Division of Public Health, Michigan State University College of Human Medicine, 200 East 1stSt, Room 366, Flint, MI, 48503, United States.
Butler Hospital, Warren Alpert Medical School of Brown University, 345 Blackstone Blvd, Providence, RI, 02906, United States.
Drug Alcohol Depend. 2021 Oct 1;227:109014. doi: 10.1016/j.drugalcdep.2021.109014. Epub 2021 Aug 28.
Alcohol use disorder predicts poor health outcomes among women returning to the community from jail. Twelve-step self-help groups are free and accessible to women leaving jail, but reaching out to strangers can pose a barrier. Pilot work suggested that a volunteer-led "warm handoff" may increase post-release twelve-step self-help group attendance.
This randomized trial evaluated the effectiveness of a warm handoff intervention on post-release twelve-step attendance and alcohol use. Participants (189 women with alcohol use disorder) were recruited in jail and followed for 6 months after release. Participants were randomized to: (1) a warm handoff, in which a female twelve-step volunteer met with each woman individually in jail and the same volunteer attended the woman's first twelve-step meeting with her after release; or (2) enhanced standard care (a list of meetings and community resources). Outcomes included days abstinent from alcohol, drinks per drinking day, alcohol-related problems, twelve-step attendance, twelve-step affiliation, network support for abstinence, number of unprotected sexual occasions, and drug using days.
Among intervention participants, only 66 % were aware that the volunteer tried to contact them after jail, only 38 % reported post-jail contact with their volunteers (typically phone), and only four went to meetings with their volunteers post-release. Of 8 post-release outcomes, intervention effects differed on only one (alcohol-related problems).
Although twelve-step self-help group attendance predicted alcohol abstinence, the volunteer-led warm handoff intervention did not increase twelve-step attendance. The twelve-step tradition of Attraction may inhibit the active outreach required to connect women to services after jail release.
酒精使用障碍会预测从监狱返回社区的女性的健康状况不佳。十二步自助小组对离开监狱的女性是免费且可及的，但与陌生人联系可能会构成障碍。初步研究表明，志愿者主导的“热情交接”可能会增加出狱后参加十二步自助小组的人数。
这项随机试验评估了热情交接干预措施对出狱后参加十二步自助小组和饮酒的效果。参与者（189 名患有酒精使用障碍的女性）在监狱中招募，并在释放后随访 6 个月。参与者随机分为：（1）热情交接组，其中一名女性十二步志愿者在监狱中与每位女性单独会面，同一名志愿者在释放后陪同该女子参加她的第一次十二步会议；或（2）增强标准护理组（一系列会议和社区资源列表）。结果包括从酒精中禁欲的天数、每天饮酒量、与酒精相关的问题、十二步自助组的出勤率、十二步自助组的归属、网络对戒酒的支持、无保护性行为的次数和吸毒的天数。
在干预组中，只有 66%的人知道志愿者在出狱后试图与他们联系，只有 38%的人报告说在出狱后与他们的志愿者有过联系（通常是电话），只有 4 人在出狱后与他们的志愿者一起参加了会议。在 8 项出狱后的结果中，干预效果仅在一项上有所不同（与酒精相关的问题）。
尽管十二步自助小组的出勤率预测了酒精戒断，但志愿者主导的热情交接干预并没有增加十二步自助小组的出勤率。十二步自助小组的吸引力传统可能会抑制在出狱后主动联系女性以提供服务所需的联系。
