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Abukari MH, Appiah CA, Kwarteng A, Iddrisu S. Cardiovascular risk assessment of people living in prison in the Northern region of Ghana. INTERNATIONAL JOURNAL OF PRISON HEALTH 2024; 20:102-115. [PMID: 38984556 DOI: 10.1108/ijoph-09-2022-0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2024]
Abstract
PURPOSE The health of people living in prisons (PLP) frequently remains marginalised in national development discourse, particularly in resource-constrained settings like Ghana. This study aims to determine the prevalence of cardiovascular disease (CVD) risk factors among PLP at a prison facility in the Northern Region of Ghana. DESIGN/METHODOLOGY/APPROACH A cross-sectional study involving 134 male persons in prison, aged 18-79 years, was conducted to assess their dietary habits, tobacco use, alcohol consumption, sleep behaviour and physical activity practices. Serum lipid profile, fasting blood glucose (FBG), blood pressure (BP) and body mass indices of participants were also measured. FINDINGS Almost half (48.1%) of the participants had abnormal lipid levels. Those with FBG in the diabetes range (= 7.0 mmol/l) constituted 3.9%, while 16.7% were in the impaired FBG range (6.1-6.9 mmol/l). Participants with BP within the pre-hypertension range were 54.5%. The majority of participants (92%) had a low daily intake of fruits and vegetables. Few participants were active smokers (5%) and alcohol users (2%). The average sleep duration at night among the participants was 5.54 ± 2.07 h. The majority (74%) of the participants were sedentary. About a quarter of the participants (24.6%) had overweight/obesity. ORIGINALITY/VALUE This study highlights the CVD risks among PLP. Findings suggest the need for targeted interventions, such as dietary and lifestyle modification strategies, regular physical activity and routine screening for diabetes, dyslipidaemia and hypertension. These interventions within the prison space could significantly improve the cardiovascular health of PLP in resource-limited settings.
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Affiliation(s)
| | - Collins Afriyie Appiah
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Alexander Kwarteng
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Sherifa Iddrisu
- Department of Nutrition and Dietetics, Tamale Technical University, Tamale, Ghana
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Fennessy A, Homer MS, Ensaff H. Nudging food choice in a prison setting: an investigation using food choice data. J Hum Nutr Diet 2024; 37:270-279. [PMID: 37933808 DOI: 10.1111/jhn.13252] [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: 03/30/2023] [Accepted: 09/29/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND The prison population presents complex health needs and is disproportionately affected by poor health, compared to the general population. Diet has a clear role in prisoner health, and the prison food environment within which food choices are made is relatively under-researched. The aim of this study was to examine whether food choices in a women's prison changed after the introduction of a new menu design by the catering team. METHODS The adjusted menu design incorporated an emoticon (a smiley face) placed next to designated 'Healthy Choice' foods on the menu sheets, which were used to preselect meals. Data comprised all women's (n = 865) food choices (more than 115,000 selections) for a period of 8 weeks (with the new menu) as well as 8 weeks prior (baseline period). The study design was a pre-post intervention study, and food selection was examined using chi-square tests and binary logistic regression models. RESULTS The selection of promoted foods overall significantly increased under the new menu design (with the emoticon nudge strategy) compared to baseline; the effect size, however, was small according to the usual guidelines (21.4% compared to 20% at baseline; χ2 (1) = 32.6, p < 0.001, φ = 0.02). Individuals were 11% more likely (p < 0.001) to select the promoted 'Healthy Choice' foods under the adjusted food choice architecture. A significant effect was found for lunch and evening meal - but not for desserts. A minority of individual food items that were promoted had significant positive changes in selection, and were 1.3-4 times as likely to be selected when emoticons had been introduced, compared to baseline. CONCLUSIONS Further research is needed to examine the potential added benefit of multiple complementary nudge strategies, and the relevance of the preselection of foods in advance of consumption.
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Affiliation(s)
- A Fennessy
- HM Prison & Probation Service, London, UK
- Nutritional Sciences and Epidemiology, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - M S Homer
- School of Education, University of Leeds, Leeds, UK
- School of Medicine, University of Leeds, Leeds, UK
| | - H Ensaff
- Nutritional Sciences and Epidemiology, School of Food Science and Nutrition, University of Leeds, Leeds, UK
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Alves J, Martinho G, Gonçalves M, Maia Â. Assessment of the Health Status of Women in Prison: A Comparison between Drug Users versus Non-users. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2023; 67:1615-1629. [PMID: 36377114 DOI: 10.1177/0306624x221132218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
This study aims to analyze the history of substances use, clinical diagnoses, contacts with healthcare, and health complaints. Also, it aims to compare the health status of substance users versus non-users. Health records of 93 detained women from a prison in northern Portugal, with a mean age of 38.02 years old, were reviewed and coded using both International Classification of Primary Care-2 and International Classification of Diseases-10th. Data revealed high percentages of detainees with a history of substance use and pre-existing clinical diagnosis. During the first month of imprisonment, on average, participants had complained to a health professional 14.63 times. Substance users were younger and presented more mental health problems and health complaints. Health policies and professional practices in prison must include immediate assessment of a woman's health concerns and foster the development of efficient protocols to address those problems, especially substance use disorder treatment.
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Affiliation(s)
- Joana Alves
- School of Psychology, University of Minho, Braga, Portugal
| | | | | | - Ângela Maia
- School of Psychology, University of Minho, Braga, Portugal
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Almoayad F, Benajiba N, Earle J, Aboul-Enein BH, Sidhu A, Sajja A, Dodge E. A Scoping Review of Nutrition Education Interventions Applied in Prison Settings. Curr Nutr Rep 2023; 12:845-863. [PMID: 37796393 DOI: 10.1007/s13668-023-00497-6] [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] [Accepted: 09/29/2023] [Indexed: 10/06/2023]
Abstract
PURPOSE OF REVIEW Over 11 million individuals are incarcerated globally, facing health challenges such as obesity, diabetes, and cardiovascular disease, possibly exacerbated by prison diets. The objective of this scoping review is to explore the various available types of nutrition education interventions that currently exist in the literature applied in prison settings. RECENT FINDINGS Utilizing the PRISMA Extension for Scoping Reviews, 19 databases were searched for studies on nutrition interventions in prisons from 2000 to May 2023, guided by the "PICO" structure. Inclusion criteria encompassed articles in five languages from peer-reviewed journals focusing solely on nutrition education interventions. Rayyan QCRI software was utilized for screening and data extraction. Fifteen international studies were analyzed, covering various countries and targeting different populations in prisons. Interventions varied from nutrition education to comprehensive health programs. The outcomes were inconsistent, with some showing health improvements and others encountering challenges. Few utilized established theoretical frameworks, indicating a research gap. The range of interventions highlights the potential complexity of nutrition education interventions within prisons. Implementing recognized theoretical frameworks may enhance effectiveness. The diverse outcomes highlight the challenges in creating impactful programs, emphasizing foundational issues. Recommendations focus on rigorous research designs and understanding prison-specific complexities. Nutrition education interventions in incarcerated settings present varied results, emphasizing the need for well-structured, theoretically grounded, and carefully evaluated programs. Future strategies should recognize the multifaceted nature of correctional facilities, aiming for holistic approaches to improve health in prisons.
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Affiliation(s)
- Fatmah Almoayad
- Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Nada Benajiba
- Joint Research Unit in Nutrition and Food, RDC-Nutrition AFRA/IAEA, Ibn Tofail University-CNESTEN, Rabat, 14000, Kenitra, Morocco
| | - Johanna Earle
- Applied Nutrition Graduate Program, College of Professional Studies, Northeastern University, 360 Huntington Ave., Boston, MA, 02115, USA
| | - Basil H Aboul-Enein
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
| | - Amrita Sidhu
- Health Promotion & Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston, 1200 Pressler Street, Houston, TX, 77030, USA
| | - Anusha Sajja
- Health Promotion & Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston, 1200 Pressler Street, Houston, TX, 77030, USA
| | - Elizabeth Dodge
- Applied Nutrition Graduate Program, College of Professional Studies, University of New England, Portland, ME, 04103, USA
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Fradley MF, Kathryn Allison M, Steely Smith MK, Bossard M, Zielinski MJ. Justice-Involved, Sexually Victimized Women's Perspectives on the Acceptability of Receiving Trauma-Focused Therapy in Prison. Violence Against Women 2023; 29:2964-2985. [PMID: 37674415 DOI: 10.1177/10778012231200480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
Incarcerated women report high rates of sexual victimization. Interviews with 63 previously incarcerated women survivors of sexual violence explored perceptions toward receiving trauma-focused therapy while incarcerated and postrelease trauma-focused therapy utilization. Nearly all participants (97%) recommended that trauma-focused therapy be available to incarcerated women. Most believed that prisons are acceptable places to receive trauma-focused therapy, without qualification (65%); some reported mixed feelings or indicated acceptability but identified factors that would increase acceptability (33%). Notably, most were currently experiencing trauma-related symptoms, but few had attended trauma-focused therapy following release. Findings indicate that access to prison-based trauma-focused therapy is necessary and acceptable.
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Affiliation(s)
- Marley F Fradley
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - M Kathryn Allison
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Mollee K Steely Smith
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - MeeSoh Bossard
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Melissa J Zielinski
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
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Mutz M, Müller J. Health decline in prison and the effects of sporting activity: results of the Hessian prison sports study. HEALTH & JUSTICE 2023; 11:34. [PMID: 37642783 PMCID: PMC10463329 DOI: 10.1186/s40352-023-00237-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 08/21/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Previous studies about health in prisons conclude that incarceration has detrimental consequences for physical and mental health. It is associated with weight gain, decreased fitness, increased cardiovascular risks, and increased risks for mental illnesses, like depression and anxiety. This article examines the relationships between sports activity and health developments among prisoners. We analyze data from the Hessian Prison Sports Study, conducted in 12 prisons of the federal state of Hesse, Germany. RESULTS Based on quantitative survey data of 568 prisoners in regular custody, our empirical findings show that inmates perceive substantial health declines since incarceration. They report substantial decreases in general health (d=-0.52) and life satisfaction (d=-0.84) as well as an increased number of health problems (d = 0.71). However, sport has a potential to buffer this decline of health. Prisoners engaged in sports report a less negative development of their health compared to inactive prisoners. The greater the amount of time spent with sports activities, the better are the health trajectories found. CONCLUSION Findings add to the public health and prison sport literature by demonstrating health benefits of sporting activities in a vulnerable population group that almost inevitably is exposed to manifold strains and burdens.
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Affiliation(s)
- Michael Mutz
- Justus-Liebig-University Giessen, Kugelberg 62, 35394, Giessen, Germany.
| | - Johannes Müller
- Justus-Liebig-University Giessen, Kugelberg 62, 35394, Giessen, Germany
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Pat P, Edin K, Jegannathan B, San Sebastian M, Richter Sundberg L. "Overcrowded but lonely": exploring mental health and well-being among young prisoners in Cambodia. Int J Prison Health 2023; ahead-of-print:628-640. [PMID: 37365938 PMCID: PMC10812882 DOI: 10.1108/ijph-02-2023-0011] [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] [Received: 02/07/2023] [Revised: 03/22/2023] [Accepted: 05/25/2023] [Indexed: 06/28/2023]
Abstract
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.
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Affiliation(s)
- Puthy Pat
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Kerstin Edin
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
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Parchinski K, Di Paola A, Wilson AP, Springer SA. The relationship between reincarceration and treatment of opioid use disorder with extended-release naltrexone among persons with HIV. DRUG AND ALCOHOL DEPENDENCE REPORTS 2023; 7:100159. [PMID: 37159815 PMCID: PMC10163604 DOI: 10.1016/j.dadr.2023.100159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 05/11/2023]
Abstract
Background In the United States, a disproportionate number of persons with HIV (PWH) and opioid use disorder (OUD) are involved in the justice system. Medications for OUD (MOUD) can reduce convictions and incarceration time in persons with OUD. Extended-release naltrexone (XR-NTX) has been shown to reduce craving of opioids, recurrence of use, and overdose and help achieve or maintain HIV viral suppression in PWH with OUD involved with the justice system. Objectives This retrospective study aimed to describe factors associated with reincarceration and to evaluate if XR-NTX was associated with reduced reincarceration among PWH and OUD who were released to the community from incarceration. Methods Data from participants released to the community from incarceration from a completed randomized controlled trial was analyzed using a generalized linear model to estimate odds ratios associated with reincarceration and a Kaplan-Meier survival analysis to determine time to reincarceration and non-reincarcerated individuals were compared. Results Of the 77 participants, 41 (53.2%) were reincarcerated during the 12-month study period. The mean time to reincarceration was 190 days (SD=108.3). Compared with participants who remained in the community, reincarcerated participants were more likely to have major depressive disorder at study baseline, increased opioid cravings, longer mean lifetime incarceration, and a higher physical quality of life score. XR-NTX was not significantly associated statistically with reincarceration in this analysis. Conclusion Reducing reincarceration is a public health priority, given the high proportion of PWH and OUD in the U.S. justice system as well as high degrees of persons returning to the community and having care interrupted due to reincarceration. This analysis determined that potentially identifying depression in recently released individuals could improve HIV outcomes, decrease recurrence of opioid use, and reduce reincarceration.
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Affiliation(s)
- Kaley Parchinski
- Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, Yale School of Medicine, New Haven, CT, United States
- Medical College of Georgia, Augusta, Georgia, United States
| | - Angela Di Paola
- Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, Yale School of Medicine, New Haven, CT, United States
| | - Allison P. Wilson
- Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, Yale School of Medicine, New Haven, CT, United States
- The Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Sandra A. Springer
- Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, Yale School of Medicine, New Haven, CT, United States
- Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, CT, United States
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Bright AM, Higgins A, Grealish A. Women's experiences of prison-based mental healthcare: a systematic review of qualitative literature. Int J Prison Health 2022; 19:181-198. [PMID: 35192246 PMCID: PMC10427976 DOI: 10.1108/ijph-09-2021-0091] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/25/2021] [Accepted: 01/11/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE The rate of female committals to prison has grown rapidly in recent years. Women in prison are likely to have trauma histories and difficulties with their mental health. This paper aims to synthesise the findings of qualitative literature to gain a deeper understanding of the experiences of women in the context of prison-based mental health care. DESIGN/METHODOLOGY/APPROACH A systematic search of five academic databases, Cumulative Index to Nursing and Allied Health Literature, Applied Social Sciences Index and Abstracts, Psychological Information Database (PsycINFO), Excerpta Medica DataBASE (EMBASE) and Medline, was completed in December 2020. This study's search strategy identified 4,615 citations, and seven studies were included for review. Thomas and Harden's (2008) framework for thematic synthesis was used to analyse data. Quality appraisal was conducted using the Joanna Briggs Institute Checklist for Qualitative Research (Lockwood et al., 2015). FINDINGS Four analytic themes were identified that detail women's experiences of prison-based mental health care: the type of services accessed and challenges encountered; a reduction in capacity to self-manage mental well-being; the erosion of privacy and dignity; and strained relationships with prison staff. There is a paucity of research conducted with women in the context of prison-based mental health care. The findings suggest there is a need for greater mental health support, including the need to enhance relationships between women and prison staff to promote positive mental health. ORIGINALITY/VALUE To the best of the authors' knowledge, this is the first systematic review conducted on the experiences of women in the context of prison-based mental health care.
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Affiliation(s)
- Ann-Marie Bright
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Agnes Higgins
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Annmarie Grealish
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland and Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, UK
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Norris WK, Allison MK, Fradley MF, Zielinski MJ. 'You're setting a lot of people up for failure': what formerly incarcerated women would tell healthcare decision makers. HEALTH & JUSTICE 2022; 10:4. [PMID: 35103865 PMCID: PMC8808972 DOI: 10.1186/s40352-022-00166-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 12/30/2021] [Indexed: 05/13/2023]
Abstract
BACKGROUND Incarcerated women have a higher prevalence of health problems than the general population; however, little is known about their perspectives on the healthcare they receive. Here, we conducted semi-structured interviews with women who had been incarcerated (n = 63) which asked what they would tell healthcare decision-makers about their experiences of healthcare in prisons and the community post-incarceration if provided the opportunity. All participants had a history of sexual violence victimization and had at least one period of incarceration in a community corrections center in Arkansas due to the goals of the larger study from which data were drawn. RESULTS Four themes arose when participants were asked what they would tell people who make decisions about community healthcare: 1) the healthcare system is not working (52%; n = 33), 2) have compassion for us (27%; n = 17), 3) recognize that we have specific and unique needs (17%; n = 11), and 4) the transition from incarceration is challenging and requires more support (22%; n = 14). Three themes arose when we asked participants what they would tell people who make decisions about healthcare in prisons: 1) we had experiences of poor physical healthcare in prison (44%; n = 28), 2) more specialty care is needed in prison (49%; n = 31), and 3) healthcare providers treat women in prison poorly (37%; n = 23). CONCLUSIONS Our findings underscore the need for systemic changes including greater oversight of prison-based healthcare services, enhanced access to medical subspecialties in prisons, and healthcare provider training on the unique needs of incarcerated and previously incarcerated women. Polices that expand healthcare access are also likely to benefit formerly incarcerated women given the challenges they experience seeking community-based care.
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Affiliation(s)
- Whitney K Norris
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | - Marley F Fradley
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Melissa J Zielinski
- University of Arkansas for Medical Sciences, Little Rock, AR, USA.
- University of Arkansas, Fayetteville, AR, USA.
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van de Baan FC, Montanari L, Royuela L, Lemmens PHHM. Prevalence of illicit drug use before imprisonment in Europe: results from a comprehensive literature review. DRUGS: EDUCATION, PREVENTION AND POLICY 2022. [DOI: 10.1080/09687637.2021.1879022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Frank C. van de Baan
- Public Health Unit, European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal
| | - Linda Montanari
- Public Health Unit, European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal
| | - Luis Royuela
- Public Health Unit, European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal
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Zielinski MJ, Karlsson ME, Bridges AJ. "I'm not alone, my story matters": Incarcerated women's perspectives on the impact and acceptability of group psychotherapy involving imaginal exposure to sexual assault memories. HEALTH & JUSTICE 2021; 9:25. [PMID: 34591180 PMCID: PMC8482612 DOI: 10.1186/s40352-021-00148-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 07/28/2021] [Indexed: 05/27/2023]
Abstract
BACKGROUND Although it is clear that incarcerated women need access to effective therapies for trauma sequelae, some have argued that one of the most effective treatments - exposure therapy - should not be provided in carceral settings due to the presumed lack of safety and stability making such an intervention inappropriate. Group therapy, the typical mode of intervention in prisons, has also been presumed to be unacceptable for exposure-based processing due to assumptions that hearing others' trauma narratives would be traumatizing and unhelpful to listeners. However, there is a lack of data to support either of the aforementioned assumptions. This study examined the acceptability of an exposure-based group therapy for women survivors of sexual violence who were currently incarcerated (N = 61) by asking women themselves about their experiences completing an exposure-based group therapy protocol (SHARE; Survivors Healing from Abuse: Recovery through Exposure) while incarcerated. We assessed women's reasons for enrolling in the group, satisfaction with various therapy components (e.g., exposure, skill-building) and the treatment overall, and experiences of both sharing and listening to trauma narratives using a feedback survey that included a mix of multiple-choice and open-ended questions. Treatment dropout was examined as an additional index of acceptability. RESULTS Treatment completion was very high (88.8%). Nearly all women who completed the group reported that they would recommend it to other incarcerated women (96.7%, with the remaining 3.3% reporting "it depends"). Qualitative results revealed overwhelmingly positive feedback about the effect of the group and indicated that sharing and listening to trauma narratives in a group setting serve discrete but dually important functions. Specifically, women almost universally experienced listening to others' trauma narratives (i.e., exposures) in the SHARE group context as helpful-making them feel less alone and normalizing their experiences. Sharing one's own story primarily provided an emotional release and/or transformation (i.e., an intrapersonal rather than interpersonal function). CONCLUSIONS Our findings challenge common concerns about the appropriateness of 1) prison as a context for trauma-focused treatments, including exposure and 2) sharing trauma narratives in a group setting. Unless empirical evidence demonstrating harm is uncovered, best practices for PTSD and other trauma-related sequelae-those recommended in reputable treatment guidelines and interventions like SHARE that incorporate components shown to be effective (e.g., cognitive challenging, exposure)-should be offered to incarcerated women as part of standard of care.
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Affiliation(s)
- Melissa J Zielinski
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, 4301 W. Markham Street Little Rock, Little Rock, AR, 72205, USA.
- Department of Psychological Sciences, University of Arkansas, AR, Fayetteville, USA.
| | - Marie E Karlsson
- Centre for Sexology and Sexuality Studies, Malmö University, Malmö, Sweden
| | - Ana J Bridges
- Department of Psychological Sciences, University of Arkansas, AR, Fayetteville, USA
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Gabrysch C, Sepúlveda C, Bienzobas C, Mundt AP. 'Maybe It Is Only in Prison That I Could Change Like This' The Course of Severe Mental Illnesses During Imprisonment - A Qualitative 3-Year Follow-Up Study From Chile. Front Psychol 2020; 11:1208. [PMID: 32581971 PMCID: PMC7294909 DOI: 10.3389/fpsyg.2020.01208] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 05/11/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Severe mental illness (SMI) among imprisoned individuals is a global health concern. Quantitative research indicates on average mental health symptom improvements during imprisonment, however, it cannot reflect multifaceted factors influencing the course of SMI. This study aimed to explore the subjective course of SMI during imprisonment and to identify influencing factors. METHODS The study has a 3-year-follow-up design of imprisoned individuals in Chile. We conducted semi-structured interviews with 10 men and 9 women at follow-up who had either major depression or psychosis (severe mental illnesses) at baseline. We included individuals who deteriorated, remained stable or improved their mental health according to quantitative assessments. We explored the subjective course of their mental health condition during the follow-up period. Qualitative data was transcribed and coded using NVivo Software for quantitative content analysis. Qualitative data was also manually coded and was subsequently analyzed using the thematic analysis method with an inductive approach. We developed the final themes using the results of this analysis in combination with the inclusion criteria. RESULTS The mental health of 10 individuals subjectively improved, 6 experienced deteriorations, and 3 did not perceive any change. Good infrastructure, structure/occupation, intrapersonal resources (will to change, spirituality) and supportive relationships were identified as factors improving mental health. Factors deteriorating mental health were identified as bad infrastructure (e.g., no running water and bad housing conditions) and crowding, lack of psychological treatment, exposure to violence, interpersonal stress (conflictive relationships and separation from family), perceived injustice through sentencing, intrapersonal stressors and previous medical conditions. DISCUSSION SMI in prison can improve in a supportive environment under certain conditions. These conditions include the improvement of infrastructure (housing and healthcare), the opportunity to work or study, protection from violence during imprisonment, and to develop intrapersonal resources and family relationships. To reduce SMI in prisons the improvement of these conditions should become a priority.
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Affiliation(s)
- Caroline Gabrysch
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry and Mental Health, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Carolina Sepúlveda
- Department of Psychology, Universidad Academia de Humanismo Cristiano, Santiago, Chile
| | - Carolina Bienzobas
- Department of Psychology, Universidad Academia de Humanismo Cristiano, Santiago, Chile
| | - Adrian P. Mundt
- Medical Faculty, Universidad San Sebastián, Puerto Montt, Chile
- Medical Faculty, Universidad Diego Portales, Santiago, Chile
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14
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Sousa LMPD, Matos INDB, Paiva TRLD, Gomes SM, Freitas CHSDM. [Regime of scarcity: food in the female penitentiary system]. CIENCIA & SAUDE COLETIVA 2020; 25:1667-1676. [PMID: 32402050 DOI: 10.1590/1413-81232020255.34612019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 08/07/2019] [Indexed: 11/21/2022] Open
Abstract
The female prison population is on the increase in the world. This population is being exposed to precarious conditions of confinement that often prevent or hinder access to food of effective and equitable quality, thereby representing a considerable problem within the scope of public health. This paper aims to understand the aspects of food in the female penitentiary system of the state of Paraíba. It involved research with a qualitative approach, developed in all the female prisons in the state of Paraíba. The participants of this research are 16 women in the prison context. These results show that the context of incarceration makes it impossible to guarantee the right to food, concerning food availability, adequacy, accessibility and stability of supply. The condition of incarcerated women affects the dimension of the right of access to adequate food. Food for human beings must be understood as a process of using nature to produce healthy and civilized people. For this, it is essential that practices that promote the right to healthy food should consider the principles that relate to it and, thus, overcome discriminatory and authoritarian practices.
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Affiliation(s)
| | | | | | - Sávio Marcelino Gomes
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil,
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15
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Mikalauskienė V, Laurinavičius A. Nuteistųjų adaptaciją pataisos įstaigose prognozuojantys veiksniai. PSICHOLOGIJA 2019. [DOI: 10.15388/psichol.2019.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Adaptacija pataisos įstaigoje – tai įkalinto asmens psichologinis ir elgesinis atsakas į pataisos įstaigos aplinką ir įkalinimo situaciją (Fedock, 2017). Sėkmingai adaptavęsi nuteistieji geba patenkinti savo pagrindinius poreikius, nekonfliktuoja nei su pataisos įstaigos administracija, nei su kitais nuteistaisiais, nepatiria stiprių neigiamų emocijų ir t.t. Manoma, kad nesėkminga adaptacija pataisos įstaigoje siejasi su mažesne motyvacija keisti savo nusikalstamą elgesį ir recidyvu (Loper, 2002; Zamble & Porporino, 1988). Nors nuteistųjų adaptacija pataisos įstaigose ir ją prognozuojančiais veiksniais užsienio mokslininkai domisi jau kelis dešimtmečius, Lietuvoje tokių tyrimų ypač trūksta. Šio tyrimo tikslas – nustatyti laisvės atėmimo bausmę atliekančių nuteistųjų adaptaciją Lietuvos pataisos įstaigose prognozuojančius veiksnius. Tyrime dalyvavo nuteistieji vyrai (N = 331) iš 5 Lietuvos pataisos įstaigų, jų amžius svyravo nuo nuo 18 iki 68 metų (M = 35,17, SD = 10,75). Adaptacijai įvertinti buvo naudojama Kalėjimo problemų skalė (Zamble & Porporino, 1988), Beck depresijos klausimyno antroji leidimo versija (Beck, Steer, & Brown, 1996) ir Beck nerimo klausimynas (Beck, Epstein, Brown, & Steer, 1988). Adaptacijos veiksniai buvo įvertinti demografinių duomenų anketa bei Kriminalinių nuostatų modifikuota skale (Simourd, 1997). Nustatyta, jog adaptaciją geriausiai prognozuoja kriminalinės nuostatos ir bendravimas su draugais arba partnere. Tirti veiksniai paaiškino iki 16 % adaptaciją vertinančių kintamųjų sklaidos.
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16
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Smoyer AB. Food in correctional facilities: A scoping review. Appetite 2019; 141:104312. [DOI: 10.1016/j.appet.2019.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 05/18/2019] [Accepted: 06/03/2019] [Indexed: 10/26/2022]
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17
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Walsh C, Hubley AM, To MJ, Norena M, Gadermann A, Farrell S, Hwang SW, Palepu A. The effect of forensic events on health status and housing stability among homeless and vulnerably housed individuals: A cohort study. PLoS One 2019; 14:e0211704. [PMID: 30730929 PMCID: PMC6366888 DOI: 10.1371/journal.pone.0211704] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 01/18/2019] [Indexed: 11/30/2022] Open
Abstract
We sought to characterize the association between a forensic event (arrest or incarceration) with housing vulnerability and mental and physical health status over a four-year follow-up among a cohort of homeless and vulnerably housed individuals in Vancouver, Toronto and Ottawa. Data were obtained from the Health and Housing in Transition Study, a prospective cohort study of homeless and vulnerably housed individuals between 2009 and 2012. Participants were interviewed in-person at baseline (N = 1190) and at four annual follow-up time points. We used generalized estimating equations to characterize the independent associations between a forensic event and the number of residential moves and SF-12 physical and mental health component scores over the four-year follow-up period. We analyzed data from 1173 homeless and vulnerably housed participants. Forensic events were reported by 446 participants at baseline. In multivariate analyses, a history of forensic event in the preceding twelve months was independently associated with an increased number of residential moves over the four-year follow-up period (ARR 1.24; 95% CI 1.19-1.3). It was not, however, independently associated with a change in physical or mental health status (respective ß-estimates; 95% CI: -0.34; -1.02, 0.34, and -0.69; -1.5, 0.2). Female gender and a history of problematic substance use were significantly associated with all three primary outcomes. This suggests arrest or incarceration is associated with increased housing vulnerability. The results underline the importance of supporting individuals experiencing arrest or incarceration with post-release planning in order to obtain stable housing after discharge.
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Affiliation(s)
- Charles Walsh
- Division of General Internal Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Anita M. Hubley
- Department of Education Counselling Psychology and Special Education, University of British Columbia, Vancouver, BC, Canada
| | - Matthew J. To
- Centre for Urban Health Solutions, St. Michael’s Hospital, Toronto, ON, Canada
| | - Monica Norena
- Centre for Health Evaluation and Outcome Sciences, St. Paul’s Hospital, Vancouver, BC, Canada
| | - Anne Gadermann
- Centre for Health Evaluation and Outcome Sciences, St. Paul’s Hospital, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | | | - Stephen W. Hwang
- Centre for Urban Health Solutions, St. Michael’s Hospital, Toronto, ON, Canada
| | - Anita Palepu
- Division of General Internal Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
- Centre for Health Evaluation and Outcome Sciences, St. Paul’s Hospital, Vancouver, BC, Canada
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Stephenson AL, Bell N. Finding meaningful work in difficult circumstances: A study of prison healthcare workers. Health Serv Manage Res 2018; 32:69-77. [PMID: 29999425 DOI: 10.1177/0951484818787698] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Prisons are rigidly structured institutions housing-in some cases-violent and unstable residents. To discover the positive job attributes and perceived challenges in this extreme practice environment, we employed exploratory qualitative content analysis on the written-in responses of 269 prison health workers in one state's Department of Corrections. Two researchers independently analyzed and coded the data. Using an iterative process, we categorized the responses into themes and critical underlying meanings. Positive job attributes included meaningful work, stability, variety of ailments treated, and feelings of support. Perceived challenges included ineffective leadership, constraints on the ability to effectively execute the role, perceived inequity, and organizational culture. The results of our study suggest that there are lessons to be learned from correctional health workers that could inform policy and management outside of the prison walls specifically as it pertains to motivating and engaging providers through meaningful work. Specifically, health organizations would improve the experience of their clinicians by offering a broader scope of practice experience, schedule stability, reducing bureaucratic redundancies, and-ultimately-restoring the sense of purpose within the work itself.
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Affiliation(s)
- Amber L Stephenson
- 1 David D. Reh School of Business, Clarkson University, Schenectady, NY, USA
| | - Nicolette Bell
- 2 Pennsylvania Department of Corrections, Mechanicsburg, PA, USA
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Sprague C, Scanlon ML, Radhakrishnan B, Pantalone DW. The HIV Prison Paradox: Agency and HIV-Positive Women's Experiences in Jail and Prison in Alabama. QUALITATIVE HEALTH RESEARCH 2017; 27:1427-1444. [PMID: 27742766 DOI: 10.1177/1049732316672640] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Incarcerated women face significant barriers to achieve continuous HIV care. We employed a descriptive, exploratory design using qualitative methods and the theoretical construct of agency to investigate participants' self-reported experiences accessing HIV services in jail, in prison, and post-release in two Alabama cities. During January 2014, we conducted in-depth interviews with 25 formerly incarcerated HIV-positive women. Two researchers completed independent coding, producing preliminary codes from transcripts using content analysis. Themes were developed iteratively, verified, and refined. They encompassed (a) special rules for HIV-positive women: isolation, segregation, insults, food rationing, and forced disclosure; (b) absence of counseling following initial HIV diagnosis; and (c) HIV treatment impediments: delays, interruption, and denial. Participants deployed agentic strategies of accommodation, resistance, and care-seeking to navigate the social world of prison and HIV services. Findings illuminate the "HIV prison paradox": the chief opportunities that remain unexploited to engage and re-engage justice-involved women in the HIV care continuum.
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Affiliation(s)
- Courtenay Sprague
- 1 University of Massachusetts Boston, Boston, Massachusetts, USA
- 2 University of the Witwatersrand, Johannesburg, South Africa
| | | | | | - David W Pantalone
- 1 University of Massachusetts Boston, Boston, Massachusetts, USA
- 3 Fenway Health, Boston, Massachusetts, USA
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