Implementation of SAMHSA-funded Offender Re-Entry Programs Addressing Substance Use and Co-occurring Disorders among Justice Involved Latino Adults

Objectives: Racial and ethnic minorities have high rates of incarceration and persons entering the criminal justice system have disproportionate rates of mental health and substance use disorders Justice involved individuals do not receive adequate treatment resulting in greater risk of recidivism and relapse. This study examines the facilitators and barriers to implementing a SAMHSA-funded Offender Re-Entry Program (ORP) to better understand the factors that influence successful implementation of integrated bilingual/bicultural treatment, recovery, and re-entry services for recently incarcerated adult Latino individuals with substance use and co-occurring behavioral health disorders. Methods: Structured interviews were conducted with leadership, direct staff, and non-direct staff involved in the development and implementation of the Rumbo a Casa ORP at Casa Esperanza, Inc. Using the Consolidated Framework for Implementation Research (CFIR), we investigated the domains and constructs that were critical to successful implementation. Interviews were analyzed using NVivo 11 software. Results: Qualitative analyses show that across all domains, inner setting, particularly the implementation climate of an organization, is reported most often as influencing (positively or negatively) the implementation of the program. Findings show that the current process structure and the characteristics of individuals are greatly impacting program implementation as reported by direct staff. These findings demonstrate that the process of implementation which includes planning, engaging, executing, reflecting and evaluating constructs is essential for the successful implementation an offender-reentry program. Dedicated leadership is necessary to enhance implementation of fundamental program activities using a Plan-Do-Study-Act (PDSA) quality improvement cycle. Conclusion: An established implementation research framework can identify key issues critical to the implementation and evaluation processes. This study provides a deepened understanding of components critical to the successful implementation of an ORP and adds to the limited implementation research knowledge on evidence-based care approaches for justice involved Latino adults.