Digital health technology improving successful community reintegration of recently released justice-involved individuals with Substance Use Disorders. - PROJECT ABSTRACT
With over 12 million arrested each year, the United States incarcerates more people both in absolute numbers
and per capita than any other country in the world. Social determinants of health (SDH) influence health and
wellbeing, including risk for mental and behavioral health related conditions like substance use disorders
(SUD). For example, justice-involved individuals have four to nine times the rate of SUD than the general
population and four times the rate of mental health disorder. The justice system has become the de facto
service provider for individuals struggling with SUD and mental illness but the programs and services available
are very limited. Lack of access to services in prison, during the reentry process, and in the community results
in common occurrences of relapse, overdose and overdose deaths, and recidivism. Equipping justice-involved
individuals with SUD, especially those recently released, with support tools could be key in improving reentry
by reducing the likelihood of relapse and recidivism. The data highlight that the first few months after release
are critical to the successful reentry. To address the needs of recently released justice-involved individuals,
communities need to consider SDH factors such as homelessness, mental health, substance abuse, adequate
health care, education, employment assistance, and family support. Digital health technology can help recently
released individuals navigate their new environment and adapt to the changes that occurred during their
incarceration. Technology makes it possible to provide localized support – such as access to location-specific
information about risk reduction, housing, accessing medical care, SUD treatment program options and
availability, and support groups – that is not available through traditional mechanisms or even through
aftercare programming. It transforms support services from fragmented, disparate services to centralized, one-
stop shopping that is available 24/7 for people in need. Q2i successfully developed and deployed the Opioid
Addiction Recovery Support (OARS) care team portal and mobile application used by healthcare organizations
to support Medication-Assisted Treatment programs and recovery from opioid use disorder (OUD). In this
application, Q2i’s OARS will be modified using iterative development methodology to create OARS-VC that (1)
provides a self-support virtual coach (VC) to address the needs of recently released justice involved individuals
with OUD reentering the community, and (2) connects to other organizations for communication and data
exchange when required and appropriate. We will conduct usability studies after each major iteration to collect
feedback (interviews) about usability and functionality. After the third iteration, we will conduct a 2-week field
usability test. We will also develop a framework to identify best recruitment methods and study designs to
study digital health innovations for recently released justice-involved individuals with OUD/SUD. The OARS-VC
aims to improve long-term recovery from SUD, reduce relapse and recidivism rates, and support successful
reentry and transition into the community for justice-involved individuals.
