Overview

This trial is active, not recruiting.

Condition alcohol and drug abuse
Treatments motivational interviewing case management, resource referrals
Sponsor Public Health Institute, California
Collaborator National Institute on Drug Abuse (NIDA)
Start date January 2014
End date March 2018
Trial size 330 participants
Trial identifier NCT01977092, 1R01DA034973-01A1, R01DA034973-01A1

Summary

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.

United States No locations recruiting
Other Countries No locations recruiting

Study Design

Allocation randomized
Endpoint classification efficacy study
Intervention model parallel assignment
Masking open label
Primary purpose treatment
Arm
(Experimental)
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).
motivational interviewing case management
(Other)
Respondents will receive SLH services as usual along with a list of resources that can be used to address a variety of problems.
resource referrals

Primary Outcomes

Measure
Change in criminal justice outcomes
time frame: Baseline, 6-mo, 12-mo
Change in Alcohol and Drug Use (Alcohol Severity Index & Timeline Follow Back)
time frame: Baseline, 6-mo, 12-mo
Change in needle use and injection, sexual risk behaviors, and HIV status and testing.
time frame: Baseline, 6-mo and 12-mo

Secondary Outcomes

Measure
Change in Alcohol Severity Index (ASI) Scales
time frame: Baseline, 6-mo and 12-mo
Change in housing stability
time frame: Baseline, 6-mo and 12-mo
Change in work and income history
time frame: Baseline, 6-mo and 12-mo

Eligibility Criteria

Male or female participants at least 18 years old.

Inclusion Criteria: - Be 18 years or older - Speak English - Entered the sober living house in the last month - 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

Additional Information

Official title Reducing Offenders' HIV Risk: MI Enhanced Case Management With Drug-Free Housing
Principal investigator Doug Polcin, Ed.D
Description 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.
Trial information was received from ClinicalTrials.gov and was last updated in July 2016.
Information provided to ClinicalTrials.gov by Public Health Institute, California.