Violence Reduction Using The Principles Of Risk-Need-Responsivity

Violence presents unique challenges to individuals, communities, and the justice system. The Risk-Need-Responsivity (RNR) model is framed as addressing how to respond to individuals with various forms of violent or violent-related behaviors. The emphasis is on linking individuals to appropriate services and using services and programs that can assist the individuals with learning to manage their aggressive behaviors. Much of the techniques involve addressing situational responses that occur in natural community environments; the models for delivering services and facilitating change tend to be limited to group-based therapy sessions that are not necessarily adaptable to these environmental cues (where emotions and situations are deemed to be high). Some progress has been made in adaptive therapies that extend past group sessions using interrupters, navigators, or others. But, given the complexities of community environments, there is a need for a systemic RNR framework that looks at the issues related to community capacity and relationship factors that affect the ability of the community to be responsive. This Article will describe the systemic RNR framework and use an example from St. Louis, Missouri, in terms of the implications for improving outcomes on how best to reduce violence

A Statistical Method for Synthesizing Meta-Analyses

Multiple meta-analyses may use similar search criteria and focus on the same topic of interest, but they may yield different or sometimes discordant results. The lack of statistical methods for synthesizing these findings makes it challenging to properly interpret the results from multiple meta-analyses, especially when their results are conflicting. In this paper, we first introduce a method to synthesize the meta-analytic results when multiple meta-analyses use the same type of summary effect estimates. When meta-analyses use different types of effect sizes, the meta-analysis results cannot be directly combined. We propose a two-step frequentist procedure to first convert the effect size estimates to the same metric and then summarize them with a weighted mean estimate. Our proposed method offers several advantages over existing methods b

Design and Evaluation of the Probation/Parole and Reentry Coach App (PARCA): A Platform to Support a Successful Reentry into Community

Justice-involved people (JIP), especially those with substance use disorder (SUD), face multiple challenges and inadequate resources as they re-enter their communities post-incarceration. Technology interventions have proven to be feasible in supporting this unique population. In this study, we applied iterative development methodology and user-centered design to develop and evaluate a technology artifact called Probation/Parole and Reentry Coach App (PARCA) composed of a JIP mobile app and justice team (JT) portal. PARCA assists recently released JIP with SUD with their reentry. We completed three feedback cycles involving healthcare and criminal justice experts and JIP (N=16) in design workshops, interviews, and usability studies. We collected and analyzed qualitative (semi-structured interviews) and quantitative (System Usability Scale and app use) data. As a pilot study that focuses on qualitative observations, the results indicate that PARCA provides an excellent usability experience for JIP (SUS scores>80) and is useful and satisfactory (based on qualitative responses)

Racial disparity and the legitimacy of the criminal justice system: Exploring consequences for deterrence.

Abstract: Minority (over) representation in the criminal justice system remains a puzzle, both from a policy and an intervention perspective. Cross-sectional reviews of the policies and practices of the criminal justice system often find differential rates of involvement in the criminal justice system that are associated with the nature of the criminal charge/act or characteristics of the offender; however, longitudinal reviews of the race effect often show it to be confounded by procedural and extralegal variables. This review focuses on how the cumulative policies and practices of the criminal justice system contribute to churning, or the recycling of individuals through the system. In conducting our review, we describe how the same criminal justice processes and practices adversely affect select communities. The consequences of policies and procedures that contribute to churning may affect the legitimacy of the criminal justice system as a deterrent to criminal behavior. A research agenda on issues related to legitimacy of the criminal justice system aimed at a better understanding of how this affects individual and community behavior is presented

A Call to Action: A Blueprint for Academic Health Sciences in the Era of Mass Incarceration

Over 100 million Americans have criminal records, and the U.S. incarcerates seven times more citizens than most developed countries. The burden of incarceration disproportionately affects people of color and ethnic minorities, and those living in poverty. While 95% of incarcerated people return to society, recidivism rates are high with nearly 75% arrested again within five years of release. Criminal records impede access to employment and other social services such as shelter and health care. Justice-involved people have higher rates of substance, mental health, and some chronic medical disorders than the general population; furthermore, the incarcerated population is rapidly aging. Only a minority of academic health science centers are engaged in health services research, workforce training, or correctional health care. This commentary provides rationale and a blueprint for engagement of academic health science institutions to harness their capabilities to tackle one of the country\u27s most vexing public health crises

Alcopops Disproportionately Consumed by Minors in Sexual Assault Cases

Alcohol is present in a large proportion of sexual assault cases. However, research largely overlooks the role that providing alcoholic beverages – particularly those with high-alcohol- content and/or whose flavors mask the taste of alcohol – may have in making young people more vulnerable to being assaulted. This research is especially important given the rise in the availability of sugar-sweetened alcopops and their high-alcohol-content counterparts “supersized alcopops,” which contain up to 5.5 standard alcoholic drinks. In the current study, we examined whether alcopops and supersized alcopops, relative to beer, were involved in disproportionately more sexual assault cases involving victims who were minors (\u3c 18 years old) rather than adults. In this secondary data analysis, we used Nexis Uni to search legal documents for the brands of supersized alcopop (Four Loko), alcopop (Smirnoff Ice), and beer (Bud Light) most commonly consumed by underage drinkers. Inclusion criteria were U.S. sexual assault cases occurring from 2010 to 2019 and involving victims who consumed one of these three alcohol brands. Two researchers coded information from the case facts, compared coding, and reaching consensus. Thirty-six cases were included for analyses. Compared to victims of sexual assault who consumed beer, victims who consumed supersized alcopops or alcopops were significantly more likely to be minors. Similar results were observed after adjusting for the victim being given the alcohol by the perpetrator, which was strongly associated with the victim being a minor. This study provides initial evidence that sexual assault perpetrators may disproportionately use alcopops and supersized alcopops for the sexual victimization of minors

The Juvenile Justice Behavioral Health Services Cascade: A New Framework for Measuring Unmet Substance Use Treatment Services Needs Among Adolescent Offenders

Overview—Substance use and substance use disorders are highly prevalent among youth under juvenile justice (JJ) supervision, and related to delinquency, psychopathology, social problems, risky sex and sexually transmitted infections, and health problems. However, numerous gaps exist in the identification of behavioral health (BH) problems and in the subsequent referral, initiation and retention in treatment for youth in community justice settings. This reflects both organizational and systems factors, including coordination between justice and BH agencies. Methods and Results—This paper presents a new framework, the Juvenile Justice Behavioral Health Services Cascade (“Cascade”), for measuring unmet substance use treatment needs to illustrate how the cascade approach can be useful in understanding service delivery issues and identifying strategies to improve treatment engagement and outcomes for youth under community JJ supervision. We discuss the organizational and systems barriers for linking delinquent youth to BH services, and explain how the Cascade can help understand and address these barriers. We provide a detailed description of the sequential steps and measures of the Cascade, and then offer an example of its application from the Juvenile Justice – Translational Research on Interventions for Adolescents in the Legal System project (JJ-TRIALS), a multi-site research cooperative funded by the National Institute on Drug Abuse. Conclusion—As illustrated with substance abuse treatment, the Cascade has potential for informing and guiding efforts to improve behavioral health service linkages for adolescent offenders, developing and testing interventions and policies to improve interagency and cross-systems coordination, and informing the development of measures and interventions for improving the implementation of treatment in complex multisystem service settings

The perfect storm: incarceration and the high-risk environment perpetuating transmission of HIV, hepatitis C virus, and tuberculosis in Eastern Europe and Central Asia.

Despite global reductions in HIV incidence and mortality, the 15 UNAIDS-designated countries of Eastern Europe and Central Asia (EECA) that gained independence from the Soviet Union in 1991 constitute the only region where both continue to rise. HIV transmission in EECA is fuelled primarily by injection of opioids, with harsh criminalisation of drug use that has resulted in extraordinarily high levels of incarceration. Consequently, people who inject drugs, including those with HIV, hepatitis C virus, and tuberculosis, are concentrated within prisons. Evidence-based primary and secondary prevention of HIV using opioid agonist therapies such as methadone and buprenorphine is available in prisons in only a handful of EECA countries (methadone or buprenorphine in five countries and needle and syringe programmes in three countries), with none of them meeting recommended coverage levels. Similarly, antiretroviral therapy coverage, especially among people who inject drugs, is markedly under-scaled. Russia completely bans opioid agonist therapies and does not support needle and syringe programmes-with neither available in prisons-despite the country's high incarceration rate and having the largest burden of people with HIV who inject drugs in the region. Mathematical modelling for Ukraine suggests that high levels of incarceration in EECA countries facilitate HIV transmission among people who inject drugs, with 28-55% of all new HIV infections over the next 15 years predicted to be attributable to heightened HIV transmission risk among currently or previously incarcerated people who inject drugs. Scaling up of opioid agonist therapies within prisons and maintaining treatment after release would yield the greatest HIV transmission reduction in people who inject drugs. Additional analyses also suggest that at least 6% of all incident tuberculosis cases, and 75% of incident tuberculosis cases in people who inject drugs are due to incarceration. Interventions that reduce incarceration itself and effectively intervene with prisoners to screen, diagnose, and treat addiction and HIV, hepatitis C virus, and tuberculosis are urgently needed to stem the multiple overlapping epidemics concentrated in prisons

Cohort profile: seek, test, treat and retain United States criminal justice cohort

Abstract Background The STTR treatment cascade provides a framework for research aimed at improving the delivery of services, care and outcomes of PLWH. The development of effective approaches to increase HIV diagnoses and engage PLWH in subsequent steps of the treatment cascade could lead to earlier and sustained ART treatment resulting in viral suppression. There is an unmet need for research applying the treatment cascade to improve outcomes for those with criminal justice involvement. Methods The Seek, Test, Treat, and Retain (STTR) criminal justice (CJ) cohort combines data from 11 studies across the HIV treatment cascade that focused on persons involved in the criminal justice system, often but not exclusively for reasons related to substance use. The studies were conducted in a variety of CJ settings and collected information across 11 pre-selected domains: demographic characteristics, CJ involvement, HIV risk behaviors, HIV and/or Hepatitis C infections, laboratory measures of CD4 T-cell count (CD4) and HIV RNA viral load (VL), mental illness, health related quality of life (QoL), socioeconomic status, health care access, substance use, and social support. Results The STTR CJ cohort includes data on 11,070 individuals with and without HIV infection who range in age from 18 to 77 years, with a median age at baseline of 37 years. The cohort reflects racial, ethnic and gender distributions in the U.S. CJ system, and 64% of participants are African-American, 12% are Hispanic and 83% are men. Cohort members reported a wide range of HIV risk behaviors including history of injection drug use and, among those who reported on pre-incarceration sexual behaviors, the prevalence of unprotected sexual intercourse ranged across studies from 4% to 79%. Across all studies, 53% percent of the STTR CJ cohort reported recent polysubstance use. Conclusions The STTR CJ cohort is comprised of participants from a wide range of CJ settings including jail, prison, and community supervision who report considerable diversity in their characteristics and behavioral practices. We have developed harmonized measures, where feasible, to improve the integration of these studies together to answer questions that cannot otherwise be addressed