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Ghareghozloo M, Moridi M, Alimardi M, Safari K, Moghadam ZB. Development and psychometric evaluation of the sexual and reproductive health needs of incarcerated women scale: a methodological study. J Public Health (Oxf) 2024; 46:e65-e77. [PMID: 38102950 DOI: 10.1093/pubmed/fdad257] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND This study aimed to develop and validate a comprehensive tool designed to assess the sexual and reproductive health (SRH) needs of incarcerated women. METHODS A methodological study was conducted from January to March 2023 in two female prisons in Tehran and Hamedan, Iran. The participant pool consisted of women who had been incarcerated for a minimum of 6 months and were aged between 15 and 49 years. The instrument development involved two phases. Phase I involved a literature review and interviews with incarcerated women to understand their SRH needs. Phase II assessed psychometric properties to establish the scale's validity and reliability. RESULTS The SRH Needs of Incarcerated Women (SRH-NIW) scale was refined, comprising 37 items across six domains: pregnancy and childbirth services, parenting services, family planning and sexual health services, personal and medical care services, screening services and infection control services. Exploratory factor analysis explained 66.15% of variance. The Content Validity Ratio and Content Validity Index were 0.8 and 0.94, respectively, indicating high content validity. Average Variance Extracted values ranged from 0.592 to 0.698. The whole scale showed a Cronbach's alpha of 0.823, and the Intra-class Correlation Coefficient was 0.879. CONCLUSION The SRH-NIW scale is a valid and reliable tool for assessing the SRH needs of incarcerated women. It can enhance healthcare services and interventions for incarcerated women, potentially leading to policy improvements within the prison system.
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Affiliation(s)
- Mohadeseh Ghareghozloo
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran 141973317, Iran
| | - Maryam Moridi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran 141973317, Iran
| | - Masoud Alimardi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran 1417613151, Iran
| | - Kolsoom Safari
- School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria 3086, Australia
| | - Zahra Behboodi Moghadam
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran 141973317, Iran
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Rockey N, Cervantes L, LeMasters K, Rizzolo K. Challenging Health Inequities in Incarceration: a Call for Equitable Care for Kidney Disease and Hypertension. Curr Hypertens Rep 2023; 25:437-445. [PMID: 37773248 DOI: 10.1007/s11906-023-01267-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2023] [Indexed: 10/01/2023]
Abstract
PURPOSE OF REVIEW To review the current literature on care of hypertension and chronic kidney disease for people who are currently and formerly incarcerated, and to make recommendations for improving outcomes. RECENT FINDINGS There is a growing body of literature describing care for kidney disease and hypertension for incarcerated and formerly incarcerated individuals that documents the provision of care itself, notably that many jails contract with private companies; the system is not designed to provide sustained, chronic disease care; and the transition from incarceration to community is fraught with gaps in care. However, deficiencies in data collection and regulation still limit our understanding of the quality of care provided in jails and prisons. Furthermore, more data is needed to understand the impact of structural racism in the criminal legal system on overall disparities in care for hypertension and kidney disease. Insurance coverage rates for people who were formerly incarcerated continue to be lower than the general population despite Medicaid expansion in many states. There is little recent data regarding kidney replacement therapy for this population despite known variation in dialysis modalities and transplant programs by state. Transitions clinics, which connect people who were formerly incarcerated with care in the community upon release, are growing and are important avenues by which to deliver care. People who are incarcerated are disproportionately affected by hypertension and kidney disease, yet data regarding the extent of these inequities and availability of quality care is lacking. More work is needed to understand the care of individuals with kidney disease and hypertension in prisons and to improve outcomes for these common chronic conditions. Both providing effective treatment of kidney disease and hypertension in prisons and jails and providing coordinated, quality transition to community care upon release represents an important opportunity for reform in care for a marginalized population.
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Affiliation(s)
- Nathan Rockey
- Department of Medicine, University of Colorado School of Medicine, Aurora, USA
| | - Lilia Cervantes
- Department of Medicine, University of Colorado School of Medicine, Aurora, USA
- Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Katherine LeMasters
- Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Katherine Rizzolo
- Section of Nephrology, Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center, 650 Albany Street, EBRC508, Boston, Massachusetts, 02118, USA.
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Emerson A, Valleroy E, Knittel A, Ramaswamy M. Sex and aging: Perspectives of older adult women with experience of incarceration. J Women Aging 2023; 35:487-503. [PMID: 36840534 PMCID: PMC10450097 DOI: 10.1080/08952841.2023.2180246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 02/26/2023]
Abstract
To explore perspectives on sexuality, sexual health, and sexual health care of older adult women with a history of criminal legal system involvement, we conducted phone interviews with women aged 50 years or older who were living in the community but had a history of jail and/or prison incarceration. Interview questions and initial analysis were guided by the sexual health framework for public health and Mitchell's sexual wellness model. Data analysis followed a framework method. Nine women, aged 53-66, participated in phone interviews between December 2020 and December 2021. Slightly over half the participants were Black; none were Hispanic. Most were single. We formulated a sex-in-aging (SAGE) framework comprising three categories and two overarching themes. Women with a history of criminal-legal system involvement have heterogeneous views on sex and sexual health and describe a range of desire and sexual activity as they age, including shifting ideas about what they expect from partners, how they keep themselves safe in sexual and intimate relationships, and how life circumstances that are often associated with criminal legal system involvement (substance use, trauma) impact their interest in sex as they age. The SAGE framework integrates these categories and themes and offers a starting point for further research and intervention development.
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Affiliation(s)
- Amanda Emerson
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Ella Valleroy
- School of Biological and Chemical Sciences, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Andrea Knittel
- Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Megha Ramaswamy
- Department of Population Health, University of Kansas Medical Center, Kansas City, Kansas, USA
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Crawford AD, Ricks TN, Polinard E, Abbyad CW. What is Known About Reproductive Autonomy Among Justice-Involved Black Women?: A Scoping Review. J Transcult Nurs 2023; 34:375-388. [PMID: 37431805 DOI: 10.1177/10436596231183180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2023] Open
Abstract
OBJECTIVE There are approximately 231,000 women detained daily within the nation's jail and prison systems with women of color making up nearly half of those experiencing incarceration. The purpose of this scoping review was to synthesize the literature on the reproductive autonomy of Black women influenced by incarceration, using the three tenets of reproductive justice. METHODS We searched PubMed, CINAHL, SocINDEX, and PsycINFO for research related to reproductive justice written in English and published in the United States from 1980 to 2022. A review of 440 article titles and abstracts yielded 32 articles for full-text review; nine articles met inclusion. RESULTS Eight addressed Tenet 1; five mentioned Tenet 2; none addressed Tenet 3. Recognition of the influence of incarceration on the reproductive autonomy of Black women is limited. CONCLUSION The findings from this review suggest a need to address (a) reproductive choice, (b) support goals, and (c) support of justice-involved Black women.
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Wennerstrom A, Sugarman OK, Reilly B, Armstrong A, Whittington A, Bachhuber MA. Health services use among formerly incarcerated Louisiana Medicaid members within one year of release. PLoS One 2023; 18:e0285582. [PMID: 37200349 DOI: 10.1371/journal.pone.0285582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 04/27/2023] [Indexed: 05/20/2023] Open
Abstract
OBJECTIVES To determine the association between enrollment in Medicaid prior to release compared with post-release, and the use of health services and time to the first service use after release among Louisiana Medicaid members within one year of release from Louisiana state corrections custody. METHODS We conducted a retrospective cohort study linking Louisiana Medicaid and Louisiana state corrections release data. We included individuals ages 19 to 64 years released from state custody between January 1, 2017 and June 30, 2019 and enrolled in Medicaid within 180 days of release. Outcome measures included receipt of general health services (primary care visits, emergency department visits, and hospitalizations), cancer screenings, specialty behavioral health services, and prescription medications. To determine the association between pre-release Medicaid enrollment and time to receipt of health services, multivariable regression models were used which accounted for significant differences in characteristics between the groups. RESULTS Overall, 13283 individuals met eligibility criteria and 78.8% (n = 10473) of the population was enrolled in Medicaid pre-release. Compared with those enrolled in Medicaid prior to release, those enrolled post-release were more likely to have an emergency department visit (59.6% versus 57.5%, p = 0.04) and hospitalization (17.9% versus 15.9%, p = 0.01) and less likely to receive outpatient mental health services (12.3% versus 15.2%, p<0.001) and prescription drugs. Compared with those enrolled in Medicaid prior to release, those enrolled post-release had a significantly longer time to receiving many services including a primary care visit (adjusted mean difference: 42.2 days [95% CI: 37.9 to 46.5; p<0.001]), outpatient mental health services (42.8 days [95% CI: 31.3 to 54.4; p<0.001]), outpatient substance use disorder service (20.6 days [95% CI: 2.0 to 39.2; p = 0.03]), and medication for opioid use disorder (40.4 days [95% CI: 23.7 to 57.1; p<0.001]) as well as inhaled bronchodilators and corticosteroids (63.8 days [95% CI: 49.3 to 78.3, p<0.001]), antipsychotics (62.9 days [95% CI: 50.8 to 75.1; p<0.001]), antihypertensives (60.5 days [95% CI: 50.7 to 70.3; p<0.001]), and antidepressants (52.3 days [95% CI: 44.1 to 60.5; p<0.001]). CONCLUSION Compared with Medicaid enrollment post-release, pre-release Medicaid enrollment was associated with higher proportions of, and faster access to, a wide variety of health services. Regardless of enrollment status, we found prolonged times between release and receipt of time-sensitive behavioral health services and prescription medications.
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Affiliation(s)
- Ashley Wennerstrom
- Center for Healthcare Value and Equity, School of Medicine, Louisiana State University Health Sciences Center-New Orleans, New Orleans, LA, United States of America
- Department of Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center-New Orleans, New Orleans, LA, United States of America
| | - Olivia K Sugarman
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Bruce Reilly
- Voice of the Experienced, New Orleans, LA, United States of America
| | - Andrea Armstrong
- Loyola College of Law, New Orleans, LA, United States of America
| | - Angel Whittington
- College of Pharmacy, Office of Outcomes Research and Evaluation, University of Louisiana Monroe, Monroe, LA, United States of America
| | - Marcus A Bachhuber
- Center for Healthcare Value and Equity, School of Medicine, Louisiana State University Health Sciences Center-New Orleans, New Orleans, LA, United States of America
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Wennerstrom A, Sugarman OK, Page KM, Whittington A, Martin D, Reilly B, Bachhuber MA. Mixed Method Evaluation of Louisiana's Prerelease Medicaid Enrollment Program, 2017-2019. Med Care 2022; 60:512-518. [PMID: 35471484 PMCID: PMC9357425 DOI: 10.1097/mlr.0000000000001729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Over 600,000 people leave US prisons annually. Many are eligible for Medicaid upon release but may need support to enroll. Carceral facilities in nearly half of states have implemented systems to facilitate Medicaid access for those leaving incarceration, but there is limited information on program implementation models or outcomes. OBJECTIVES To evaluate implementation and initial outcomes of Louisiana's prison-based Prerelease Medicaid Enrollment Program. METHODS In this mixed-methods study, we assessed enrollment in Louisiana Medicaid at time of release from prison in the 2 years (2017-2018) after Program implementation, as well as reasons for Medicaid closure (ie, loss of coverage) and health services use 6 months postrelease. In May-June 2019, we conducted interviews statewide with program implementers (n=16) and focus groups in New Orleans, Louisiana with formerly incarcerated Program participants (n=16). RESULTS A total of 4476 people were included in the quantitative analysis. There was a 34.3 (95% confidence interval: 20.7-47.9) percentage point increase in Medicaid enrollment upon release. Nearly all (98.6%) attended at least 1 outpatient visit and almost half (46.7%) had 1 emergency department visit within 6 months of release. Not responding to information requests was the most common reason for Medicaid closure. Program implementers and formerly incarcerated participants identified Program strengths, barriers, and suggestions for improvement. CONCLUSIONS The program was successful in rapidly increasing Medicaid enrollment at the time of prison release and facilitating the use of health care services.
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Affiliation(s)
- Ashley Wennerstrom
- Department of Medicine, Section of Community and Population Medicine
- Department of Behavioral and Community Health Sciences, Louisiana State University Health Sciences Center—New Orleans, School of Public Health, New Orleans
| | - Olivia K. Sugarman
- Department of Medicine, Section of Community and Population Medicine
- Department of Behavioral and Community Health Sciences, Louisiana State University Health Sciences Center—New Orleans, School of Public Health, New Orleans
| | - Karissa M. Page
- Bureau of Health Services Financing, Louisiana Department of Health, Baton Rouge
| | - Angel Whittington
- College of Pharmacy, Office of Outcomes Research & Evaluation, University of Louisiana-Monroe, Monroe
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