“The Struggle is Real”: Punitive assessment in community services

Assessment tools are pivotal for the work of frontline community services providers, shaping client relationships, access to supports and producing evidence for agencies that need to allocate resources, demonstrate outcomes and secure funding. These tools are combined and used cumulatively, as marginalized individuals are cared for – but also controlled and punished - within these systems (e.g. in shelters, street outreach, mental health or re entry supports). Punishment literature has clarified that risk tools are impactful but also contested and resisted. Still, we know little about how the process is experienced and negotiated by frontline by practitioners working with people pushed through the ‘revolving doors'. Drawing from two years of ethnographic fieldwork and 105 interviews with community practitioners, I examine tools and practices used to ‘assess’ criminalized and marginalized individuals. I show that practitioners are producing evidence about problems occurring outside legal institutions while relying on criminal justice logics and engaging with criminal justice spaces and paces. I highlight the challenges service providers face and negotiate, focusing on three themes: the composition of tools, the process of using them, and the service context in which they are used. I argue that despite discretionary efforts and adaptations, community practitioners remain frustrated by assessment tools and practices, and particularly by their inability to meet the needs they are assessing.

Novel Recruitment Methods for Research Among Young Adults in Rural Areas Who Use Opioids: Cookouts, Coupons, and Community-Based Staff

Objectives Rural communities in the United States are increasingly becoming epicenters of substance use and related harms. However, best practices for recruiting rural people who use drugs (PWUD) for epidemiologic research are unknown, because such strategies were developed in cities. This study explores the feasibility of web- and community-based strategies to recruit rural, young adult PWUD into epidemiologic research. Materials and Methods We recruited PWUD from rural Kentucky to participate in a web-based survey about opioid use using web-based peer referral and community-based strategies, including cookouts, flyers, street outreach, and invitations to PWUD enrolled in a concurrent substance use study. Staff members labeled recruitment materials with unique codes to enable tracking. We assessed eligibility and fraud through online eligibility screening and a fraud detection algorithm, respectively. Eligibility criteria included being aged 18-35, recently using opioids to get high, and residing in the study area. Results Recruitment yielded 410 complete screening entries, of which 234 were eligible and 151 provided complete, nonfraudulent surveys (ie, surveys that passed a fraud-detection algorithm designed to identify duplicate, nonlocal, and/or bot-generated entries). Cookouts and subsequent web-based peer referrals accounted for the highest proportion of screening entries (37.1%, n = 152), but only 29.6% (n = 45) of entries from cookouts and subsequent web-based peer referrals resulted in eligible, nonfraudulent surveys. Recruitment and subsequent web-based peer referral from the concurrent study yielded the second most screening entries (27.8%, n = 114), 77.2% (n = 88) of which resulted in valid surveys. Other recruitment strategies combined to yield 35.1% (n = 144) of screening entries and 11.9% (n = 18) of valid surveys. Conclusions Web-based methods need to be complemented by context-tailored, street-outreach activities to recruit rural PWUD.