Dewey Jodie M, Hibbard Patrick, Watson Dennis P, Konchak Juleigh Nowinski, Hinami Keiki
Chestnut Health System's Lighthouse Institute, 221 W. Walton Street, Chicago, IL, 60610, USA.
Cook County Health, 1950 W. Polk Street, Chicago, IL, 60612, USA.
Health Justice. 2024 Sep 14;12(1):37. doi: 10.1186/s40352-024-00293-6.
Roughly 24-36% of people who are incarcerated in the U.S. are formally diagnosed with opioid use disorder (OUD). Once released, individuals involved with the criminal legal system (CLS) face increased risks of return to use and fatality and are 129 times more likely to die from an overdose within the first two weeks of release compared to those without CLS involvement. People who are CLS-involved and who are seeking a recovery living environment can access temporary stable housing through recovery homes. However, entering a recovery home can be difficult due to fragmentation among recovery housing organizations and their non-uniform application and screening procedures. A navigation pilot program was implemented to provide clients with recovery home placement advice, pre-screening, and referrals in Cook County, IL. Existing research on recovery homes has rarely examined the importance of recovery housing navigation for enhancing service engagement among CLS-involved individuals receiving medications for OUD.
Semi-structured qualitative interviews were conducted with 22 clients and three recovery housing navigators as part of a program evaluation of the navigation program pilot. Qualitative software was used to organize and qualitatively analyze transcripts through several rounds of coding producing emergent themes, which were then triangulated, and expanded using navigator data.
Clients seeking recovery home services reported multiple prior challenges securing safe and supportive recovery living environments. Despite low initial expectations, clients described their interactions with housing navigators in favorable terms and felt navigators worked with them effectively to identify and meet their housing and substance use needs in a timely manner. Clients also commented on their partnerships with the navigator throughout the process. Interactions with navigators also calmed fears of rejection many clients had previously experienced and still harbored about the process, which bolstered client-navigator relationships and client motivation to engage with additional services.
Evidence from this study suggests recovery home navigation can improve the speed and efficiency with which clients are connected to appropriate services that are tailored to their specific needs as well as increase client motivation to engage with a myriad of recovery services.
在美国，约24% - 36%被监禁的人被正式诊断为患有阿片类物质使用障碍（OUD）。一旦获释，涉及刑事法律系统（CLS）的个人面临复吸和死亡风险增加，与未涉及CLS的人相比，他们在获释后的头两周内死于药物过量的可能性要高129倍。涉及CLS且寻求康复生活环境的人可以通过康复之家获得临时稳定住房。然而，由于康复住房组织之间的分散以及其申请和筛选程序不一致，进入康复之家可能会很困难。在伊利诺伊州库克县实施了一个导航试点项目，为客户提供康复之家安置建议、预筛选和转介服务。现有的关于康复之家的研究很少探讨康复住房导航对于提高接受OUD药物治疗的CLS相关个体的服务参与度的重要性。
作为导航项目试点的项目评估的一部分，对22名客户和三名康复住房导航员进行了半结构化定性访谈。使用定性软件通过几轮编码来组织和定性分析访谈记录，生成新出现的主题，然后进行三角验证，并利用导航员数据进行扩展。
寻求康复之家服务的客户报告了在获得安全且支持性的康复生活环境方面之前面临的多重挑战。尽管最初期望不高，但客户对他们与住房导航员的互动给予了积极评价，并认为导航员有效地与他们合作，及时识别并满足他们的住房和物质使用需求。客户还评论了他们在整个过程中与导航员的合作关系。与导航员的互动也消除了许多客户之前经历过且仍然怀有的对该过程被拒绝的恐惧，这加强了客户与导航员的关系以及客户参与其他服务的积极性。
本研究的证据表明，康复之家导航可以提高客户与根据其特定需求量身定制的适当服务建立联系的速度和效率，并增加客户参与众多康复服务的积极性。
