Journal of correctional health care : the official journal of the National Commission on Correctional Health Care最新文献

While compensation for research participation is common practice in community settings, the type and amount of compensation provided in carceral settings varies substantially. This is notable given the potential for compensation to unduly influence participation in research activities, particularly for vulnerable populations, such as people who are incarcerated. We aimed to conduct community-engaged research to better understand the potential impacts of different compensation approaches. We conducted interviews (N = 21) concerning ethical research approaches and compensation practices in carceral settings among cisgender men experiencing incarceration at the Rhode Island Department of Corrections. Interviews were recorded, transcribed, coded, and analyzed using framework analysis. Participants were favorable toward compensating individuals enrolled in research in the carceral setting. Participants had a range of views on compensation methods for individuals participating in research with most participants preferring monetary compensation, although some suggested nonmonetary compensation such as food or hygiene products. Regarding appropriate compensation for participating in a one-hour, low-risk research activity, participants volunteered a range of payment amounts. By gathering the perspectives of people who are incarcerated, our data offer guidance for conducting research among populations experiencing incarceration, institutional review boards, and carceral institutions developing policies for research compensation.

A national, anonymous, online survey was administered inviting 3,161 correctional health professionals to examine the associations between facility characteristics and the availability of medications for opioid use disorder (MOUD) in jails and prisons. Responses from 268 participants representing 212 correctional facilities were analyzed. We used multivariate logistic regression to identify associated facility characteristics, and open-ended responses were analyzed using content analysis. Facilities in the Western United States had higher odds of providing MOUD compared with those in the Midwest (adjusted odds ratio [AOR] = 3.67, 95% confidence interval [CI]: 1.28-10.99). Jails had higher odds of offering MOUD than prisons (AOR = 2.13, OR = 0.47, 95% CI: 0.21-0.99). Qualitative analysis revealed key supports for facilitating MOUD implementation and common barriers.

Pregnant individuals with opioid use disorder (OUD) are incarcerated at higher rates than the general pregnant population and are overrepresented within the carceral system. Although OUD treatment reduces overdose risk and improves perinatal outcomes, incarceration can be a barrier to timely access and continuity of care. We describe the implementation of an integrated perinatal medications for opioid use disorder (MOUD) clinic ("the clinic") within the single state prison facility housing pregnant individuals in North Carolina. The clinic provides prenatal care, screening for substance use disorders, MOUD, recovery-focused counseling and case management, referral to mental and behavioral health services, and coordination of care after release with community clinicians. Implementation successes included faster initiation and continuation of MOUD, increased staff capacity, improved collaboration among key stakeholders, and reduced costs associated with perinatal OUD care. Challenges involved consistent intake screening, adherence to withdrawal surveillance protocols, postpartum maintenance of treatment, and continuity of therapy upon release. This novel program integrates physical and behavioral health services to support initiation and maintenance of MOUD for pregnant and postpartum individuals during incarceration. Future steps include incorporating patient perspectives and expanding partnerships to further decrease overdose morbidity and mortality.

Roughly 1.8 million individuals were detained or incarcerated in U.S. correctional facilities in 2022. Prior research has found that incarcerated persons are at increased risk for foodborne outbreaks. We aim to summarize recent national outbreak surveillance data and describe the nexus between disease burden and the law to inform prevention efforts. First, we describe epidemiological data for single-state correctional and all noncorrectional foodborne outbreaks during 1998-2022 that were reported to the Centers for Disease Control and Prevention's Foodborne Disease Outbreak Surveillance System. Second, we summarize state statutes and regulations for seven key food safety provisions in the 10 states with the largest incarcerated populations. Incarcerated and detained individuals experience nearly seven times as many outbreak-associated illnesses per 100,000 individuals than the public. Further, the median number of illnesses per outbreak in correctional settings is nearly six times greater than noncorrectional settings. All 10 states codified all or most of the seven food safety provisions for food service establishments, whereas express legal requirements instituting these provisions within correctional facilities were largely absent. Legal interventions, rigorous food safety practices, and collaborations with health departments are critical tools needed to reduce foodborne outbreaks in correctional facilities.

A patient-centered HIV care model (PCHCM) can improve antiretroviral treatment adherence and viral suppression outcomes. No studies have evaluated viral suppression among people with HIV (PWH) in carceral settings under this model. This study compares HIV virologic suppression among PWH in Washington state prisons under a PCHCM to all PWH in Washington between 2008 and 2019. We conducted three analyses of a retrospective cohort of 403 PWH in prison. Prison-wide annual viral suppression proportions among total HIV population and the HIV population tested each year were compared with Washington public health surveillance data. Average changes in viral suppression proportions at intake and release were summarized and tested for statistically significant differences. Prison-wide HIV viral suppression increased from 61.4% in 2008 to 86.0% in 2019, surpassing most annual statewide proportions. Viral suppression proportions among those with at least one yearly viral load test were even higher. Between 2015 and 2019, > 95% of incarcerated PWH achieved viral suppression. Average viral suppression proportions increased during incarceration from 59.1% at intake to 92.4% at release between 2008 and 2019 (p < 0.05). Prison populations can reach near universal viral suppression under a PCHCM, suggesting a higher threshold from which to judge the effectiveness of HIV carceral care.

Incarcerated pregnant and postpartum people are a marginalized group at risk of adverse health outcomes. Routine carceral policies such as search protocols; work, housing, and bunk assignments; and provision of clothing and hygiene products may not be designed for optimal pregnancy and postpartum health. This study examined federal and state statutes and regulations that amend carceral policies to accommodate pregnancy and the postpartum period through a systematic review in WestLaw. We analyzed content from returned statutes and regulations and developed summaries of statutes and regulations for each type of accommodation. Our search revealed that no federal policies exist protecting accommodations during this period. Few states enshrine access to recommended accommodations during pregnancy or postpartum. Only 22 states have policies related to accommodations, and only 10 of these were related to the postpartum period. To protect the health of incarcerated pregnant and postpartum people, states and the federal government should pass or amend legislation that codifies recommended accommodations for pregnant and postpartum incarcerated people. Policymakers should also consider mandatory oversight of carceral institutions to ensure policies are consistently communicated and enforced.

Congenital syphilis is a major global public health problem with cases rapidly increasing in the United States. This article presents a case of an incarcerated pregnant individual who tested negative on routine screening at prison entry, and for whom a third trimester syphilis test likely prevented mother-to-child syphilis transmission. Third trimester syphilis screening in carceral settings is a critical tool in the prevention of congenital syphilis. Yet there are no consensus guidelines recommending universal repeat screening in the third trimester. Many cases of congenital syphilis are missed because of late maternal seroconversion following early-stage syphilis or reinfection, supporting the implementation of universal third trimester screening for syphilis, particularly in carceral settings. The case and reflection on clinical experience of similar cases reported here underscore the importance of universal re-screening for syphilis early in the third trimester to prevent congenital syphilis.

Introduction: People from prison often present to acute hospitals with complex and chronic health conditions. Their presentation to acute hospitals poses unique challenges for health care professionals (HCPs) who work outside prison hospitals. This systematic review aimed synthesize evidence on the experiences of HCPs caring for people from prison in acute hospitals. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines informed the structure of this review. The protocol was registered in PROSPERO (CRD42025625502). Electronic databases were searched for relevant primary studies published in English language between January 01, 2004, and January 31, 2025. Additional citation and manual searches were completed. Data were extracted, and a narrative synthesis was completed. The search identified 753 studies, of which 10 studies met the inclusion criteria. The ten studies were from four countries and involved 1,515 HCPs. The included studies identified diverse experiences, and a narrative synthesis identified four themes: (1) emotional and ethical distress, (2) disrupted clinical roles, (3) dehumanizing practices and bias, and (4) advocacy and empathetic resilience. Context-specific protocols are needed, with joint training for HCPs and prison officers jointly produced by hospitals and the criminal justice system.

Incarcerated individuals are the only population in the United States with a constitutional guarantee to health care, yet their surgical needs remain poorly characterized. We aimed to assess the burden of surgical disease and patterns of surgical consultation among incarcerated patients. Over 1 year, 332 incarcerated individuals presented with surgical conditions to a single Level 1 Trauma Center Emergency Department. Of these, 135 patients (40%) were evaluated by a surgeon, and 57 (43% of those evaluated) were admitted during their initial visit. Within 90 days, 104 patients (31%) returned to the emergency department, and 31 (30% of return visits) required admission. Outpatient follow-up was recommended for 165 patients (53%), yet only two-thirds (n = 109) received outpatient care.