Tillson Martha, Fallin-Bennett Amanda, Staton Michele
University of Kentucky Center on Drug and Alcohol Research, Lexington, KY, USA.
University of Kentucky College of Arts and Sciences, Department of Sociology, Lexington, KY, USA.
J Clin Transl Sci. 2022 Aug 10;6(1):e106. doi: 10.1017/cts.2022.441. eCollection 2022.
Justice system-involved women with opioid use disorder (OUD) experience layered health risks and stigma, yet peer navigation services during reentry may support positive outcomes. This manuscript offers a program description of a women's peer navigation intervention delivered pre- and post-release from jail to remove barriers to women's access to OUD treatment, including medications for opioid use disorder (MOUD).
All data were collected as part of a NIH/NIDA-funded national cooperative, the Justice Community Opioid Innovation Network (JCOIN) project. Through the larger study's intervention, women in jail with OUD are connected via videoconference to a peer navigator, who provides an initial reentry recovery assessment and 12+ weeks of recovery support sessions post-release. Qualitative analyses examined peers' notes from initial sessions with women (N = 50) and in-depth interviews with peers (N = 3).
Peers' notes from initial sessions suggest that women anticipate challenges to successful recovery and community reentry. More than half of women (51.9%) chose OUD treatment as their primary goal, while others selected more basic needs (e.g. housing, transportation). In qualitative interviews, peers described women's transitions to the community as unpredictable, creating difficulties for reentry planning, particularly for rural women. Peers also described challenges with stigma against MOUD and establishing relationships via telehealth, but ultimately believed their role was valuable in providing resource referrals, support, and hope for recovery.
For women with OUD, peer navigation can offer critical linkages to services at release from jail, in addition to hope, encouragement, and solidarity. Findings provide important insights for future peer-based interventions.
涉及司法系统且患有阿片类物质使用障碍(OUD)的女性面临多重健康风险和耻辱感,但重返社会期间的同伴导航服务可能有助于取得积极成果。本手稿介绍了一项针对女性的同伴导航干预计划,该计划在女性入狱前和出狱后实施,以消除女性获得OUD治疗(包括阿片类物质使用障碍药物治疗[MOUD])的障碍。
所有数据均作为美国国立卫生研究院/美国国立药物滥用研究所资助的全国性合作项目——司法社区阿片类创新网络(JCOIN)项目的一部分收集。通过该大型研究的干预措施,患有OUD的在押女性通过视频会议与一名同伴导航员建立联系,该导航员会进行初步的重返社会恢复评估,并在女性出狱后提供12周以上的恢复支持课程。定性分析检查了同伴与女性初次会面(N = 50)的记录以及对同伴的深入访谈(N = 3)。
同伴初次会面记录显示,女性预计在成功康复和重返社区方面会面临挑战。超过一半的女性(51.9%)选择OUD治疗作为主要目标,而其他女性则选择了更基本的需求(如住房、交通)。在定性访谈中,同伴将女性向社区的过渡描述为不可预测的,这给重返社会计划带来了困难,尤其是对农村女性而言。同伴还描述了对MOUD的耻辱感以及通过远程医疗建立关系方面的挑战,但最终认为他们的角色在提供资源推荐、支持和康复希望方面很有价值。
对于患有OUD的女性,同伴导航除了能带来希望、鼓励和团结外,还可以在出狱时提供与服务的关键联系。研究结果为未来基于同伴的干预措施提供了重要见解。