The goals of the study are to reduce drug and alcohol use and recidivism among homeless female offenders (HFOs) in California. To achieve these goals, our team of UCLA and UCSF researchers plan to utilize our successful community participatory approaches to refine a gender-sensitive intervention program, Female Ex-Offender Mentoring in Care (FEM-CARE), with the help of a community advisory board. This study is based upon our team’s history of research promoting theoretically-based, culturally-sensitive nurse-led interventions that have resulted in significant reductions in drug and alcohol use among homeless persons, many of whom have had a history of incarceration. We will assess the impact of the FEM-CARE or Health Promotion (HP) control program on reduction of drug and alcohol use and recidivism.

Specific objectives include:

• Guided by a Community Advisory Board (CAB) made up of HFOs and addiction staff, further conceptualize our community-based program, FEM-CARE, to address the needs of HFOs enrolled in a residential drug treatment programs (RDT) and then refine the program in focus group discussions with 12 HFOs.

• Conduct a pilot randomized clinical trial (RCT) to assess the impact of the FEM-CARE program for 65 HFOs at six-month follow-up compared with 65 HFOs receiving a control Health Promotion (HP) program, in

terms of a) self-reported and objective measures of drug and alcohol use; and b) prevalence of recidivism and number of days to first reincarceration.