University of Illinois at Chicago Community Outreach Intervention Projects School of Public Health

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University of Illinois at Chicago Community
Outreach Intervention ProjectsSchool of Public
Health

• PI Larry Ouellet, PhD
• Enhancing Linkages to HIV Primary Care
• in Jail Settings
• Grantee Meeting
• 10/25/2007 10/26/2007
• Rockville, MD

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Project Aims

• Improve HIV counseling and testing in jails
• Improve access to and use of primary care for
  HIV-positive female inmates
• gender-responsive case management model
• needs assessments and discharge planning in CCJ
• services in community for at least 6 months after
  release
• Better understand the associations between HIV
  infection, incarceration, and vulnerabilities in
  relation to gender inequality

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Intervention Components

• Identify HIV-positive women in the CCJ
• Provide baseline needs assessment, discharge
  planning, and an HIV clinic visit in the jail
• Asset mapping
• Community-based case management and care after
  release
• Meet the woman immediately after release
• Provide case management services built on asset
  mapping
• Assist women in becoming proficient at obtaining
  needed health care, social services, and other
  resources
• Reduce risk practices, including for transmission
  of HIV

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Intervention Model
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Goals and Objectives

• Goal 1 To reduce barriers to access for primary
  care and services
• establish linkages between incarcerated women and
  services
• improve rates of adherence to care
• achieve better access to needed services
• Goal 2 To improve quality of life and reduce
  recidivism
• achieve reductions in problems identified in case
  management sessions
• reduce the number of lost to follow-up cases
• reduce incarceration at 6-months post-release
• Goal 3 To reduce risks of HIV transmission
• achieve high attendance at case management and
  group sessions
• reduce HIV risk behaviors
• reduce new STD infections

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Enhancements

• More HIV testing
• More HIV rapid testing
• More pre-release planning
• Pre-release link to specific case manager
• Quick contact at release
• Post-release help in getting medical care and
  other services
• Post-release help in service utilization

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Partners in the Project

Co-I Tina Richardson, MD Co-I Chad Zawitz, MD
Cook County Jail/Cermak Health Services
South Side Help Center
Community Liaison, Vanessa Smith Case manager
TBN
Community Outreach Intervention Projects
(COIP) School of Public Health University of
Illinois at Chicago
PI Larry Ouellet, PhD Co-I Sage Kim, PhD Eval
Chyvette Williams, PhD
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COIP History

• Founded 1986
• Developed Indigenous Leader Model
• Initial work HIV prevention with injection drug
  users their sex partners
• COIP combines community-based services and
  research

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COIP Five Storefront Offices

• South Side West Englewood
• West Side Austin
• North Side Uptown
• Near Northwest Side Humboldt Park
• Southeast Side South Chicago
• Also a motorhome serves West Side

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COIP Current Services

• Street outreach
• HIV counseling and testing
• case management
• counseling drug abuse, risk reduction
• syringe exchange
• free medical dental care for HIV-positive
  persons
• referrals to drug treatment and many other
  services
• testing for syphilis, other STDs, HAV/HBV/HCV
• vaccination for hepatitis A and B
• support groups
• friendly peers to talk with

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Cook County Jail, Chicago IL

• The largest single-site jail in the US
• Over 100,000 incarcerations per year
• 63 African American, 17 Hispanic, 19 White
• Proportion of female inmates 16
• Over 16,000 bookings per year
• Over 85 of women are substance users
• 4 of women in CCJ HIV positive in 2002 (vs. 2
  of men blind-serosurveillance)

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Project Targets in Chicago

• Target population HIV-positive women inmates
• Target areas 11 of Chicagos 77 community areas
• Highest rates of incarceration of women in jail
• Elevated rates of STDs/HIV, hepatitis, TB,
  homelessness, drug-related offenses
• Clustered on South Side and West Side
• Residents predominately African American

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West Side
The Loop
Areas targeted by project
South Side
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Data Collection Evaluation

• Process evaluation
• Enrollment
• Linkages with providers, meetings with the case
  manager
• Number of counseling sessions, services offered
• Program fidelity
• Outcome evaluation
• Services received in relation to needs and
  assets, and use of services
• Adherence to care appointments and treatment
  outcomes
• Behaviors at baseline (30 days before
  incarceration) and
• at one and six months post-release
• Data Collection
• Reporting to the Center and local specific
• Follow-up survey
• At the COIP sites, utilizing A-CASI
• Non-cash grocery voucher compensation

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Expected Challenges Possible Solutions

• Difficulties in helping clients access all
  services they need
• Solution staff will do community liaison work
  with community providers to increase program
  visibility, develop new resources, and make the
  most of existing resources
• Difficult to fully document use of off-site
  services
• Solution use year-1 to establish or enhance
  information sharing agreements
• Constructing uniform data collection instruments
• Solution flexibility in working with the
  Evaluation Center

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• Contact Information
• Principal Investigator
• Lawrence Ouellet, Ph.D.
• Director, Community Outreach Intervention
  Projects
• Research Associate Professor
• Epidemiology and Biostatistics (MC 923)
• School of Public Health
• University of Illinois at Chicago
• 1603 W. Taylor
• Chicago, IL 60612-4394
• Phone [phone]
• Email ljo_at_uic.edu
• Evaluator
• Chyvette Williams, Ph.D.
• Assistant Professor
• Health and Policy Administration (MC 923)
• School of Public Health