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Reducing drug use, human immunodeficiency virus risk, and recidivism among young men leaving jail: Evaluation of the REAL MEN re-entry program

Open access
Freudenberg, Nicholas, Ramaswamy, Megha, Daniels, Jessie, Crum, Martha, Ompad, Danielle C., Vlahov, David·2010·Journal of Adolescent Health
DOI 10.1016/j.jadohealth.2010.01.008PMC PMC2963792
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Abstract

Purpose This study assesses the impact of REAL MEN (Returning Educated African-American and Latino Men to Enriched Neighborhoods), an intervention designed to reduce drug use, risky sexual behavior and criminal activity among 16-18-year-old males leaving New York City jails. Methods Participants (N = 552) were recruited in city jails and randomly assigned to receive an intensive 30-hour jail/community-based intervention or a single jail-based discharge planning session. All participants were also referred to optional services at a community-based organization (CBO). One year after release from jail, 397 (72%) participants completed a follow-up interview. Logistic and ordinary least squares regression was used to evaluate the impact of the intervention on drug use, risky sexual behavior, criminal justice involvement, and school/work involvement post release. Results Assignment to REAL MEN and, independently, use of CBO services, significantly reduced the odds of substance dependence (odds ratio [OR] = .52, p ≤ .05; OR = .41, p ≤ .05, respectively) 1 year after release. Those assigned to the intervention spent 29 fewer days in jail compared with the comparison group (p ≤ .05). Compared to non-CBO visitors, those who visited the CBO were more likely to have attended school or found work in the year after release (OR = 2.02, p ≤ .01). Conclusions Jail and community services reduced drug dependence 1 year after release and the number of days spent in jail after the index arrest. While these findings suggest that multifaceted interventions can improve outcomes for young men leaving jail, rates of drug use, risky sexual behavior, and recidivism remained high for all participants after release from jail, suggesting the need for additional policy and programmatic interventions.

Verified 2026-10-09 · 1 reference not checked yet

AI snapshot

Written from the paper’s full text.

TL;DR

REAL MEN, a 30-hour jail-and-community reentry intervention for 16–18-year-old males leaving New York City jails, was evaluated in a randomized trial with 552 participants and 397 (72%) followed one year after release. Assignment to REAL MEN and/or use of community-based organization (CBO) services was associated with reduced substance dependence, fewer days in jail, and greater school/work involvement, though drug use, risky sex, and recidivism remained high overall.

Key findings

  • Assignment to REAL MEN significantly reduced the odds of substance dependence one year after release (OR=.52, p≤.05); independently, at least one CBO visit also reduced substance dependence (OR=.41, p≤.05). For those attending four or more REAL MEN sessions, the effect was stronger (OR=.401, p≤.05).
  • REAL MEN assignment reduced hard drug use after release (OR=.166, p≤.05), though only 5% of the sample reported such use in the 90 days before follow-up; it did not significantly affect daily marijuana smoking, reported by 32% at follow-up.
  • Participants who used both REAL MEN and CBO services were one-third as likely to engage in sexual risk behaviors post-release (OR=.33, p≤.05), and CBO visitors were more than twice as likely to have been in school or worked for at least seven months after release (OR=2.02, p≤.01); those in both components had even higher constructive outcomes (OR=2.68, p≤.05).
  • Among those incarcerated after the index incarceration, REAL MEN-assigned participants spent about 29 fewer days in jail (p≤.05); the paper estimates this could yield savings up to $7,308 per person based on a 2003 New York City jail cost of $252/day, while cautioning that days in jail were self-reported.

Methods

  • Randomized trial: 552 male adolescents aged at least 16 but under 19 were recruited in New York City jails (2003–2007) and randomly assigned to a 30-hour jail/community psychosocial educational intervention or a single jail-based discharge planning session; all were referred to optional CBO services.
  • Follow-up interviews were conducted approximately 12 months after release; 397 participants (72%) completed follow-up. Logistic regression tested outcomes in substance use, sexual risk, criminal justice, and school/work domains, and OLS regression examined days incarcerated.
  • Analyses compared random assignment groups, participation in four or more REAL MEN sessions, any CBO visit, and mutually exclusive treatment combinations, controlling for baseline characteristics.

Limitations

  • The paper states that it relies on self-reported drug and sexual behavior and self-reported days incarcerated, all subject to memory lapses and social biases; attrition may have biased results despite controls; the sample may differ on unmeasured dimensions and was recruited from one city, limiting generalizability; no participants identified as gay, bisexual, or transgender or reported sexual contact with other young men, so their needs are not addressed; and no cost-benefit analysis was conducted.
  • Evident from the text: CBO participation was not randomly assigned and reflects self-selection, so CBO-related findings may be confounded by unmeasured differences between those who did and did not attend.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.jadohealth.2010.01.008

Cites

31 of 32 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 16 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Participants who visited the CBO were more than twice as likely to have been either in school or have worked for at least seven months after release compared with those who did not seek CBO services (OR=2.02, p≤.01).

    “Finally, participants who visited the CBO were more than twice as likely (OR=2.02, p≤.01) to have been either in school or have worked for at least seven months after release, compared to those who did not seek services from the CBO.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Self-reported measures of drug use, sexual behavior, and days incarcerated are sufficiently accurate to detect intervention effects despite memory lapses and social biases.
    • Rests on an assumption: Attrition from the original sample did not bias results after controlling for identified variables.
    • Rests on an assumption: CBO participation effects are not entirely due to self-selection.
  • Findingown data

    The offer of more intensive services and active outreach increased overall post-release CBO participation rates almost three-fold (45% vs. 17%, p≤.001).

    “Thus, the offer of more intensive services and active outreach increased overall post-release participation rates almost three-fold (45% vs. 17%, p≤.001).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: CBO participation effects are not entirely due to self-selection.
  • Findingown data

    The REAL MEN intervention did not have a significant effect on post-release daily marijuana smoking.

    “However, the REAL MEN intervention did not have a significant effect on post-release daily marijuana smoking, reported by 32% of the sample in the follow-up interview.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Self-reported measures of drug use, sexual behavior, and days incarcerated are sufficiently accurate to detect intervention effects despite memory lapses and social biases.
    • Rests on an assumption: Attrition from the original sample did not bias results after controlling for identified variables.
  • Findingown data

    Participants who participated in both REAL MEN and the CBO were one-third as likely to engage in sexual risk behaviors post-release as those who attended only REAL MEN sessions and did not visit the CBO (OR=.33, p≤.05).

    “Those who participated in both were one-third as likely to engage in sexual risk behaviors (OR=.33, p≤.05) post-release as those who attended only REAL MEN sessions but did not visit the CBO.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Self-reported measures of drug use, sexual behavior, and days incarcerated are sufficiently accurate to detect intervention effects despite memory lapses and social biases.
    • Rests on an assumption: Attrition from the original sample did not bias results after controlling for identified variables.
    • Rests on an assumption: CBO participation effects are not entirely due to self-selection.
  • Findingown data

    Among participants assigned to REAL MEN, attending four or more educational sessions was associated with a more pronounced reduction in the odds of alcohol or drug dependence at follow-up (OR=.401, p≤.05).

    “For those participants who attended four or more sessions, the effect was more pronounced (OR= .401, p≤.05)”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Self-reported measures of drug use, sexual behavior, and days incarcerated are sufficiently accurate to detect intervention effects despite memory lapses and social biases.
    • Rests on an assumption: Attrition from the original sample did not bias results after controlling for identified variables.
  • May combine two claims. 14
  • Classified as probably not a substantial claim. 5

  • May combine two claims.

    Findingown data

    The REAL MEN project demonstrated the capacity to recruit and engage male adolescents to voluntarily participate in services while in jail and after release, and to maintain contact with them after release.

    “In summary, the REAL MEN project demonstrated the capacity to recruit and engage male adolescents to voluntarily participate in services while in jail and after their release, as well as the ability to maintain contact with them after release.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Neither assignment to the REAL MEN intervention alone nor participation in the CBO alone reduced risky sexual behaviors.

    “While neither assignment to the REAL MEN intervention alone nor participation in the CBO alone reduced risky sexual behaviors, the combined impact of these services did.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Self-reported measures of drug use, sexual behavior, and days incarcerated are sufficiently accurate to detect intervention effects despite memory lapses and social biases.
    • Rests on an assumption: Attrition from the original sample did not bias results after controlling for identified variables.

  • May combine two claims.

    Findingown data

    Participation in either the REAL MEN intervention or visits to the CBO did not appear to affect criminal justice outcomes post-release.

    “As Table 2 shows, participation in either the REAL MEN intervention or visits to the CBO did not appear to affect criminal justice outcomes post-release.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Self-reported measures of drug use, sexual behavior, and days incarcerated are sufficiently accurate to detect intervention effects despite memory lapses and social biases.
    • Rests on an assumption: Attrition from the original sample did not bias results after controlling for identified variables.

  • May combine two claims.

    Findingown data

    Of the 277 male adolescents assigned to jail and community services, 177 (64%) participated in at least four educational sessions, 125 (45%) made at least one visit to the CBO, and 111 (40%) participated in four or more educational sessions and made a visit to the CBO.

    “Of the 277 male adolescents assigned to jail and community services, 177 (64%) participated in at least four educational sessions, 125 (45%) made at least one visit to the CBO, and 111 (40%) participated in four or more educational sessions and made a visit to the CBO.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Rates of drug use, risky sexual behavior, and recidivism remained high for all participants after release from jail.

    “rates of drug use, risky sexual behavior, and recidivism remained high for all participants after release from jail”
    • Also stated in: § Discussion · plain
      “the levels of marijuana and alcohol use, risky sexual behavior, and recidivism remained high for all groups at the time of the second interview”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Self-reported measures of drug use, sexual behavior, and days incarcerated are sufficiently accurate to detect intervention effects despite memory lapses and social biases.
    • Rests on an assumption: Attrition from the original sample did not bias results after controlling for identified variables.

  • May combine two claims.

    Premisecitation

    Many incarcerated youth struggle with drug and alcohol problems, as well as educational and psychological difficulties.

    “many incarcerated youth struggle with drug and alcohol problems [3,4], as well as educational [3,5] and psychological difficulties [4,6]”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [3] Freudenberg, 2008, Coming home from jail: The social and health consequences of community reentry for women, male adolescents, and their families and communities, Am J Public Health source

      Not checked in the free run.

    • cites [4] Lader, 2003, Psychiatric morbidity among young offenders in England and Wales, Int Rev Psychiatry source

      Not checked in the free run.

    • cites [5] Ramchand, 2009, Seven-year life outcomes of adolescent offenders in Los Angeles, Am J Public Health source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Many adolescents are incarcerated on drug use or sales charges.

    “Many adolescents are incarcerated on drug use or sales charges [1,2]”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [1] Freudenberg, 2007, Comparison of health and social characteristics of people leaving New York City jails by age, gender, and race/ethnicity: Implications for public health interventions, Public Health Rep source

      Not checked in the free run.

    • cites [2] Levine, 2008

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Previous research and other studies suggest that interventions while individuals are in jail or in the days and weeks after release have the potential to be cost-effective, achieve high retention rates, and protect adolescents from returning to drug use, crime, or HIV risk behavior.

    “Our previous research [13,14,15], as well as other studies [16,17], suggest that interventions while individuals are in jail – or in the days and weeks after they are released – have the potential to be cost-effective, achieve high retention rates, and protect adolescents from returning to drug use, crime, or HIV risk behavior.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [13] Needels, 2005, Community case management for former jail inmates: Its impacts on rearrest, drug use, and HIV risk, J Urban Health source

      Not checked in the free run.

    • cites [14] Freudenberg, 1998, Linking women in jail to community services: Factors associated with rearrest and retention of drug-using women following release from jail, J Am Med Womens Assoc

      Not checked in the free run.

    • cites [15] Robert Wood Johnson Foundation. Health link program provided health and community services to current and former inmates of New York City's Rikers Island jail. Available at: http://www.rwjf.org/pr/product.jsp?id=16734. Accessed July 22, 2009.

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Participants were randomly assigned to receive a single jail-based discharge planning session or a 30-hour psychosocial educational group-based intervention that began in jail and continued in the community after release.

    “After the interview, participants were randomly assigned to receive a single jail-based discharge planning session or a 30-hour psychosocial educational group-based intervention that began in jail and continued in the community after release.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductreasoning

    The sample resembles the larger population of adolescent males leaving New York City jails on basic demographic characteristics but may differ on other unmeasured dimensions, limiting generalizability.

    “While our sample resembles the larger population of adolescent males leaving New York City jails on basic demographic characteristics, it may differ on other unmeasured dimensions, which limits our ability to make generalizations.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    Follow-up completers differed from non-completers on several baseline indicators, and all models controlled for these factors.

    “The participants who completed the follow-up interview (N=397) were different from those who did not (N=155) on a few indicators”
    • Also stated in: § Participants · plain
      “All models in this evaluation controlled for these factors.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    Participants randomly assigned to the intervention differed from comparison participants on baseline indicators, suggesting the intervention group was at a slight disadvantage, and multivariate analyses controlled for these baseline characteristics.

    “In multivariate analyses of treatment effectiveness, we controlled for these baseline characteristics, along with several other baseline controls.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    The Time 2 follow-up interview was completed by 397 participants, a follow-up rate of 72%.

    “The Time 2 interview was completed by 397 participants – a follow-up rate of 72%.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    The study did not conduct a cost-benefit analysis, so it could not assess whether the benefits of this approach exceed its costs.

    “Finally, we did not conduct a cost-benefit analysis, and were thus not able to assess whether the benefits of this approach exceed its costs.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    None of the participants identified as gay, bisexual or transgendered, or reported any sexual contact with other young men, so the findings do not address the special needs of jailed adolescents who identify as gay.

    “In addition, none of the participants enrolled in the study identified as gay, bisexual or transgendered, or reported any sexual contact with other young men, perhaps reflecting both the powerful social desirability of heteronormativity and the danger of such a disclosure within a jail. Thus, findings reported here do not address the special needs of jailed adolescents who identify as gay.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Attrition from the original sample may have biased results, although the study controlled for relevant variables it was able to identify.

    “In addition, it is possible that attrition from the original sample may have biased results, although we controlled for relevant variables we were able to identify.”
    Quote in the paperNot a substantial claim
16 of 16

  • The paper relies on this without support.

    Most adolescents are released from jail within a few weeks of arrest, usually without access to community services.

    “Most adolescents are released from jail within a few weeks of arrest, usually without access to community services.”

  • The paper relies on this without support.

    Self-reported measures of drug use, sexual behavior, and days incarcerated are sufficiently accurate to detect intervention effects despite memory lapses and social biases.

    “It relies on self-reported data on drug and sexual behavior and on the number of days spent incarcerated – all subject to memory lapses and social biases.”

  • The paper relies on this without support.

    Attrition from the original sample did not bias results after controlling for identified variables.

    “In addition, it is possible that attrition from the original sample may have biased results, although we controlled for relevant variables we were able to identify.”

  • The paper relies on this without support.

    CBO participation effects are not entirely due to self-selection.

    “Since individuals were not randomly assigned to the CBO, their participation reflects self-selection.”
4 of 4

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • In a study of 16 to 18 year old African American and Latino males being released from jail, those who received an eight session, 30-hour educational program that included building racial pride had spent fewer days in jail, were more likely to have attended school and found work, and had reduced odds of substance abuse one year after release.

    “The study found that one year after release, those who had received the comprehensive intervention had spent fewer days in jail, were more likely to have attended school and found work, and had reduced odds of substance abuse [123].”

    From Reducing Racial Inequities in Health: Using What We Already Know to Take Action (2019) · cites this paper as [123]

Cites

Flagged first, then by citations

1 of the 33 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. Lowenkamp, 2005, Developing successful reentry programs: Lessons from the ‘what works’ research, Correct Today, 71

Cited by

Sorted by citations

Related

Authors
Freudenberg, N., Ramaswamy, M., Daniels, J., Crum, M., Ompad, D. C., & Vlahov, D.
Affiliations
  • City University of New York (US)
  • University of Kansas (US)
  • The Graduate Center, CUNY (US)
  • New York Academy of Medicine (US)
Corresponding author
Freudenberg, Nicholas
ORCID
Venue
Journal of Adolescent Health
Publisher
Elsevier BV
Published
2010-11
Volume
47
Issue
5
Pages
448-455
ISSN
1054-139X (ISSN-L)
DOI
10.1016/j.jadohealth.2010.01.008
PMC
PMC2963792
OpenAlex
W1992714001
Semantic Scholar
cd53c6fd85bb1b6b924b91773cc8589975b233f8
Cited by
49
References
33
Citations by year
2026: 1 · 2025: 1 · 2024: 1 · 2023: 2 · 2022: 1 · 2021: 2 · 2019: 4 · 2018: 5 · 2017: 3 · 2016: 2 · 2015: 9 · 2014: 5 · 2013: 5 · 2012: 3
FWCI
12.59
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of Adolescent Health (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • New York Academy of Medicine
  • National Institute on Drug Abuse (R01DA014725)
Topics
  • Social Sciences › Sociology and Political Science › Criminal Justice and Corrections Analysis
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Social Sciences › Sociology and Political Science › Crime Patterns and Interventions
Keywords
young men, drug use, HIV risk, sexual risk behavior, recidivism, substance dependence, community organizations, discharge planning, African American men, Hispanic men, school attendance, employment, adolescent boys, New York City jails
MeSH terms
Adolescent, Humans, Male, New York City, Prisoners, Sexual Behavior, Program Evaluation, HIV Infections, Community Networks, Substance-Related Disorders, Young Adult

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