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Using Values to Enhance Inmates' Response to Substance Use and HIV Risk Feedback

Not Applicable
Conditions
Substance Use
HIV Risk Behavior
Interventions
Behavioral: Risk Feedback
Behavioral: Values Affirmation
Registration Number
NCT03501732
Lead Sponsor
George Mason University
Brief Summary

A key component of effective offender treatment is an initial assessment of risk factors followed by feedback to facilitate problem awareness and engagement in appropriate treatment and/or behavior change. Feedback regarding areas of high risk, however, can be experienced as threatening.

The investigators propose to develop, fine-tune, and pilot-test a computerized system for risk assessment and feedback, including evaluation of a brief pre-feedback prosocial values affirmation exercise (Cohen \& Sherman, 2014) aimed at decreasing defensiveness and increasing inmates' willingness to access and process risk-relevant information and to utilize post-release treatment resources, thereby reducing post-release substance misuse, HIV risk behavior, and criminal recidivism. Participants will be 170 jail inmates nearing release into the community - 20 pilot participants and 150 study participants randomly assigned to one of three conditions: (1) Values Affirmation + Personalized Risk Feedback; (2) Personalized Risk Feedback only; (3) Control. The baseline and risk assessment, values affirmation manipulation, and personalized risk feedback will be presented via touch-screen computers, requiring minimal training to administer. Analyses will assess:

1. The feasibility of utilizing a computerized system to assess and share risk information with jail inmates, including a brief values affirmation exercise to reduce defensiveness;

2. The acceptability of this approach from the perspectives of jail staff and inmates themselves;

3. The impact of the intervention on observed proximal outcomes (mechanisms of action), such as time spent viewing feedback, electing to print a copy of informational and treatment resources, and consequent changes in perceptions of risk, treatability, etc.;

4. The impact of the intervention on key post-release outcomes including engagement in relevant treatment services, substance misuse, HIV risk behaviors, re-offense and re-arrest;

5. The links between proximal outcomes (MOAs) and key post-release outcomes;

6. Potential moderators of treatment effectiveness.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
150
Inclusion Criteria
  • Sufficient proficiency in spoken English to understand computer-assisted assessments and feedback
  • post-sentencing with a sentence (i.e., less than 12 months) likely to be served out at the jail (vs. a state or federal prison) and likely to be released into the community. The invitation to participate will be timed so treatment is delivered toward the end of incarceration (within one week of release) to minimize decay of effects, and to capitalize on the motivational value of the up-coming release.
Exclusion Criteria
  • Those with detainers to other jurisdictions and to Immigration and Customs Enforcement (ICE)

Study & Design

Study Type
INTERVENTIONAL
Study Design
FACTORIAL
Arm && Interventions
GroupInterventionDescription
Risk FeedbackRisk FeedbackSham Values Affirmation with Risk Feedback in substance use and HIV domains of risk
Values Affirmation plus Risk FeedbackValues AffirmationValues Affirmation with Risk Feedback in substance use and HIV domains of risk
Values Affirmation plus Risk FeedbackRisk FeedbackValues Affirmation with Risk Feedback in substance use and HIV domains of risk
Primary Outcome Measures
NameTimeMethod
Changes in substance use3 months post-release (Time 2)

Changes in substance use -- among those who were identified at risk and who thus received feedback, pre-post incarceration changes in terms of pre-incarceration standard deviations. If more than one domain of feedback, average standard deviation change.

Changes in HIV risk behavior3 months post-release (Time 2)

Changes in HIV risk behavior -- among those who were identified at risk and who thus received feedback, pre-post incarceration changes in terms of pre-incarceration standard deviations. If more than one domain of feedback (risky sex, risky needle use), average standard deviation change.

Secondary Outcome Measures
NameTimeMethod
Requests Community ResourcesImmediately following intervention (Time 1)

Choose to print a copy of community resources in domain(s) of risk

Changes in accuracy of perceptions of normative risk behaviorImmediately following intervention (Time 1)

Changes in accuracy of perceptions of normative behavior (pre-post intervention changes in terms of pre-intervention standard deviations) in areas of risk/feedback

Makes Use of Community Resources3 months post-release (Time 2)

Makes use of relevant community services during 3 months post-release

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