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

Studies have shown lower screening for sexually transmitted infections (STIs) during the COVID-19 pandemic. It is unclear how the pandemic affected STI testing among juvenile justice-involved youth, especially for extragenital gonorrhea and chlamydia. Retrospective chart review was conducted between March 2020 and June 2021 utilizing electronic health records of youth seen at a preadjudication facility in the southwest United States. Rates of extragenital testing were compared with prepandemic rates. Overall, 574 youth were observed; 86% were male, mean age was 15.4 years, and 48.6% were Black. Of the youth reporting performing oral sex, 57% were tested for oropharyngeal STIs compared to 33.5% in 2018 to 2019. Twenty percent of those reporting anal receptive sex were tested for rectal infections compared to 25.9% before the pandemic. Pandemic testing for oropharyngeal STIs increased but rectal testing decreased. Overall, testing rates remained low.

This study examined the impact of prompting only and prompting combined with independent group-oriented contingency on incarcerated adolescent males' physical activity level during a sport-leadership program. An alternating treatment design was employed to allow for the evaluation among multiple treatment conditions. The study occurred during 35 consecutive sport programming lessons at a juvenile correctional facility. Participants were 16 adolescent males (M_age = 18.79). Two behavior modification strategies, prompting only and prompting combined with independent group-oriented contingency, were employed. Data were plotted graphically so visual analysis could be determined in order to explore any functional associations between the treatment conditions (e.g., interventions) and target behavior (e.g., step count). Prompting only slightly increased physical activity, whereas prompting in conjunction with independent group-oriented contingency elevated activity levels by 36%, with a smaller standard deviation indicating that all participants were equivalently physically active. The results of this study underpin the expansive benefits of sport-leadership programming, not just in similar programs' ability to develop life skill integration, positively impact life during incarceration, improve attitudes, and promote physical activity, but also to provide elevated opportunities for youth to be physically active.

Los Angeles County has been facing a syphilis crisis since 2018. Cases of ocular syphilis have become increasingly identified and reported in the past few years, predominantly in HIV-positive men. Here we report a case of ocular syphilis in an otherwise healthy 49-year-old male in the Los Angeles County jail. This case study emphasizes the importance of increasing awareness of ocular syphilis so that it can be diagnosed promptly to prevent irreversible vision loss. Health care providers who work in the correctional facility setting need to be aware of this disease entity given that they serve a population with high risk of sexually transmitted diseases (STDs). This case study further stresses the importance of initial screening for sexual history and/or history of STDs within this population.

Justice-involved youth are known to be at elevated risk of substance use disorder (SUD). This review examines literature published over a 10-year period and summarizes evidence-based practices for screening, treatment, and linkage to care for justice-involved youth as well as barriers and facilitators that may arise during implementation. Strategies to incorporate a health equity lens and trauma-informed approaches are discussed. Despite high prevalence of substance use and research showing that treatment reduces recidivism, few juvenile justice systems universally screen and treat youth with SUD. There is limited developmentally appropriate guidance available for those seeking to better address substance use in juvenile justice settings. This review highlights gaps in the literature, which must be addressed to increase access to treatment and improve outcomes for this vulnerable youth population.

Despite the scale, inequity, and consequences of mass incarceration, health care provider knowledge and awareness on correctional health remain limited. Understanding the educational experiences of health professions learners and the studies used to evaluate them can provide useful information about current gaps to guide future curricular improvement. To address this need, we conducted a scoping review of peer-reviewed studies examining United States-based academic health professions educational programs on correctional health. Studies were coded based on study characteristics, learner outcomes, and degree to which they contained elements described in relevant position statements by two professional medical associations. Overall, 27 articles (1975-2021) were included. Learner outcomes were primarily documented at the "reactions" (93%) and "learning" (52%) levels of the Kirkpatrick model (1979), relative to "behaviors" (11%) and "long-term outcomes" (0%). Comparison of curricula to select position statements revealed multiple content gaps in the realms of prevalent conditions requiring expertise (e.g., violence and self-harm); ethical and medical-legal considerations (e.g., privatization of correctional health care); and correctional health care systems, structures, and administration. Taken together, findings highlight gaps in, and opportunities for, correctional health educational programs. Addressing health care workforce training needs is a necessary yet insufficient step to achieving health equity for populations affected by incarceration.

Continued uncertainty on overrepresentation of autism spectrum disorder (ASD) in the criminal justice system (CJS), although important, has shifted focus away from other questions of CJS treatment of neurodiverse individuals and left little guidance on best practice for people with ASD. For ASD individuals involved in sex offenses, there remains even less guidance. Because aspects of ASD symptomatology can highly influence sexual behaviors in ways that differ from neurotypical sex offending, it is imperative that clinicians and correctional professionals know more about this potential influence of ASD on sex offending behaviors. This knowledge should then inform efforts to enact more effective and equitable policies when interacting with the ASD population. This article reviews the connection between ASD symptoms and sexual behaviors as well as the lack of ASD-oriented sex education that could result in sex offending charges. A review of literature examining sex offending risk and its relation to ASD follows. Recommendations for more equitable treatment are discussed for different aspects of the correctional system, including forensic assessment, treatment efforts, and correctional staff interactions.

Millions are confined in U.S. jails each year, often with unmet health and social needs. After release, many will visit the emergency department (ED). To illuminate their patterns of ED use, this study linked records from all individuals detained at a Southern urban jail over a 5-year period with health records from a large health care system with three EDs. Over half used the ED at least once, and of those who received care at the health system, 83% visited the ED. Jail-involved people made up 4.1% of the health care system's ED users but 21.3% of its chronic frequent ED users. Frequent ED use was associated with more frequent jail bookings and with co-occurring serious mental illness and substance use disorder. Health systems and jails have a common interest in addressing the needs of this population. Individuals with co-occurring disorders should be prioritized for intervention.

The goal of the intensive outpatient program was to provide services to individuals who presented with co-occurring mental health and substance abuse disorders. These services were provided to incarcerated individuals during their involvement with a large Midwestern jail facility in efforts to reduce recidivism. Behavior change is a difficult process for any population, but for those with co-occurring mental health and substance abuse disorders, it is particularly challenging. With psychotherapeutic interventions, there may be therapeutic benefits that are occurring through outcomes such as increased insight into one's problems, attitudinal shifts, or improved coping that cannot be captured by tracking recidivism.