UCLA-Amity Parolee Health Promotion Study

Homeless parolees pose a particular challenge for successful reentry into the community as
they have underlying mental health issues combined with substance use and abuse and must
contend with unstable housing situations, disorganized lives, unemployment, and limited
access to health care and social services. Generally about 50% of all parolees scheduled to
enroll in community-based drug treatment fail to enroll and less than 10% of enrollees
actually complete treatment. Not surprisingly, about two-thirds of all individuals on parole
are rearrested and return to custody within three years of release from prison. Recent data
also revealed homeless persons who were least likely to complete a Hepatitis A/B (HAV/HBV)
vaccine series were young (< 40) men who had been discharged from prison. Therefore, it is
critical to engage paroled adults in comprehensive intervention programs that not only
protect them from hepatitis B, but also reduce risky behavior, promote access to health
care, social and employment services, and enable positive coping and communication skills.

Building upon advice from community partners who have successfully treated parolees and the
research team's experience with hepatitis vaccination work, this study is designed to
conduct a prospective, three-group study that randomly assigns 700 ready-for-discharge
parolees, scheduled to enter a community residential drug treatment program, to enter one of
three groups: 1) a PCPC (Parolee Comprehensive Care + Phone Coaching Program), which
includes nurse case management and specialized hepatitis education sessions and referrals,
the HAV/HBV vaccination series (to all eligible) and coach-facilitated mentoring (mostly by
cell-phone); 2) a Parolee Brief Hepatitis Education + HBV vaccination + Phone Coaching
(PBCP) Program, which includes brief hepatitis/HIV education, the HAV/HBV vaccination and
coach-facilitated mentoring; or 3) a Usual Care (UC) control program, which includes brief
general health information, and the HAV/HBV vaccine. This study will advance the research
team's knowledge about drug treatment and HBV vaccine completion and recidivism among
homeless parolees. Findings from this study can inform targeted interventions and lay the
groundwork for health policy decisions that may impact hepatitis and HIV risk reduction and
recidivism in this group who are a reservoir for these viruses in the general population,
and are returning to prison at unprecedented numbers.

Inclusion Criteria:

1. Parolees enrolled in Amity's Amistad's program;

2. Age 18-60;

3. Discharged from prison or jail within the last six months;

4. History of drug use 12 months prior to most recent incarceration;

5. Previously homeless prior to most recent incarceration; and

6. Willing to provide informed consent

Exclusion Criteria:

1. Monolingual speakers of languages other than English; and

2. Persons judged to be cognitively impaired by the research staff.