A systematic review of prison-based behavioural

A systematic review of prison-based behavioural substance abuse treatment programs for men Inclusion criteria Prison-based substance abuse treatment

Treatment participants are prison inmates

Research participants are men only, or men and women prisoners

Published 1 January 1995 to 3 1 December 2015

Available in English Exclusion criteria Papers that related to previously published data

Pharmacotherapy based substance abuse treatment

Mental health and substance abuse comorbidity treatments

Grey literature Prison-based alcohol and other drug use treatment for Aboriginal and non-Aboriginal men<br>

A systematic review of prison-based behavioural substance abuse treatment programs for men Methodology:
PRISMA - Preferred Reporting Items for Systematic Reviews and Meta-Analyses 
Dictionary for Effective Public Health Practice Project and associated Quality Assessment Tool for Quantitative Studies
Long and Godfrey’s (2004): An Evaluation Tool to Assess the Quality of Qualitative Research Studies
Independently review

Search strategy
Word strings covering four domains were used:
Participant group or setting;
Substance abuse disorders;
Provision of treatment or care; and
Identifying as being research/evaluation:

Prison OR gaol OR jail OR detain* OR arrest* OR justice or (justice system) OR crim* OR (criminal justice) OR offend* OR parol* OR probation OR correction* or (correctional centre) or (correctional center) or (correctional facility) or (correctional institution) or (correctional service). 5 Prison-based alcohol and other drug use treatment for Aboriginal and non-Aboriginal men<br>

6 Prison-based alcohol and other drug use treatment for Aboriginal and non-Aboriginal men<br>

7 Prison-based alcohol and other drug use treatment for Aboriginal and non-Aboriginal men<br>

8 Table 1: Substance abuse treatment characteristics (n=25) Prison-based alcohol and other drug use treatment for Aboriginal and non-Aboriginal men<br>

Treatment characteristics (n=25) USA (n=15), Canada (n=2), Taiwan (n=2), Australia (n=1), Croatia (n=1), Japan (n=1),
Poland (n=1), United Kingdom (n=1), South Korea (n=1)

Treatment settings
• Therapeutic community (n=8) [post-prison care x 3]
Residential treatment (n=7) [post-prison care x 1]
• Group treatment (n=7) [post-prison x 0]
Therapeutic prison facility (n=3) [post-prison care x 1]

Treatment approaches described
Cognitive behavioural therapy (n=8)
12-Step program e.g. Alcoholics Anonymous (n=6)
Psychoeducational (n=6)
Therapeutic community (n=9)
MATRIX model (n=2)
Meditation/mindfulness (n=2) 9 Prison-based alcohol and other drug use treatment for Aboriginal and non-Aboriginal men<br>

10 Prison-based alcohol and other drug use treatment for Aboriginal and non-Aboriginal men [<br>

11 Prison-based alcohol and other drug use treatment for Aboriginal and non-Aboriginal men [ Table 2: Appraisal of quantitative papers (n = 24)<br>

Appraisal of quantitative papers (n = 24) Global rating:
Strong (n=5): Arseneault (2015) , Bowes (2012) , Knight (1997) , Welsh (2007) , Wexler (1999)
Moderate (n=6): Chaple (2014), Inciardi (1997) , Joe (2010) , Lee H (2014) ,
Lee K-H (2011), Pelissier (2001)
Weak (n=13): Welsh (2010), Bowen (2006), Crundall (1997), Davis (2014), Gossage (2003), Linhorst (2012), Matsumoto (2014), Raney (2005), Slaski (2006), Stohr (2002), Turley (2004), Vaughn (2003),
Vukadin (2004)

Study design
Strong: Randomised control trial (n=1), clinical control trial (n=5)
Moderate: Cohort analytical (n=11),
Weak: Cohort (n= 6), time series (n=1)

Selection bias:
Strong [no bias] (n=1)
Moderate (n=17)
Weak (n=6)

Data collection:
Strong: validated survey tools (n=12) – 53 survey tools catalogued
Moderate: survey based on a validated survey tool (n=1)
Weak: none validated survey tools (n=11) 12 Prison-based alcohol and other drug use treatment for Aboriginal and non-Aboriginal men<br>

Appraisal of quantitative papers (n = 24) Exposure level to the AoD treatment program: Directly reported in 4 papers. Though, participants were reported as graduates or to have completed program in 13 papers.
Unintended exposure to similar program: It is likely that the residential and therapeutic community treatment setting would preclude exposure to similar programs. However, only three papers reported directly on unintended exposure.
Integrity or consistency of the program: reported directly in two, though all professionally facilitated programs had a curriculum.


Dropout/withdrawal:
Strong (n=9) [reported and accounted for]
Moderate (n=7) [not clearly reported, not accounted for]
Weak (n=7) [missing participants!]
Not applicable (n=1) 13 Prison-based alcohol and other drug use treatment for Aboriginal and non-Aboriginal men<br>

Qualitative paper (Staton et al. 2000) The paper was of poor quality, it was a general summary of a residential treatment program and
had inmates and staff participants.

 
The methodological framework was vague, with no description of the participant groups and no detail about the context of the interviews, for example if data were collected via audio recording or by written notes.
 
Key findings were not stated concisely.
 
It was not always clear if the reported results were from the inmate or staff participants.
 
The authors reported the program as successful in changing behaviour so that participants were less likely to abuse substances upon release but all data was collected in prison. 14 Prison-based alcohol and other drug use treatment for Aboriginal and non-Aboriginal men<br>

15 Prison-based alcohol and other drug use treatment for Aboriginal and non-Aboriginal men Table 3: Aims and outcome of evaluations (n = 25)<br>

Aims, outcome and measures Aims were to evaluate the AoD treatment program (n=25); process (n=3), impact (n=7), outcome
(n=11), impact and outcome (n=2), impact and process (n=2).
 
Comparison between:
Treatment and control (n=10)
Different treatments (n=5)
Multiple treatment groups and a control (n=1)
Times series comparison of treatment groups (n=1)

Measures: Substance use (n=12), Substance use self-efficacy (n=8), drug use harm reduction knowledge (n=6), satisfaction with program (n=4), social functioning (n=4), psychological functioning (n=4), problem solving skills (n=3) and arrest or re-imprisonment (n=10) 16 Prison-based alcohol and other drug use treatment for Aboriginal and non-Aboriginal men<br>

Results summary and discussion Global rating:
Strong: (n=5) Arseneault (2015), Bowes (2012), Knight (1997), Welsh (2007), Wexler (1999)
Moderate: (n=7) Chaple (2014), Inciardi (1997), Joe (2010), Lee H (2014),
Lee K-H (2011), Pelissier (2001), Welsh (2010)
Weak: (n=12) Welsh (2010), Bowen (2006), Crundall (1997), Davis (2014), Gossage (2003), Linhorst (2012), Matsumoto (2014), Raney (2005), Slaski (2006), Stohr (2002), Turley (2004), Vaughn (2003), Vukadin (2004)


Of the 12 program ranked as being methodologically strong or moderate
Four measured alcohol and other drug use post prison
Three reported statistically significant reduction in alcohol and other drug use
One of the three conducted an intention to treat analysis 17 Prison-based alcohol and other drug use treatment for Aboriginal and non-Aboriginal men<br>

18 Prison-based alcohol and other drug use treatment for Aboriginal and non-Aboriginal men<br>

Conclusions Both previous reviews, Pearson et al (1999) Mitchell et al (2006), reported that prison based
therapeutic community treatment is the most effective in reducing AoD use post-prison. However,
neither of these reviews assessed methodological quality.




A Systematic Review of Prison-based Behavioural Substance Abuse Treatment
Programs for Men

Quality of papers is improving overtime. But we cannot conclude from four methodologically sound
papers over 21 years that prison based AoD treatment is effective. Particularly as only one of the
four conducted an intention to treat analysis. However; of the treatment models reviewed it appears
that therapeutic community treatment offer the best results. 19 Prison-based alcohol and other drug use treatment for Aboriginal and non-Aboriginal men<br>

Michael Doyle Phone 02 9385 9259Email: mdoyle@kirby.unsw.edu.au 20 Thank you
Any questions? Michael Doyle Phone: 0403 129 210Email: mdoyle@kirby.unsw.edu.au Prison-based alcohol and other drug use treatment for Aboriginal and non-Aboriginal men<br>