Objectives This study conducted a randomized controlled trial with 600 recently released homeless men exiting California jails and prisons. Methods The purpose of this study was to primarily ascertain how different levels of intensity in peer coaching and nurse-partnered intervention programs may impact reentry outcomes; specifically: (a) an intensive peer coach and nurse case managed (PC-NCM) program; (b) an intermediate peer coaching (PC) program with brief nurse counseling; and (c) the usual care (UC) program involving limited peer coaching and brief nurse counseling. Secondary outcomes evaluated the operational cost of each program. Results When compared to baseline, all three groups made progress on key health-related outcomes during the 12-month intervention period; further, 84.5 % of all participants eligible for hepatitis A/B vaccination completed their vaccine series. The results of the detailed operational cost analysis suggest the least costly approach (i.e., UC), which accounted for only 2.11 % of the total project expenditure, was as effective in achieving comparable outcomes for this parolee population as the PC-NCM and PC approaches, which accounted for 53.98 % and 43.91 %, respectively, of the project budget. Conclusions In this study, all three intervention strategies were found to be comparable in achieving a high rate of vaccine completion, which over time will likely produce tremendous savings to the public health system.
Background Homeless female exoffenders (homeless female offenders) exiting jail and prison are at a critical juncture during re-entry and transitioning into the community setting. Objective The purpose of the study was to compare the effect of a dialectical behavioral therapy-corrections modified (DBT-CM) program with a health promotion (HP) program on achieving drug and alcohol abstinence among female parolees/probationers residing in the community. Methods We conducted a multicenter parallel randomized controlled trial with 130 female parolees/probationers (aged 19–64) residing in the community randomly assigned to either DBT-CM (n = 65) or HP (n = 65). The trial was conducted in four community-based partner sites in Los Angeles (LA) and Pomona, California from February, 2015 to November, 2016. Treatment assignment was carried out using a computer-based URN randomization program. The primary outcome was drug and alcohol use abstinence at six-month follow up. Results Analysis was based on data from 116 participants with complete outcome data. Multivariable logistic regression revealed that the DBT-CM program remained an independent positive predictor of decrease in drug use among the DBT-CM participants at six months (p = .01) as compared with the HP program participants. Being non-White (p < .05) and having higher depressive symptom scores (p < .05) were associated with lower odds of drug use abstinence (i.e., increased the odds of drug use) at six months. Discussion DBT-CM increased drug and alcohol abstinence at six month follow-up, compared to a health promotion program.
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