Community Corrections Supervision Research Articles

Effects of in vivo NRT sampling on smoking abstinence and NRT adherence: A randomized clinical trial

BackgroundNicotine replacement therapy (NRT) is an effective treatment but is associated with poor adherence during smoking cessation attempts. This study aimed to determine if In Vivo Sampling, an experiential intervention that includes sampling of NRT in-session, increases NRT adherence and smoking abstinence compared to standard smoking cessation behavioral counseling. MethodsEligible participants were under community corrections supervision and smoked five or more cigarettes per day for the past year. Participants were randomly assigned to receive either In Vivo Sampling or standard smoking cessation behavioral counseling. Both interventions involved four 30-minute sessions and received 12 weeks of combination NRT. Self-reported NRT adherence, quit attempts, and carbon monoxide (CO)-verified smoking cessation were measured at one, three-, and six-months post-intervention. ResultsFrom 2017–2022, 515 participants were enrolled and randomized. The In Vivo Sampling group had significantly greater mean adherence to patch and lozenge NRT regimens (71 % vs. 60 %, OR: 1.63, 95 % CI: 1.36–1.96, p<.001). The In Vivo group had a significantly higher likelihood of quit attempts across time (61 % vs. 53 %, OR: 1.4, 95 % CI: 1.05–1.87, p=.021). Groups did not significantly differ on the percent of participants who had quit smoking at 6 months post-intervention (17 % In Vivo Sampling vs. 13 % standard counseling, OR: 1.43, p=.24). ConclusionIn Vivo Sampling demonstrated better NRT adherence and quit attempts but similar cessation rates to standard behavioral counseling. The In Vivo Sampling intervention represents a novel approach that increased behaviors typically associated with successful cessation over standard behavioral counseling.

Trajectories of Change in Acute Dynamic Risk Ratings and Associated Risk for Recidivism in Paroled New Zealanders: A Joint Latent Class Modelling Approach

ObjectivesPrior studies indicate risk for recidivism declines with time spent in the community post-incarceration. The current study tested whether declines in risk scores occurred uniformly for all individuals in a community corrections sample or whether distinct groups could be identified on the basis of similar trajectories of change in acute risk and time to recidivism. We additionally tested whether accounting for group heterogeneity improved prospective prediction of recidivism.MethodsThis study used longitudinal, multiple-reassessment data gathered from 3,421 individuals supervised on parole in New Zealand (N = 92,104 assessments of theoretically dynamic risk factors conducted by community corrections supervision officers). We applied joint latent class modelling (JLCM) to model group trajectories of change in acute risk following re-entry while accounting for data missing due to recidivism (i.e., missing not at random). We compared accuracy of dynamic predictions based on the selected joint latent class model to an equivalent joint model with no latent class structure.ResultsWe identified four trajectory groups of acute dynamic risk. Groups were consistently estimated across a split sample. Trajectories differed in direction and degree of change but using the latent class structure did not improve discrimination when predicting recidivism.ConclusionsThere may be significant heterogeneity in how individuals’ assessed level of acute risk changes following re-entry, but determining risk for recidivism should not be based on probable group membership. JLCM revealed heterogeneity in early re-entry unlikely to be observed using traditional analytic approaches.

397 Factors needing attention to implement effective drug treatment in community correctional in Puerto Rico

OBJECTIVES/GOALS: The complex health profile of those supervised by community corrections places them at a greater risk of morbidity and mortality from social disruption, infection, and of substance misuse, relapse, and overdose. This study aims to explore individual and social determinants of SUD and treatment utilization for this population. METHODS/STUDY POPULATION: A secondary data analysis was conducted using an administrative database from the Department of Corrections of Puerto Rico (DoC-PR) that included individuals under community supervision between 2015 and 2018 (N=13,163). Two logistic regression analysis were performed to predict SUD and SUD treatment utilization. The predictors included in the models were: a) age, b) gender, c) civil status, d) education level, e) employment status, f) income, g) number of dependents, h) housing zone, I) type of crime, j) offender classification k) community sentence classification, and k) sentence duration. RESULTS/ANTICIPATED RESULTS: A total of 4,531 cases (34.4%) were identified with an SUD and of these 79.2% were enrolled in treatment. Significant predictors of SUD included a parole sentence (vs probation), commission of felony, decreasing sentence duration and recidivism. Significant demographic variables include, male, single, younger age, unemployed, residing in an urban zone and decreasing income. Significant predictors for SUD treatment utilization were a probation sentence, older age and residing in a rural zone. Mandated treatment may explain a higher likelihood of treatment utilization, yet prevalent modalities consist of residential abstinence based, non-professionalized services known to have poor treatment outcomes. The current data set does not include follow up data to assess changes in treatment utilization. DISCUSSION/SIGNIFICANCE: We should aim to prevent health and social disparities and risk of sentence revocation associated with interventions that lack evidence to support their effectiveness. Next steps should address challenges and opportunities for the adoption of EBPPs for individuals with an SUD under community corrections supervision.

Views of Community Corrections Supervision and Their Predictors: An Officer and Offender Comparison

Appropriate supervision strategies are the backbone of community corrections. The success of community supervision is dependent upon the attitudes of both officers and offenders. Despite this, research on offenders’ attitudes toward community corrections supervision is surprisingly very limited. The current study investigated attitudes of officers and offenders toward and predictors of four different community supervision strategies based on data collected in Hubei, China, in 2103 and 2016. The study found that among demographics, community variables, and value factor, the mutual trust value factor was the most important predictor of community supervision strategies by both officers and offenders. Additional findings and policy implications are discussed.

Psychiatric Disorders and HIV Drug Risk Behaviors Among Individuals Under Community Correctional Supervision.

The prevalence of human immunodeficiency virus (HIV) is nearly three times higher in the incarcerated population than in the general population in the United States, and over half of the incarcerated population has a psychiatric diagnosis. Individuals under community corrections supervision continue to receive limited attention regarding HIV prevention and surveillance. Anxiety-related, depressive-related, and post-traumatic stress disorders are high in the community corrections population and may be potential correlates of HIV risk behaviors. Examining the link between psychiatric diagnosis and HIV risk behavior within the community correctional setting may shed light on who is at greatest risk for HIV. Individuals within community corrections who participated in a clinical trial completed questionnaires and semistructured interviews to screen for psychiatric disorders and HIV risk behaviors. Multivariate analyses revealed that individuals of younger age, of White race, and with anxiety disorders engaged in greater HIV drug risk behaviors, providing preliminary implications for whom testing and prevention efforts should be emphasized.

Challenges to Employing Shared Decision Making With Adults Under Community Supervision Who Have a Mental Illness.

Adults under community corrections supervision and who have a mental illness (MI) are expected to comply with conditions of release which often include involvement with supportive social services. The rates of technical violation, arrest, and incarceration that result from failure to comply with these mandates are exceedingly high. Shared decision making among officer-supervisors and client-supervisees is a promising approach to promote engagement in community corrections services among supervisees who have MI. This paper reviews recent research on shared decision making and identifies three barriers to its implementation in this context: (1) a lack of role clarity, (2) a predilection for risk avoidance, and (3) stigma toward supervisees. Empirically supported recommendations are suggested to aid in overcoming these obstacles, facilitate shared decision making, and promote recovery among this population: (1) unification of supervisor rehabilitative and public safety roles, (2) maximizing opportunities for self-determination through low-stakes events and/or enhancement of supervisee strengths and capabilities, and (3) supervisor training in principles of mental health recovery.

Drug Testing and Community Supervision Outcomes

The requirement to submit to drug testing is either a standard or special condition of adult community correctional supervision in most jurisdictions. Positive drug test results are one of the most common violations of probation that result in official action by a supervising officer. This study examines the relationship between individual characteristics, drug test results, and federal supervision outcomes. Results indicate that individual risk score and offense category are associated with positive drug tests. Furthermore, testing positive for hard drugs is associated with revocation for new crimes and non-drug technical violations, but testing positive for cannabis only is not associated with supervision revocation for either reason.

Characteristics Associated with a History of Physical and Sexual Abuse in a Community Corrections Sample

Background: Most predictors of future criminal justice involvement are gender neutral. However, recent research has stressed the importance of physical and sexual abuse as a precursor of incarceration for women. Purpose: The aim of the present study was to assess the influence of a history of physical and sexual abuse on mental health, substance use, and criminal justice history for men and women under community corrections supervision. Methods: A sample of 613 (203 women and 410 men) participants completed structured clinical interviews and questionnaires assessing demographics, mental health and abuse history (physical vs. sexual), substance use, and criminal justice involvement. Results: Results of multivariate analyses indicated that for men, physical abuse was linked to White race, a higher number of arrests, history of a person offense, family problems, and suicidality; while sexual abuse was linked to White race, family problems, suicidality, and antisocial personality disorder. For women, physical abuse was only associated with meeting criteria for an anxiety or depressive disorder; while sexual abuse was linked to reporting a history of a substance offense, meeting criteria for an anxiety or depressive disorder, and increased suicidality. Substance use was not associated with any form of abuse in either gender. Conclusions: In general, abuse was associated with worse mental health and more severe criminal justice involvement. Women reported much greater rates of abuse and our results provide some support for the idea that a history of abuse may be an important precursor to criminal justice involvement for individuals under community corrections supervision.

Mental health treatment among older adults with mental illness on parole or probation

BackgroundThe number of older adults on parole and probation is growing at an unprecedented rate, yet little is known about the mental health needs and treatment utilization patterns among this group. The objective of this study is to compare the prevalence of serious or moderate mental illness (SMMI), and the proportion of those with SMMI who receive mental health treatment, among community-dwelling older adults on correctional supervision (parole or probation) vs. not on correctional supervision.MethodsDesign: Cross-sectional analysis of data from the 2008–2014 National Surveys for Drug Use and Health (NSDUH).Setting: Population-based national survey data.Participants: Older adults (age ≥ 50) who participated in the NSDUH between 2008 and 2014 (n = 44,624). Participants were categorized according to whether they were on parole or probation during the 12 months prior to survey completion (n = 379) vs. not (n = 44,245).Measurements: Probable SMMI was defined using a validated measure in the NSDUH. Mental health treatment included any outpatient mental health services or prescriptions over the 12 months prior to survey completion. We compared the prevalence of SMMI, and the proportion of those with SMMI who received any treatment, by correctional status.ResultsOverall, 7% (N = 3266) of participants had SMMI; the prevalence was disproportionately higher among those on parole or probation (21% vs. 7%, p < 0.001). Sixty-two percent of those with SMMI received any mental health treatment, including 81% of those on parole or probation and 61% of those who were not (p < 0.001). This result remained statistically significant after logistic regression accounted for differences in sociodemographics and health.ConclusionsSMMI is disproportionally prevalent among older adults on parole or probation, and community correctional supervision programs may be facilitating linkages to needed community-based mental health treatment.

Self-initiated gradual smoking reduction among community correction smokers

IntroductionSmoking remains the leading cause of preventable death in the United States. Many smoking cessation guidelines advise smokers to quit precipitately; however, most quit attempts involve a more gradual cessation. Characteristics of individuals who tend to reduce prior to quitting and the effectiveness of pre-quit reduction are not well understood. This study examined individual differences and smoking cessation outcomes between individuals who self-initiated gradual reduction in cigarettes per day (CPD) and those who did not reduce prior to quit date. MethodsThis study is a secondary analysis from a randomized clinical trial of smoking cessation with pharmacotherapy among individuals under community corrections supervision. We compared participants who self-initiated smoking reduction by at least 25% between baseline and the first treatment session (n = 128) to participants who either increased or did not reduce smoking between baseline and the first treatment session (n = 354). ResultsAfrican American race, no previous cigar smoking, no previous use of pharmacotherapy for smoking cessation, less withdrawal symptoms at baseline, and older age at first smoking were associated with being a self-initiated gradual reduction in univariate analyses. Individuals who self-initiated gradual reduction also had a had a greater likelihood of achieving at least one quit during the one-year study period as compared to those who did not reduce prior to the intervention. ConclusionsIndividuals who self-initiate gradual reduction differ from those who increase or do not change their smoking prior to a quit date. Gradual reduction also increased success in quitting.

Food acquisition methods and correlates of food insecurity in adults on probation in Rhode Island.

BackgroundIndividuals under community corrections supervision may be at increased risk for food insecurity because they face challenges similar to other marginalized populations, such as people experiencing housing instability or substance users. The prevalence of food insecurity and its correlates have not been studied in the community corrections population.MethodsWe conducted a cross-sectional study in 2016, surveying 304 probationers in Rhode Island to estimate the prevalence of food insecurity, identify food acquisition methods, and determine characteristics of groups most at-risk for food insecurity. We used chi-square and Fisher’s exact tests to assess differences in sociodemographics and eating and food acquisition patterns, GIS to examine geospatial differences, and ordinal logistic regression to identify independent correlates across the four levels of food security.ResultsNearly three-quarters (70.4%) of the participants experienced food insecurity, with almost half (48.0%) having very low food security. This is substantially higher than the general population within the state of Rhode Island, which reported a prevalence of 12.8% food insecurity with 6.1% very low food security in 2016. Participants with very low food security most often acquired lunch foods from convenience stores (and less likely from grocery stores) compared to the other three levels of food security. Participants did not differ significantly with regards to places for food acquisition related to breakfast or dinner meals based upon food security status. In adjusted models, being homeless (AOR 2.34, 95% CI: 1.31, 4.18) and depressed (AOR 3.12, 95% CI: 1.98, 4.91) were independently associated with a greater odds of being in a food insecure group. Compared to having help with meals none of the time, participants who reported having meal help all of the time (AOR 0.28, 95% CI: 0.12, 0.64), most of the time (AOR 0.31, 95% CI: 0.15, 0.61), and some of the time (AOR 0.54, 95% CI: 0.29, 0.98) had a lower odds of being in a food insecure group. Food insecure participants resided in different neighborhoods than food secure participants. The highest density of food insecure participants resided in census tracts with the lowest median incomes for the general population. The areas of highest density for each level of food security for our participants were in the census tracts with the lowest levels of full-time employment for the general population.ConclusionsThe prevalence of food insecurity and very low food security were markedly higher in our probation population compared to the general RI population. These findings suggest that access to food on a regular basis is a challenge for adults on probation. Depression and being homeless were independently associated with a greater odds of being in a food insecure group. In addition to intervening directly on food insecurity, developing interventions and policies that address the contributing factors of food insecurity, such as safe housing and treatment for depression, are critical.

Gaging the impact of multiple substance use on community corrections involvement

Historically, research has demonstrated that multiple substance use, compared to single substance use, poses additional challenges for treatment throughout the continuum of care including referrals, interventions, and relapse prevention. However, it appears that this pattern cannot be easily generalized to all criminal justice settings as evidenced by mixed findings across criminal justice samples. The purpose of the current study is to investigate possible differences in legal and substance-related outcomes between multiple substance users and single substance users within a community corrections sample. Structured clinical interviews were conducted to divide 531 individuals under community corrections supervision into three groups including multiple substance users, single substance users, and non-substance users. Results indicated that while multiple substance users were arrested more frequently and had more problems with family members, there were no differences compared to their single substance using counterparts in terms of depressive disorders, anxiety disorders, or types of offense. These findings contrast with previous research on samples outside of community corrections suggesting that multiple substance use requires tailored interventions with consideration to context of their use. Discussion includes limitations to generalizability and assessment of substance use as well as implications for treatment and future research.

Risky business, risk assessment, and other heteronormative misnomers in women’s community corrections and reentry planning

This article uses ethnographic and interview data to explore how halfway house and community corrections staff in a women’s halfway house in the northeastern region of the U.S. police women’s sexuality and the ensuing complications of being queer and under supervision. In this setting, women are required to create a Reentry Home Plan that is approved by Community Corrections Officers, putting into tension some women’s newly emerging queer identity and/or nonnormative relationship schema that they see as “healthier” and more stable than heterosexual relationships, with Probation or Parole Officers’ heteronormative ideals that disapprove nontraditional home plans. This study shows how these women negotiate a marginalized sexual identity and resist biased forms of heteronormative surveillance that extend beyond the legislative parameters of community corrections supervision. It also illustrates the tensions between correctional staff, who view residents’ nonnormative relationships as potential sources of risk, and the supervised women, as they develop community release plans.

Hallucinogen use is associated with a decreased likelihood of positive urine drug screen following entry into community corrections supervision

Hallucinogen use is associated with a decreased likelihood of positive urine drug screen following entry into community corrections supervision

The Connection Between Thwarted Belongingness, Alcohol Consumption, Suicidal, and Homicidal Ideation in a Criminal Justice Sample.

To determine if thwarted belongingness in combination with frequent alcohol use increased suicidal and homicidal ideation when known predictors were controlled for (eg, depressive disorders, anxiety disorders, drug use, race, sex, age, and employment status). This study utilized an archival database. Participants were 574 individuals at an outpatient substance abuse treatment facility who were under community corrections supervision. The average age was 34.5 (SD = 10.9) years; there were 371 (64.6%) men and 287 (50.0%) Black participants. Data were originally gathered from face-to-face interviews with the participants by their case manager or an intake specialist when they entered treatment. Self-reported suicidal and homicidal ideation was used as a dependent variable in unadjusted and adjusted binary logistic regressions to determine the influence of thwarted belongingness and frequent alcohol use. Thwarted belongingness alone (ie, without frequent alcohol use) was associated with risk for suicidal ideation, and was approaching significance for homicidal ideation. The combination of thwarted belongingness and frequent alcohol use was associated with the greatest risk for suicidal and homicidal ideation. Cocaine use and employment status were also identified as significant predictors for suicidal and homicidal ideation in the fully adjusted models. Thwarted belongingness in combination with frequent alcohol use seems to have a large and meaningful relationship with both suicidal and homicidal ideation. Additional research is needed to better understand the relationship between alcohol, thwarted belongingness, and outcomes such as suicide and homicide.

Predictors of medication adherence and smoking cessation among smokers under community corrections supervision

IntroductionIndividuals in the U.S. criminal justice system now represent over 12% of all current U.S. smokers. With smoking banned in most U.S. jails and prisons, the cessation focus for this population has shifted to individuals who are under community correction supervision (e.g., probation, parole). The aim of this study was to examine predictors of successful smoking cessation among criminal justice individuals supervised in the community. MethodsFive hundred participants under community corrections supervision were randomized to receive either four sessions of smoking cessation counseling or no counseling in conjunction with 12weeks of bupropion treatment plus brief physician advice to quit. Logistic regression analyses examined associations of smoking variables with medication adherence and successful abstinence. Mediation analysis evaluated the indirect effects of medication adherence on smoking abstinence. ResultsThe strongest associate of medication adherence was previous use of bupropion, while the strongest associate of smoking abstinence was medication adherence. Mediation analysis indicated that previous use of bupropion indirectly increased cessation rates through the pathway of increased medication adherence. ConclusionsThese results highlight the importance of medication adherence for smoking cessation among community corrections smokers. Providing exposure to medication may be a promising intervention to increase medication adherence and subsequent cessation rates in this population.

Factors Associated With Receiving Rapid HIV Testing Among Individuals on Probation or Parole.

Despite the strong correlation between HIV and corrections, testing and prevention efforts have largely been ignored among community corrections populations. The current study is a secondary analysis to compare characteristics of individuals under community corrections supervision who completed rapid HIV testing with those who refused such testing (N = 2,382) in Baltimore, Maryland, and Providence, Rhode Island. Results indicate that the following variables were significantly associated with the receipt of rapid HIV testing: being female (p = .024), Black race (p = .004), homeless (p = .016), early age of crime onset (p = .001), more drug use during the past 90 days (p = .033), and previously tested for hepatitis C virus/hepatitis B virus (p = .024). Such findings make it especially important that individuals under community supervision be linked with services in the community to ensure that HIV testing and health care planning occur simultaneously.

Risk factors for concurrent use of benzodiazepines and opioids among individuals under community corrections supervision

BackgroundThe use of heroin and prescription opioids has increased over the past decade. The concurrent use of opioids with other depressants such as benzodiazepines increases the risk of overdose death compared with use of either drug alone. This study examined factors associated with concurrent use of opioids and benzodiazepines in a criminal justice sample in the state of Alabama. MethodsThe Addiction Severity Index (ASI) and urine drug screen results from 28,570 individuals who were under community corrections supervision from 2002–2012 were examined for independent or concurrent opioid and benzodiazepine use. Multinomial logistic regression analyses were conducted to determine associations between socio-demographic characteristics and drug use. ResultsConcurrent use was detected in 11.5% of the sample. Concurrent use of opioids and benzodiazepines or use of either drug alone was associated with being White, female, married, prescribed psychiatric medications, having seen a physician in the past two years, cannabis use, and having a drug-related offense. Concurrent users were more likely to be unemployed or disabled and have received counseling, and less likely to have completed college, live with relatives or friends, have a history of hallucinations, or have an offense against a person relative to nonusers. DiscussionWhile significant overlap of risk factors exists between individuals with concurrent use versus sole use of opioids or benzodiazepines, individuals with concurrent use generally have more social dysfunction than individuals who tested for either substance alone. Concurrent users may need more psychosocial resources and intensive treatments to promote recovery.

Race and Medication Adherence Moderate Cessation Outcomes in Criminal Justice Smokers.

Smokers in the criminal justice system represent some of the most disadvantaged smokers in the U.S., as they have high rates of smoking (70%-80%) and are primarily uninsured, with low access to medical interventions. Few studies have examined smoking-cessation interventions in racially diverse smokers, and none have examined these characteristics among individuals supervised in the community. The purpose of this study is to determine if four sessions of standard behavioral counseling for smoking cessation would differentially aid smoking cessation for African American versus non-Hispanic white smokers under community corrections supervision. An RCT. Five hundred smokers under community corrections supervision were recruited between 2009 and 2013 via flyers posted at the community corrections offices. All participants received 12 weeks of bupropion plus brief physician advice to quit smoking. Half of the participants received four sessions of 20-30 minutes of smoking-cessation counseling following tobacco treatment guidelines, whereas half received no additional counseling. Generalized estimating equations were used to determine factors associated with smoking abstinence across time. Analyses were conducted in 2014. The end-of-treatment abstinence rate across groups was 9.4%, with no significant main effects indicating group differences. However, behavioral counseling had a differential effect on cessation: whites who received counseling had higher quit rates than whites who did not receive counseling. Conversely, African Americans who did not receive counseling had higher average cessation rates than African Americans who received counseling. Overall, medication-adherent African American smokers had higher abstinence rates relative to other smokers. Racial disparities in smoking cessation are not evident among those who are adherent to medication. More research is needed to better understand the differential effect that behavioral counseling might have on treatment outcomes between white and African American smokers under community corrections supervision.

Incarceration, Prisoner Reentry, and Communities.

Since the mid-1970s the United States has experienced an enormous rise in incarceration and accompanying increases in returning prisoners and in post-release community correctional supervision. Poor urban communities are disproportionately impacted by these phenomena. This review focuses on two complementary questions regarding incarceration, prisoner reentry, and communities:(1) whether and how mass incarceration has affected the social and economic structure of American communities, and (2) how residential neighborhoods affect the social and economic reintegration of returning prisoners. These two questions can be seen as part of a dynamic process involving a pernicious "feedback" loop, in which mass incarceration undermines the structure and social organization of some communities, thus creating more criminogenic environments for returning prisoners and further diminishing their prospects for successful reentry and reintegration.