Langdon Kirsten J, Jiménez Muñoz Paola, Block Amanda, Scherzer Caroline, Ramsey Susan
Department of Psychiatry, Rhode Island Hospital, Providence, RI, USA.
Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.
Subst Abuse. 2022 Sep 27;16:11782218221127111. doi: 10.1177/11782218221127111. eCollection 2022.
Despite the extensive benefits of implementing Medications for Opioid Use Disorder (MOUD) in jail/prison, criminal justice-involved populations face significant challenges when transitioning back to the community following a period of incarceration. These risk factors are associated with increased drug use and discontinuation of evidence-based care. Novel intervention strategies are needed to support this high-risk period of transition. The primary objective of this protocol was to gather perspectives from the target population to optimize feasibility and acceptability of a combined in-person and text message-delivered intervention designed to support community reentry and continuation of MOUD.
Participants (n = 8), who had prior experience engaging in MOUD while in jail/prison, were recruited from an outpatient primary care clinic in Rhode Island. A semi-structured interview was conducted to assess barriers/facilitators to technology following release, experiences of community reentry and OUD treatment, perceptions of continuum of care, and feasibility/acceptability of the intervention. All interviews were coded independently by 2 research assistants.
Participants reacted positively toward an intervention designed to support the transition to community-based care. Most participants denied any apprehension about using this type of platform. Obtaining a cell phone following release was endorsed as generally viable; however, special consideration must be paid to the consistency of cell phone service as well as digital literacy. Participants readily agreed on the utility of structured, daily text messages that provide motivational reminders and distress tolerance skill suggestions as well as the opportunity to access "on-demand" support.
Overall, individuals engaged in MOUD while in jail/prison were receptive to a motivational- and distress tolerance-based digital health intervention to support recovery. Incorporating thematic results on suggested structural changes may increase the usability of this intervention to promote continuation of MOUD following release from jail/prison.
尽管在监狱中实施阿片类药物使用障碍药物治疗（MOUD）有诸多益处，但涉及刑事司法的人群在监禁一段时间后回归社区时面临重大挑战。这些风险因素与药物使用增加和循证治疗中断有关。需要新的干预策略来支持这一高风险的过渡时期。本方案的主要目标是收集目标人群的意见，以优化一种结合面对面和短信方式提供的干预措施的可行性和可接受性，该干预措施旨在支持社区重新融入和MOUD的持续进行。
从罗德岛的一家门诊初级保健诊所招募了8名在监狱中曾有过MOUD治疗经历的参与者。进行了一次半结构化访谈，以评估释放后使用技术的障碍/促进因素、社区重新融入和阿片类药物使用障碍治疗的经历、对连续护理的看法以及干预措施的可行性/可接受性。所有访谈均由2名研究助理独立编码。
参与者对旨在支持向社区护理过渡的干预措施反应积极。大多数参与者否认对使用这种平台有任何担忧。释放后获得手机被认为总体上是可行的；然而，必须特别考虑手机服务的稳定性以及数字素养。参与者一致认为，结构化的每日短信很有用，这些短信能提供激励提醒和痛苦耐受技能建议，还能提供获得“按需”支持的机会。
总体而言，在监狱中接受MOUD治疗的个体接受基于激励和痛苦耐受的数字健康干预以支持康复。纳入关于建议的结构变化的主题结果可能会提高这种干预措施的可用性，以促进从监狱释放后MOUD的持续进行。
