LEAD Program Evaluation: Recidivism Report

The LEAD program was established in 2011 as a means of diverting those suspected of low-level drug and prostitution criminal activity to case management and other supportive services instead of jail and prosecution. The primary aim of the LEAD program is to reduce criminal recidivism. Secondary aims include reductions in criminal justice service utilization and associated costs as well as improvements for psychosocial, housing and quality-of-life outcomes. Because LEAD is the first known pre-booking diversion program of its kind in the United States, an evaluation is critically needed to inform key stakeholders, policy makers, and other interested parties of its impact. The evaluation of the LEAD program described in this report represents a response to this need.Background: This report was written by the University of Washington LEAD Evaluation Team at the request of the LEAD Policy Coordinating Group and fulfills the first of three LEAD evaluation aims. Purpose: This report describes findings from a quantitative analysis comparing outcomes for LEAD participants versus "system-as-usual" control participants on shorter- and longer-term changes on recidivism outcomes, including arrests (i.e., being taken into custody by legal authority) and criminal charges (i.e., filing of a criminal case in court). Arrests and criminal charges were chosen as the recidivism outcomes because they likely reflect individual behavior more than convictions, which are more heavily impacted by criminal justice system variables external to the individual. Findings: Analyses indicated statistically significant recidivism improvement for the LEAD group compared to the control group on some shorter- and longer-term outcomes

Community-Based Participatory Research (Cbpr): Towards Equitable Involvement Of Community In Psychology Research

Community-based participatory research (CBPR) answers the call for more patient-centered, community-driven research approaches to address growing health disparities. CBPR is a collaborative research approach that equitably involves community members, researchers, and other stakeholders in the research process and recognizes the unique strengths that each bring. The aim of CBPR is to combine knowledge and action to create positive and lasting social change. With its origins in psychology, sociology, and critical pedagogy, CBPR has become a common research approach in the fields of public health, medicine, and nursing. Although it is well aligned with psychology\u27s ethical principles and research aims, it has not been widely implemented in psychology research. The present article introduces CBPR to a general psychology audience while considering the unique aims of and challenges in conducting psychology research. In this article, we define CBPR principles, differentiate it from a more traditional psychology research approach, retrace its historical roots, provide concrete steps for its implementation, discuss its potential benefits, and explore practical and ethical challenges for its integration into psychology research. Finally, we provide a case study of CBPR in psychology to illustrate its key constructs and implementation. In sum, CBPR is a relevant, important, and promising research framework that may guide the implementation of more effective, culturally appropriate, socially just, and sustainable community-based psychology research

Community-based Participatory Research (CBPR): Towards Equitable Involvement of Community in Psychology Research

Community-based participatory research (CBPR) answers the call for more patient-centered, community-driven research approaches to address growing health disparities. CBPR is a collaborative research approach that equitably involves community members, researchers, and other stakeholders in the research process and recognizes the unique strengths that each bring. The aim of CBPR is to combine knowledge and action to create positive and lasting social change. With its origins in psychology, sociology and critical pedagogy, CBPR has become a common research approach in the fields of public health, medicine and nursing. Although it is well-aligned with psychology\u27s ethical principles and research aims, it has not been widely implemented in psychology research. The present article introduces CBPR to a general psychology audience while taking into account the unique aims of and challenges in conducting psychology research. In this article, we define CBPR principles, differentiate it from a more traditional psychology research approach, retrace its historical roots, provide concrete steps for its implementation, discuss its potential benefits, and explore practical and ethical challenges for its integration into psychology research. Finally, we provide a case study of CBPR in psychology to illustrate its key constructs and implementation. In sum, CBPR is a relevant, important and promising research framework that may guide the implementation of more effective, culturally appropriate, socially just, and sustainable community-based psychology research

Community-Based Participatory Research (CBPR): Towards Equitable Involvement of Community in Psychology Research

Community-based participatory research (CBPR) answers the call for more patient-centered, community-driven research approaches to address growing health disparities. CBPR is a collaborative research approach that equitably involves community members, researchers, and other stakeholders in the research process and recognizes the unique strengths that each bring. The aim of CBPR is to combine knowledge and action to create positive and lasting social change. With its origins in psychology, sociology, and critical pedagogy, CBPR has become a common research approach in the fields of public health, medicine, and nursing. Although it is well aligned with psychology’s ethical principles and research aims, it has not been widely implemented in psychology research. The present article introduces CBPR to a general psychology audience while considering the unique aims of and challenges in conducting psychology research. In this article, we define CBPR principles, differentiate it from a more traditional psychology research approach, retrace its historical roots, provide concrete steps for its implementation, discuss its potential benefits, and explore practical and ethical challenges for its integration into psychology research. Finally, we provide a case study of CBPR in psychology to illustrate its key constructs and implementation. In sum, CBPR is a relevant, important, and promising research framework that may guide the implementation of more effective, culturally appropriate, socially just, and sustainable community-based psychology research

Health Care and Public Service Use and Costs Before and After Provision of Housing for Chronically Homeless Persons With Severe Alcohol Problems

Context: Chronically homeless individuals with severe alcohol problems often have multiple medical and psychiatric problems and use costly health and criminal justice services at high rates.Objective: To evaluate association of a ?Housing First? intervention for chronically homeless individuals with severe alcohol problems with health care use and costs.Design, Setting, and Participants: Quasi-experimental design comparing 95 housed participants (with drinking permitted) with 39 wait-list control participants enrolled between November 2005 and March 2007 in Seattle, Washington.Main Outcome Measures: Use and cost of services (jail bookings, days incarcerated, shelter and sobering center use, hospital-based medical services, publicly funded alcohol and drug detoxification and treatment, emergency medical services, and Medicaid-funded services) for Housing First participants relative to wait-list controls.Results: Housing First participants had total costs of $8 175 922 in the year prior to the study, or median costs of$4066 per person per month (interquartile range [IQR], $2067-$8264). Median monthly costs decreased to $1492 (IQR,$337-$5709) and$958 (IQR, $98-$3200) after 6 and 12 months in housing, respectively. Poisson generalized estimating equation regressions using propensity score adjustments showed total cost rate reduction of 53% for housed participants relative to wait-list controls (rate ratio, 0.47; 95% confidence interval, 0.25-0.88) over the first 6 months. Total cost offsets for Housing First participants relative to controls averaged $2449 per person per month after accounting for housing program costs.Conclusions: In this population of chronically homeless individuals with high service use and costs, a Housing First program was associated with a relative decrease in costs after 6 months. These benefits increased to the extent that participants were retained in housing longer.Concerns about high public system costs incurred by chronically homeless individuals have inspired nationwide efforts to eliminate chronic homelessness. Homeless people have high barriers to health care access generally but use acute care services at high rates. Mortality rates among homeless adults are 3 or more times that of the general population.Chronically homeless people with severe alcohol problems, sometimes referred to as chronic public inebriates, are highly visible on the streets and are costly to the public through high use of publicly funded health and criminal justice systems resources. Typical interventions such as shelters, abstinence-based housing, and treatment programs fail to reverse these patterns for this population. Health conditions and mortality rates within this population are similar to those found in developing countries. Average age at death is estimated to be 42 to 52 years, with 30% to 70% of deaths related to alcohol.The provision of housing reduces hospital visits, admissions, and duration of hospital stays among homeless individuals, and overall public system spending is reduced by nearly as much as is spent on housing. One type of supportive housing, called Housing First, removes the requirements for sobriety, treatment attendance, and other barriers to housing entrance. Thus far, Housing First (HF) approaches have primarily targeted homeless people with serious mental illnesses and co-occurring substance use disorders.An HF program in Seattle?known as 1811 Eastlake?targets homeless adults with severe alcohol problems who use local crisis services at the highest levels. The project has been controversial because residents are allowed to drink in their rooms. The current study evaluated outcomes of the project on public use and costs for housed participants compared with wait-list controls and secondarily evaluated changes in reported alcohol use for housed participants and the effects of housing duration on service use