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"When people who use drugs can't differentiate between medical care and cops, it's a problem." Compounding risks of law Enforcement Harassment & Punitive Healthcare Policies. "当吸毒者无法区分医疗和警察时,这就是个问题"。执法骚扰和惩罚性医疗保健政策的复杂风险。
IF 3.5 Q1 Social Sciences Pub Date : 2024-02-06 DOI: 10.1186/s40352-023-00256-3
Bayla Ostrach, Vanessa Hixon, Ainsley Bryce

Background: Community-based harm reduction programming is widely recognized as an effective strategy for reducing the increased risks for and spread of HIV, HCV, and for reducing the growing rate of overdose deaths among people who use drugs (PWUD). PWUD in the United States (US) are a highly justice-involved population, also at increased risk for law enforcement interaction, arrest, and incarceration. These risks compound and interact in the context of criminalization and law enforcement surveillance. Justice involvement increases risks for overdose and for riskier injecting behavior among PWUD, in turn increasing HCV and HIV risks. In Central and Southern Appalachia specifically, PWUD have identified fear of law enforcement harassment and arrest as a barrier to engaging in harm reduction behavior, and a deterrent to seeking help at the scene of an overdose. Moreover, stigmatizing and punitive treatment in healthcare settings can deter PWUD from seeking care, with life or death consequences. This evaluation research study assessing the successes and impacts of a grant-funded project to increase access to safer drug consumption supplies and overdose prevention education for PWUD, including justice-involved participants of a syringe access program (SAP), in public housing and beyond in a South-Central Appalachian setting used key informant and opportunistic sampling. Mixed-methods data were compiled and collected including secondary program data; primary interview and participant-observation data.

Results: The evaluation research identified that grant deliverables were largely achieved, despite challenges presented by the COVID-19 pandemic. In addition, SAP participants and staff reported larger themes surrounding grant-funded activities, in which they perceived that widespread local law enforcement harassment of PWUD increased participants' risks for overdose death and infectious disease risks and that punitive local healthcare settings and policies acted as deterrents to care-seeking for many PWUD.

Conclusions: Overall, the evaluation research found that participants' experiences with and perceptions of local law enforcement harassment combined with their understandings and experiences of local punitive healthcare settings and policies; together compounding and increasing overdose risks and negative health consequences for local justice-involved PWUD.

背景:以社区为基础的减低伤害计划被广泛认为是一种有效的策略,可以降低艾滋病毒和丙型肝炎病毒增加的风险和传播,并降低吸毒者(PWUD)中日益增长的过量吸毒致死率。在美国,吸毒者是一个极易卷入司法的群体,他们面临的执法互动、逮捕和监禁风险也在增加。在刑事定罪和执法监督的背景下,这些风险相互叠加、相互作用。司法介入增加了吸毒过量的风险和注射行为的风险,进而增加了感染丙型肝炎病毒和艾滋病毒的风险。特别是在阿巴拉契亚中部和南部,PWUD 认为害怕执法骚扰和逮捕是参与减少伤害行为的障碍,也是在用药过量现场寻求帮助的阻力。此外,医疗机构中的污名化和惩罚性治疗也会阻碍残疾人寻求治疗,从而造成生死攸关的后果。这项评估研究采用关键信息提供者和机会取样的方法,评估了一个由拨款资助的项目所取得的成功和产生的影响,该项目旨在增加公共住房及其他阿巴拉契亚中南部地区的公共住房中的吸毒者(包括注射器使用计划(SAP)的司法参与者)获得更安全的药物消费用品和预防用药过量教育的机会。采用混合方法编制和收集数据,包括二级计划数据、一级访谈和参与者观察数据:评估研究结果表明,尽管 COVID-19 大流行带来了挑战,但赠款的交付目标基本实现。此外,SAP 的参与者和工作人员还报告了围绕资助活动的更大主题,他们认为当地执法部门对吸毒者和残 疾人的广泛骚扰增加了参与者吸毒过量死亡和感染传染病的风险,而当地惩罚性的医疗保健环境和政策也阻碍了许多吸毒者和残 疾人寻求医疗服务:总体而言,评估研究发现,参与者对当地执法骚扰的经历和看法与他们对当地惩罚性医疗环境和政策的理解和经历相结合,共同加剧和增加了吸毒过量风险以及对当地参与司法活动的残疾人健康造成的负面影响。
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引用次数: 0
Dementia care pathways in prisons - a comprehensive scoping review. 监狱中的痴呆症护理路径--全面范围审查。
IF 3.5 Q1 Social Sciences Pub Date : 2024-01-20 DOI: 10.1186/s40352-023-00252-7
Samantha Treacy, Steven Martin, Nelum Samarutilake, Veronica Phillips, Ben R Underwood, Tine Van Bortel

Background: The number of older people in prison is growing. As a result, there will also be more prisoners suffering from dementia. The support and management of this population is likely to present multiple challenges to the prison system.

Objectives: To examine the published literature on the care and supervision of people living in prison with dementia and on transitioning into the community; to identify good practice and recommendations that might inform the development of prison dementia care pathways.

Methods: A scoping review methodology was adopted with reporting guided by the PRISMA extension for scoping reviews checklist and explanation.

Results: Sixty-seven papers were included. Most of these were from high income countries, with the majority from the United Kingdom (n = 34), followed by the United States (n = 15), and Australia (n = 12). One further paper was from India.

Discussion: The literature indicated that there were difficulties across the prison system for people with dementia along the pathway from reception to release and resettlement. These touched upon all aspects of prison life and its environment, including health and social care. A lack of resources and national and regional policies were identified as important barriers, although a number of solutions were also identified in the literature, including the development of locally tailored policies and increased collaboration with the voluntary sector.

Conclusion: To our knowledge, this is the most comprehensive and inclusive review of the literature on dementia care pathways in prison to date. It has identified a number of important areas of concern and opportunities for future research across the prison system, and its operations. This will hopefully lead to the identification or adaptation of interventions to be implemented and evaluated, and facilitate the development of dementia care pathways in prisons.

背景:监狱中的老年人越来越多。因此,患有痴呆症的囚犯也会越来越多。对这一人群的支持和管理可能会给监狱系统带来多重挑战:研究已发表的有关监狱痴呆症患者的护理和监管以及向社区过渡的文献;确定良好实践和建议,为制定监狱痴呆症护理路径提供参考:方法:采用范围界定综述方法,在 PRISMA 扩展范围界定综述核对表和解释的指导下进行报告:结果:共纳入 67 篇论文。其中大部分来自高收入国家,大多数来自英国(34 篇),其次是美国(15 篇)和澳大利亚(12 篇)。还有一篇论文来自印度:文献表明,在整个监狱系统中,痴呆症患者在从接收到释放和重新安置的过程中都会遇到困难。这些困难涉及监狱生活及其环境的方方面面,包括医疗和社会关怀。缺乏资源以及国家和地区政策被认为是重要的障碍,尽管文献中也指出了一些解决方案,包括制定适合当地情况的政策以及加强与志愿部门的合作:据我们所知,这是迄今为止对监狱中痴呆症护理路径的文献进行的最全面、最全面的综述。它确定了一些重要的关注领域,以及今后在监狱系统及其运作中开展研究的机会。希望这将有助于确定或调整要实施和评估的干预措施,并促进监狱痴呆症护理路径的发展。
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引用次数: 0
Mental health disparities in young adults with arrest history: a survey-based, cross-sectional analysis. 有逮捕史的年轻成年人的心理健康差异:基于调查的横截面分析。
IF 3.5 Q1 Social Sciences Pub Date : 2024-01-02 DOI: 10.1186/s40352-023-00257-2
Onur Baser, Katarzyna Rodchenko, Yixuan Zeng, Amy Endrizal

Background: Over 4.53 million arrests were made in 2021 in the United States. People under 26 years of age were more likely to be arrested than older people. Although mental health disparities are prominent in the incarcerated population, the subject has not been closely examined among young adults specifically.

Objectives: This study examines how criminal justice involvement, specifically arrests, affects the mental health of adults between 18 and 25 years of age.

Methods: We analyzed secondary data using the 2021 National Survey on Drug Use and Health (NSDUH). The study used a subsample of 13,494 people aged 18 to 25 years, including 7,330 women and 6,164 men. History of arrest was the key independent variable. Depression, serious mental illness (SMI), substance use, suicidal ideation, and suicide attempt were the outcome variables. We performed five multivariate logistic regression models for each outcome variable, controlling for race/ethnicity, income, and education level for men and women separately.

Results: Of 13,494 respondents, 6.63% had a history of arrest. Among young women, a history of arrest was associated with significantly higher adjusted odds ratios for all mental health concerns. Most notably, a history of arrest increased the likelihood of substance use by a factor of 15.19, suicide attempts by 2.27, SMI by 1.79, suicidal ideation by 1.75, and depression by 1.52. Among young men, a history of arrest was associated with increased adjusted odds ratios (AORs) for substance use (AOR, 13.37; p < .001), suicidal ideation (AOR, 1.45; p = .011), and suicide attempt (AOR, 1.82; p = .044).

Conclusions: We found a strong relationship between young people having an arrest history and mental health concerns. More specifically, a history of arrest was associated with all mental health concerns among young women, while it was associated with only substance use and suicide among young men. Providing arrestees with appropriate mental health care would benefit them and the criminal justice system by decreasing the odds of recidivism.

背景:2021 年,美国共逮捕了 453 万多人。与老年人相比,26 岁以下的人更容易被捕。尽管精神健康差异在被监禁人群中非常突出,但这一问题还没有专门针对年轻成年人进行过仔细研究:本研究探讨了刑事司法参与(特别是逮捕)如何影响 18 至 25 岁成年人的心理健康:我们利用 2021 年全国毒品使用和健康调查(NSDUH)的二手数据进行了分析。研究使用了 13,494 个 18 至 25 岁的子样本,其中包括 7,330 名女性和 6,164 名男性。被捕史是关键的自变量。抑郁、严重精神疾病(SMI)、药物使用、自杀意念和自杀未遂是结果变量。我们针对每个结果变量分别建立了五个多变量逻辑回归模型,并分别对男性和女性的种族/民族、收入和教育水平进行了控制:在 13 494 名受访者中,6.63% 的人有过被捕史。在年轻女性中,被捕史与所有心理健康问题的调整后几率比较大相关。最明显的是,有过被捕史的人使用药物的可能性增加了 15.19 倍,自杀未遂的可能性增加了 2.27 倍,SMI 的可能性增加了 1.79 倍,有自杀倾向的可能性增加了 1.75 倍,抑郁的可能性增加了 1.52 倍。在年轻男性中,被捕史与药物使用的调整几率比(AORs)增加有关(AOR, 13.37; p 结论):我们发现,有逮捕史的年轻人与心理健康问题之间存在密切关系。更具体地说,被捕史与年轻女性的所有心理健康问题都有关,而只与年轻男性的药物使用和自杀有关。为被捕者提供适当的心理健康护理将降低他们再次犯罪的几率,从而使他们和刑事司法系统受益。
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引用次数: 0
Correction: Training cognition in older male prisoners: lessons learned from a feasibility study. 改正:训练老年男性囚犯的认知能力:从可行性研究中汲取的经验教训。
IF 3.5 Q1 Social Sciences Pub Date : 2023-12-30 DOI: 10.1186/s40352-023-00254-5
Sandra Verhülsdonk, Claire Bohn, Nora Neyer, Tillmann Supprian, Julia Christl, Elke Kalbe, Ann-Kristin Folkerts
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引用次数: 0
Correction: Evaluating police drug diversion in England: protocol for a realist evaluation. 更正:英格兰警方毒品转用评估:现实主义评估协议。
IF 3.5 Q1 Social Sciences Pub Date : 2023-12-19 DOI: 10.1186/s40352-023-00255-4
Alex Stevens, Nadine Hendrie, Matthew Bacon, Steve Parrott, Mark Monaghan, Emma Williams, Dan Lewer, Amber Moore, Jenni Berlin, Jack Cunliffe, Paul Quinton
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引用次数: 0
"The COVID-19 pandemic and operational challenges, impacts, and lessons learned: a multi-methods study of U.S. prison systems". "COVID-19大流行病与业务挑战、影响和经验教训:对美国监狱系统的多方法研究"。
IF 3.5 Q1 Social Sciences Pub Date : 2023-12-05 DOI: 10.1186/s40352-023-00253-6
Meghan A Novisky, Jennifer Tostlebe, David Pyrooz, Jose Antonio Sanchez

Background: The purpose of this study was to examine how the COVID-19 pandemic changed U.S. prison operations and influenced the daily work of prison staff.

Methods: In collaboration with the National Institute of Corrections, we administered a survey to 31 state correctional agencies in April 2021 and conducted five focus groups with 62 correctional staff.

Results: Using a framework of bounded rationality, we find that daily operations were strained, particularly in the areas of staffing, implementing public health policy efforts, and sustaining correctional programming. While prison systems and staff were under-prepared to respond to the pandemic, they attempted to address complex problems with the limited resources they had.

Conclusions: Results underscore a need in corrections for prioritizing further developments and reviews of collaborative policies and practices for managing crisis situations. Seeking avenues for leveraging technological innovations to improve operations and facilitate enhanced communication are especially warranted. Finally, meaningful reductions in the prison population, changes in physical infrastructure, and expansions of hiring and retention initiatives are critical for positioning prisons to manage future emergencies.

背景:本研究旨在探讨 COVID-19 大流行如何改变了美国监狱的运作并影响了监狱工作人员的日常工作:我们与美国国家教养研究所合作,于 2021 年 4 月对 31 个州的教养机构进行了调查,并与 62 名教养人员进行了五次焦点小组讨论:利用有界理性框架,我们发现日常运作非常紧张,尤其是在人员配备、公共卫生政策的实施以及教养计划的持续开展等方面。虽然监狱系统和工作人员在应对大流行病方面准备不足,但他们试图用有限的资源解决复杂的问题:研究结果表明,惩教机构需要优先考虑进一步发展和审查管理危机局势的合作政策和实践。尤其需要寻求利用技术创新来改善运作和促进加强沟通的途径。最后,有意义地减少监狱人口、改变有形基础设施以及扩大招聘和留住人才的举措,对于使监狱能够管理未来的紧急情况至关重要。
{"title":"\"The COVID-19 pandemic and operational challenges, impacts, and lessons learned: a multi-methods study of U.S. prison systems\".","authors":"Meghan A Novisky, Jennifer Tostlebe, David Pyrooz, Jose Antonio Sanchez","doi":"10.1186/s40352-023-00253-6","DOIUrl":"10.1186/s40352-023-00253-6","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to examine how the COVID-19 pandemic changed U.S. prison operations and influenced the daily work of prison staff.</p><p><strong>Methods: </strong>In collaboration with the National Institute of Corrections, we administered a survey to 31 state correctional agencies in April 2021 and conducted five focus groups with 62 correctional staff.</p><p><strong>Results: </strong>Using a framework of bounded rationality, we find that daily operations were strained, particularly in the areas of staffing, implementing public health policy efforts, and sustaining correctional programming. While prison systems and staff were under-prepared to respond to the pandemic, they attempted to address complex problems with the limited resources they had.</p><p><strong>Conclusions: </strong>Results underscore a need in corrections for prioritizing further developments and reviews of collaborative policies and practices for managing crisis situations. Seeking avenues for leveraging technological innovations to improve operations and facilitate enhanced communication are especially warranted. Finally, meaningful reductions in the prison population, changes in physical infrastructure, and expansions of hiring and retention initiatives are critical for positioning prisons to manage future emergencies.</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10696818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138488636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correction: Health decline in prison and the effects of sporting activity: results of the hessian prison sports study. 更正:监狱中的健康下降和体育活动的影响:黑森州监狱体育研究的结果。
IF 3.5 Q1 Social Sciences Pub Date : 2023-12-04 DOI: 10.1186/s40352-023-00251-8
Michael Mutz, Johannes Müller
{"title":"Correction: Health decline in prison and the effects of sporting activity: results of the hessian prison sports study.","authors":"Michael Mutz, Johannes Müller","doi":"10.1186/s40352-023-00251-8","DOIUrl":"10.1186/s40352-023-00251-8","url":null,"abstract":"","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10694874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138478814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
No health without access: using a retrospective cohort to model a care continuum for people released from prison at an urban, safety net health system. 没有获取就没有健康:使用回顾性队列对城市安全网卫生系统中出狱人员的护理连续体进行建模。
IF 3.5 Q1 Social Sciences Pub Date : 2023-11-18 DOI: 10.1186/s40352-023-00248-3
Michael Frank, Ryan Loh, Rachel Everhart, Hermione Hurley, Rebecca Hanratty

Background: Release from prison is characterized by discontinuity of healthcare services and results in poor health outcomes, including an increase in mortality. Institutions capable of addressing this gap in care seldom collaborate in comprehensive, data-driven transition of care planning. This study harnesses information from a data exchange between correctional facilities and community-based healthcare agencies in Colorado to model a care continuum after release from prison.

Methods: We merged records from Denver Health (DH), an urban safety-net healthcare system, and the Colorado Department of Corrections (CDOC), for people released from January 1 to June 30, 2021. The study population was either (a) released to the Denver metro area (Denver and its five neighboring counties), or (b) assigned to the DH Regional Accountable Entity, or (c) assigned to the DH medical home based on Colorado Department of Healthcare Policy and Financing attribution methods. Outcomes explored were outpatient, acute care, and inpatient utilization in the first 180 days after release. We used Pearson's chi-squared tests or Fisher exact for univariate comparisons and logistic regression for multivariable analysis.

Results: The care continuum describes the healthcare utilization at DH by people released from CDOC. From January 1, 2021, to June 30, 2021, 3242 people were released from CDOC and 2848 were included in the data exchange. 905 individuals of the 2848 were released to the Denver metro area or attributed to DH. In the study population of 905, 78.1% had a chronic medical or psychological condition. Within 180 days of release, 31.1% utilized any health service, 24.5% utilized at least one outpatient service, and 17.1% utilized outpatient services two or more times. 10.1% utilized outpatient services within the first 30 days of release.

Conclusions: This care continuum highlights drop offs in accessing healthcare. It can be used by governmental, correctional, community-based, and healthcare agencies to design and evaluate interventions aimed at improving the health of a population at considerable risk for poor health outcomes and death.

背景:从监狱释放的特点是保健服务不连续性,导致健康状况不佳,包括死亡率上升。能够解决这一护理差距的机构很少在全面的、数据驱动的护理规划过渡中进行合作。本研究利用来自科罗拉多州惩教机构和社区医疗机构之间的数据交换信息来模拟出狱后的护理连续体。方法:我们合并了来自丹佛健康(DH),一个城市安全网医疗保健系统和科罗拉多州惩教部(CDOC)的记录,这些记录来自2021年1月1日至6月30日释放的人员。研究人群要么(a)被释放到丹佛都市区(丹佛及其邻近的五个县),要么(b)分配到卫生部区域问责实体,或者(c)根据科罗拉多州医疗保健政策和融资部门的归因方法分配到卫生部医疗之家。研究结果包括出院后180天的门诊、急诊和住院情况。我们使用皮尔逊卡方检验或Fisher精确检验进行单变量比较,使用逻辑回归进行多变量分析。结果:护理连续体描述了从CDOC释放的人在DH的医疗保健利用。从2021年1月1日到2021年6月30日,从CDOC释放了3242人,其中2848人被纳入数据交换。2848人中有905人被释放到丹佛市区或被认为是卫生部的人。在905名研究人群中,78.1%患有慢性医学或心理疾病。出院后180天内,31.1%的人使用过任何医疗服务,24.5%的人使用过至少一次门诊服务,17.1%的人使用过两次或两次以上门诊服务。10.1%的人在出院后30天内使用了门诊服务。结论:这种连续的护理突出了获得医疗保健的下降。它可被政府、惩教所、社区和卫生保健机构用于设计和评估干预措施,旨在改善健康状况不佳和死亡风险较大的人群的健康。
{"title":"No health without access: using a retrospective cohort to model a care continuum for people released from prison at an urban, safety net health system.","authors":"Michael Frank, Ryan Loh, Rachel Everhart, Hermione Hurley, Rebecca Hanratty","doi":"10.1186/s40352-023-00248-3","DOIUrl":"10.1186/s40352-023-00248-3","url":null,"abstract":"<p><strong>Background: </strong>Release from prison is characterized by discontinuity of healthcare services and results in poor health outcomes, including an increase in mortality. Institutions capable of addressing this gap in care seldom collaborate in comprehensive, data-driven transition of care planning. This study harnesses information from a data exchange between correctional facilities and community-based healthcare agencies in Colorado to model a care continuum after release from prison.</p><p><strong>Methods: </strong>We merged records from Denver Health (DH), an urban safety-net healthcare system, and the Colorado Department of Corrections (CDOC), for people released from January 1 to June 30, 2021. The study population was either (a) released to the Denver metro area (Denver and its five neighboring counties), or (b) assigned to the DH Regional Accountable Entity, or (c) assigned to the DH medical home based on Colorado Department of Healthcare Policy and Financing attribution methods. Outcomes explored were outpatient, acute care, and inpatient utilization in the first 180 days after release. We used Pearson's chi-squared tests or Fisher exact for univariate comparisons and logistic regression for multivariable analysis.</p><p><strong>Results: </strong>The care continuum describes the healthcare utilization at DH by people released from CDOC. From January 1, 2021, to June 30, 2021, 3242 people were released from CDOC and 2848 were included in the data exchange. 905 individuals of the 2848 were released to the Denver metro area or attributed to DH. In the study population of 905, 78.1% had a chronic medical or psychological condition. Within 180 days of release, 31.1% utilized any health service, 24.5% utilized at least one outpatient service, and 17.1% utilized outpatient services two or more times. 10.1% utilized outpatient services within the first 30 days of release.</p><p><strong>Conclusions: </strong>This care continuum highlights drop offs in accessing healthcare. It can be used by governmental, correctional, community-based, and healthcare agencies to design and evaluate interventions aimed at improving the health of a population at considerable risk for poor health outcomes and death.</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10656837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136399655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effectiveness of take ACTION online naloxone training for law enforcement officers. 执法人员“采取行动”在线纳洛酮培训的有效性。
IF 3 Q1 CRIMINOLOGY & PENOLOGY Pub Date : 2023-11-18 DOI: 10.1186/s40352-023-00250-9
Chin Hwa Dahlem, Rohan Patil, Lara Khadr, Robert J Ploutz-Snyder, Carol J Boyd, Clayton J Shuman

Background: Training law enforcement officers (LEOs) to administer naloxone is a recommended strategy to reduce overdose deaths in the United States. To achieve this, an evidence-based and scalable naloxone training curriculum that is easy to use and readily scalable is needed. Convenient web-based training is a flexible method for delivering educational interventions particularly for LEOs who have irregular or shifting schedules. This study examined the effectiveness of a comprehensive web-based naloxone training that was created in partnership with LEOs on their knowledge, confidence, and attitudes regarding naloxone.

Methods: From May 2019 to September 2020, five law enforcement departments from Michigan participated in web-based naloxone training. A total of 182 LEOs (77% male) were in the final sample based on matching pre-and post-test surveys. LEOs were assessed on knowledge, confidence, and attitudes towards naloxone. Negative binomial and Poisson regression was conducted to assess associations between knowledge, confidence, and attitudes towards naloxone before and after training.

Results: Significant improvements in overdose knowledge and confidence were revealed across all departments with median (IQR) total composite scores for knowledge increasing from 35 (32, 37) to 40 (39, 42) (p < 0.01) and confidence increasing from 18.5 (15, 20) to 20 (20, 25) (p < 0.01). Median (IQR) attitude scores did not change.

Conclusion: Our web-based naloxone training was effective in improving knowledge and confidence for LEOs but did not significantly improve LEOs attitudes towards naloxone across most departments. The web-based format is readily scalable and quickly disseminated and meets the immediate need for LEO overdose training. Additional intervention is needed to address the negative attitudes of LEOs regarding naloxone.

背景:在美国,培训执法人员(LEOs)管理纳洛酮是减少过量死亡的推荐策略。为实现这一目标,需要一个基于证据且可扩展的纳洛酮培训课程,该课程易于使用且易于扩展。便利的网络培训是提供教育干预的一种灵活方法,特别是对于那些时间表不规律或多变的低水平学生。本研究考察了一个综合性的基于网络的纳洛酮培训的有效性,该培训是与leo合作创建的,旨在提高他们对纳洛酮的知识、信心和态度。方法:2019年5月至2020年9月,密歇根州5个执法部门参加基于网络的纳洛酮培训。根据测试前和测试后的匹配调查,最终样本中共有182名LEOs(77%为男性)。评估了leo对纳洛酮的知识、信心和态度。采用负二项回归和泊松回归评估训练前后对纳洛酮的知识、信心和态度之间的关系。结果:各科室用药过量知识和信心均有显著提高,知识综合得分中位数(IQR)从35分(32,37分)上升至40分(39,42分)(p)。结论:基于网络的纳洛酮培训可有效提高LEOs对纳洛酮的知识和信心,但对大多数科室LEOs对纳洛酮的态度没有显著改善。基于网络的格式易于扩展和快速传播,并满足LEO过量培训的迫切需要。需要采取额外的干预措施来解决leo对纳洛酮的负面态度。
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引用次数: 0
How legal problems are conceptualized and measured in healthcare settings: a systematic review. 法律问题是如何概念化和衡量在医疗保健设置:一个系统的审查。
IF 3.5 Q1 Social Sciences Pub Date : 2023-11-18 DOI: 10.1186/s40352-023-00246-5
Joshua R Vest, Rachel J Hinrichs, Heidi Hosler

Legal problems encompass issues requiring resolution through the justice system. This social risk factor creates barriers in accessing services and increases risk of poor health outcomes. A systematic review of the peer-reviewed English-language health literature following the PRISMA guidelines sought to answer the question, how has the concept of patients' "legal problems" been operationalized in healthcare settings? Eligible articles reported the measurement or screening of individuals for legal problems in a United States healthcare or clinical setting. We abstracted the prevalence of legal problems, characteristics of the sampled population, and which concepts were included. 58 studies reported a total of 82 different measurements of legal problems. 56.8% of measures reflected a single concept (e.g., incarcerated only). The rest of the measures reflected two or more concepts within a single reported measure (e.g., incarcerations and arrests). Among all measures, the concept of incarceration or being imprisoned appeared the most frequently (57%). The mean of the reported legal problems was 26%. The literature indicates that legal concepts, however operationalized, are very common among patients. The variation in measurement definitions and approaches indicates the potential difficulties for organizations seeking to address these challenges.

法律问题包括需要通过司法系统解决的问题。这一社会风险因素造成了获得服务的障碍,并增加了不良健康结果的风险。根据PRISMA指南对同行评议的英语卫生文献进行了系统回顾,试图回答以下问题:患者“法律问题”的概念是如何在医疗保健环境中实施的?符合条件的文章报告了美国医疗保健或临床环境中对个人法律问题的测量或筛选。我们对法律问题的普遍性、抽样人口的特征以及包括哪些概念进行了抽象。58项研究报告了总共82种不同的法律问题测量方法。56.8%的措施反映了单一概念(例如,仅监禁)。其余的措施在一项报告的措施中反映了两个或两个以上的概念(例如监禁和逮捕)。在所有措施中,监禁或被监禁的概念出现得最频繁(57%)。报告的法律问题的平均值为26%。文献表明,法律概念,然而操作,是非常普遍的病人。度量定义和方法的变化表明了寻求解决这些挑战的组织的潜在困难。
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引用次数: 0
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