Warren Alpert Medical School, Brown University, Providence, RI, United States of America.
Harvard Department of Psychology, Harvard University, Cambridge, MA, United States of America.
J Subst Abuse Treat. 2019 Sep;104:28-33. doi: 10.1016/j.jsat.2019.06.001. Epub 2019 Jun 10.
Medications for opioid use disorder (MOUD) in the criminal justice setting is an effective way to address opioid use disorder and prevent associated deaths in the community. The Rhode Island Department of Corrections (RIDOC) is the first statewide correctional system in the United States to offer comprehensive MOUD services to incarcerated individuals.However, due to stigma, eligible individuals may be reluctant to engage with MOUD. This study aims to 1) evaluate the efficacy of an educational video intervention about MOUD and 2) characterize MOUD-related attitudes in a general incarcerated population.
Participants were recruited from eight elective classes offered to soon-to-be-released incarcerated individuals at RIDOC. Participants viewed an eight-minute video featuring incarcerated individuals speaking about their experiences using MOUD, designed to reduce MOUD-related stigma. Participants were administered surveys prior to and after watching the video to assess changes in MOUD knowledge (MOUD-K) and MOUD attitudes (MOUD-A).
This evaluation of the intervention included 80 incarcerated participants (median age = 35, 93% male, 36% non-Hispanic White, and 26% non-Hispanic Black). Forty percent indicated non-medical opioid use within six months prior to incarceration; 13% had previously used MOUD. Significant improvements in MOUD-K scores (t(65) = -7.0, p < 0.0001) and MOUD-A scores (t(69) = -5.8, p < 0.0001) were detected after participants viewed the video. The intervention yielded greater ΔMOUD-A scores among those identifying as non-Hispanic Black, compared to non-Hispanic Whites (β = 2.6, CI = 0.4, 4.8).
The educational video improved both knowledge and positive attitudes towards MOUD, with changes in MOUD attitudes being influenced by race. These findings may inform future MOUD educational programs, thereby helping to reduce opioid use disorder-related morbidity and mortality.
在刑事司法环境中，治疗阿片类药物使用障碍（MOUD）的药物是解决阿片类药物使用障碍和预防社区相关死亡的有效方法。罗得岛惩教署（RIDOC）是美国第一个为被监禁个人提供全面 MOUD 服务的全州惩教系统。然而，由于耻辱感，符合条件的个人可能不愿意接受 MOUD。本研究旨在 1）评估关于 MOUD 的教育视频干预的效果，2）描述一般监禁人群中与 MOUD 相关的态度。
参与者从 RIDOC 向即将获释的被监禁个人提供的八门选修课程中招募。参与者观看了一段八分钟的视频，视频中介绍了一些被监禁的个人讲述他们使用 MOUD 的经验，旨在减少 MOUD 相关的耻辱感。在观看视频前后，参与者接受了调查，以评估 MOUD 知识（MOUD-K）和 MOUD 态度（MOUD-A）的变化。
这项干预措施的评估包括 80 名被监禁的参与者（中位数年龄为 35 岁，93%为男性，36%为非西班牙裔白人，26%为非西班牙裔黑人）。40%的人表示在入狱前六个月内曾有非医疗性阿片类药物使用；13%的人曾使用过 MOUD。参与者观看视频后，MOUD-K 评分（t(65)=-7.0，p<0.0001）和 MOUD-A 评分（t(69)=-5.8，p<0.0001）均显著提高。与非西班牙裔白人相比，黑人参与者的 MOUD-A 评分变化更大（β=2.6，CI=0.4，4.8）。
教育视频提高了对 MOUD 的知识和积极态度，MOUD 态度的变化受到种族的影响。这些发现可能为未来的 MOUD 教育项目提供信息，从而有助于降低阿片类药物使用障碍相关的发病率和死亡率。
