Substance use awareness and behavioral outcomes in correctional social work: examining the knowledge-action gap

This study aims to examine the relationship between substance use awareness and behavioral severity among incarcerated men convicted of drug-related offenses, with a particular focus on the knowledge-action gap in correctional settings.

A cross-sectional correlational design was used with 150 incarcerated individuals in open correctional institutions in Türkiye. Data were collected using the Substance Use Awareness Scale (SUAS), the Drug Use Disorders Identification Test (DUDIT) and the DUDIT-Extended (DUDIT-E). Non-parametric analyses were conducted to assess associations between awareness, substance use severity and selected risk factors.

Participants demonstrated moderate-to-high awareness of substance-related harms; however, overall awareness was not significantly associated with overall substance use severity. A modest negative association was identified between overall awareness and substance use frequency. Positive perceptions of substance use were strongly associated with overall DUDIT-E severity and modestly associated with substance use frequency. Peer-related influences and an earlier age of substance use initiation were also associated with greater behavioral risk. The findings support the existence of a knowledge-action gap in correctional settings, suggesting that awareness alone may be insufficient to produce meaningful behavioral change among incarcerated individuals with substance use problems.

This study has several limitations. First, its cross-sectional design limits causal interpretation of the relationships between awareness and behavioral outcomes. Second, the sample consisted exclusively of male inmates from open correctional institutions within a single region, limiting generalizability to other correctional populations and settings. Third, reliance on self-report measures may have introduced recall and social desirability bias. Despite these limitations, the study contributes to the correctional rehabilitation literature by highlighting the knowledge-action gap and emphasizing the need for multidimensional intervention models. Future longitudinal and multi-site studies are recommended to strengthen the evidence base.

The findings suggest that awareness-based rehabilitation programs alone may be insufficient to reduce substance use behaviors in correctional settings. Correctional rehabilitation services should therefore incorporate multidimensional intervention models that combine psychoeducation with motivational interviewing, cognitive-behavioral strategies and peer-based support programs. Addressing social learning processes, peer influence and motivational barriers may improve treatment engagement and behavioral outcomes among incarcerated individuals. The results also highlight the importance of integrating evidence-based psychosocial interventions into correctional rehabilitation policies and prison health services to support long-term behavioral change and reduce recidivism risk.

The findings highlight the broader social and structural dimensions of substance use within correctional populations. The identified knowledge-action gap suggests that informational approaches alone may be insufficient to address substance-related behaviors among incarcerated individuals. Strengthening psychosocial support systems, peer-based rehabilitation models and reintegration services may contribute to more effective social inclusion and reduce relapse and recidivism risks. The study also underscores the importance of developing correctional policies that address social environment and behavioral determinants alongside cognitive awareness to support sustainable rehabilitation and community reintegration outcomes.

This study contributes to the limited literature examining the relationship between substance use awareness and behavioral severity within correctional populations, particularly in a non-Western context. Unlike many awareness-focused studies, the research empirically demonstrates a knowledge-action gap among incarcerated men convicted of drug-related offenses. By integrating cognitive dissonance theory, social learning theory and the risk-need-responsivity framework, the study offers a multidimensional interpretation of why awareness may fail to translate into behavioral change. The findings provide original insight into correctional rehabilitation and prison health by emphasizing the need for context-sensitive and theory-driven intervention models.