International Journal of Prisoner Health最新文献

Purpose: Valid and reliable measurement is critical to the assessment and evaluation of health interventions. However, few scholars have examined the psychometric properties of "gold standard" measures in carceral settings, and no research has explored the reliability, validity and factor structure of the 26-item World Health Organization Quality of Life (WHOQOL) BREF among older adults incarcerated in prison, a large and growing population marked by substantial chronic and life-limiting illness. This study aims to examine the reliability, validity and factor structure of the WHOQOL-BREF.

Design/methodology/approach: Secondary data from a large-scale study with older adults (age 45+) incarcerated in a Midwestern state were used (N = 499). Floor and ceiling effects were examined, as was the reliability of the measure (Cronbach's alpha). The structural validity of a four-factor and second-order four-factor model of the WHOQOL-BREF was examined using confirmatory factor analysis. Model data fit was examined using chi-square, standardized root mean square residual, comparative fit indices, Akaike information criterion and the Bayesian Information Criterion. Pearson product-moment correlation coefficients were also used to assess validity.

Findings: Results indicate adequate construct validity and reliability for the WHOQOL-BREF using the current sample. Model-data fit indexes also reveal adequate structure of the measure relative to other older adult samples. Non-random data and item exclusion are noteworthy limits, and future researchers are encouraged to co-conceptualize and operationalize life quality with older adults who are incarcerated.

Originality/value: To the best of the authors' knowledge, this is the first study to explore the psychometric properties of the WHOQOL-BREF among older adults incarcerated in prison.

Purpose: Prisoners with substance use disorder (SUD) are at risk of mental health problems. Given the common co-occurring of psychopathic traits with SUDs, probably because of underlying impulsive traits (Ellingson et al., 2018), this study aims to examine the relation between psychopathy (impulsive antisociality and fearless dominance) and the functioning of incarcerated individuals with SUD. The authors investigated whether impulsivity (motor, nonplanning and attentional) can account for the relationship between one psychopathy facet (impulsive antisociality) and craving and mental health problems.

Design/methodology/approach: The authors assessed self-reported impulsivity, psychopathy, craving and mental health problems in 121 male incarcerated individuals with SUD and calculated cross-sectional linear regression analyses and mediation models.

Findings: Impulsive antisociality was positively related to all impulsivity facets, craving and mental health problems. Attentional impulsivity mediated the relationship of impulsive antisociality with craving and mental health problems. Fearless dominance was related to lower attentional and nonplanning impulsivity, craving and mental health problems.

Research limitations/implications: Future studies should investigate these relations in longitudinal studies and evaluate tailored approaches, for example, mindfulness interventions.

Practical implications: Interventions to reduce craving and improve mental health might be important for those who display self-centered, antisocial behavior but are less relevant for those with fearless, dominant interpersonal behavior. Addressing attentional impulsivity may be of special interest in this regard.

Originality/value: To the best of the authors' knowledge, this study was the first to investigate the mediating role of different impulsivity facets for the association of impulsive antisociality with craving and with mental health problems in incarcerated individuals with SUD.

Purpose: Young prisoners are one of the most vulnerable groups in society for mental health problems and ill-being. Therefore, there is a crucial need to understand their physical, psychological and social situations. This study aims to explore young Cambodian prisoners' experiences and perceptions of mental health and well-being, their determinants and their coping strategies.

Design/methodology/approach: Six focus group discussions were carried out in three prisons with a total of 48 young prisoners between the ages of 15 and 24 years (50% women, 50% men). Semi-structured questions guided the discussions, and thematic analysis was applied to analyse the data.

Findings: Young prisoners reported multifaceted experiences of mental health and well-being. The majority described adverse mental health experiences, while some revealed better well-being, partly influenced by the socio-economic support from outside the prisons and previous involvement or not in drug abuse. The experience of physical overcrowding without emotional attachment among the fellow prisoners was perceived as the overarching determinant of loneliness and mental health problems, while socio-emotional support and rituals were described as the most important coping mechanisms.

Originality/value: This pioneering study from Cambodia gives young prisoners an opportunity to voice their experiences and perceptions of mental health and well-being in the prison setting. The findings in this study underline the importance of prison authorities tackling overcrowding to promote well-being and reduce mental health problems. Also, the coping mechanisms outlined by the participants should be considered when planning psychosocial interventions.

Purpose: The US prison population has recently reached an all-time high, with women representing the fastest growing subpopulation. Correctional health-care system in the USA remains fragmented and nonuniform in practice, particularly in women's health care, with poor transitions between incarceration and release. This study aims to examine the qualitative health-care experiences of women while incarcerated and their transition into the community health-care setting. Additionally, this study also examined the experiences of a subset of women who were pregnant while incarcerated.

Design/methodology/approach: After obtaining institutional review board approval, adult, English-speaking women with a history of incarceration within the past 10 years were interviewed using a semi-structured interview tool. Interview transcripts were analyzed using inductive content analysis.

Findings: The authors completed 21 full interviews and identified six themes that were both the most significant and most novel: "feeling stigmatized and insignificant," "care as punishment," "delay in care," "exceptions to the rule," "fragmentation of care" and "obstetric trauma and resilience."

Originality/value: Women face numerous barriers and hardships when accessing basic and reproductive health-care services while incarcerated. This hardship is particularly challenging for women with substance use disorders. The authors were able to describe for the first time, partially through their own words, novel challenges described by women interacting with incarceration health care. Community providers should understand these barriers and challenges so as to effectively reengage women in care upon release and improve the health-care status of this historically marginalized group.

Purpose: This study aims to estimate the overall SARS-CoV-2 seroprevalence and evaluate the accuracy of an antibody rapid test compared to a reference serological assay during a COVID-19 outbreak in a prison complex housing over 13,000 prisoners in Brasília.

Design/methodology/approach: The authors obtained a randomized, stratified representative sample of each prison unit and conducted a repeated serosurvey among prisoners between June and July 2020, using a lateral-flow immunochromatographic assay (LFIA). Samples were also retested using a chemiluminescence enzyme immunoassay (CLIA) to compare SARS-CoV-2 seroprevalence and 21-days incidence, as well as to estimate the overall infection fatality rate (IFR) and determine the diagnostic accuracy of the LFIA test.

Findings: This study identified 485 eligible individuals and enrolled 460 participants. Baseline and 21-days follow-up seroprevalence were estimated at 52.0% (95% CI 44.9-59.0) and 56.7% (95% CI 48.2-65.3) with LFIA; and 80.7% (95% CI 74.1-87.3) and 81.1% (95% CI 74.4-87.8) with CLIA, with an overall IFR of 0.02%. There were 78.2% (95% CI 66.7-89.7) symptomatic individuals among the positive cases. Sensitivity and specificity of LFIA were estimated at 43.4% and 83.3% for IgM; 46.5% and 91.5% for IgG; and 59.1% and 77.3% for combined tests.

Originality/value: The authors found high seroprevalence of anti-SARS-CoV-2 antibodies within the prison complex. The occurrence of asymptomatic infection highlights the importance of periodic mass testing in addition to case-finding of symptomatic individuals; however, the field performance of LFIA tests should be validated. This study recommends that vaccination strategies consider the inclusion of prisoners and prison staff in priority groups.

Purpose: People who use drugs (PWUD) have been disproportionately affected by the COVID-19 pandemic. This study aims to examine changes in illicit opioid use and related factors among incarcerated PWUD in Quebec, Canada, during the pandemic.

Design/methodology/approach: The authors conducted an observational, cross-sectional study in three Quebec provincial prisons. Participants completed self-administered questionnaires. The primary outcome, "changes in illicit opioid consumption," was measured using the question "Has your consumption of opioid drugs that were not prescribed to you by a medical professional changed since March 2020?" The association of independent variables and recent changes (past six months) in opioid consumption were examined using mixed-effects Poisson regression models with robust standard errors. Crude and adjusted risk ratios with 95% confidence intervals (95% CIs) were calculated.

Findings: A total of 123 participants (median age 37, 76% White) were included from January 19 to September 15, 2021. The majority (72; 59%) reported decreased illicit opioid consumption since March 2020. Individuals over 40 were 11% less likely (95% CI 14-8 vs 18-39) to report a decrease, while those living with others and with a history of opioid overdose were 30% (95% CI 9-55 vs living alone) and 9% (95% CI 0-18 vs not) more likely to report decreased illicit opioid consumption since March 2020, respectively.

Originality/value: The authors identified possible factors associated with changes in illicit opioid consumption among incarcerated PWUD in Quebec. Irrespective of opioid consumption patterns, increased access to opioid agonist therapy and enhanced discharge planning for incarcerated PWUD are recommended to mitigate the harms from opioids and other drugs.

Purpose: Prisons in Africa face unprecedented challenges during Coronavirus disease 2019 (COVID-19). In July 2020, the first prison system case of COVID-19 was notified in Zimbabwe. Subsequently, the Zimbabwe Prisons and Correctional Services released their COVID-19 operational plan. The purpose of the study was to assess preparedness, prevention and control of COVID-19 in selected prisons in Zimbabwe.

Design/methodology/approach: A multi-method situation assessment of COVID-19 preparedness was conducted across three Zimbabwean prisons. The World Health Organization checklist to evaluate preparedness, prevention and control of COVID-19 in prisons was administered to frontline health managers. Information garnered was further explored during site observation and in multi-stakeholder key informant interviews with policymakers, prison health directorate, frontline health-care professionals, officers in charge and non-governmental organizations (n = 26); focus group discussions with correctional officers (n = 18); and male/female prisoners (n = 36). Data was triangulated and analyzed using content thematic analysis.

Findings: Outdated infrastructure, severe congestion, interrupted water supply and inadequate hygiene and sanitation were conducive to ill-health and spread of disease. Health professionals had been well-trained regarding COVID-19 disease control measures. COVID-19 awareness among prisoners was generally adequate. There was no routine COVID-19 testing in place, beyond thermo scanning. Access to health care was good, but standards were hindered by inadequate medicines and personnel protective equipment supply. Isolation measures were compromised by accommodation capacity issues. Flow of prison entries constituted a transmission risk. Social distancing was impossible during meals and at night.

Originality/value: This unique situation assessment of Zimbabwean prisons' preparedness and approach to tackling COVID-19 acknowledges state and prison efforts to protect prisoners and staff, despite infrastructural constraints and inadequate resourcing from government.

Purpose: The purpose of this paper is to demonstrate that the eventual legalisation of assisted dying in England and Wales should extend to persons deprived of liberty, as well.

Design/methodology/approach: Using a relational view of dignity strengthens the argument that the need to protect the dignity of persons deprived of liberty requires the extension of the legalisation of assisted dying to persons deprived of liberty once generally achieved in England and Wales.

Findings: Three aspects make dignity a relational concept - dignity being attributed by society, dignity working as a restraint on others and dignity requiring specific behaviours. All these elements support the claim that assisted dying should be available to persons deprived of liberty, once legalised in England and Wales.

Originality/value: Both the legalisation of assisted dying for persons deprived of liberty and the concept of relational dignity have to date found little attention. With a legalisation of assisted dying being debated in England and Wales, it is pertinent to discuss its application to persons deprived of liberty, who would undoubtedly not automatically benefit from a future Assisted Dying Act.

Purpose: This paper reports on insights from an evaluation of Birth Companions (BC) (a UK-based charity) perinatal support in two prison settings in England. The initiative involved the provision of group and/or one-to-one perinatal support and training women prisoners as peer supporters.

Design/methodology/approach: A mixed-methods study was undertaken that involved observations of support groups and peer support supervision sessions (n = 9); audio recorded interviews (n = 33) with prison and health-care staff, women in prison, peer supporters and BC staff; analysis of existing routinely collected data by BC and notes undertaken during regular meetings (n = 10) with the BC Project Manager. Thematic analysis was undertaken supported by MAXQDA qualitative data analysis software.

Findings: BC provided instrumental/practical support, emotional support, information support, signposting to services and advocating for women to the prison concerning their perinatal needs and rights. Key themes revealed that support had an impact on the lives of perinatal women by creating a safe place characterised by meaningful interactions and women-centred approaches that facilitated access to wider care and support. The service made a difference by empowering women and providing added value for peer supporters, prison, health-care and BC staff. Key enablers and strategies for the care of perinatal women and the delivery of perinatal support are also detailed.

Originality/value: Through longitudinal data and the involvement of a range of stakeholders, this study evidences the subtleties of support provided by BC and the potential it has to make a difference to perinatal women in prison and those volunteering or working within the prison system.