Health and Justice最新文献

Background: Prisons are well understood to be hotspots of the COVID-19 pandemic. Yet, little is known about the impacts the COVID-19 pandemic has had on pregnant and postpartum people in prison. We conducted a secondary analysis of 63 semi-structured qualitative interviews (December 2021-May 2023) with subject matter experts, primarily perinatal program staff working in prisons, to better understand how perinatal support programs for people in prison were impacted by the COVID-19 pandemic.

Results: We identified nine themes in interviews as impacting perinatal support programming for incarcerated pregnant and postpartum people during the COVID-19 pandemic: 1) prison COVID-19 preventative practices and their influences on perinatal support programs; 2) COVID-19 quarantine and confinement of pregnant and postpartum people; 3) changes in the pregnant and postpartum population and reentry support; 4) changes to birth support during incarceration; 5) lack of communication and inconsistency between the DOC and perinatal support programs; 6) DOC staffing and staff turnover; 7) lack of access to volunteer-led programming and visiting; 8) relationships between perinatal support programs and DOC healthcare providers; and 9) relationships between perinatal support programs and hospitals. Results were organized into a modified socioecological model, allowing us to view different spheres of influence, how they interact and overlap, and as we describe in the discussion section, where practitioners and policy-makers might intervene. In particular, we focused on the organizational, relational, and structural levels, with multiple themes organized into each level. All of these themes, together, help provide information on how the COVID-19 pandemic impacted perinatal support programs in prisons.

Conclusions: The COVID-19 pandemic had drastic impacts on prison operations and perinatal support programs, with cascading influences on the health and wellbeing of pregnant and postpartum people who are incarcerated. We conclude with a series of recommendations, developed by the research team and a community research council of formerly incarcerated individuals, that aim to address pandemic-related health disparities and promote health equity among those disproportionately impacted by the COVID-19 pandemic.

Background: Criminal legal involved (CLI) individuals face a heightened risk of opioid misuse and overdose, yet access to medications for opioid use disorder (MOUD) is limited, particularly in criminal legal settings. Negative attitudes and misinformation about MOUD are prevalent among legal system actors, creating a barrier to MOUD access. This study examines the effectiveness of informational and narrative messages in correcting misinformation and promoting positive attitudes toward MOUD among criminal legal system (CLS) professionals.

Method: Using state/federal websites, social media groups, and professional connections to correctional and behavioral health agencies nationwide, we recruited individuals who were currently working in corrections and behavioral health in criminal legal settings in the United States (N = 502). An online experiment was conducted with four message conditions: no message control, informational message, first-person narrative message, and dialogue message. The study assessed attitudes toward MOUD use and support for greater access in these settings, as well as information processing outcomes including narrative transportation (i.e., becoming immersed in a story), perceived realism, and counterarguing.

Results: Compared to no message control, both the first-person narrative message (p = .006) and the dialogue message (p = .026) produced more positive attitudes toward MOUD; the informational message marginally improved positive attitudes (p = .080). The dialogue message also increased support for MOUD access in jails/prisons compared to control (p = .003). Neither the narrative nor the informational messages significantly reduced negative attitudes. The first-person (p = .050) and dialogue (p = .030) messages both generated significantly greater transportation compared to the informational message.

Conclusion: Both informational and narrative messages can improve attitudes toward MOUD use in criminal legal settings. Well-designed educational messages aimed at changing attitudes and reducing barriers to promoting MOUD use in criminal legal settings are warranted.

Background: Peer support services (PSS) have become increasingly formalized in many healthcare settings. While use of PSS in the criminal-legal space is expanding, no comprehensive reviews of program designs and outcomes are available to characterize current approaches. This scoping review sought to identify PSS models for individuals with health-related needs transitioning from incarceration to the community and summarize key features and outcomes related to the models.

Results: A search of PubMed, PsycInfo, Web of Science, National Criminal Justice Reference Service, Criminal Justice Abstracts, Criminal Justice Database, Embase, CINAHL, and Social Services Abstracts databases resulted in a total of 66 studies that described 49 unique PSS programs delivered at re-entry. Fifty-six of these studies also reported on implementation factors and program outcomes. Programs varied in terms of target populations, staffing, services offered, setting, and duration. Quantitative outcomes most commonly surrounded linkage to services, substance use, mental health, HIV, and recidivism. Lived experience of peers, extensive engagement with participants, participant-centered support, and collaboration between agencies were highlighted as key factors that supported program implementation, while challenges largely related to staffing and participant outreach.

Conclusions: The heterogeneity in program design and the mixed results in both quantitative and qualitative outcomes likely reflect the need for programs to be responsive to the specific communities served. This review highlights innovative approaches within the growing use of PSS to support the health-related needs of individuals reentering the community after incarceration and may guide future research, design, implementation, and evaluation of such programs in the criminal-legal space.

Background: We describe a longitudinal mixed methods program evaluation protocol for a novel peer-led housing program for older men transitioning from prison to the community after completing long sentences of incarceration. The program departs from traditional community corrections models by providing peer-run housing designed to build and enhance peer and community social ties. This previously untested program relies on the principles of network alteration and provides a case study for examining interpersonal mechanisms underlying behavioral health and justice related outcomes.

Methods: We use mixed methods and longitudinal social network analysis to evaluate the program, while also applying implementation science to document program development. We focus our evaluation on key health and social outcomes, including mental health, substance use, stress, health risk behaviors, well-being, financial security, housing, and recidivism. With longitudinal surveys, we collect (1) dynamic network data of resident and staff relationships and (2) behavioral health/social data of participants. We also administer longitudinal resident and staff interviews. Resident interviews focus on interpersonal relationships and reentry experiences, while staff interviews describe program implementation. We apply longitudinal statistical models to complete (i.e., sociocentric) network data within the house to examine how dynamic network properties connect to changes in residents' health, behavioral, and social outcomes. We integrate longitudinal survey, individual-level (i.e., egocentric) network, and qualitative data to understand how the program works. To evaluate program impacts for long-term health and social outcomes, we use an untreated matched sample to compare 6- and 12-months post-prison release outcomes using administrative data related to rearrest/reincarceration and behavioral health.

Pre-implementation results: We use a logic model to present and organize pre-implementation results from interviews with program staff and peer mentors. Our results describe program design and intended goals, while highlighting how the program is rooted in principles of peer support, trauma-informed care, and restorative justice to address unique stressors of incarceration to foster responsibility and facilitate reintegration.

Discussion: Community program evaluation research allows us to document real-world contextual factors that may drive intervention effectiveness. Results of the mixed methods evaluation will provide a comprehensive understanding of one network-based program's ability to support health and social outcomes of older, previously incarcerated men. Results may inform future reentry services.

Background: Indigenous Māori are imprisoned on a mass scale by the nation-state currently known as New Zealand, driven by racialised inequities that occur across the criminal legal system and a rapidly expanding carceral state. Lack of reliable data limits the ability to monitor and evaluate the health and disability impacts of imprisonment on Māori. We examined ethnicity data quality; specifically, potential miscounting of Māori in prison. All individuals who experienced at least one night of imprisonment between 2018 and 2021 were selected from the Department of Corrections (Corrections) data in the Stats NZ Integrated Data Infrastructure (IDI). We compared counts and proportions of Māori using two sources of ethnicity information; Corrections and IDI's core data. Within this cohort, we compared self-identified ethnicity from the 2018 Census with ethnicity recorded in Corrections data available in the IDI (via individual linkage), to assess levels of match between datasets and calculate net undercount.

Results: Lesser numbers of Māori were recorded in the Corrections data compared to the IDI's core data (52% versus 57% of the study cohort), a pattern observed across all age and gender groups, and amongst those sentenced and on remand. For the linked analysis, only one third (34%) of the cohort linked to the IDI central spine had self-identified ethnicity from the 2018 Census. Of this group, 46% self-identified as Māori ethnicity. When this information was compared to ethnicity information reported by Corrections for the same individuals, there was a 12% undercount of Māori in Corrections data. The net undercount of Māori was 6%, equating to at least an extra 405 Māori imprisoned than what is publicly reported by government.

Conclusions: Reliable data inclusive of high-quality ethnicity data are critical for understanding and monitoring Māori health in terms of resource allocation, policy decisions, and performance of health and disability services for Māori imprisoned in NZ. Systemic undercounting of Māori in prisons is a breach of Indigenous rights to monitor and evaluate impacts of government actions and inactions for Māori. We do not accept the inevitability of prisons but whilst prisons exist, and until there are no prisons left on Māori whenua (lands), an all-of-government approach to prioritisation of high-quality ethnicity data across the criminal legal system that meets obligations to Te Tiriti o Waitangi and international human rights instruments is urgently required.

Background: As the opioid overdose crisis continues to produce excessive morbidity and mortality in the United States, government agencies have applied various approaches to prevent overdoses, including law-enforcement efforts (e.g., arresting people who use drugs, interrupting drug traffickers, etc.) and treatment-based approaches (e.g., naloxone, medications for opioid use disorder, etc.). Public perception and support of these approaches are relevant for informing policy, allocating resources, and effectively implementing community interventions to prevent drug-related harms.

Methods: Using an embedded informational survey design, we experimentally assessed whether public support for strategies to prevent overdose in South Carolina is influenced by language from federal agencies describing treatment- or enforcement-based approaches. Respondents were randomly assigned to one of three groups: (1) enforcement -based approach, (2) treatment-based approach, or (3) the control condition. Those assigned to experimental groups were presented with statistics on drug overdose deaths, followed by an informational prompt with language about overdose prevention approaches from either DEA (enforcement) or NIH (treatment), while the control group received no informational prompt.

Results: Findings from a sample of 4,675 respondents indicated that those assigned the DEA prompt were significantly more likely to support enforcement-based approaches in arresting drug traffickers and people who use drugs (AME = 0.060, p < 0.001). On the other hand, those assigned to the NIH prompt were significantly more likely to agree that both law enforcement (AME = 0.065, p < 0.0001) and clinicians (AME = 0.044, p < 0.05) are capable of preventing drug overdose deaths.

Conclusions: These findings shed light on public perceptions of approaches to addressing the opioid epidemic and limited modifiability when presented with language from federal agencies. This may inform future research, practice, and/or policy aiming to maintain public safety while also providing treatment options to people who use drugs in order to reduce overdose deaths.

Youth impacted by the juvenile legal system (JLS) disproportionately experience health and healthcare inequities, including those related to substance use, mental health, and sexual and reproductive health. Structural racism is a primary driver of JLS systems contact and health inequities, interacting with other forms of oppression to negatively impact minoritized youth at every step of the JLS process. Despite the growing unmet need for tailored, empirically-driven programmatic and policy solutions, research focused on this multiply marginalized group often fails to explore or address racism as a factor shaping these inequities and identifying relevant health solutions. We use the Public Health Critical Race Praxis to offer recommendations for improving data collection and quality in longitudinal research addressing health inequities among JLS-impacted youth and families. Recommendations stem from a team of federally funded researchers and clinicians representing different career development stages, training backgrounds, and lived experiences, all of whom are working to address health inequities. Given the challenges JLS-impacted youth face and the significant need for rigorous research illuminating their health outcome and service needs, clinical and translational researchers would benefit from guidance on how to apply antiracist principles and research strategies to successfully engage JLS-impacted youth and families in longitudinal studies.