Evidence map›Paper›PMID 39585486›Full record

ArticleHealth & justice2024

The role of community health workers in re-entry of people with HIV and substance use disorder released from jail: a mixed methods evaluation of a pilot study.

Afeefah Khazi-Syed, Emily Hoff, Maverick Salyards, Laura Hansen, Nicholas Campalans, Zoe Pulitzer, Christina Melton Crain, Hue Nguyen, Shira Shavit, Robrina Walker and 1 more

Abstract read
In one paragraph

Article in Health & justice, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Afeefah Khazi-SyedUniversity of Texas Southwestern Medical School, Dallas, TX, USA.
Emily HoffDepartment of Internal Medicine, Division of Infectious Diseases, Johns Hopkins, Baltimore, MD, USA.
Maverick SalyardsDepartment of Internal Medicine, Division of Infectious Diseases and Geographic Medicine, University of Texas Southwestern, Dallas, TX, USA.
Laura HansenDepartment of Internal Medicine, Division of Infectious Diseases and Geographic Medicine, University of Texas Southwestern, Dallas, TX, USA.
Nicholas CampalansDepartment of Internal Medicine, University of California San Francisco, San Francisco, CA, USA.
Zoe PulitzerDepartment of Internal Medicine, Division of Infectious Diseases and Geographic Medicine, University of Texas Southwestern, Dallas, TX, USA.
Christina Melton CrainUnlocking Doors®, Dallas, TX, USA.
Hue NguyenUnlocking Doors®, Dallas, TX, USA.
Shira ShavitDepartment of Family and Community Medicine, University of California San Francisco, San Francisco, CA, USA.
Robrina WalkerThe Emmes Company, Rockville, MD, USA.
Ank E NijhawanDepartment of Internal Medicine, Division of Infectious Diseases, Johns Hopkins, Baltimore, MD, USA. Ank.Nijhawan@UTSouthwestern.edu.ORCID http://orcid.org/0000-0003-0522-4110

Funding

NORTH AND CENTRAL TEXAS CTSA FOR PEDIATRIC RESEARCHUL1RR024982 · NCRR · UT SOUTHWESTERN MEDICAL CENTER · PI TOTO, ROBERT DANIEL · 2007 to 2011
$27.9M
A Community-Clinic Collaboration to Improve Outcomes in HIV+ Substance Users Released from JailR34DA045592 · NIDA · UT SOUTHWESTERN MEDICAL CENTER · PI NIJHAWAN, ANK ELISABETH · 2018 to 2020
$729k
Intramural Research Program, National Institute on Drug Abuse DA 045592NCATS NIH HHS UL1RR024982NCRR NIH HHS UL1 RR024982NIDA NIH HHS R34 DA045592
6 · The paper itself

Abstract

backgroundIncarcerated individuals face high rates of mental illness, substance use disorders and communicable diseases including HIV, with increased health complications and mortality in the early post-release period. Multiple re-entry interventions linking justice-involved individuals to community resources via peer navigation have emerged, though limited data exist on the mechanics and personal impact of these approaches. This paper quantifies and evaluates a pilot study of a combined Community Health Worker (CHW)-re-entry intervention for individuals released from jail who use substances and have HIV to inform future large-scale applications.

methodsA mixed-methods analysis of a CHW-re-entry intervention utilized in a pilot randomized controlled trial involving people with HIV who have a history of substance (stimulant, opioid or alcohol) use in Dallas, TX was conducted using an explanatory sequential design. Quantitative assessments of the intervention measured interaction types, time spent, and topics discussed and explored associations between the "dose" of intervention and patient outcomes. Qualitative analyses of CHW field notes and end-of-study participant interviews were triangulated with quantitative findings to elucidate the intervention's impact.

resultsOf the 17/31 participants assigned to the intervention, 16 interacted with the CHW on at least one occasion, and 6 successfully completed a visit with the re-entry organization. Most CHW interactions occurred by phone (66%) or in person (28%). Frequently discussed topics included substance use, housing, and physical health. On average, participants spent 7.65 h (range 0-37.18, SD = 9.33) engaged with the intervention over 6 months. Intervention dose was associated with improved HIV control, decreased stimulant use, higher rates of recidivism, and improved clinical appointment show rate. Qualitative analyses revealed key intervention components, paralleling benefits of study participation alone: outreach, nonjudgmental approach, motivation and accountability.

conclusionsA CHW-re-entry intervention, while resource-intensive, shows preliminary promise in improving HIV and some substance use outcomes. Frequent telephone and in-person contact, with an empathetic yet goal-oriented approach, fostered participant support and motivation to address HIV and substance use. Participants reported that engagement in research provided accountability and a sense of purpose. Future studies should focus on optimizing implementation of CHW-based interventions to enhance impact on vulnerable populations.

Indexed as

Community health workerHIVIncarcerationJailLinkage to careRe-entrySubstance use

Identifiers

PMID39585486
PMCPMC11587591

What OpenQuestion holds

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LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.