让近期入狱的无家可归女性实现戒毒戒酒：一项将辩证行为疗法-病例管理与健康促进项目进行比较的随机对照试验。
Achieving Drug and Alcohol Abstinence Among Recently Incarcerated Homeless Women: A Randomized Controlled Trial Comparing Dialectical Behavioral Therapy-Case Management With a Health Promotion Program.
作者信息
Nyamathi Adeline M, Shin Sanghyuk S, Smeltzer Jolene, Salem Benissa E, Yadav Kartik, Ekstrand Maria L, Turner Susan F, Faucette Mark
机构信息
Adeline M. Nyamathi, ANP, PhD, FAAN, is Founding Dean and Distinguished Professor, Sue & Bill Gross School of Nursing, University of California, Irvine. At the time this work was completed, she was Distinguished Professor, School of Nursing, University of California, Los Angeles. Sanghyuk S. Shin, PhD, is Assistant Professor, Sue & Bill Gross School of Nursing, University of California, Irvine. At the time the work was completed, he was Assistant Professor-In-Residence, School of Public Health, University of California, Los Angeles. Jolene Smeltzer, MSN, RN, is Student, Mervyn M. Dymally School of Nursing, Los Angeles, California. Benissa E. Salem, PhD, MSN, RN, is Assistant Adjunct Professor and Project Director, School of Nursing, University of California, Los Angeles. Kartik Yadav, MSCR, is Project Director, Sue & Bill Gross School of Nursing, University of California, Irvine. At the time this research was completed, he was Project Director, School of Nursing, University of California, Los Angeles. Maria L. Ekstrand, PhD, is Professor, School of Medicine, University of California, San Francisco. Susan F. Turner, PhD, is Professor, Department of Criminology, Law and Society, University of California, Irvine. Mark Faucette, BS, is Vice President, Amistad de Los Angeles, California.
出版信息
Nurs Res. 2017 Nov/Dec;66(6):432-441. doi: 10.1097/NNR.0000000000000249.
BACKGROUND
Homeless female ex-offenders (homeless female offenders) exiting jail and prison are at a critical juncture during reentry and transitioning into the community setting.
OBJECTIVE
The purpose of the study was to compare the effect of a dialectical behavioral therapy-case management (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 years) 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 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 6-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 6 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 6 months.
DISCUSSION
DBT-CM increased drug and alcohol abstinence at 6-month follow-up, compared to an HP program.
背景
出狱和刑满释放的无家可归女性罪犯（无家可归的女性罪犯）在重新进入社会并过渡到社区环境的过程中处于关键阶段。
目的
本研究的目的是比较辩证行为疗法-个案管理（DBT-CM）项目与健康促进（HP）项目对社区中女性假释/缓刑人员实现戒毒和戒酒的效果。
方法
我们进行了一项多中心平行随机对照试验，将130名居住在社区的女性假释/缓刑人员（年龄19 - 64岁）随机分为DBT-CM组（n = 65）或HP组（n = 65）。该试验于2015年2月至2016年11月在加利福尼亚州洛杉矶和波莫纳的四个社区合作地点进行。治疗分配使用基于计算机的瓮随机化程序。主要结局是6个月随访时的戒毒和戒酒情况。
结果
分析基于116名有完整结局数据的参与者的数据。多变量逻辑回归显示，与HP项目参与者相比，DBT-CM项目在6个月时仍是DBT-CM参与者中药物使用减少的独立阳性预测因素（p = .01）。非白人（p < .05）和抑郁症状评分较高（p < .05）与6个月时戒毒戒酒的较低几率相关（即增加了药物使用的几率）。
讨论
与HP项目相比，DBT-CM在6个月随访时增加了戒毒和戒酒的比例。
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