Barriers between offenders and primary health care after release from prison: a case study

Carswell, Claire; Noble, Helen; Farrow, David

doi:10.12968/pnur.2017.28.9.386

Cited by 5 publications

(4 citation statements)

References 12 publications

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“…There are likely to be some important differences among different populations experiencing incarceration who are eligible for PrEP, and characterizing these nuances in clinical care will be important to fully understanding what is required to encourage PrEP uptake and engagement in care among criminal justice–involved individuals. Finally, this population experiences many challenges in being linked to care while also experiencing extremely high risk for HIV acquisition [ 10 , 17 , 58 , 59 ]. Successful implementation of PrEP care within the criminal justice system and linking criminal justice–involved individuals to PrEP care in the community has the potential to significantly reduce the spread of HIV both within the criminal justice setting and the broader community, and is an important step to ending the HIV epidemic in the United States [ 60 , 61 ].…”

Section: Discussionmentioning

confidence: 99%

Defining the Pre-exposure Prophylaxis Care Continuum Among Recently Incarcerated Men at High Risk for HIV Infection: Protocol for a Prospective Cohort Study

Murphy¹,

Sosnowy²,

Rogers³

et al. 2022

JMIR Res Protoc

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Background HIV disproportionately impacts criminal justice–involved individuals, including men who experience incarceration. Men make up the vast majority of those experiencing incarceration as well as those newly diagnosed with HIV infection. Pre-exposure prophylaxis (PrEP) is a highly effective biomedical intervention that significantly reduces the risk of HIV acquisition. However, implementation in criminal justice systems is limited. Little is known about effective PrEP implementation and use in this unique public health context. Objective The aim of this study is to characterize the experience of implementing PrEP clinical care in a criminal justice setting for men vulnerable to HIV acquisition. Methods This article describes a PrEP care continuum for men experiencing incarceration who are at increased risk of HIV acquisition, which can help conceptualize approaches to evaluating PrEP implementation. Results The outlined study will enroll 100 men experiencing incarceration at high risk for HIV acquisition prior to release into the community. The goal is to initiate PrEP prior to release and link individuals to PrEP providers in the community, capturing barriers and facilitators to PrEP use during this uniquely vulnerable time period for HIV acquisition. Conclusions Based on the proposed care continuum and what is known about HIV risk and prevention efforts in the criminal justice context, we outline key future research efforts to better understand effective approaches to preventing HIV infection among this vulnerable population. The described approach presents a powerful public health opportunity to help end the HIV epidemic. International Registered Report Identifier (IRRID) DERR1-10.2196/31928

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Section: Discussionmentioning

confidence: 99%

Defining the Pre-exposure Prophylaxis Care Continuum Among Recently Incarcerated Men at High Risk for HIV Infection: Protocol for a Prospective Cohort Study

Murphy¹,

Sosnowy²,

Rogers³

et al. 2022

JMIR Res Protoc

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“…The importance of continuity of care was also highlighted by the United Nations in the Mandela Rules (rule 24.2), which emphasised that prison health care services should be organised in close connection to the general health care system and in such a way that it ensures continuity of care and treatment, including for HIV, other infectious diseases, and drug dependency (UN Office on Drugs and Crime, 2015). Research consistently emphasised both the importance and ongoing challenges of continuity of care during the transition from prisons to the community (Kouyoumdjian, Wiwcharuk and Green 2015;Carswell et al, 2017). For instance, an Australian medical record study showed that for female prisoners the transfer of health information from prison to community care was better in situations where a formal programme of information exchange existed, suggesting that outside such formal programmes transfer of health information is limited (Abbott et al, 2017a).…”

Section: Primary Care During and After Detention And Continuity Of Ca...mentioning

confidence: 99%

The health of detainees and the role of primary care: Position paper of the European Forum for Primary Care

Groenewegen

Dirkzwager

Dam³

et al. 2022

Prim Health Care Res Dev

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This position paper aims to increase awareness among primary care practitioners and policymakers about the specific and complex health needs of people who experience incarceration. We focus on the importance of primary care and of continuity of care between prison and community. We highlight what is known from the literature on the health of people who experience incarceration, on the organisation of prison health care, and on the role of primary care both during and after detention. We present three case descriptions of detainees’ encounters with the organisation of prison health care in three European countries. Finally, we describe the position that the European Forum for Primary Care takes. Prisoners and ex-prisoners have a worse physical and mental health compared with a cross-section of the population. However, access to good quality treatment and care is often worse than in the outside situation. In particular, well-organised primary care in the prison context could benefit prisoners and, indirectly, society at large. Moreover, continuity of care between the community and the prison situation needs improvement.

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“…Individuals in the criminal justice system (CJS) have a high prevalence of physical and mental health-care needs, have lower psychological well-being 2 and experience significant problems in accessing health and social care services. 3 Services for those with multimorbidities who are under community supervision often appear fragmented. 4 Key barriers to access to health-care services include general practice registration, long waiting times for appointments and a perception of not being supported by services to make contact, such as probation.…”

Section: Scientific Backgroundmentioning

confidence: 99%

Individual health trainers to support health and well-being for people under community supervision in the criminal justice system: the STRENGTHEN pilot RCT

et al. 2019

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Background Little is known about the effectiveness or cost-effectiveness of interventions, such as health trainer support, to improve the health and well-being of people recently released from prison or serving a community sentence, because of the challenges in recruiting participants and following them up. Objectives This pilot trial aimed to assess the acceptability and feasibility of the trial methods and intervention (and associated costs) for a randomised trial to assess the effectiveness and cost-effectiveness of health trainer support versus usual care. Design This trial involved a pilot multicentre, parallel, two-group randomised controlled trial recruiting 120 participants with 1 : 1 individual allocation to receive support from a health trainer and usual care or usual care alone, with a mixed-methods process evaluation, in 2017–18. Setting Participants were identified, screened and recruited in Community Rehabilitation Companies in Plymouth and Manchester or the National Probation Service in Plymouth. The intervention was delivered in the community. Participants Those who had been out of prison for at least 2 months (to allow community stabilisation), with at least 7 months of a community sentence remaining, were invited to participate; those who may have posed an unacceptable risk to the researchers and health trainers and those who were not interested in the trial or intervention support were excluded. Interventions The intervention group received, in addition to usual care, our person-centred health trainer support in one-to-one sessions for up to 14 weeks, either in person or via telephone. Health trainers aimed to empower participants to make healthy lifestyle changes (particularly in alcohol use, smoking, diet and physical activity) and take on the Five Ways to Well-being [Foresight Projects. Mental Capital and Wellbeing: Final Project Report. 2008. URL: www.gov.uk/government/publications/mental-capital-and-wellbeing-making-the-most-of-ourselves-in-the-21st-century (accessed 24 January 2019).], and also signposted to other options for support. The control group received treatment as usual, defined by available community and public service options for improving health and well-being. Main outcome measures The main outcomes included the Warwick–Edinburgh Mental Well-being Scale scores, alcohol use, smoking behaviour, dietary behaviour, physical activity, substance use, resource use, quality of life, intervention costs, intervention engagement and feasibility and acceptability of trial methods and the intervention. Results A great deal about recruitment was learned and the target of 120 participants was achieved. The minimum trial retention target at 6 months (60%) was met. Among those offered health trainer support, 62% had at least two sessions. The mixed-methods process evaluation generally supported the trial methods and intervention acceptability and feasibility. The proposed primary outcome, the Warwick–Edinburgh Mental Well-being Scale scores, provided us with valuable data to estimate the sample size for a full trial in which to test the effectiveness and cost-effectiveness of the intervention. Conclusions Based on the findings from this pilot trial, a full trial (with some modifications) seems justified, with a sample size of around 900 participants to detect between-group differences in the Warwick-Edinburgh Mental Well-being Scale scores at a 6-month follow-up. Future work A number of recruitment, trial retention, intervention engagement and blinding issues were identified in this pilot and recommendations are made in preparation of and within a full trial. Trial registration Current Controlled Trials ISRCTN80475744. Funding This project was funded by the National Institute for Health Research Public Health Research programme and will be published in full in Public Health Research; Vol. 7, No. 20. See the National Institute for Health Research Journals Library website for further project information.

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Barriers between offenders and primary health care after release from prison: a case study

Cited by 5 publications

References 12 publications

Defining the Pre-exposure Prophylaxis Care Continuum Among Recently Incarcerated Men at High Risk for HIV Infection: Protocol for a Prospective Cohort Study

Defining the Pre-exposure Prophylaxis Care Continuum Among Recently Incarcerated Men at High Risk for HIV Infection: Protocol for a Prospective Cohort Study

The health of detainees and the role of primary care: Position paper of the European Forum for Primary Care

Individual health trainers to support health and well-being for people under community supervision in the criminal justice system: the STRENGTHEN pilot RCT

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