Institute for Health Policy Studies

Based on availability of case management services, drug-involved women offenders entered either a probation case management (PCM) intervention (n = 65) or standard probation (n = 44). Participants were placed in the case management condition until all slots were filled, then placed in standard probation until case management slots opened. Participants were interviewed at program entry and at 6- and 12-month follow-up using measures of substance abuse, psychiatric symptoms, and social support. Results showed modest change over time in both conditions, but PCM did not result in more services or treatment, or better outcomes than standard probation. These findings are discussed in the context of study limitations and in the context of state initiatives like those in Arizona and California designed to apply treatment as an alternative to incarceration.

The National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN) is intended to test promising drug abuse treatment models in multisite clinical trials and to support adoption of new interventions into clinical practice. Using qualitative research methods we asked the following question: how might the technology of multisite clinical trials be modified to better support adoption of tested interventions? A total of 42 participants, representing eight organizational levels ranging from clinic staff to clinical trial leaders, were interviewed about their role in the clinical trial, its interactions with clinics, and intervention adoption. Among eight clinics participating in the clinical trial, we found adoption of the tested intervention in one clinic only. Analysis of interview data revealed four conceptual themes likely to affect adoption and may be informative in future multisite clinical trials. Planning for adoption in the early stages of protocol development will better serve the aim of integrating new interventions into practice.

Drug courts have been in existence since 1989, yet few process evaluations have appeared in the literature to help inform the discussion about their effectiveness. This article reports findings from a process evaluation of a drug court program in San Mateo, California. The evaluation was designed to document the history of the program, to examine program strengths and areas of improvement, to access the roles and relationships among the various agencies involved and to describe the impact of the drug court program on the justice and drug treatment systems. Methods included review of available drug court program documents, interviews with key stakeholders, and focus groups with drug court participants. The main findings were: support for the continuation of drug court, enhanced collaboration among all agencies, and an increased awareness of the needs of substance-using clients in the criminal justice system. Potential lessons for other drug courts include the importance of building strong collaborations and maintaining good communication, recognizing competing interests in developing procedures for drug court, and considering changes in eligibility criteria as experience with drug court model expands.

In 1981 an influential Japanese study showed an association between passive smoking and lung cancer. This article documents the tobacco industry's attempts to refute this study by producing a credible alternative study.