With over 12 million arrested each year, the United States incarcerates more people both in absolute numbers and per capita than any other country in the world. Social determinants of health (SDH) influence health and wellbeing, including risk for mental and behavioral health related conditions like substance use disorders (SUD). For example, justice-involved individuals have four to nine times the rate of SUD than the general population and four times the rate of mental health disorder. The justice system has become the de facto service provider for individuals struggling with SUD and mental illness but the programs and services available are very limited. Lack of access to services in prison, during the reentry process, and in the community results in common occurrences of relapse, overdose and overdose deaths, and recidivism. Equipping justice-involved individuals with SUD, especially those recently released, with support tools could be key in improving reentry by reducing the likelihood of relapse and recidivism. The data highlight that the first few months after release are critical to the successful reentry. To address the needs of recently released justice-involved individuals, communities need to consider SDH factors such as homelessness, mental health, substance abuse, adequate health care, education, employment assistance, and family support. Digital health technology can help recently released individuals navigate their new environment and adapt to the changes that occurred during their incarceration. Technology makes it possible to provide localized support such as access to location-specific information about risk reduction, housing, accessing medical care, SUD treatment program options and availability, and support groups that is not available through traditional mechanisms or even through aftercare programming. It transforms support services from fragmented, disparate services to centralized, one- stop shopping that is available 24/7 for people in need. Q2i successfully developed and deployed the Opioid Addiction Recovery Support (OARS) care team portal and mobile application used by healthcare organizations to support Medication-Assisted Treatment programs and recovery from opioid use disorder (OUD). In this application, Q2is OARS will be modified using iterative development methodology to create OARS-VC that (1) provides a self-support virtual coach (VC) to address the needs of recently released justice involved individuals with OUD reentering the community, and (2) connects to other organizations for communication and data exchange when required and appropriate. We will conduct usability studies after each major iteration to collect feedback (interviews) about usability and functionality. After the third iteration, we will conduct a 2-week field usability test. We will also develop a framework to identify best recruitment methods and study designs to study digital health innovations for recently released justice-involved individuals with OUD/SUD. The OARS-VC aims to improve long-term recovery from SUD, reduce relapse and recidivism rates, and support successful reentry and transition into the community for justice-involved individuals.
Public Health Relevance Statement: PROJECT NARRATIVE-Public Health Relevance The social determinants of health (SDH) such as living conditions and access to healthcare can significantly affect health outcomes, especially for recently released justice-involved individuals with substance use disorder (SUD). The lack of effective support solutions that comprehensively address SDH for these individuals results in a high percentage of individuals being rearrested, experiencing overdoses and overdose deaths. The technology breakthrough to be developed in this project will give recently released justice-involved individuals with SUD, with a focus on opioid use, access to a smartphone application that provides information and connections to services (including, employment, food, transportation, support groups, health care) and related organizations including treatment programs, to help support and improve reentry into the community post incarceration.
Project Terms: Address; Affect; Aftercare; Area; Awareness; behavioral health; Car Phone; Caring; Case Manager; Cellular Phone; Cessation of life; Collaborations; Communication; Communities; community reintegration; Country; Criminology; Data; data exchange; design; Development; digital; Disease; Education; Educational workshop; Effectiveness; efficacy testing; Employment; Environment; experience; family support; Feasibility Studies; Feedback; Female; Food; Foundations; General Population; Health; health care availability; health care service organization; Health Services; Health Services Accessibility; Health Technology; Healthcare; Homelessness; Housing; Imprisonment; improved; Individual; informant; innovation; Interview; Justice; Letters; Location; Measures; Medical; medication-assisted treatment; Mental disorders; Mental Health; Methodology; Methods; mobile application; mobile computing; Modeling; mortality; Neighborhood Health Center; New England; New Hampshire; novel; Opiate Addiction; opioid use; opioid use disorder; Outcome; Overdose; overdose death; Participant; Patients; Personal Satisfaction; Pharmaceutical Preparations; Phase; Population; premature; Prisoner; Prisons; Process; programs; Public Health; public health relevance; rearrest; recidivism; Recovery; recruit; Relapse; Reporting; Research; Research Design; Research Personnel; Risk; Risk Reduction; service providers; Services; Small Business Technology Transfer Research; smartphone Application; social health determinants; Substance abuse problem; Substance Use Disorder; Support Groups; support tools; Supported Employment; System; Technology; Testing; Thinking; Time; Transportation; treatment program; United States; usability; virtual coach; Work
