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A randomized clinical trial of tailored interventions for health promotion and recidivism reduction among homeless parolees: outcomes and cost analysis

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Abstract

Objectives

This study conducted a randomized controlled trial with 600 recently released homeless men exiting California jails and prisons.

Methods

The purpose of this study was to primarily ascertain how different levels of intensity in peer coaching and nurse-partnered intervention programs may impact reentry outcomes; specifically: (a) an intensive peer coach and nurse case managed (PC-NCM) program; (b) an intermediate peer coaching (PC) program with brief nurse counseling; and (c) the usual care (UC) program involving limited peer coaching and brief nurse counseling. Secondary outcomes evaluated the operational cost of each program.

Results

When compared to baseline, all three groups made progress on key health-related outcomes during the 12-month intervention period; further, 84.5 % of all participants eligible for hepatitis A/B vaccination completed their vaccine series. The results of the detailed operational cost analysis suggest the least costly approach (i.e., UC), which accounted for only 2.11 % of the total project expenditure, was as effective in achieving comparable outcomes for this parolee population as the PC-NCM and PC approaches, which accounted for 53.98 % and 43.91 %, respectively, of the project budget.

Conclusions

In this study, all three intervention strategies were found to be comparable in achieving a high rate of vaccine completion, which over time will likely produce tremendous savings to the public health system.

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Notes

  1. Detailed description and instruction of this instrument can be found at www.datcap.com.

  2. Opportunity costs here refer to the full value of all resources (or total economic costs) utilized by a treatment program regardless of whether a direct expenditure is made. Such costs include actual program expenditures (as budgeted) and any in-kind contributions free of charge or subsidized by any public or private entities. Prison-based TC programs often utilize institutional resources (such as facilities, utilities, and security) because of their locations.

  3. We also conducted separate analyses for each of the two 6-month observations and found no significant differences in any of the outcome measures.

References

  • Adimora, A. A., Schoenbach, V. J., & Floris-Moore, M. A. (2009). Ending the epidemic of heterosexual HIV transmission among African Americans. American Journal of Preventive Medicine, 37(5), 468–471. doi:10.1016/j.amepre.2009.06.020.

    Article  Google Scholar 

  • Anglin, M. D., Danila, B., Tyan, T., & Mantius, K. (1996). Staying in Touch: A Fieldwork Manual of Tracking Procedures for Locating Substance Abusers for Follow-up Studies. Washington, D.C: National Evaluation Data and Technical Assistance Center (NEDTAC).

    Google Scholar 

  • Bahr, S. J., Harris, L., Fisher, J. K., & Harker Armstrong, A. (2010). Successful reentry: what differentiates successful and unsuccessful parolees? International Journal of Offender Therapy and Comparative Criminology, 54(5), 667–692. doi:10.1177/0306624x09342435.

    Article  Google Scholar 

  • Beck, A., & Shipley, B. (1989). Recidivism of prisoners released in 1983 (B. o. J. S. U.S. Department of Justice, Trans.). Washington, D.C.

  • Brooks, R. A., Lee, S. J., Stover, G. N., & Barkley, T. W., Jr. (2009). Condom attitudes, perceived vulnerability, and sexual risk behaviors of young Latino male urban street gang members: implications for HIV prevention. AIDS Education and Prevention, 21(5 Suppl), 80–87. doi:10.1521/aeap.2009.21.5_supp.80.

    Article  Google Scholar 

  • California Department of Corrections and Rehabilitation. (2014a). 2013 Outcome Evaluation Report. Sacramento, CA: Retrieved from http://www.cdcr.ca.gov/Adult_Research_Branch/Research_documents/Outcome_evaluation_Report_2013.pdf.

  • California Department of Corrections and Rehabilitation. (2014b). Weekly Report of Population as of Midnight. Sacramento, CA: Retrieved from http://www.cdcr.ca.gov/Reports_Research/Offender_Information_Services_Branch/WeeklyWed/TPOP1A/TPOP1Ad140611.pdf.

  • Cartier, J. J., Greenwell, L., & Prendergast, M. L. (2008). The persistence of HIV risk behaviors among methamphetamine-using offenders. Journal of Psychoactive Drugs, 40(4), 437–446. doi:10.1080/02791072.2008.10400650.

    Article  Google Scholar 

  • Center for Faith-Based Community Initiatives. (2008). Ready4reentry: Prisoner reentry toolkit for faith-based and community organizations. Washington, D.C.: Retrieved from http://csgjusticecenter.org/nrrc/publications/ready4reentry-prisoner-reentry-toolkit-for-faith-based-and-community-initiatives-2/.

  • Centers for Disease Control and Prevention. (2012). Hepatitis B In-Short. Retrieved from http://www.cdc.gov/vaccines/vpd-vac/hepb/in-short-adult.htm#who.

  • Chesson, H. W., Blandford, J. M., Gift, T. L., Tao, G., & Irwin, K. L. (2004). The estimated direct medical cost of sexually transmitted diseases among American youth, 2000. Perspective in Sexual Reproductive Health, 36(1), 11–19. doi:10.1363/psrh.36.11.04.

    Article  Google Scholar 

  • Clarke, J. G., Stein, M. D., Hanna, L., Sobota, M., & Rich, J. D. (2001). Active and former injection drug users report of HIV risk behaviors during periods of incarceration. Substance Abuse, 22(4), 209–216. doi:10.1080/08897070109511463.

    Google Scholar 

  • Davis, L. M., Nicosia, N., Overton, A., Miyashiro, L., Derose, K. P., Fain, T., & Williams, E. (2009). Understanding the Public Health Implications of Prisoner Reentry in California: Phase I Report. Santa Monica: RAND.

    Google Scholar 

  • Durose, M. R., Cooper, A. D., & Snyder, H. N. (2014). Recidivism of Prisoners Released in 30 States in 2005: Patterns from 2005 to 2010. Washington D.C.

  • Fenton, K. A. (2007). Changing epidemiology of HIV/AIDS in the United States: implications for enhancing and promoting HIV testing strategies. Clinical Infectious Diseases, 45(Suppl 4), S213–S220. doi:10.1086/522615.

    Article  Google Scholar 

  • Fickenscher, A., Lapidus, J., Silk-Walker, P., & Becker, T. (2001). Women behind bars: health needs of inmates in a county jail. Public Health Reports, 116(3), 191–196.

    Article  Google Scholar 

  • French, M. T. (2001a). Economic evaluation of alcohol treatment services. Recent Developments in Alcoholism, 15, 209–228.

    Google Scholar 

  • French, M. T. (2001b). The role of health economics in substance abuse research. Recent advances and future opportunities. Overview. Recent Developments in Alcoholism, 15, 201–208.

    Google Scholar 

  • French, M. T., Dunlap, L. J., Zarkin, G. A., McGeary, K. A., & McLellan, A. T. (1997). A structured instrument for estimating the economic cost of drug abuse treatment. The drug abuse treatment cost analysis program (DATCAP). Journal of Substance Abuse Treatment, 14(5), 445–455.

    Article  Google Scholar 

  • French, M. T., McCollister, K. E., Alexandre, P. K., Chitwood, D., & McCoy, C. B. (2004). Revolving roles in drug related crime: the cost of chronic drug users as victims and perpetrators. Journal of Quantitative Criminology, 20(3), 217–241.

    Article  Google Scholar 

  • French, M. T., Zavala, S. K., McCollister, K. E., Waldron, H. B., Turner, C. W., & Ozechowski, T. J. (2008). Cost-effectiveness analysis of four interventions for adolescents with a substance use disorder. Journal of Substance Abuse Treatment, 34(3), 272–281. doi:10.1016/j.jsat.2007.04.008.

    Article  Google Scholar 

  • Glaze, L. E., & Herberman, E. J. (2013). Correctional Populations in the United States, 2012 (O. o. J. P. U.S. Department of Justice, Trans.). Washington, D.C.

  • Gold, M. R., Siegel, J. E., Russell, L. B., & Weinstein, M. C. (1996). Cost-effectiveness in health and medicine. Oxford: Oxford University Press.

    Google Scholar 

  • Goldsmith, C. (2011). Hepatitis. Minneapolis: Twenty-First Century Books.

    Google Scholar 

  • Grinstead, O. A., Faigeles, B., Comfort, M., Seal, D., Nealey-Moore, J., Belcher, L., & Morrow, K. (2005). HIV, STD, and hepatitis risk to primary female partners of men being released from prison. Women’s Health, 41(2), 63–80. doi:10.1300/J013v41n02_05.

    Article  Google Scholar 

  • Harawa, N. T., Bingham, T. A., Butler, Q. R., Dalton, K. S., Cunningham, W. E., Behel, S., & MacKellar, D. A. (2009). Using arrest charge to screen for undiagnosed HIV infection among new arrestees: a study in Los Angeles County. Journal of Correctional Health Care, 15(2), 105–117. doi:10.1177/1078345808330038.

    Article  Google Scholar 

  • Harrison, P. M., & Beck, A. J. (2006). Prison and jail inmates at midyear 2005. Washington D.C.: Bureau of Justice Statistics Retrieved from http://bjs.ojp.usdoj.gov/content/pub/pdf/pjim05.pdf.

  • Hennessey, K. A., Kim, A. A., Griffin, V., Collins, N. T., Weinbaum, C. M., & Sabin, K. (2009). Prevalence of infection with hepatitis B and C viruses and co-infection with HIV in three jails: a case for viral hepatitis prevention in jails in the United States. Journal of Urban Health, 86(1), 93–105. doi:10.1007/s11524-008-9305-8.

    Article  Google Scholar 

  • Jafa, K., McElroy, P., Fitzpatrick, L., Borkowf, C. B., Macgowan, R., Margolis, A., & Sullivan, P. S. (2009). HIV transmission in a state prison system, 1988–2005. PloS One, 4(5), e5416. doi:10.1371/journal.pone.0005416.

    Article  Google Scholar 

  • James, D. J. (2004). Profile of Jail Inmates, 2002. Washington, D.C.: Bureau of Justice Statistics.

    Google Scholar 

  • Khan, M. R., Doherty, I. A., Schoenbach, V. J., Taylor, E. M., Epperson, M. W., & Adimora, A. A. (2009). Incarceration and high-risk sex partnerships among men in the United States. Journal of Urban Health, 86(4), 584–601. doi:10.1007/s11524-009-9348-5.

    Article  Google Scholar 

  • Kim, W. R. (2009). Epidemiology of hepatitis B in the United States. Hepatology, 49(5 Suppl), S28–S34. doi:10.1002/hep.22975.

    Article  Google Scholar 

  • Knealing, T. W., Roebuck, M. C., Wong, C. J., & Silverman, K. (2008). Economic cost of the therapeutic workplace intervention added to methadone maintenance. Journal of Substance Abuse Treatment, 34(3), 326–332. doi:10.1016/j.jsat.2007.04.013.

    Article  Google Scholar 

  • Knight, K., Simpson, D. D., & Hiller, M. L. (2002). In C. G. Leukefeld, F. Tims, & D. Farabee (Eds.), Screening and Referral for Substance-Abuse Treatment in the Criminal Justice System. New York: Springer.

    Google Scholar 

  • Kunz, F. M., Jr., French, M. T., & Bazargan-Hejazi, S. (2004). Cost-effectiveness analysis of a brief intervention delivered to problem drinkers presenting at an inner-city hospital emergency department. Journal of Studies on Alcohol and Drugs, 65(3), 363–370.

    Article  Google Scholar 

  • Langan, P. A., & Levin, D. J. (2002). Recidivism of Prisoners Released in 1994. Washington D.C.: Bureau of Justice Statistics.

    Google Scholar 

  • Lazarus, R., & Folkman, S. (1984). Stress, appraisal and coping. New York: Springer.

    Google Scholar 

  • Lipsey, M. W. (2001). Re: unsolved problems and unfinished business. American Journal of Evaluation, 22(3), 325–328.

    Article  Google Scholar 

  • Longshore, D., Hawkin, A., Urada, D., & Anglin, M. D. (2006). Evaluation of the Substance Abuse and Crime Prevention Act: SACPA Cost Analysis Report (years 1 and 2) (C. D. o. A. a. D. Programs, Trans.). Los Angeles: University of California, Los Angeles, Integrated Substance Abuse Program.

    Google Scholar 

  • McCollister, K. E., French, M. T., Inciardi, J. A., Butzin, C. A., Martin, S. S., & Hooper, R. M. (2003). Post-release substance abuse treatment for criminal offenders: a cost effectiveness analysis. Journal of Quantitative Criminology, 19(4), 389–407.

    Article  Google Scholar 

  • Milloy, M. J., Wood, E., Small, W., Tyndall, M., Lai, C., Montaner, J., & Kerr, T. (2008). Incarceration experiences in a cohort of active injection drug users. Drug and Alcohol Review, 27(6), 693–699.

    Article  Google Scholar 

  • Morgan, B. D., & Rossi, A. P. (2007). Difficult-to-manage HIV/AIDS clients with psychiatric illness and substance abuse problems: a collaborative practice with psychiatric advanced practice nurses. Journal of the Association of Nurses in AIDS Care, 18(6), 77–84. doi:10.1016/j.jana.2007.06.001.

    Article  Google Scholar 

  • Mundt, M. P., French, M. T., Roebuck, M. C., Manwell, L. B., & Barry, K. L. (2005). Brief physician advice for problem drinking among older adults: an economic analysis of costs and benefits. Journal of Studies on Alcohol and Drugs, 66(3), 389–394.

    Article  Google Scholar 

  • Nyamathi, A. (1989). Comprehensive health seeking and coping paradigm. Journal of Advanced Nursing, 14(4), 281–290.

    Article  Google Scholar 

  • Nyamathi, A., Leake, B., Albarran, C., Zhang, S., Hall, E., Farabee, D., & Faucette, M. (2011a). Correlates of depressive symptoms among homeless men on parole. Issues in Mental Health Nursing, 32(8), 501–511. doi:10.3109/01612840.2011.569111.

    Article  Google Scholar 

  • Nyamathi, A., Nandy, K., Greengold, B., Marfisee, M., Khalilifard, F., Cohen, A., & Leake, B. (2011b). Effectiveness of intervention on improvement of drug use among methadone maintained adults. Journal of Addictive Diseases, 30(1), 6–16. doi:10.1080/10550887.2010.531669.

    Article  Google Scholar 

  • Nyamathi, A., Branson, C., Kennedy, B., Salem, B., Khalilifard, F., Marfisee, M., Getzoff, D., & Leake, B. (2012a). Impact of nursing interventions on decreasing substances among homeless youth. American Journal on Addictions, 21(6), 558–565.

    Article  Google Scholar 

  • Nyamathi, A. M., Marlow, E., Branson, C., Marfisee, M., & Nandy, K. (2012b). Hepatitis A/B vaccine completion among homeless adults with history of incarceration. Journal of Forensic Nursing, 8(1), 13–22. doi:10.1111/j.1939-3938.2011.01123.x.

    Article  Google Scholar 

  • Nyamathi, A., Kennedy, B., Branson, C., Salem, B., Khalilifard, F., Marfisee, M., & Leake, B. (2013). Impact of nursing intervention on improving HIV, hepatitis knowledge and mental health among homeless young adults. Community Mental Health Journal, 49(2), 178–184. doi:10.1007/s10597-012-9524-z.

    Article  Google Scholar 

  • Nyamathi, A., Salem, B., Marshall, L., Idemundia, F., Mata, R., Khalilifard, F., & Leake, B. (2014). Substance use trends among younger vs. older homeless parolees. Journal of Addictive Diseases, 33(2), 124–133. doi:10.1080/10550887.2014.909694.

    Article  Google Scholar 

  • Palmer, T. (1995). Programmatic and nonprogrammatic aspects of successful intervention: new directions in research. Crime and Delinquency, 41, 100–131.

    Article  Google Scholar 

  • Pearson, F. S., & Lipton, D. S. (1999). A meta-analytic review of the effectiveness of corrections-based treatments for drug abuse. The Prison Journal, 79(4), 384–410.

    Article  Google Scholar 

  • Petersilia, J. (2001). Prisoner reentry: public safety and reintegration challenges. The Prison Journal, 81(3), 360–375.

    Article  Google Scholar 

  • Petersilia, J. (2003). When prisoners come home - Parole and prisoner reentry. New York: Oxford University.

    Google Scholar 

  • Rich, J. A. (2001). Primary care for young African American men. Journal of American College Health, 49(4), 183–186. doi:10.1080/07448480109596301.

    Article  Google Scholar 

  • Rosenberg, M. (2003). In L. Leu (Ed.), Nonviolent Communication: A Language of Life (2nd ed.). Encintas: PuddleDance Press.

    Google Scholar 

  • Schlotfeldt, R. (1981). Nursing in the future. Nursing Outlook, 29, 295–301.

    Google Scholar 

  • Seiter, R. P., & Kadela, K. R. (2003). Prisoner reentry: what works, what does not, and what is promising. Crime and Delinquency, 49(3), 360–388.

    Article  Google Scholar 

  • Shanahan, C. W., Beers, D., Alford, D. P., Brigandi, E., & Samet, J. H. (2010). A transitional opioid program to engage hospitalized drug users. Journal of General Internal Medicine, 25(8), 803–808. doi:10.1007/s11606-010-1311-3.

    Article  Google Scholar 

  • Simpson, D., & Chatham, L. (1995). TCU/DATAR forms manual. Fort Worth: Texas Institute of Behavioral Research, Texas Christian University.

    Google Scholar 

  • Staton, M., Leukefeld, C., & Webster, J. M. (2003). Substance use, health, and mental health: problems and service utilization among incarcerated women. International Journal of Offender Therapy and Comparative Criminology, 47(2), 224–239.

    Article  Google Scholar 

  • Stewart, A. L., Hays, R. D., & Ware, J. E., Jr. (1988). The MOS short-form general health survey. Reliability and validity in a patient population. Medical Care, 26(7), 724–735.

    Article  Google Scholar 

  • Stout, R. L., Wirtz, P. W., Carbonari, J. P., & Del Boca, F. K. (1994). Ensuring balanced distribution of prognostic factors in treatment outcome research. Journal of Studies on Alcohol and Drugs, 12, 70–75.

    Google Scholar 

  • Travis, J., & Waul, M. (2004). Prisoners once removed: The impact of incarceration and reentry on children, family and communities. Washington, D.C.: The Urban Institute.

    Google Scholar 

  • van der Hilst, C. S., Ijtsma, A. J., Slooff, M. J., & Tenvergert, E. M. (2009). Cost of liver transplantation: a systematic review and meta-analysis comparing the United States with other OECD countries. Medical Care Research Review, 66(1), 3–22. doi:10.1177/1077558708324299.

    Article  Google Scholar 

  • Wilkins, T., Zimmerman, D., & Schade, R. R. (2010). Hepatitis B: diagnosis and treatment. American Family Physician, 81(8), 965–972.

    Google Scholar 

  • World Health Organization. (2012). Hepatitis A Fact Sheet. (328). Geneva, Switzerland: Retrieved from http://www.who.int/mediacentre/factsheets/fs328/en/.

  • Wright, B. J., Zhang, S. X., & Farabee, D. (2014). Prisoner reentry research from 2000 to 2010: results of a narrative review. Criminal Justice Review, 39(1), 37–57.

    Article  Google Scholar 

  • Zavala, S. K., French, M. T., Henderson, C. E., Alberga, L., Rowe, C., & Liddle, H. A. (2005). Guidelines and challenges for estimating the economic costs and benefits of adolescent substance abuse treatments. Journal of Substance Abuse Treatment, 29(3), 191–205. doi:10.1016/j.jsat.2005.06.004.

    Article  Google Scholar 

  • Zhang, S. X., Roberts, R. E. L., & Callanan, V. J. (2006a). The cost effectiveness of providing correctional services—a cost benefit analysis of a statewide parole program in California. Journal of Criminal Justice, 34(4), 341–350.

    Article  Google Scholar 

  • Zhang, S. X., Roberts, R. E. L., & Callanan, V. J. (2006b). Preventing parolees from returning to prison through community-based reintegration. Crime and Delinquency, 52(4), 551–571.

    Article  Google Scholar 

  • Zhang, S. X., Roberts, E. L. R., & McCollister, K. E. (2009). An economic analysis of the in-prison therapeutic community model on prison management costs. Journal of Criminal Justice, 37(4), 388–395.

    Article  Google Scholar 

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Acknowledgments

This study was funded by1R01DA27213-01.

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Authors and Affiliations

  1. University of California at Los Angeles, School of Nursing, Room 2-250, Factor Building, Los Angeles, CA, 90095-1702, USA

    Adeline M. Nyamathi, Benissa E. Salem & Kartik Yadav

  2. San Diego State University, San Diego, CA, USA

    Sheldon Zhang

  3. University of California Los Angeles, Integrated Substance Abuse Programs, San Diego, CA, USA

    David Farabee & Betsy Hall

  4. University of California, San Francisco, School of Nursing, San Diego, CA, USA

    Elizabeth Marlow

  5. Amity Foundation, Los Angeles, CA, USA

    Mark Faucette & Doug Bond

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  1. Adeline M. Nyamathi
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  2. Sheldon Zhang
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Correspondence to Adeline M. Nyamathi.

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Nyamathi, A.M., Zhang, S., Salem, B.E. et al. A randomized clinical trial of tailored interventions for health promotion and recidivism reduction among homeless parolees: outcomes and cost analysis. J Exp Criminol 12, 49–74 (2016). https://doi.org/10.1007/s11292-015-9236-9

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