title: A randomized clinical trial of tailored interventions for health promotion and recidivism reduction among homeless parolees: outcomes and cost analysis.
abstract: OBJECTIVE
  This study conducted a randomized controlled trial with 600 recently released homeless men exiting California jails and prisons.
  
  
  METHODS
  The purpose of this study was to primarily ascertain how different levels of intensity in peer coaching and nurse-partnered intervention programs may impact reentry outcomes; specifically: (a) an intensive peer coach and nurse case managed (PC-NCM) program; (b) an intermediate peer coaching (PC) program with brief nurse counseling; and (c) the usual care (UC) program involving limited peer coaching and brief nurse counseling. Secondary outcomes evaluated the operational cost of each program.
  
  
  RESULTS
  When compared to baseline, all three groups made progress on key health-related outcomes during the 12-month intervention period; further, 84.5 % of all participants eligible for hepatitis A/B vaccination completed their vaccine series. The results of the detailed operational cost analysis suggest the least costly approach (i.e., UC), which accounted for only 2.11 % of the total project expenditure, was as effective in achieving comparable outcomes for this parolee population as the PC-NCM and PC approaches, which accounted for 53.98 % and 43.91 %, respectively, of the project budget.
  
  
  CONCLUSIONS
  In this study, all three intervention strategies were found to be comparable in achieving a high rate of vaccine completion, which over time will likely produce tremendous savings to the public health system.
authors.affiliation: University of California at Los Angeles, School of Nursing, Room 2-250, Factor Building, Los Angeles, CA 90095-1702, USA.
authors.forename: Adeline M
authors.initials: AM
authors.lastname: Nyamathi
authors.affiliation: San Diego State University, San Diego, CA, USA.
authors.forename: Sheldon
authors.initials: S
authors.lastname: Zhang
authors.affiliation: University of California at Los Angeles, School of Nursing, Room 2-250, Factor Building, Los Angeles, CA 90095-1702, USA.
authors.forename: Benissa E
authors.initials: BE
authors.lastname: Salem
authors.affiliation: University of California Los Angeles, Integrated Substance Abuse Programs, San Diego, CA, USA.
authors.forename: David
authors.initials: D
authors.lastname: Farabee
authors.affiliation: University of California Los Angeles, Integrated Substance Abuse Programs, San Diego, CA, USA.
authors.forename: Betsy
authors.initials: B
authors.lastname: Hall
authors.affiliation: University of California, San Francisco, School of Nursing, San Diego, CA, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Marlow
authors.affiliation: Amity Foundation, Los Angeles, CA, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Faucette
authors.affiliation: Amity Foundation, Los Angeles, CA, USA.
authors.forename: Doug
authors.initials: D
authors.lastname: Bond
authors.affiliation: University of California at Los Angeles, School of Nursing, Room 2-250, Factor Building, Los Angeles, CA 90095-1702, USA.
authors.forename: Kartik
authors.initials: K
authors.lastname: Yadav
keywords: Community reentry; Cost analysis; Parolees; Recidivism; Vaccination