PARCA (a digital tool) to improve Justice and Health

PROJECT SUMMARY/ABSTRACT Nearly 4.4 million individuals are on community supervision in the United States, with the majority (about 80%) being supervised under probation.1 Justice involved persons (JIPs) have a 474% increased lifetime experience with heroin, a 303% increased use of OxyContin in the last 12 months, and a 256% increased use in pain medication in the last 12 months, compared to the general population.3 One important step in addressing substance use and addiction is getting individuals engaged in the treatment process, as initiation and retention rates are very low for substance use treatment among this population. Q2i successfully developed the Probation/Parole And Reentry Coach Application (PARCA) technology, which includes a Justice Team (JT) Dashboard connected to a mobile app designed for JIPs. The platform enables JIPs to set and manage their personal goals while assisting them in addressing the social determinants of health (SDOH) in order to facilitate and supplement the substance use treatment process. It provides a step-by-step guide and identifies local services and resources that the JIPs can connect with to accomplish these goals. At the same time, it gives the JT a dashboard that enables greater insight on how a JIP is managing their plan. This increased connection and communication between the JT and the JIP is designed to improve the community supervision process. In this Phase 1/Phase 2 Fast Track STTR application, Q2i’s PARCA platform will be refined and implemented in Dallas and Hidalgo Counties to test its efficacy. The primary goal of Phase I is to enhance the PARCA platform for JIP. The study team will accomplish this by recruiting three sets of 2 PPOs/Case Managers willing to use PARCA with five of their clients who have used any opioids in the last 12 months (total JIPs = 30) for 2- weeks. The team will conduct interviews with PPOs and their clients that will inform our user-centered design iterations. Initial interviews will describe barriers and challenges to successful community supervision including accessing MOUD treatment and how PARCA can be improved to address these challenges. Follow- up interviews will describe feasibility (use of the PARCA platform features) and acceptability (engagement with PARCA platform through user engagement logs) of using PARCA platform to locate and access MOUD treatment. The overall goal of Phase II is to test the relative efficacy of supervision as usual (SAU) and PARCA in helping JIPs under community supervision engage in substance use treatment process and reduce subsequent involvement in criminal behavior. Using a stepped wedge effectiveness design, we will evaluate the PARCA platform across probation/parole officers (PPOs) (N=60), probationers/parolees (N=600). PPOs will be randomized in three clusters of 20 people to utilize PARCA. Lastly, we will assess the acceptability and feasibility of PARCA platform by supervision officers and justice-involved persons (JIPs) and whether PARCA improves the working alliance between supervisors and JIPs.