Selected Resource Insecurities and Abstinence Self-Efficacy Among Urban and Rural Incarcerated Women with Opioid Use Disorder

J Health Care Poor Underserved. 2024;35(4):1068-1088. doi: 10.1353/hpu.2024.a943978.

Abstract

Purpose: To investigate the relationship between selected resource insecurities (i.e., food, housing, and transportation) and abstinence self-efficacy among women with criminal legal system (CLS)-involvement and opioid use disorder (OUD) and examine potential moderating effects of living in a rural or urban area.

Methods: Data were collected as part of the NIDA-funded Kentucky Justice Community Opioid Innovation Network (JCOIN) trial. Women (N = 900) were randomly selected from nine Kentuckyjails, screened for OUD, enrolled, and interviewed. Measures included resource insecurity and a single-item measure of abstinence self-efficacy.

Findings: Results from a multivariable regression analysis examining independent correlates of abstinence self-efficacy demonstrated significant associations with food insecurity (p = .008), controlling for sociodemographic covariates. Rurality moderated the relationship between transportation and abstinence self-efficacy (p = .001).

Conclusions: Resource insecurity, particularly transportation insecurity in rural areas, may reduce abstinence self-efficacy. Addressing resource disadvantages is vital to improving treatment engagement and recovery among women.

MeSH terms

  • Adult
  • Female
  • Food Insecurity
  • Housing
  • Humans
  • Kentucky
  • Middle Aged
  • Opioid-Related Disorders* / psychology
  • Prisoners* / psychology
  • Prisoners* / statistics & numerical data
  • Rural Population* / statistics & numerical data
  • Self Efficacy*
  • Transportation
  • Urban Population* / statistics & numerical data
  • Young Adult