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Project Title: Emergent social environments as predictors of recovery
resident outcomes
Funding
Source: National Institute of Alcohol Abuse and Alcoholism
Leonard
A. Jason, Ph.D., Principal Investigator
John
Light, Ph.D., Co-Investigator
Ed
Stevens, Ph.D., Project Director
Abstract
The
proposed research tests a dynamic systems-based theory, which explains how
recovery house residents’ recovery-related attitudes, behaviors, and social
relationships co-evolve, and how these emergent individual characteristics and
house-level social structures subsequently link to individuals’ recovery
endpoints. The theory adapts concepts from group and social network dynamics,
placing them within a broader community mental health framework. It is
operationalized and tested by measuring relationships of trust, friendship, and
advice/mentoring as dynamic multiplex
social networks (Snijders et al., 2012)—multiple,
simultaneous interdependent relationships--that exist within each house. These
relationships are assumed to co-evolve over time, affecting and affected by
recovery-related attitudes and behaviors, and personal networks outside the
house. By pooling dynamic relationships across houses, we will apply the
Stochastic Actor-Oriented Modeling framework (Snijders
et al., 2010) to estimate a set of stochastic, continuous-time difference
equations. This model will then be subjected to theoretical analyses designed
to suggest possible strategies for improving outcomes (e.g. maintaining
residence) for this population. Our proposed study will identify mechanisms through which social environments
affect health outcomes, and thereby contribute to reducing unnecessary
health care costs by improving the effectiveness of the residential recovery
home system in the US and also restructuring and improving other
community-based recovery settings. These types of improvements could lead to
better client care and treatment outcomes. Our
proposed research would
provide significant insight on within house structure and dynamics as
predictors of an individual’s likelihood of maintaining a positive recovery
trajectory; it would provide information on the interactions of external
recovery behaviors (e.g. AA), external ego-centered networks (scope,
composition, dynamics), and within-setting social networks, and it might
identify points of “failure” where the individual reaches a significant likelihood
of relapse. In addition, this work should result in an initial framework for
the study of network dynamics in recovery homes which should facilitate both
the theoretical development and empirical investigation of the broader domain
of recovery homes.
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NIH
Minority Supplement
Mayra
Guerrero, a graduate student in the DePaul University community psychology
doctoral program, received a Minority Supplement for $136,899 from the National
Institute on Alcohol Abuse and Alcoholism for the years 2016-2019. Mayra will
be involved in the collection and the analysis of cross-sectional data
representing the social networks of military veterans and non-veterans within
recovery homes called Oxford Houses (the largest self-help residential program
for people in recovery, with over 2,000 homes nationally, and serving over
25,000 people last year). The parent five year NIH grant was awarded to Leonard
Jason and is titled: Emergent social environments as predictors of recovery
resident outcomes. Mayra’s supplement will give her the opportunity to
strengthen her analytic skills through her mentorship with me and a
multidisciplinary group of experts in alcohol and substance abuse recovery and
social network analysis. This mentorship group includes John Light, a
sociologist at Oregon Research Institute, who is a leading expert in the field
of social network analysis. Others who will be involved with mentoring Myra
include Nate Doogan at Ohio State University, who has
a doctorate in social work, and is an expert in dynamic social networks and
simulations. Another mentor is Ed Stevens, who is a former graduate of our
Community Program at DePaul, and Ed is an expert in addictions, dynamic systems
and modelling. Receiving mentorship from this team will give Mayra the
opportunity to learn from and collaborate with experts in alcohol and substance
abuse recovery, and social network analysis, and will provide Mayra expanded
research capabilities that will allow her to conduct rigorous independent
research that is culturally informed, theoretically-driven, and
methodologically sound.
Completed
Grants
Project Title: Community participatory intervention
with high-risk African-American women
Funding Source: National Center on Minority Health and Health Disparities
Leonard A. Jason, Ph.D., Principal Investigator
Doreen Salina, Ph.D., Co-Investigator
Daphna Ram, Ph.D., Project Director
It is critical to evaluate gender-specific residential
post-release programs that provide at-risk women with supports that serve to
increase abstinence from substance use, reduce HIV risk behaviors, reduce
psychological symptoms, decrease recidivism, and help attain better health
outcomes. It is important to identify the types of settings or interventions that
might promote health service utilization and more positive health outcomes
following release from jail. Structure and supportive recovery homes may be
effective in promoting health outcomes and increasing positive health behaviors
through social support (Jason et al., 2006b). From initial contact onward, the
DePaul research team and the Oxford House community have been active
participants and both endeavored to maintain the alliance. The University team
not only strived to cultivate collaborative and cooperative relationships with
Oxford House, but also was committed to active involvement in the process of
creating change. Some examples of collaborative endeavors of the research team
and Oxford House include the involvement in the establishment of the first
Men’s, first Women's, and first Women with Children’s Oxford Houses in
Illinois, as well as historical and ongoing involvement in activities that
support the national growth of Oxford House. The present study examined the
potentially different roles of abstinence-specific and general social support
for African-American women who are exiting from the criminal justice system. A
pretest-posttest experimental design will be employed that compares
communal-living settings supportive of abstinence (i.e., Oxford House
condition) to a usual care condition. We hypothesized that women assigned to
the Oxford House condition will report reduced HIV risk behaviors and better
health outcomes (i.e., better medical adherence and health service
utilization), decreased recidivism, increased abstinence from substance use,
improved psychological functioning, and higher levels of support than women
assigned to the usual care condition at all follow-up intervals. Our data have
now been collected and we are involved in data analysis.
Project
Title: Reducing
Health Disparities within the Hispanic/Latino Population
Funding
Source: National Institute of Alcohol Abuse and Alcoholism
Leonard
A. Jason, Ph.D., Principal Investigator
Josefina
Alvarez, Ph.D., Co-Principal Investigator
Julia
DiGangi, Ph.D., Project Director
Culturally-modified Oxford Houses may be a more effective
option for Hispanic/Latino individuals who are Spanish-dominant, less
comfortable with U.S. culture, or identify more strongly with their ethnic
culture. In these Houses, all residents are Hispanic/Latino, and participants
have the option of speaking English, Spanish, or a mixture of both languages.
Culturally-modified Oxford Houses provide a more culturally-congruent
experience such as welcoming visits by extended family members. In addition,
residents of Culturally-modified Oxford Houses are more likely to use
culturally-congruent communication styles, characterized by an emphasis on
relationships, downplaying direct conflict in relationships in order to preserve
harmony, and respect. In the present study, we compared the outcomes of
Hispanic/Latino individuals assigned to a Culturally-modified Oxford Houses to
those assigned to a Traditional Oxford House. Data have been collected and
analyzed, and we are currently writing up several final papers on this data
set.
Project Title: Abstinent Social Support in Oxford
House
Funding Source: National Institute of Drug Abuse
Leonard A. Jason, Ph.D., Principal Investigator
Bradley Olson, Ph.D., Co-Principal Investigator
Ron Harvey, Ph.D., Project Director
The
primary aim of this project was to employ a randomized design to more closely
study the role played by post-release aftercare in the outcomes of 270 criminal
offenders who received in-prison substance abuse treatment. This study compared
the relative effectiveness of Therapeutic Community (TC) aftercare to an
Oxford House (OH) aftercare alternative that provides a supportive living
environment without the professional treatment of TC aftercare. Bringing
scientific methods to the examination of TCs and the OH community-based
recovery models for addiction will help identify the active ingredients of
these recovery settings. Few if any comparison groups have provided a
residential setting that emphasizes socialization and abstinence from drugs and
alcohol, a hallmark of TC aftercare settings. The proposed study utilized
ex-offenders randomly assigned to either TCs, OHs, or usual care post-release
settings, and examine program effects (i.e., substance use, criminal and health
outcomes), and economic factors associated with these models. All data have
been collected and are now being analyzed. Research findings from a study that
contrasts these different approaches has the potential of influencing practice
and informing policy.