Supporting women leaving prison through peer health mentoring: a participatory health research study

McLeod, Katherine; Korchinski, Mo; Young, Pam; Milkovich, Tammy; Hemingway, Christine A.; DeGroot, Michelle; Condello, Lara-Lisa; Fels, Lynn; Buxton, Jane A.; Janssen, Patricia A.; Granger-Brown, Alison; Ramsden, Vivian R.; Buchanan, Marla J.; Martin, Ruth Elwood

doi:10.9778/cmajo.20190106

Cited by 18 publications

(44 citation statements)

References 25 publications

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“…Research conducted in humanitarian settings is often limited in the types of studies that can take place [48] given the context and constraints in humanitarian settings. This is not unique to PR, engaging vulnerable or hard to reach populations remains an issue in many different areas of PR but much can be learned about effective engagement practices by comparing the literature, for example, from PR research experiences in the fields of HIV [49], women discharged from prison [50] and mental health research [51] among others. The studies included in this scoping review provided some insight into how PR was applied, the challenges, and indications of the value of such approaches in humanitarian settings.…”

Section: Discussionmentioning

confidence: 99%

Key issues for participatory research in the design and implementation of humanitarian assistance: a scoping review

Ormel

Salsberg

Hunt

et al. 2020

Global Health Action

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Background: Participatory approaches that engage affected populations are increasingly applied in humanitarian health programs in concert with emerging accountability frameworks and the rapid growth of research in these settings. Participatory initiatives within this domain appear to be largely adopted at an operational level and are infrequently reported as a component of research efforts. Yet the evidence of the benefits of research involving community members is growing worldwide. This is the first review of participatory research (PR) in humanitarian settings. Objectives: This study sought to understand the extent to which PR values and practices have been adopted in humanitarian health programs and to explore key issues in applying PR in this context. Methods: This scoping review was based on the approach developed by Arksey and O'Malley. The search for relevant peer-reviewed articles included scientific databases, a humanitarian database, targeted journals and online resources published since 2009. Eleven articles were retrieved and reviewed to identify practices and key issues related to conducting PR in humanitarian settings. Results: Four key themes were identified: building trust with local research stakeholders and participants; the importance of contextual understanding; implications of collaborating with affected populations in PR, and neutrality of researchers and Non-Governmental Organizations (NGOs). Study teams considered PR as a valued approach where there was mistrust or a need for contextualized understanding. The studies described how adaptations made during the study optimized collaboration with affected populations and how the presence of NGOs influenced the approach and results of PR. Conclusions: One of the most important contributions of humanitarian health programs is to develop 'medical practices that are better adapted to the living conditions and priorities of patients who are generally ignored'. Participatory approaches, such as PR, support the development of health-related practices that are more relevant and sustainable for affected populations.

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Section: Discussionmentioning

confidence: 99%

Key issues for participatory research in the design and implementation of humanitarian assistance: a scoping review

Ormel

Salsberg

Hunt

et al. 2020

Global Health Action

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“…Prisons concentrate populations of people who have experienced or are experiencing health and social inequities including trauma and violence, homelessness and/or vulnerable housing, poverty and harmful substance use ( Western and Pettit, 2010 ; Kouyoumdjian et al , 2016 ). When leaving prison people face systemic barriers which impact their health and well-being, including unmet needs for housing, health care, clothing and treatment services ( Geller and Curtis, 2011 ; Fahmy et al , 2018 ; McLeod et al , 2020 ), and access to culturally safe services for Indigenous Peoples. COVID-19 has increased barriers as community resources such as treatment centres, recovery houses, harm reduction and healthcare services, indigenous friendship centers and shelters are closed or running with decreased capacity ( Faculty of Arts, 2020 ; McLeod and Martin, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

“…Research on peer mentorship programs in the context of the criminal legal system has demonstrated immense benefits, including improved health outcomes ( South et al , 2014 ; Cunningham et al , 2018 ; McLeod et al , 2019 ), feelings of belonging ( Collica, 2010 ; Fels et al , 2014 ; South et al , 2016 ) and connection with employment and disability services ( Hunter and Boyce, 2009 ; Redcross et al , 2016 ; Harrod, 2019 ). For many people, release can mean feelings of stress and hopelessness ( Kitson-Boyce et al , 2018 ; Liem and Weggemans, 2018 ; McLeod et al , 2020 ), peers are uniquely positioned to walk alongside people in offering comfort, wisdom and support.…”

Section: Introductionmentioning

confidence: 99%

“…Peer health mentors (PHM), who have themselves experienced incarceration, meet people when they are released to provide mentorship and support to access services such as housing, clothing, food, health care and social assistance. Though the formal mentorship period is three days, PHM often remain in contact with clients to provide ongoing support ( McLeod et al , 2020 ). At the time of this study, ten PHM are employed with the program.…”

Section: Introductionmentioning

confidence: 99%

“…In a 2018 study of the UTG program, 85% of participants had accessed at least one community resource within three days of release and 93% reported that their mentor assisted them to access resources. ( McLeod et al , 2020 ). PHM also offer moral, emotional and spiritual support, while meeting individual needs as they arise.…”

Section: Introductionmentioning

confidence: 99%

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Supporting people leaving prisons during COVID-19: perspectives from peer health mentors

McLeod

Timler

Korchinski

et al. 2021

IJPH

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Purpose Currently, people leaving prisons face concurrent risks from the COVID-19 pandemic and the overdose public health emergency. The closure or reduction of community services people rely on after release such as treatment centres and shelters has exacerbated the risks of poor health outcomes and harms. This paper aims to learn from peer health mentors (PHM) about changes to their work during overlapping health emergencies, as well as barriers and opportunities to support people leaving prison in this context. Design/methodology/approach The Unlocking the Gates (UTG) Peer Health Mentoring Program supports people leaving prison in British Columbia during the first three days after release. The authors conducted two focus groups with PHM over video conference in May 2020. Focus groups were recorded and transcribed, and themes were iteratively developed using narrative thematic analysis. Findings The findings highlighted the importance of peer health mentorship for people leaving prisons. PHM discussed increased opportunities for collaboration, ways the pandemic has changed how they are able to provide support, and how PHM are able to remain responsive and flexible to meet client needs. Additionally, PHM illuminated ways that COVID-19 has exacerbated existing barriers and identified specific actions needed to support client health, including increased housing and recovery beds, and tools for social and emotional well-being. Originality/value This study contributes to our understanding of peer health mentorship during the COVID-19 pandemic from the perspective of mentors. PHM expertise can support release planning, improved health and well-being of people leaving prison and facilitate policy-supported pandemic responses.

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Association of Opioid and Stimulant Use Disorder Diagnoses With Fatal and Nonfatal Overdose Among People With a History of Incarceration

et al. 2022

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ImportanceStudies have suggested a rise in opioid- and stimulant-involved overdoses in recent years in North America. This risk may be acute for individuals who have had contact with the criminal justice system, who are particularly vulnerable to overdose risk.ObjectiveTo examine the association of opioid and/or stimulant use disorder diagnoses with overdose (fatal and nonfatal) among people with histories of incarceration.Design, Setting, and ParticipantsIn this cohort study, population-based health and corrections data were retrieved from the British Columbia Provincial Overdose Cohort, which contains a 20% random sample of residents of British Columbia. The analysis included all people in the 20% random sample who had a history of incarceration between January 1, 2010, and December 31, 2014. Outcomes were derived from 5-years of follow-up data (January 1, 2015, to December 31, 2019). Statistical analysis took place from January 2022 to June 2022.ExposuresSubstance use disorder diagnosis type (ie, opioid use disorder, stimulant use disorder, both, or neither), sociodemographic, health, and incarceration characteristics.Main Outcomes and MeasuresHazard ratios (HRs) are reported from an Andersen-Gill model for recurrent nonfatal overdose events and from a Fine and Gray competing risk model for fatal overdose events.ResultsThe study identified 6816 people (5980 male [87.7%]; 2820 aged &lt;30 years [41.4%]) with histories of incarceration. Of these, 293 (4.3%) had opioid use disorder only, 395 (6.8%) had stimulant use disorder only, and 281 (4.1%) had both diagnoses. During follow-up, 1655 people experienced 4026 overdoses including 3781 (93.9%) nonfatal overdoses, and 245 (6.1%) fatal overdoses. In adjusted analyses, the hazard of both fatal (HR, 2.39; 95% CI, 1.48-3.86) and nonfatal (HR, 2.45; 95% CI, 1.94-3.11) overdose was highest in the group with both opioid and stimulant use disorder diagnoses.Conclusions and RelevanceThis cohort study of people with a history of incarceration found an elevated hazard of fatal and nonfatal overdose among people with both opioid and stimulant use disorder diagnoses. This study suggests an urgent need to address the service needs of individuals who have had contact with the criminal justice system and who co-use opioids and stimulants.

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Supporting women leaving prison through peer health mentoring: a participatory health research study

Cited by 18 publications

References 25 publications

Key issues for participatory research in the design and implementation of humanitarian assistance: a scoping review

Key issues for participatory research in the design and implementation of humanitarian assistance: a scoping review

Supporting people leaving prisons during COVID-19: perspectives from peer health mentors

Association of Opioid and Stimulant Use Disorder Diagnoses With Fatal and Nonfatal Overdose Among People With a History of Incarceration

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