Abstract
BackgroundThe acceptability, feasibility and effectiveness of web-based interventions among criminal justice involved populations are understudied. This study is a secondary analysis of baseline characteristics associated with criminal justice system (CJS) status as treatment outcome moderators among participants enrolling in a large randomized trial of a web-based psychosocial intervention (Therapeutic Education System [TES]) as part of outpatient addiction treatment.MethodsWe compared demographic and clinical characteristics, TES participation rates, and the trial’s two co-primary outcomes, end of treatment abstinence and treatment retention, by self-reported CJS status at baseline: 1) CJS-mandated to community treatment (CJS-mandated), 2) CJS-recommended to treatment (CJS-recommended), 3) no CJS treatment mandate (CJS-none).ResultsCJS-mandated (n = 107) and CJS-recommended (n = 69) participants differed from CJS-none (n = 331) at baseline: CJS-mandated were significantly more likely to be male, uninsured, report cannabis as the primary drug problem, report fewer days of drug use at baseline, screen negative for depression, and score lower for psychological distress and higher on physical health status; CJS-recommended were younger, more likely single, less likely to report no regular Internet use, and to report cannabis as the primary drug problem. Both CJS-involved (CJS -recommended and -mandated) groups were more likely to have been recently incarcerated. Among participants randomized to the TES arm, module completion was similar across the CJS subgroups. A three-way interaction of treatment, baseline abstinence and CJS status showed no associations with the study’s primary abstinence outcome.ConclusionsOverall, CJS-involved participants in this study tended to be young, male, and in treatment for a primary cannabis problem. The feasibility and effectiveness of the web-based psychosocial intervention, TES, did not vary by CJS-mandated or CJS-recommended participants compared to CJS-none. Web-based counseling interventions may be effective interventions as US public safety policies begin to emphasize supervised community drug treatment over incarceration.
Highlights
The acceptability, feasibility and effectiveness of web-based interventions among criminal justice involved populations are understudied
Therapeutic Education System (TES) module completion and acceptability Among participants randomized to the TES arm, module completion was similar across the criminal justice system (CJS) subgroups
Recent incarceration and self-reported criminal activity The mean days of self-reported criminal activity obtained at baseline were similar across CJS subgroups; on average 4–6 days of the last 90 days were characterized by criminal behavior, the most common of which were directly drug-related or driving while intoxicated [Table 2]
Summary
The acceptability, feasibility and effectiveness of web-based interventions among criminal justice involved populations are understudied. This study is a secondary analysis of baseline characteristics associated with criminal justice system (CJS) status as treatment outcome moderators among participants enrolling in a large randomized trial of a web-based psychosocial intervention (Therapeutic Education System [TES]) as part of outpatient addiction treatment. Other studies have shown that mandated treatment outcomes are generally identical and often better compared to voluntary treatment in CJS-involved populations (Farabee et al, 1998; NIDA, 2014; Taxman, 1998). Further studies of CJS-involved individuals in community drug treatment programs have revealed mixed outcomes compared to non-CJS treatment populations (Farabee et al, 1998; Lee et al, 2012). A recent study of male probationers demonstrated greater unmet needs for substance abuse treatment compared to non-CJS substance abusers (Feucht and Gfroerer, 2011)
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