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

The epidemic of opioid overdose brought a major health crisis to the front line of public health in the United States. Early efforts have focused on the prevention of production, distribution, and consumption of the drugs. However, there is little information about youth populations at risk for opioid overdose and their response to targeted treatment plans. The San Bernardino County Youth Opioid Response (SBCYOR) coalition in collaboration with the San Bernadino County (SBC) Probation Department organized a safety net system for at-risk youth by improving communication among county resources. This program mainly focused on individuals aged 12 to 24 years in the county's detention centers along with educational and prevention projects such as naloxone programs for first responders in the region. To describe the impact of the SBCYOR program on at-risk youth, we compare the frequencies of patients referred and treated with medications for opioid use disorder (MOUD) at the SBC Probation Department, which was responsible for individuals from age 12 to less than 18 years, with those from the West Valley Detention Center (WVDC), which was responsible for adults (18 to 24 years of age), from September 2020 through June 2022. Similar proportions of youths were referred for treatment of opioid use disorder (OUD) at the respective sites (3.7% SBC Probation Department, 3.6% WVDC). Of these, however, 78.0% were treated with MOUD at SBC Probation Department compared with only 7.1% at WVDC. SBCYOR coalition partners were able to transform their services into a comprehensive medical and behavioral health program for the incarcerated youth population at risk for OUD.

Many people with HIV (PWH) in jail have not been well engaged in HIV treatment in the community. This study aimed to assess the impact of a data exchange paired with care coordination for PWH on HIV outcomes after jail release. We developed an automated process to match jail booking records with HIV surveillance data. Health department HIV relinkage specialists and jail release planners used the data in weekly case conferences to facilitate care coordination for PWH who were out of care (no CD4 or viral load [VL] reported in the past 12 months) or viremic (VL ≥ 200 copies/mL) before booking. We compared VL testing within 3 months after release and viral suppression (VL < 200 copies/mL) within 6 months after release in preintervention (October 1, 2016-October 1, 2017) versus postintervention (April 1, 2018-February 1, 2019) periods using Cox proportional hazard models. Comparing 153 bookings among PWH in the preintervention period to 80 in the postintervention period, VL testing after release did not differ (47% vs. 55%; adjusted hazard ratio [aHR]: 1.05, 95% confidence interval [CI]: 0.68-1.64) nor did viral suppression (35% vs. 44%; aHR: 1.28 [95% CI: 0.80-2.05]). Data exchange and care coordination are insufficient to improve postrelease outcomes among PWH without additional interventions in the jail and community.

Diabetes is prevalent among incarcerated individuals, necessitating effective management within prison settings. This study aims to assess diabetes management among incarcerated individuals and analyze the methodological aspects of relevant research focusing on incarcerated individuals with diabetes. A systematic search was conducted in PubMed, Web of Science, Scopus, and Google Scholar databases, with data parameters from 1990 to 2021 and following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, to investigate diabetes management in incarcerated individuals. The search yielded 706 records, from which 14 English-language quantitative studies meeting inclusion criteria were selected for analysis. These studies were predominantly retrospective with low levels of evidence. However, they consistently demonstrated the beneficial effects of dietary interventions, educational programs, and nursing guidance on diabetes management in incarcerated populations. This study highlights the need for more comprehensive and high-evidence research to further explore health professionals' practices with incarcerated individuals with diabetes and the effectiveness of diabetes management. Such studies are crucial for improving the quality of care provided to this vulnerable population.

Due to the complex nature of correctional facilities, correctional health care professionals (CHPs) are at high risk of experiencing the harms of helping such as burnout, vicarious trauma, and post-traumatic stress disorder (PTSD). Although traditionally applied to military populations, the construct of moral injury has gained increasing application to health care and bears relevance to correctional health care. This qualitative study examines the prevalence of moral injury among CHPs while considering the moral dilemmas and ethical challenges of delivering care in a carceral environment. Employing an interpretative phenomenological analysis (IPA), 25 semi-structured interviews were conducted with a diverse sample of CHPs, selected through nonprobability, purposive sampling. Rigorous thematic analysis, guided by IPA principles, was used. The data revealed five key themes: moral injury is an occupational hazard for correctional health care workers; incidental versus cumulative moral injury; role of institutional betrayal; the intersectional relationship among moral injury, PTSD, and burnout; and the road to moral repair. These themes offer insights into the prevalence and effects of moral injury in correctional health care while offering solutions to navigating moral injury. These findings contribute to a deeper understanding of the complex ethical and psychological dynamics within correctional health care settings and explore implications for practice, policy, and future research.

Prevalence of adverse childhood experiences (ACEs) and the extent to which they relate to health among young adults (ages 18-25) returning home from jail is underexamined. To build on the growing literature examining associations between ACE exposure among young people involved with carceral systems and health, we (1) measured ACE prevalence and (2) explored associations between ACEs and health/well-being indicators among young adults experiencing reentry. Using a telephone survey on reentry experiences, participants completed an ACE screening, single-item responses on health and social indicators, and five-item responses on substance misuse. Fisher's exact tests and t tests compared sociodemographic and health-related factors by the levels of ACEs. Among the 85 participants, 66 (78%) reported four or more ACEs and 48 (56%) reported six or more ACEs, including divorced parents (n = 69, 81%), witnessing violence (n = 63, 74%), and household member incarceration (n = 60, 71%). Higher exposure to ACEs was associated with mental health diagnoses, psychiatric medication prescriptions, psychiatric hospitalizations, drug dependence, binge drinking, and cannabis misuse. High ACE exposure among young adults experiencing reentry portends worse mental health and high rates of substance use. Findings signify an opportunity to apply a trauma-focused developmental framework to support emerging adults during the crucial reentry period.

This opinion consolidates regulatory frameworks, legal cases, workforce data, and research studies to advocate for the advancement of licensed practical nurses to registered nurses within correctional health care. By emphasizing adherence to nursing scope of practice and proposing a sustainable workforce development model, this article aims to enhance patient care and elevate standards in correctional facilities.

With an aging prison population facing various chronic diseases, the importance of palliative and end-of-life care (EOLC) in correctional facilities is heightened. This systematic review aimed to identify facilitators and barriers to palliative and EOLC in prisons. PubMed, Web of Science, Scopus, and Cochrane databases were searched for primary qualitative studies (January 2014 to December 2022) in English. Eligible studies focused on people in prison, health care professionals, administrators, and governors regarding palliative or EOLC provision within prison settings. Five studies were included, from Australia, France, the United Kingdom, and the United States, whose overall quality was moderate to high. Key facilitators included access to family, support from prison staff, specialized care availability, and cultural/spiritual support. Barriers encompassed discomfort, patient-clinician relationship constraints, time limitations, protocol uncertainty, restricted patient agency, negative attitudes, inequality, conflicting priorities, and lack of grief support. Addressing these barriers and leveraging facilitators will be crucial in ensuring equitable access to compassionate EOLC for individuals experiencing incarceration. Policymakers, health care providers, and correctional authorities must prioritize the enhancement of palliative care services within prisons, supported by further research and targeted interventions to address disparities and optimize care provision.