Study
The Step’n Out study by Friedmann and colleagues (2011) was a randomized controlled trial, which compared Collaborative Behavioral Management (CBM) with standard parole. The study took place between 2004 and 2008. The study used a six-site trial to evaluate whether CBM improved parolees’ substance use and re-arrest during a 9-month follow up. The following six sites were involved in the study: Providence, R.I.; Bridgeport and Hartford, Conn.; Wilmington, Del.; Richmond, Va.; and Portland, Ore.
The study population comprised individuals with pre-incarceration substance use disorders who were initiating parole. In addition, they had to have 1) been 18 years or older; 2) been English-speaking; 3) had probable drug dependence prior to incarceration (defined by a score of at least 3 or higher on the TCU Drug Screen or mandated drug treatment); 4) had substance use treatment as a mandated or recommended condition of parole; and 5) had a moderate-to-high risk of drug relapse and/or recidivism (defined by a score of 7 or greater on the Lifetime Criminality Screening Form or two or more prior drug-related treatment episodes or convictions). Participants were excluded from the study if they had psychotic symptoms or had correctional or supervision conditions that prohibited study participation, including failure to be paroled, being mandated to a special parole caseload, or being transferred to a non-participating site.
Randomized treatment assignment was balanced by gender, in-prison or transitional residential treatment, incarceration for more or fewer than 18 months, and risk of recidivism. The 288 participants in the CBM intervention were 46 percent female, with an average age of 34 years. The racial and ethnic composition was 49.7 percent Black, 35.4 percent white, 14.0 percent Hispanic, 1.0 percent Native American, 0.4 percent Asian, and 11.5 percent other racial/ethnic groups. The 281 comparison participants in standardized parole were 48 percent female, with an average age of 33.7 years. The racial and ethnic composition was, 53.0 percent Black, 35.2 percent white, 11.0 percent Hispanic, 1.4 percent Asian, 0.7 percent Native American, and 8.2 percent other racial/ethnic groups.
Interviews were conducted to gather demographic data at intake, and follow-up interviews were conducted at the study termination at 9 months. Bivariate t-tests, Wilcoxon rank sum tests, and Pearson chi-squared tests were used to compare the intervention and control groups on baseline measures. An intent-to-treat approach was taken, meaning once the participants were randomized and they had attended at least a single session with a parole officer, their data was analyzed regardless of their later protocol adherence.
General estimating equation models were used to analyze the effects of the intervention on the outcome of substance use. Re-arrest was analyzed using logistic regression models.
