Descriptive statistics for the provision of treatment measure and all facility-, agency-, and state-level predictor variables are presented in . Just under half (47%) of the facilities provided intensive substance abuse treatment, while 29% provided another type of treatment (nearly all of these offered only 1-4 hours of weekly counseling or drug/alcohol education) and 24% had no substance abuse programming. We calculated chi-square statistics and found that there was significant variation in intensive treatment provision across executive administrators and states, warranting examination of these levels in HGLM.
shows the results for each separate logistic regression model examining bivariate effects for each variable on provision of treatment. Several of the aggregated state-level measures were related to the treatment outcomes. Median household income (b = <0.01, se = <0.01, OR = 1.00, p = .090), average annual change in incarceration rates (b = 0.09, se = 0.05, OR = 1.09, p = .077), percent substance dependence or abuse (b = 0.40, se = 0.17, OR = 1.50, p = .021), and percent substance abuse expenditures from Medicaid (b = 0.02, se = 0.01, OR = 1.02, p = .042) were all at least marginally significantly and positively related to the provision of treatment in state correctional institutions. Having a Republican governor was significantly and negatively related to the provision of treatment (b = -0.70, se = 0.25, OR = 0.50, p = .010). Of the administrator variables, having sufficient physical facilities (b = -0.25, se = 0.18, OR = 0.78, p = .015) and direct contact between the executive administrator and facility correctional staff (b = -0.43, se = 0.13, OR = 0.65, p = .002), were negatively related to provision of treatment, while administrator contact with intra-agency directors on issues related to substance abuse (b = 0.04, se = 0.01, OR = 1.04, p = .009) and having shared activities with other correctional agencies (b = 0.06, se = 0.03, OR = 1.06, p = .082) was positively related. None of the other administrator-level variables were significant. Again, this includes background (education or prior work experience) measures, beliefs regarding the relative importance of treatment, and attitudes in support of rehabilitation or punishment (in the form of a “just deserts” approach to sanctioning offenders; just deserts is a philosophy of punishment which contends that sanctions should be commensurate with the seriousness of the offense). The absence of an effect for rehabilitation-focused beliefs is not surprising given the very high mean (4.71 on a scale from 1 to 5) and low variability for this measure. The bivariate analyses further indicated that neither the overall organizational culture or climate for learning measures, nor any of the individual subscales that comprised these measures were significantly related to provision of treatment. Due to the limited statistical power in this analysis, we chose not to include the individual subscales in the final multivariate model; however, since culture and climate were found to contribute to EBP use in a prior NCJTP studies (Friedmann et al, 2007
; Henderson et al., 2008
), we considered keeping these overall measures in the final model. In addition to examining these bivariate relationships for data reduction purposes and to specify the final model, we assessed correlations between independent variables (tables not shown) to determine which predictors may be impacted by multicollinearity in subsequent regression analyses. This led us to drop the overall climate for learning measure (which caused model convergence problems in the multivariate model) and to pay particular attention to the effects of the few other variables identified in these analyses as sharing moderately high correlations (r
Individual Effects of Agency- and State-Level Variables on Provision of Treatment (all variables entered into separate models)
presents the results showing relationships of agency- and state-level factors with provision of intensive treatment after controlling for facility-level characteristics (size and type of facility, population served). Results from these analyses indicate that several contextual factors exert direct effects on treatment provision. At the state level, the state substance abuse/dependence measure was significantly related to the treatment outcome such that states with higher levels of substance abuse and dependence were 1.40 times more likely to provide intensive substance abuse treatment in correctional facilities (b = 0.34, se = 0.16, OR = 1.40, p = .038). On the other hand, states with Republican governors were 0.59 times as likely to provide access to treatment (b = -0.53, se = 0.23, OR = 0.59, p = .031). None of the other state-level factors were significant; however, it should be emphasized that with so few degrees of freedom at this level of analysis, power to find statistically significant relationships is limited.
Results for Fixed Effects for HGLM Models (Random Intercept Only) for Provision of Intensive Treatment
At the agency-level of analysis, intensive treatment provision was not affected by whether the agencies operated in states that were centralized, partially centralized, or decentralized in structuring correctional responsibilities. With regard to respondents' reports of agency resources and staff training opportunities, perceptions of funding support for new programming was the lone predictor found as significant after controlling for facility-, agency-, and state-level factors (b = 0.28, se = 0.12, OR = 1.32, p = .020). Indicators of coordination within agencies were associated with provision of intensive treatment; specifically level of contact with substance abuse treatment staff showed a positive relationship (b = 0.42, se = 0.09, OR = 1.52, p = .000) while contact with correctional staff was negatively related to treatment provision (b = -0.43, se = 0.22, OR = 0.65, p = .057). At the facility level, the type of facility was the only significant factor (b = 0.73, se = 0.35, OR = 2.10, p = .036); as expected, intensive treatment was more likely to be offered in prisons compared to other facility types.