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  Research: Organizational Change  
Many of ACE!’s projects in both public health and corrections also emphasize strategies for creating change and implementing evidence-based practices in organizations and agencies.
 
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Evidence Based Practices in Corrections: Maryland Division of Parole and Probation

The Pre-Release Centers of Maryland’s Department of Public Safety and Correctional Services (DPSCS) are transforming from prison-based to community-based facilities. GMU and the Maryland Division of Parole and Probation have established a memorandum of agreement to work together to improve correctional practices through provision of research, evaluation and educational services that bridge the gap between the academic and practitioner environments. As part of the new mission, goals, and objectives for these pre-release units, the agency is embarking on an organizational change strategy to adopt evidence-based practices. The objectives of this study are to: 1) measure the impact of a structured change process; 2) design and test an evidence-based communication skills training for staff; 3) measure staff commitment and understanding of organizational change, and 4) measure the impact of the new mission on offender outcomes.

EBP in Corrections. EBP in corrections is designed to address the organizational climate of the pre-release facilities of Maryland. We are involved in identifying how to translate core research findings into operational processes in a prison setting. Organizational surveys are being administered to assess the readiness for change of staff and administrators to modify practices. Surveys will be conducted periodically to assess change in the organization. We will implement procedures to monitor the translational process and then work on how to measure impact on offender and correctional system outcomes.

The Change Process.
The piloted change process within 2 pre-release facilities begins with the 2-day communications training focused on building staff communication skills. In-house change agents act as peer trainers to assist in enhancing the learning environment for these skills. A professional skills trainer provides on-site monitoring and assistance to staff. Through this continuous training model, the goal is the creation of a more open environment of team learning and to improve communication in order to increase safety and improve the outcomes of the offenders.
Listed below are some earlier studies on organizational change, conducted by Faye Taxman and other members of the ACE! team.

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JSTEPS – Using Rewards in Justice Treatment Programs: Technology & Contingency Management

This research project aims to guide each participating court through the implementation of an individualized Contingency Management (CM) protocol. CM interventions use systematic reinforcement with rewards (or punishment) to alter problem behaviors, usually substance use, in offenders. Rewards have been widely used in clinical treatment programs. They have been shown to successfully change targeted behaviors of substance abusers, including decreasing the number of positive drug tests and increasing treatment attendance. The process of developing and implementing such an intervention in criminal justice settings takes several steps. In this study, ACE! assists each court through the implementation from the formation of a local multidisciplinary team to the utilization of new technology tools, and the formation of a larger supportive network of courts also implementing a rewards system. For more information, visit the JSTEPS Study Resource Page.
VA Department of Health

This demonstration project will study the network of HIV service providers supported by Patient Navigators (PNs) utilizing Motivational Interviewing (MI) to engage, retain and support ongoing engagement of HIV-positive women in HIV care. The Virginia Department of Health (VDH) will collaborate with Centra Health to facilitate the network development between Infectious Diseases Associates of Medical Associates of Central Virginia, the Central Virginia Health District, and Piedmont Access to Health Services. ACE! faculty will serve as the primary evaluators of this project. As part of the evaluation, ACE! will survey provider staff about knowledge and attitudes regarding MI and patient navigation techniques, and will also survey practitioners in the area regarding their use of the patient navigation referral system. Additionally, GMU will analyze data on clients from the patient navigator files and data from the state Ryan White database.


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Information Sharing Policies and Practices for Correctional Health (with Allison Cuellar, Ph.D., Health Services & Policy Analysis)

Offenders are among the unhealthiest citizens on most major measures of well-being. Offenders tend to die early (Binswanger et al., 2007; Teplin, Abram, McClelland, Dulcan, & Mericle, 2002) and suffer from nearly all chronic and acute health conditions—physical health, mental health, and substance abuse. Research suggests that justice-involved people are medically underserved prior to sentencing (Feinstein et al., 1998), during periods of confinement (Chandler, Fletcher, & Volkow, 2009; Gallagher & Dobrin, 2006; Gallagher, Dobrin, & Douds, 2007; Taxman, Perdoni, & Harrison, 2007), and during periods of community supervision (Taxman, Perdoni & Harrison, 2007). The goal of this project is to disseminate models that improve the use of seamless systems of care. We aim to provide easy to access correctional health care information, conduct a gap analysis of continuum of care models, and provide a prototype of correctional health financing and caring models for to elderly, chronically ill, mentally ill, or substance abusing offenders.

Action Research to Advance Drug Treatment in the Criminal Justice System

Dr. Faye Taxman served as Principal Investigator on this project sponsored by the National Institute on Drug Abuse. This was a six-year project from October 1, 2002-August 30, 2008. As the national coordinating center for the National Institute on Drug Abuse’s research network on treatment for the criminal justice-involved addict, the cooperative involves eight other centers: the University of Miami (Howard Liddle, Ph.D.), University of California, Los Angeles (Michael Prendergast, Ph.D.), Brown University (Peter Friedmann, M.D.), University of Delaware (James Inciardi, Ph.D.), Texas Christian University (Kevin Knight, Ph.D.), National Research Institute and Development (Harry Wexler, Ph.D., Stan Sacks, Ph.D., and Nancy Jainchill, Ph.D.), and the Department of Mental Health and Addiction Services/University of Connecticut (Linda Frisman, Ph.D.). This network is involved in implementing studies to develop new instruments for better management and treatment of the offender population, to implement clinical trials to test new strategies and interventions for improving outcomes from offenders, and to implement process studies to examine how criminal justice policy makers and practitioners affect offender and system outcomes. The network is also responsible for mentoring new students and faculty in criminal justice-drug treatment issues. Related studies are:

CJ-DATS National Survey of Criminal Justice Treatment Practices. This is a multi-level survey of senior executives, administrators, program directors, and staff in correctional and drug treatment organizations. The survey involves a census of all 50 states and a nationally representative sample of counties/cities. The survey is designed to provide a systematic assessment of the availability and types of treatment provided to substance-abusing offenders throughout the criminal justice system. Surveys were collected from over 1,000 organizations on treatment and organizational issues.

CJ-DATS Step’N Out. This randomized trial is implemented in a Probation and Parole Office in Richmond, VA along with three other CJ-DATS sites. The study involves the use of positive reinforcements and contingency management protocol to engage the offender in treatment services and improve outcomes. The protocol is a collaborative behavioral management approach to parole and substance abuse treatment where the parole officer, treatment counselor and client meet to work out a contract of graduated incentives and sanctions.

HIV Prevention for Reentry Offenders. This randomized trial is implemented in two prisons in Virginia. The study examines the efficacy of a DVD focused on gender and culturally sensitive behavioral techniques to learn to manage risky behaviors. The protocol will be implemented in four CJ-DATS sites.

Evaluations of Prison Culture

Dr. Faye Taxman served as Principal Investigator (with James M. Byrne) on this project, sponsored by the National Institute of Corrections. This was a cooperative agreement from October 1, 2003-September 30, 2006. The study evaluates four different organizational strategies to change the culture of problem-prisons.
Evaluation of the Seamless System for Offenders

Dr. Faye Taxman served as Principal Investigator on this project, sponsored by the National Institute on Drug Abuse. This five-year study examines the costs and benefits of a systemic case management structure and the traditional supervision for offender populations. This project ran from January 1, 1999- December 30, 2003.
Systematic Case Management Practices in Maryland

Dr. Faye Taxman served as Principal Investigator on this project, sponsored by the Alcohol and Drug Abuse Administration. This seven-year project was to implement systemic case management practices using technology in agencies interacting with drug treatment services. This project ran from July 1, 1999-June 30, 2006.
Treatment in the Washington-Baltimore HIDTA project

Dr. Faye Taxman served as Principle Investigator on this project, funded by the Office of National Drug Control Policy of the Office of the President of the U.S. This project involved demonstrating a systemic case management approach for treating hard-core offenders consisting of two levels of treatment (e.g., continuum of care), testing, enhanced supervision, and sanctions. Twelve jurisdictions in the Washington Baltimore region participated in the project. The grant provided for a process evaluation of the 12 sites and a randomized experiment in eight sites. This project ran from January 1994-June 1999.
Evaluation of a Quality Case Review Process in Baltimore City, Maryland Criminal Justice System

Dr. Faye Taxman served as Principle Investigator on this project, funded by the Maryland Department of Public Safety and Correctional Services. The project analyzed pretrial processing in Baltimore City, Maryland. The goal was to implement an experimental design to assess the improvements in case processing procedures and pretrial detention based upon changes in policy and procedures. This project ran from September 1994-June 1998.
 

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