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83 Fed. Probation 34 (2019)
Facilitating Self-Exploration and Behavioral Change Associated with HIV Risk Reduction: A Qualitative Study of Individuals on Probation and Their Experiences Using a Decision-Making App

handle is hein.journals/fedpro83 and id is 91 raw text is: Facilitating Self-exp I oration and Behavioral Change Associated with HIV Risk Reduction: A Qualitative Study of Individuals on Probation and Their Experiences Using a Decision- Making Appl Jennifer Pankow Wayne Lehman Roxanne Muiruri Kevin Knight Texas Christian University TRANSITION FROM INCARCERATION or other restricted treatment settings (e.g., residential) back into the community is associated with high-risk behaviors known to contribute to HIV, hepatitis, and other sexually transmitted infections (MacGowan, et al., 2003; Hearn, Whitehead, Khan, & Latimer, 2015). Poor decision-making fueled by substance and/or alcohol use during reentry elevates this level of risk (Bureau of Justice Statistics, 1999), particularly when behaviors involve intravenous drug use or having unprotected sex (Abiona, Balogun, Adefuye, & Sloan, 2009; Inciardi, 1993). For those in recovery, reentry means expo- sure to triggers -people, places, and things that induce cravings, which may lead to relapse (Preston & Epstein, 2011). Research from Texas Christian University's (TCU) 1 Funding for this study was provided by the National Institute on Drug Abuse, National Institutes of Health (NIDA/NIH) through a grant to Texas Christian University (R01DA025885; Wayne E. K. Lehman, Principal Investigator). Interpretations and conclusions in this paper are entirely those of the authors and do not neces- sarily reflect the position of NIDA/NIH or the Department of Health and Human Services. Institute of Behavioral Research targeted this high-risk transition period with the devel- opment of an intervention (called StaySafe) that combines a decision-making strategy (WORK IT) with CDC health and resource information for individuals to use in think- ing about, planning for, and avoiding health risk situations. This app-based interven- tion is administered on a hand-held tablet, delivered in 12 self-directed sessions. The tablet approach provides a way to view sensi- tive health information privately, a potential benefit for anyone who might otherwise be uncomfortable talking to counselors or pro- bation officers. Additionally, health messages contained in the intervention are consistently and uniformly delivered to any number of individuals as opposed to contradictory information from other sources (e.g., from peers or staff). Unlike treatment provided in group settings, the individualized, brief approach of the StaySafe intervention (a session can be completed in 10-12 minutes) allows for flexible scheduling in coordination with post-release supervision and treatment requirements. Intervention Development and Content StaySafe incorporates elements of its predeces- sor, WaySafe, a manualized decision-making intervention that was developed for the first 5 -yearDisease RiskReduction (DRR1) research project (Lehman et al., 2015). Translating the original intervention into an app involved adapting the TCU mapping-enhanced group counseling strategy (Dansereau, Joe, & Simpson, 1993; Dees, Dansereau, Simpson, 1994) to a self-directed format, incorporat- ing mapping elements and evidence-based health information into the interactive tablet curriculum. Rather than administering the intervention to individuals in small interactive groups prior to release from incarceration, the app-based intervention approach (known as the DRR2 project; see Lehman et al., 2018) extended to the probation waiting rooms where individuals arrive for post-release meetings and behavioral health services. The core feature of the app-based approach is the evidence-based WORK IT strategy, shown to be effective for improving decision skills, self- awareness, and problem recognition in studies with adolescents (Becan, Knight, Crawley, 34 FEDERAL PROBATION Volume 83 Number 2

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