Johnson Jennifer E, Schonbrun Yael Chatav, Anderson Bradley, Kurth Megan, Timko Christine, Stein Michael
Division of Public Health, Michigan State University College of Human Medicine, 200 East 1st St Room 367, Flint, MI 48503, United States.
Butler Hospital, Warren Alpert Medical School of Brown University, 345 Blackstone Blvd, Providence, RI 02906, United States.
Contemp Clin Trials. 2017 Apr;55:39-46. doi: 10.1016/j.cct.2017.02.001. Epub 2017 Feb 7.
This article describes the protocol for a randomized effectiveness trial of a method to link alcohol use disordered women who are in pretrial jail detention with post-release 12-step mutual help groups.
Jails serve 15 times more people per year than do prisons and have very short stays, posing few opportunities for treatment or treatment planning. Alcohol use is associated with poor post-jail psychosocial and health outcomes including sexually transmitted diseases and HIV, especially for women. At least weekly 12-step self-help group attendance in the months after release from jail has been associated with improvements in alcohol use and alcohol-related consequences. Linkage strategies improve 12-step attendance and alcohol outcomes among outpatients, but have not previously been tested in criminal justice populations.
In the intervention condition, a 12-step volunteer meets once individually with an incarcerated woman while she is in jail and arranges to be in contact after release to accompany her to 12-step meetings. The control condition provides schedules for local 12-step meetings. Outcomes include percent days abstinent from alcohol (primary), 12-step meeting involvement, and fewer unprotected sexual occasions (secondary) after release from jail. We hypothesize that (Minton, 2015) 12-step involvement will mediate the intervention's effect on alcohol use, and (O'Brien, 2001) percent days abstinent will mediate the intervention's effect on STI/HIV risk-taking outcomes. Research methods accommodate logistical and philosophical hurdles including rapid turnover of commitments and unpredictable release times at the jail, possible post-randomization ineligibility due to sentencing, 12-step principles such as Nonaffiliation, and use of volunteers as interventionists.
本文描述了一项随机有效性试验的方案，该试验旨在研究一种将审前被监禁的酒精使用障碍女性与出狱后参加12步互助小组的方法相联系的策略。
监狱每年接待的人数是监狱的15倍，且服刑期很短，几乎没有治疗或治疗规划的机会。饮酒与出狱后的不良心理社会和健康后果相关，包括性传播疾病和艾滋病毒，尤其是对女性而言。出狱后的几个月里，至少每周参加一次12步自助小组与饮酒情况及与酒精相关后果的改善有关。联系策略可提高门诊患者参加12步小组的比例及改善饮酒状况，但此前尚未在刑事司法人群中进行过测试。
在干预组中，一名12步志愿者在一名被监禁女性入狱期间与其单独会面一次，并安排在其出狱后保持联系，陪她参加12步会议。对照组提供当地12步会议的时间表。结果包括出狱后戒酒天数百分比（主要指标）、参加12步会议的情况，以及无保护性行为次数减少（次要指标）。我们假设（明顿，2015年）参加12步小组将介导干预对饮酒的影响，（奥布赖恩，2001年）戒酒天数百分比将介导干预对性传播感染/艾滋病毒风险行为结果的影响。研究方法考虑到了后勤和理念方面的障碍，包括承诺的快速变化和监狱不可预测的释放时间、因判刑可能导致随机分组后不符合条件、12步原则如不结盟，以及使用志愿者作为干预者等情况。
