Combating IPV With Community Leaders in Honduras: An Evaluation of an IPV Training Program Among Teachers and Health Professionals.

Intimate partner violence (IPV) among women in Latin America, including Honduras, is serious. To help IPV victims, a community-based educational program has been implemented. This study aims to examine the impact of IPV training among teachers and health care professionals (n = 160) on increases in IPV knowledge, attitudes, and self-efficacy when dealing with IPV victims using a pretest and posttest design. We found that the treatment group who received IPV training showed significantly lower justification for IPV, higher gender equality attitudes, and higher IPV knowledge as well as higher confidence levels in identifying IPV victims and safety planning for victims. We concluded that the IPV training program using the community-based approaches has the potential to help IPV victims in Honduras. More efforts should be made to increase the educational opportunities the community members can receive.

Suicidal Ideation of Probationers. Gender Differences.

BACKGROUND: Gender is often related to different life stressors and mental health disorders, but a limited amount of research examines risks of suicidal ideation of probationers by gender. AIMS: The aim of this study was to examine gender differences in suicidal ideation of probationers. METHOD: Using a national sample of 3,014 male and 1,306 female probationers with data from the National Survey on Drug Use and Health (2009-2011), multivariate regression analysis was conducted. RESULTS: Male and female probationers display similar demographic characteristics although their life circumstances and experiences seem different. Female probationers in the study were more likely to experience financial, psychological, and residential stressors than male probationers were. Female probationers were also more likely to have received medical and/or psychiatric treatments. Female probationers were exposed to more suicidal ideation risks than male probationers were. Additionally, no protective factors to suicidal ideation were found for female probationers. CONCLUSION: The findings suggest that a gender-specific approach to suicidal ideation of probationers may lessen the prevalence of suicidal ideation of this largely neglected population.

Self-perceived health improvements among prison inmates.

Despite the extensive resources expended on providing medical care to inmates, inmates' health perception is an understudied topic. The current study investigates inmates' perception of health status while incarcerated using a sample of 136 soon-to-be released prisoners. Prisoners with poor health perception prior to their current incarceration were most likely to perceive health improvement. Sociodemographic characteristics were generally not associated with the perceived health improvement during incarceration. Analysis results suggest correctional institutions may play a vital role in delivering much-needed medical care to a segment of the prisoner population, including determining how they feel about their health. It is important to explore the policies and practices to increase continuity of health care following release to maintain perceived health improvement.

Professional confidence and job satisfaction: an examination of counselors' perceptions in faith-based and non-faith-based drug treatment programs.

Understanding substance abuse counselors' professional confidence and job satisfaction is important since such confidence and satisfaction can affect the way counselors go about their jobs. Analyzing data derived from a random sample of 110 counselors from faith-based and non-faith-based treatment programs, this study examines counselors' professional confidence and job satisfaction in both faith-based and non-faith-based programs. The multivariate analyses indicate years of experience and being a certified counselor were the only significant predictors of professional confidence. There was no significant difference in perceived job satisfaction and confidence between counselors in faith-based and non-faith-based programs. A majority of counselors in both groups expressed a high level of satisfaction with their job. Job experience in drug counseling and prior experience as an abuser were perceived by counselors as important components to facilitate counseling skills. Policy implications are discussed.

Prevalence and correlates of suicidal ideation among parolees.

OBJECTIVE: This study examined the prevalence and correlates of suicidal ideation among parolees and among persons who were not on parole. METHODS: Three years of data (2009 to 2011) from the National Survey on Drug Use and Health were analyzed. Data on sociodemographic and clinical characteristics and violent behaviors of parolees (N=1,249) and nonparolees (N=114,033) were examined as indicators of need and as predictors of suicidal ideation. Multivariate logistic regression analysis was conducted, using suicidal ideation as the dependent variable. RESULTS: Over the three years, the average prevalence of suicidal ideation among parolees (8.6%) was more than twice that among nonparolees (3.7%). Characteristics associated with decreased suicidal ideation among nonparolees, such as being married, older, and employed, were not related to lower suicidal ideation among parolees. For parolees, having health insurance decreased the likelihood of suicidal ideation by 50%. Parolees who received a past-year prescription for a mood disorder did not have higher rates of suicidal ideation, although this variable was associated with higher suicidal ideation among nonparolees. Parolees were significantly more likely than nonparolees to rate their health as poor (4.1% versus 2.6%). CONCLUSIONS: Results indicated that parolees have more life stressors and that providing them with access to health care might lower suicidal ideation. Because parolees were more likely to rate their health as poor, providing access to medical care may improve their quality of life and their chance of successful return to the community.

Causation of drug abuse and treatment strategy: a comparison of counselors' perceptions of faith-based and secular drug treatment programs.

Many offenders participate in drug abuse treatment programs while in prison or on probation or parole. Among other benefits, this treatment may lessen the risk of recidivism. Thus, understanding counselor treatment philosophy is important as their attitudes toward treatment can be influential in the strategies they use and ultimately affect treatment outcomes. Analyzing data from 110 drug abuse treatment counselors, this study compared counselors' perceptions of causation of drug abuse and treatment strategy between faith-based and secular treatment programs. It was found that counselors from faith-based programs were more likely to endorse religious models and less prone to support disease models as an explanation of drug use. With regard to treatment strategy, counselor's group affiliation was not predictive of a focus on either a client religious need or a medical treatment model. Nevertheless, the extent of counselor's religiosity was correlated with tackling clients' religious needs as a treatment strategy. On the other hand, certified (licensed) counselors were found to be more supportive of the medical model as a treatment approach. Limitations of the current study and policy implications are discussed.

The varieties of religious experience and the retention of clients in Taiwanese faith-based residential drug user treatment.

This study investigated whether subgroups of faith-based treatment clients displaying similar religious experiences and treatment performance can be theoretically specified and empirically identified. Highlighting the volitional dimension of the change process, four subgroups (i.e., non-Christians, baseline Christians, rededicated Christians, and newly converted Christians) were proposed according to the direction and magnitude of clients' change in religiosity during treatment. Data obtained for 707 subjects who entered a Christian residential therapeutic community program in Taiwan between 2000 and 2009 were analyzed. Results showed that the typology of religious experiences powerfully predicted treatment retention and completion. Issues of therapeutic specificity and relapse prevention are discussed and study's limitations are noted.

Pregnancy and drinking among women offenders under community supervision in the United States: 2004-2008.

Drinking during pregnancy raises risks of pregnancy, labor, and delivery complications in mothers and lasting neurological or behavioral consequences in babies. This public health issue has recently attracted the attention of criminal justice (CJ) researchers, as the prevalence of Fetal Alcohol Spectrum Disorders (FASDs) appears to be unusually high among offender populations. Nevertheless, in addition to becoming a main caretaker of individuals with FASDs, the CJ system already may have under its care some of the women at the highest risk of drinking during pregnancy. This study sets out to determine the prevalence, patterns, and correlates of alcohol consumption among women offenders on probation or parole in the United States. Analysis of data collected from seven waves of the National Survey on Drug Use and Health (2004-2008) were performed on women who were under community supervision during the year prior to the survey interview. Results revealed that 1.9% of women of child-bearing ages of 12-44 years in the general population were pregnant, as compared to 4.7% of comparable women under community supervision. Pregnant offenders were more likely to come from minority groups and be socially disadvantaged than their non-CJ-involved counterparts. Alarmingly, they were nearly three times as likely to have engaged in problem drinking (e.g., two drinks a day for a month) than non-CJ-involved women. Negative behavioral consequences resulting from alcohol consumption and concurrent use of other substances were also significantly more pervasive among drinkers under community supervision. Effective prevention and control of the problem requires rethinking the role of corrections systems in health promotion. Concrete recommendations are discussed.

The impact of substance user treatment participation on legal employment and income among probationers and parolees.

Employment is essential for recovery. But treatment could conflict with work schedules, and employment gains could be short lived. This study examined how employment and income varied during and after treatment, what aspects of treatment impacted on employment, and whether treatment improved income. Baseline and follow-up data were analyzed for 760 probationers and parolees in 11 US cities that participated in the 1992-1995 Drug Abuse Treatment Outcomes Study. Results showed that only residential/inpatient treatment was associated, temporarily, with employment. Retention, compliance, and self-efficacy were correlated to posttreatment employment. However, treatment had no impact on income, which was determined by education and work history.

Prevalence and risk factors of violence-related and accident-related injuries among state prisoners.

This study assessed the prevalence, nature, and risk factors of violence- and accident-related injuries among inmates in state prisons. Data from the 2004 Survey of Inmates in State Correctional Facilities (N = 14,499) were analyzed. More than 32% of inmates reported having been injured since their admission. History of violent offenses, violent victimization, and psychiatric treatment powerfully increased the risk of both types of injuries. Work assignments reduced the risk of violence-related injuries but increased the risk of accident-related injuries. Having received one type of injury raised the risk of the other type of injury. Unlike preexisting health conditions, injury can be proactively and effectively prevented. Coordination of prison services to address risk factors and implementation of prevention strategies can yield important benefits.

Racial differences in desistance from substance abuse: the impact of religious involvement on recovery.

This study examines variations by race in the relationship between religiosity and desistance from substance abuse. Although most studies have included race as a control variable, only a few studies compared the equivalence of associations among religiosity, delinquency, recovery from substance abuse, and other variables between Black and White samples. Using data from the intake and 12-month follow-up survey of the Drug Abuse Treatment Outcome Study, this study examines levels of religious involvement of Black and White drug treatment clients. In addition, it empirically tests whether religious involvement exerts differential effects on Black and White clients' recovery from substance abuse. It was found that Black clients reported higher levels of religious involvement (measured by church attendance) than did White clients. Data indicated that religious behavior at 1-year follow-up was positively associated with Black clients' recovery from substance abuse. In contrast, religious behavior was not a significant predictor of White clients' desistance from substance abuse. Directions for future research and policy implications are discussed.

Rational choice and environmental deterrence in the retention of mandated drug abuse treatment clients.

Length of treatment stay is consistently associated with positive posttreatment outcomes in the rehabilitation of drug-abusing offenders. However, past retention research centered on the examination of individual-level determinants to the exclusion of environmental predictors. In this study, the authors propose a rational choice framework in which treatment retention is viewed as a decision-making process that involves calculation of costs and benefits of remaining in treatment. Environmental factors not directly related to the treatment process are theorized to either reward or punish the course of action taken by each treatment client. Retention data from 1,984 drug-abusing felons diverted for long-term residential treatment were analyzed to test the hypotheses that criminal sanctions against drug offenses, violence in local drug markets, and lack of legitimate job opportunities act as deterrents against premature termination of treatment. Results corroborated the criminal sanction and unemployment hypotheses, but not the violence hypothesis. These findings highlight the necessity of reinforcing perceptions of arrest risks and job prospects during treatment. The study concludes with some clinical recommendations.

Collateral gains from the military? A cross-national analysis of the armed forces crime relationship.

Research has repeatedly showed that males aged between 16 and 24 years old account for a disproportionately large volume of crime. Armed forces are major employers of young males in their crime-prone ages and thus could play an essential role in crime prevention. The military is a highly structured and regimented total institution in which rigid behavioral norms and very close monitoring are imposed both on soldiers and on officers. Using data from 65 countries for the period of 1995 to 1999, this study assesses the crime-reduction function of the military by testing the influence of the relative size of the armed forces and the existence of conscription on national rates of homicide. The findings show that the size of the military and the existence of conscription are significantly related to homicide rates. Implications for future research are discussed.

Contextual barriers to successful reentry of recovering drug offenders.

Recidivism among recovering ex-offenders is usually conceptualized as an outcome of the interplay between personal traits and treatment interventions. This focus on the individual, to the exclusion of the sociolegal context in which recovery and reintegration take place, has limited extant policy initiatives. Recidivism data from 440 drug-abusing felons who had successfully completed long-term residential treatment were examined. All else being equal, recovering offenders who began their reentry during times of high unemployment, low risk of incarceration for new offenses, or both, were found to be more likely to recidivate during their first year in the community. These findings highlight the promise of blending effective drug abuse treatment with credible sanctions against drug offenses as well as the need for job training, placement, and advocacy services.

Sexual and physical victimization as predictors of HIV risk among felony drug offenders.

Injection and other drug use and high-risk sexual behaviors put criminal offenders at increased risk for HIV infection. Studies in other populations, especially females, have found that a history of sexual or physical victimization increases engagement in HIV-risk behaviors, and drug-involved offenders have high rates of such prior victimization. However, there has been little research among male offenders. In a sample of 247 male felony drug offenders in New York City, prior sexual victimization was related to a higher number of sex partners and lower proportion of protected sex acts in the 30 days before arrest. Prior physical abuse was related to cocaine injection, but not heroin injection or high-risk sex behaviors. These results suggest a complex relationship between sexual and physical abuse and HIV risk among male offenders. Assessing for specific prior abuse histories of offenders and providing targeted interventions may be useful for developing more effective primary and secondary HIV prevention services for this high-risk population.

Nonmedical use of prescription opioids among teenagers in the United States: trends and correlates.

PURPOSE: This article reports on trends and correlates of the nonmedical use of prescription opioids among youth. METHODS: Secondary analyses of data from the National Survey on Drug Use and Health were performed on youths, ages 12 to 17. RESULTS: Analyses revealed evidence of an emerging epidemic of opioid misuse among teenagers. Sub-groups of youth at particularly high risk include females, blacks, those of lower socio-economic status, and those who hold favorable attitudes toward illicit drugs, have detached parents, or have friends who use illicit drugs. Respondents' own use of other illicit drugs is the strongest predictor of their nonmedical use of prescription opioids. CONCLUSIONS: Nonmedical use of prescription opioids is a recurrent epidemic and valuable lessons from past epidemics of this nature can be learned if historical data are studied. Prevention campaigns should target groups at risk for substance abuse and focus on improving family bonds and peer-resistance skills.

Predicting treatment noncompliance among criminal justice-mandated clients: a theoretical and empirical exploration.

Compliance with therapeutic regimens constitutes an important but infrequently studied precursor of treatment engagement and is a necessary condition of successful treatment. This study builds on recent treatment process research and provides a theory-driven analysis of treatment compliance. Five hypotheses are formulated to predict treatment noncompliance among criminal justice-mandated clients. These hypotheses tap different determinants of treatment progress, including physical prime, supportive social network, conventional social involvement, treatment motivation, and risk-taking propensity. Data from 150 addicted felons participating in a diversion program are analyzed to test the hypotheses. Predictors related to these hypotheses correctly identify 58% of the fully compliant clients and 55-88% of the noncompliant clients. Most hypotheses are at least partially corroborated and a few strong correlates emerge across analyses. Clients in their physical prime, those with poorer social support, and those lacking internal desires for change were found especially likely to violate treatment program rules. Clinical implications are discussed.