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The juvenile justice system is charged with the welfare of the children it serves, yet less is known about the prosocial behaviors of adolescent youthful offenders. This study identifies patterns of prosocial behavior for 7 years among serious adolescent offenders, the correlates of each pattern, and associated patterns of secure placement. Using 7 years of monthly data from the Pathways to Desistance Study (N = 1,354), we used group-based trajectory models to identify longitudinal patterns of positive youth behaviors related to school and work among serious adolescent offenders and a joint trajectory model to assess the relationship between trajectories of institutional placement and positive youth behaviors. Four groups were identified that demonstrated a high, low, medium, and dips-then-rises likelihood of gainful activities throughout the study period. Gainful activities were negatively associated with risk for delinquency across multiple domains. Juvenile justice interventions should consider prosocial promise in addition to risk for delinquency.

This pilot proof-of-concept study examined the feasibility and acceptability of a Continuing Care mobile application (app) designed to meet the recovery and personal support needs of individuals under justice supervision who were receiving outpatient substance use disorder (SUD) treatment. The study included adults on probation or parole who were enrolled in an outpatient SUD treatment program (N = 15; 86.7% males). Participants were instructed to utilize the Continuing Care app daily for 4 weeks. At the end of the study, they completed a satisfaction questionnaire. Of the 15 participants enrolled in the study, 12 (80%) completed the Continuing Care app modules and the satisfaction questionnaire, and all of these participants indicated high levels of satisfaction with the app (on a scale of 1-10, Mean = 1.8, SD = 1.2). The Continuing Care app was well-utilized and perceived as valuable by this group of low-income, underserved, and hard-to-reach individuals. Further research is needed to refine app content and evaluate its ability to meaningfully enhance and extend the benefits of SUD treatment.

BackgroundSelf-reported antiretroviral therapy (ART) adherence measures that are associated with plasma viral load (VL) are valuable to clinicians and researchers, but are rarely examined among groups vulnerable to dropping out of care. One-seventh of all those living with HIV pass through incarceration annually and criminal-justice (CJ) involved people living with HIV (PLH) are vulnerable to falling out of care. We examined the association of self-reported ART adherence with VL in a criminal-justice sample compared to a routine-care sample.MethodsSamples: We examined data from a multisite collaboration of studies addressing the continuum of HIV care among CjJ involved persons in the Seek, Test, Treat, and Retain cohort. Data pooled from seven CJ- studies (n = 414) were examined and compared with the routine-care sample from the Centers for AIDS Research Network of Integrated Clinical Systems' seven sites (n = 11,698).MeasuresIn both samples, data on self-reported percent ART doses taken were collected via the visual analogue scale adherence measure. Viral load data were obtained by blood-draw.AnalysisWe examined the associations of adherence with VL in both cohorts using mixed effects linear regression of log-VL, and mixed effects logistic regression of binary VL (≥ 200 copies/mL) outcomes. Interactions by CD4 count and self-reported health status were also tested.ResultsAmong the CJ sample, the coefficient for log-VL was - 0.31 (95% CI = - 0.43, - 0.18; P

Interagency teams are considered an evidence-based change practice, but there is a paucity of research examining them in criminal justice (CJ) and behavioral health (BH) reform contexts. This study draws on qualitative interviews (n = 52) and survey data (n = 791) from BH and CJ leaders across the United States to examine who is on them, what they do, and effective strategies for building and sustaining them. Findings indicated that CJ–BH interagency teams often incorporate agencies from a range of CJ, BH, social service, and health agencies. Teamwork focused on connecting clients to resources or contributing to CJ–BH coalitions and resource centers. Although the team-building strategies learning about/from other agencies and system integration were significantly associated with developing more collaborations, consensus-building activities were not. These findings suggest that interagency teams need not necessarily reach consensus on goals and vision prior to working together, as this can be built through collaboration. [ABSTRACT FROM AUTHOR]

Emerging adults present an array of developmental needs that community supervision agencies should address to improve outcomes including impulsivity, inability to regulate emotions, and being less likely to consider future consequences of their behavior. This study used a randomized controlled trial (RCT) to evaluate the Hidalgo County Emerging Adult Strategy (HCEAS)�a specialized caseload for emerging adults using principles of goal setting, incentives, and identity and relationship formation. This study examines how HCEAS influences progress on stability measures and probation outcomes, and how stability measure progress affects probation success. Analyses showed that HCEAS was effective in increasing either within- or between-group progress for every stability measure except education. HCEAS decreased outcomes such as arrests, motions to revoke, and failures to appear for probation office visits. These outcomes suggest that an age-specific focus on stability factors is feasible during supervision and likely to result in improved outcomes. [ABSTRACT FROM AUTHOR]

PurposeSubstance use is linked with poor outcomes among people living with HIV (PLWH) and is associated with mental health disorders. This analysis examines the impact of decreasing substance use, even without abstinence, on depressive symptoms among PLWH.MethodsData are from PLWH enrolled in the Centers for AIDS Research Network of Integrated Clinical Sites cohort. Participants completed longitudinal assessments of substance use (modified ASSIST) and depressive symptoms (PHQ-9). Changes in substance use frequency were categorized as abstinence, reduced use, and nondecreasing use. Adjusted linear mixed models with time-updated change in substance use frequency and depressive symptom scores were used to examine associations between changes in the use of individual substances and depressive symptoms. Analyses were repeated using joint longitudinal survival models to examine associations with a high (PHQ-9 ≥10) score.ResultsAmong 9905 PLWH, 728 used cocaine/crack, 1016 used amphetamine-type substances (ATS), 290 used illicit opiates, and 3277 used marijuana at baseline. Changes in ATS use were associated with the greatest improvements in depressive symptoms: stopping ATS led to a mean decrease of PHQ-9 by 2.2 points (95% CI: 1.8 to 2.7) and a 61% lower odds of PHQ-9 score ≥10 (95% CI: 0.30 to 0.52), and decreasing ATS use led to a mean decrease of 1.7 points (95% CI: 1.2 to 2.3) and a 62% lower odds of PHQ-9 score ≥10 (95% CI: 0.25 to 0.56). Stopping and reducing marijuana and stopping cocaine/crack use were also associated with improvement in depressive symptoms.ConclusionsWe demonstrated that both substance use reduction and abstinence are associated with improvements in depressive symptoms over time.

Provisions of the Affordable Care Act offer new opportunities to apply a public health and medical perspective to the complex relationship between involvement in the criminal justice system and the existence of fundamental health disparities. Incarceration can cause harm to individual and community health, but prisons and jails also hold enormous potential to play an active and beneficial role in the health care system and, ultimately, to improving health. Traditionally, incarcerated populations have been incorrectly viewed as isolated and self-contained communities with only peripheral importance to the public health at large. This misconception has resulted in missed opportunities to positively affect the health of both the individuals and the imprisoned community as a whole and potentially to mitigate risk behaviors that may contribute to incarceration. Both community and correctional health care professionals can capitalize on these opportunities by working together to advocate for the health of the criminal justice-involved population and their communities. We present a set of recommendations for the improvement of both correctional health care, such as improving systems of external oversight and quality management, and access to community-based care, including establishing strategies for postrelease care and medical record transfers.

Objectives. To document state Medicaid pre- and postrelease initiatives for individuals in the criminal legal system with substance use disorder (SUD). Methods. An Internet-based survey was sent in 2021 to Medicaid directors in all 50 US states and the District of Columbia to determine whether they were pursuing initiatives for persons with SUD across 3 criminal legal settings: jails, prisons, and community corrections. A 90% response rate was obtained. Results. In 2021, the majority of states did not report any targeted Medicaid initiatives for persons with SUD residing in criminal legal settings. Eighteen states and the District of Columbia adopted at least 1 Medicaid initiative for persons with SUD across the 3 criminal legal settings. The most commonly adopted initiatives were in the areas of medication for opioid use disorder treatment and Medicaid enrollment. Out of 24 possible initiatives for each state (8 initiatives across 3 criminal legal settings), the 2 most commonly adopted were (1) provision of medication treatment of opioid use disorder before release from criminal legal settings (16 states) and (2) facilitation of Medicaid enrollment through suspension rather than termination of Medicaid enrollment upon entry to a criminal legal setting (14 states). Initiatives pertaining to Medicaid SUD care coordination were adopted by the fewest (9) states. Conclusions. In 2021, states' involvement in Medicaid SUD initiatives for criminal legal populations remained low. Increased adoption of Medicaid SUD initiatives across criminal legal settings is needed, especially knowing the high rate of overdose mortality among this group. (Am J Public Health. 2024;114(5):527–530. https://doi.org/10.2105/AJPH.2024.307604) [ABSTRACT FROM AUTHOR]