase initiation of medications for opioid use disorder (MOUD) among women is limited. The Kentucky Justice Community Opioid Innovation Network (JCOIN) will implement a type 1 hybrid effectiveness and implementation trial to examine an innovative MOUD pretreatment model using telehealth (alone and in combination with peer navigators) for justice-involved women in transition from jail to the community. The overall goal of the project is to increase initiation and maintenance of MOUD among high-risk justice-involved women during community reentry to reduce opioid relapse and overdose. This project and other studies through the JCOIN network have the potential to significantly impact the OUD treatment field by contributing empirical evidence about the effectiveness and implementation of innovative technologies to increase initiation and maintenance of MOUD during a critical, high-risk time of community reentry among vulnerable, justice-involved individuals in both urban and nonurban communities.
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Affiliation(s)
- Michele Staton
- University of Kentucky College of Medicine, Department of Behavioral Science, 1100 Veterans Drive, Lexington, KY 40536, USA.
| | - J Matthew Webster
- University of Kentucky College of Medicine, Department of Behavioral Science, 1100 Veterans Drive, Lexington, KY 40536, USA
| | - Carl Leukefeld
- University of Kentucky College of Medicine, Department of Behavioral Science, 1100 Veterans Drive, Lexington, KY 40536, USA
| | - Martha Tillson
- University of Kentucky Center on Drug and Alcohol Research, Lexington, KY 40536, USA; University of Kentucky College of Arts & Sciences, Department of Sociology, Lexington, KY 40508, USA
| | - Katherine Marks
- Kentucky Cabinet for Health and Family Services, Department of Behavioral Health, 275 East Main Street, Frankfort, KY, 40621, USA
| | - Carrie Oser
- University of Kentucky College of Arts & Sciences, Department of Sociology, Lexington, KY 40508, USA
| | - Heather M Bush
- University of Kentucky College of Public Health, Department of Biostatistics, 760 Press Avenue, Healthy Kentucky Bldg, Suite 260, Lexington, KY 40536-0082, USA
| | - Laura Fanucchi
- University of Kentucky Center on Drug and Alcohol Research, Lexington, KY 40536, USA; University of Kentucky College of Medicine, Division of Infectious Diseases, 740 S. Limestone St., K512, Lexington, KY 40356, USA
| | - Amanda Fallin-Bennett
- University of Kentucky College of Nursing, 520 College of Nursing Building, Lexington, KY 40536, USA
| | - Bryan R Garner
- RTI International, 3040 E. Cornwallis Rd., Research Triangle Park, NC 27709-2194, USA
| | - Kathryn McCollister
- University of Miami, Department of Public Health Sciences, 1120 N.W. 14th Street, Suite 1019, Miami, FL 33136, USA
| | - Sarah Johnson
- Kentucky Department of Corrections, 2439 Lawrenceburg Road, Frankfort, KY 40602, USA
| | - Erin Winston
- University of Kentucky Center on Drug and Alcohol Research, Lexington, KY 40536, USA
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