针对涉及刑事司法的成年人的基于网络的心理社会干预措施的可接受性和有效性。
Acceptability and effectiveness of a web-based psychosocial intervention among criminal justice involved adults.
作者信息
Lee J D, Tofighi B, McDonald R, Campbell A, Hu M C, Nunes E
机构信息
New York University School of Medicine, Department of Population Health, 227 E. 30th St., 10016, New York, NY, USA.
New York State Psychiatric Institute, Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA.
出版信息
Health Justice. 2017 Dec;5(1):3. doi: 10.1186/s40352-017-0048-z. Epub 2017 Mar 11.
BACKGROUND
The acceptability, feasibility and effectiveness of web-based interventions among criminal justice involved populations are understudied. This study is a secondary analysis of baseline characteristics associated with criminal justice system (CJS) status as treatment outcome moderators among participants enrolling in a large randomized trial of a web-based psychosocial intervention (Therapeutic Education System [TES]) as part of outpatient addiction treatment.
METHODS
We compared demographic and clinical characteristics, TES participation rates, and the trial's two co-primary outcomes, end of treatment abstinence and treatment retention, by self-reported CJS status at baseline: 1) CJS-mandated to community treatment (CJS-mandated), 2) CJS-recommended to treatment (CJS-recommended), 3) no CJS treatment mandate (CJS-none).
RESULTS
CJS-mandated (n = 107) and CJS-recommended (n = 69) participants differed from CJS-none (n = 331) at baseline: CJS-mandated were significantly more likely to be male, uninsured, report cannabis as the primary drug problem, report fewer days of drug use at baseline, screen negative for depression, and score lower for psychological distress and higher on physical health status; CJS-recommended were younger, more likely single, less likely to report no regular Internet use, and to report cannabis as the primary drug problem. Both CJS-involved (CJS -recommended and -mandated) groups were more likely to have been recently incarcerated. Among participants randomized to the TES arm, module completion was similar across the CJS subgroups. A three-way interaction of treatment, baseline abstinence and CJS status showed no associations with the study's primary abstinence outcome.
CONCLUSIONS
Overall, CJS-involved participants in this study tended to be young, male, and in treatment for a primary cannabis problem. The feasibility and effectiveness of the web-based psychosocial intervention, TES, did not vary by CJS-mandated or CJS-recommended participants compared to CJS-none. Web-based counseling interventions may be effective interventions as US public safety policies begin to emphasize supervised community drug treatment over incarceration.
背景
针对涉及刑事司法系统人群的基于网络的干预措施的可接受性、可行性和有效性研究不足。本研究是一项二次分析，该分析针对参与一项大型随机试验的参与者，该试验将基于网络的心理社会干预措施（治疗教育系统 [TES]）作为门诊成瘾治疗的一部分，研究与刑事司法系统（CJS）状态相关的基线特征作为治疗结果调节因素的情况。
方法
我们根据基线时自我报告的CJS状态，比较了人口统计学和临床特征、TES参与率，以及试验的两个共同主要结局，即治疗结束时的戒酒情况和治疗保留率：1）CJS强制要求接受社区治疗（CJS强制要求），2）CJS建议接受治疗（CJS建议），3）无CJS治疗要求（无CJS要求）。
结果
CJS强制要求组（n = 107）和CJS建议组（n = 69）在基线时与无CJS要求组（n = 331）存在差异：CJS强制要求组男性比例显著更高、未参保、报告大麻为主要药物问题、基线时报告的吸毒天数更少、抑郁筛查呈阴性、心理困扰得分更低且身体健康状况得分更高；CJS建议组更年轻、更可能单身、不太可能报告没有定期使用互联网，且报告大麻为主要药物问题。两个涉及CJS的组（CJS建议组和CJS强制要求组）近期被监禁的可能性都更高。在随机分配到TES组的参与者中，各CJS亚组的模块完成情况相似。治疗、基线戒酒情况和CJS状态的三向交互作用与研究的主要戒酒结局无关联。
结论
总体而言，本研究中涉及CJS的参与者往往年轻、男性居多，且主要因大麻问题接受治疗。与无CJS要求的参与者相比，基于网络的心理社会干预措施TES的可行性和有效性在CJS强制要求或CJS建议的参与者中并无差异。随着美国公共安全政策开始强调监督下的社区药物治疗而非监禁，基于网络的咨询干预措施可能是有效的干预手段。
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