Residents in marginalized, low-income, and predominantly African American communities (“distressed AA communities”) are more likely to experience harsher consequences of drug use in the form of higher rates on incarceration, HIV, and hepatitis C infection. Often, substance abuse and community reentry programs focus solely on individual treatment, ignoring environmental contexts in which these problems occur.
Grounded in community based participatory research (CBPR), we developed and pilot-tested Community Wise, a multilevel, 15-week behavioral health intervention. Community Wise aims to reduce substance use frequency, HIV/HCV risk behaviors, and reoffending among individuals with histories of substance use disorders and incarceration. The project was funded by the Center for Behavioral Health Services and Criminal Justice Research at Rutgers University, Newark, NJ.
What is Community Wise?
Community Wise consists of 15 two-hour group sessions, delivered weekly and designed to reduce substance use frequency, HIV/HCV risk behaviors, and reoffending by increasing critical consciousness in the community. Critical consciousness is defined by educator Paulo Freire as the ability to “perceive social, political, and economic contradictions, and to take action against the oppressive elements of reality” (p. 19). Community Wise seeks to redirect the effects of oppression away from destructive behavior and toward more outward, positive action, such as planting a community garden and/or advocating for community resources.
Pilot Evaluation Methods
Using CBPR principles, the NCCB implemented a mixed-methods evaluation with a pretest-posttest design with 56 individuals (two successive cohorts) residing in Newark, NJ and having histories of substance use disorders and incarceration . The research study aimed to examine and enhance the feasibility of Community Wise and to obtain descriptive data that would shed light on the intervention’s potential effect on substance-use frequency, HIV/HCV risk behaviors, and reoffending.
Results show moderate to large pre-post reductions in the following outcomes: number of days drinking alcohol in past 3 months (Cohen’s d = 0.36); amount of money spent on illicit drugs in past 3 months (Cohen’s d = 0.75); and number of days used illicit drugs in past 3 months (Cohen’s d = 0.85). Critical Consciousness had a moderately significant increase (Cohen’s d=0.46). AIDU measures were collected via standardized measures and drug tests (hair and saliva).
Data indicate high acceptability of the intervention among participants (e.g., high scores on engagement (3.73 (±0.93)) in the Group Climate Questionnaire; 75% intervention completion rates, despite challenges such as homelessness, AIDU, and poverty). Note that intervention completion rates in the literature are much lower among populations with fewer challenges (often 30 to 40%). This success is due to the CBPR model used to develop an intervention that is relevant to participants’ needs.
Qualitative analysis of focus groups, session videos, and clinical supervision meetings revealed that the Capacity Building Project worked best in Community Wise groups whose facilitators adhered most strictly to the intervention manual. For instance, nine months after the Community Wise graduation, participants from one of the groups with strict adherence were still working together on their project, publishing a book about their experiences transitioning to the community from incarceration. The project grew and members from other Community Wise groups joined the effort. There were no social harms identified in the pilot evaluation.
Want to know more?
You can download our Community Wise publications here.