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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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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.