Screening, Brief Intervention, and Referral to Treatment for Offenders
Condition: Substance Use; HIV Infections
MeSH terms: Substance-Related Disorders
Study type: Interventional

Summary: 
      The purpose of the study is to determine whether SBIRT is an effective intervention with
      inmates and to estimate the costs of providing SBIRT to this population.
    

Detailed description: 
      Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based
      practice that has been found to be effective in reducing alcohol and illicit drug use, mainly
      among persons recruited in medical centers, primary care offices, emergency rooms, and
      colleges and universities. But SBIRT has the potential to be applicable to other populations
      that have, or that are at risk for, substance use problems. In particular, offenders have
      high prevalence of drug and alcohol use at varying levels of severity and often do not
      receive adequate intervention, either because of limited availability of programs, low
      motivation, or lack of awareness of the consequences of their substance use.

      The scientific aims of the study are:

        1. Assess the effectiveness of SBIRT with offenders in terms of participation in brief
           intervention (if so indicated) and enrollment in treatment (if so indicated).

        2. Assess the effectiveness of SBIRT with offenders in terms of drug use, criminal
           activity, and criminal justice involvement at 12 months following baseline.

        3. Determine whether there are differences in acceptability, participation, and outcomes
           between men and women.

        4. Determine the cost of providing the SBIRT intervention with this population.

      The clinical aims of the study are:

        1. To complement the use of SBIRT within Los Angeles County's substance abuse treatment
           system.

        2. To expand prevention and treatment options for offenders with substance abuse problems.

      To our knowledge, this would be the first rigorous test of SBIRT with an offender population.

      We will recruit inmates at two Los Angeles County Sheriff jail facilities, one for men and
      one for women (25% of total sample), and randomly assign them to the treatment (SBIRT) group
      (N =400) or to the control (no intervention) group (N = 400). Baseline demographic data will
      be collected. Subjects in both groups will be screened for substance use risk using The
      Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) developed by the World
      Health Organization. Control subjects will receive only their risk score and informational
      materials regarding the health risks of substance use. Experimental subjects, in addition to
      their risk score and informational materials, will also receive a brief intervention and a
      referral to treatment appropriate to their risk score from trained health educators. The
      health educators will be provided by Homeless Health Care, Los Angeles. Twelve months after
      study admission, all study participants will be contacted for a follow-up interview. We will
      obtain records-based data on arrests and jail incarceration over the follow-up period from
      the Sheriff's Department and the California Department of Justice. We will also collect
      subject participation in publicly-funded treatment from the Substance Abuse Prevention and
      Control Division of the Los Angeles County Department of Health.
    

Intervention name(s): SBIRT; Control Group
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Screening, brief intervention, and referral to treatment.; Control subjects will receive only their risk score and informational materials regarding the health risks of substance use.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment