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Iwai Y, Li J, Isaacs TJ, Ma SJ, Elmore SNC, Kamran SC, Oladeru OT. National Survey of Oncologists' Knowledge, Attitudes, and Practice Behaviors: Caring for Cancer Patients Experiencing Incarceration. JOURNAL OF CORRECTIONAL HEALTH CARE 2024; 30:97-106. [PMID: 38466954 DOI: 10.1089/jchc.23.08.0064] [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: 03/13/2024]
Abstract
Cancer is the leading cause of illness-related death in state prisons in the United States. The experiences of physicians providing oncological care to individuals experiencing incarceration are underexplored. The study aims were to evaluate knowledge, attitudes, and practices of oncologists caring for cancer patients who are incarcerated. An online survey was distributed to a random sample of 150 oncologists from the American Society of Clinical Oncology and the American Society for Radiation Oncology from July 2020 to December 2021. Statistical analyses included two proportion Z-test, Fisher's exact test, Kruskal-Wallis test, and Cramer's V to estimate factors associated with attitudes and barriers to care. Of the 55 respondents (36.7% response rate), 21 were medical oncologists and 34 were radiation oncologists. Academic center oncologists were more likely to report caring for incarcerated patients than community or private practice oncologists (p = .04). Most (53%) incorrectly reported "heart disease" as the leading cause of death, as opposed to "cancer" (15% identified correctly). Oncologists practicing at both academic and community centers were more likely to report care coordination barriers than oncologists at academic or community centers (p < .01). We identified potential barriers in caring for incarcerated cancer patients. Future studies should explore ways to improve care coordination between oncology teams and prisons.
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Affiliation(s)
- Yoshiko Iwai
- University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Jian Li
- State University of New York Upstate Medical University, Syracuse, New York, USA
| | - Tamia J Isaacs
- Department of Radiation Oncology, University of Florida, Gainesville, Florida, USA
| | - Sung Jun Ma
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Shekinah N C Elmore
- University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Sophia C Kamran
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Kerr H, MacDonald JP. Yoga instructor for incarcerated individuals - Dr Pierre Rouzier. Br J Sports Med 2024; 58:174-175. [PMID: 38195201 DOI: 10.1136/bjsports-2023-108008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2023] [Indexed: 01/11/2024]
Affiliation(s)
- Hamish Kerr
- Sports Medicine, Albany Medical Center, Albany, New York, USA
| | - James P MacDonald
- Division of Sports Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA
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Engelberg RS, Scheidell JD, Islam N, Thorpe L, Khan MR. Associations Between Incarceration History and Risk of Hypertension and Hyperglycemia: Consideration of Differences among Black, Hispanic, Asian and White Subgroups. J Gen Intern Med 2024; 39:5-12. [PMID: 37507551 PMCID: PMC10817868 DOI: 10.1007/s11606-023-08327-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 07/10/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Studies have shown that adults with a history of incarceration have elevated cardiovascular (CVD) risk. Research on racial/ethnic group differences in the association between incarceration and CVD risk factors of hypertension and hyperglycemia is limited. OBJECTIVE To assess racial/ethnic group differences in the association between incarceration and hypertension and hyperglycemia. DESIGN We performed a secondary data analysis using the National Longitudinal Survey of Adolescent to Adult Health (Add Health). Using modified Poisson regression, we estimated the associations between lifetime history of incarceration reported during early adulthood with hypertension and hyperglycemia outcomes measured in mid-adulthood, including incident diagnosis. We evaluated whether associations varied by self-reported race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, and Asian). PARTICIPANTS The analytic sample included 4,015 Add Health respondents who self-identified as non-Hispanic White, Non-Hispanic Black, Hispanic, and Asian, and provided incarceration history and outcome data. MAIN MEASURES Outcome measures included (1) hypertension (2) systolic blood pressure ≥ 130 mmHg, and (3) hyperglycemia. KEY RESULTS In non-Hispanic Black and non-Hispanic White participants, there was not evidence of an association between incarceration and measured health outcomes. Among Hispanic participants, incarceration was associated with hyperglycemia (Adjusted Risk Ratio (ARR): 2.1, 95% Confidence Interval (CI): 1.1-3.7), but not with hypertension risk. Incarceration was associated with elevated systolic blood pressure (ARR: 3.1, CI: 1.2-8.5) and hypertension (ARR: 1.7, CI: 1.0-2.8, p = 0.03) among Asian participants, but not with hyperglycemia risk. Incarceration was associated with incident hypertension (ARR 2.5, CI 1.2-5.3) among Asian subgroups. CONCLUSIONS Our findings add to a growing body of evidence suggesting that incarceration may be linked to chronic disease outcomes. Race/ethnic-specific results, while limited by small sample size, highlight the need for long-term studies on incarceration's influence among distinct US groups.
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Affiliation(s)
- Rachel S Engelberg
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA.
- Division of General Internal Medicine, NYU Grossman School of Medicine, New York, NY, USA.
| | - Joy D Scheidell
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Nadia Islam
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Lorna Thorpe
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Maria R Khan
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
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So M, Fields D, Ajoku N, Wyatt C. Training on Corrections and Health Within U.S. Academic Health Professions Education: A Scoping Review. JOURNAL OF CORRECTIONAL HEALTH CARE 2023; 29:370-383. [PMID: 37676994 DOI: 10.1089/jchc.22.06.0042] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
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.
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Affiliation(s)
- Marvin So
- University of Minnesota Medical School, Minneapolis, Minnesota, USA
- LifeLong Medical Care William Jenkins Health Center, Richmond, California, USA
| | - Donte Fields
- Bemidji State University, Bemidji, Minnesota, USA
| | - Nneka Ajoku
- University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Christopher Wyatt
- University of Minnesota College of Pharmacy, Minneapolis, Minnesota, USA
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Hoffman KA, Thompson E, Gaeta Gazzola M, Oberleitner LMS, Eller A, Madden LM, Marcus R, Oberleitner DE, Beitel M, Barry DT. "Just fighting for my life to stay alive": a qualitative investigation of barriers and facilitators to community re-entry among people with opioid use disorder and incarceration histories. Addict Sci Clin Pract 2023; 18:16. [PMID: 36944998 PMCID: PMC10031976 DOI: 10.1186/s13722-023-00377-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 03/15/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND During the period of community re-entry immediately following release from jail or prison, individuals with opioid use disorder (OUD) face structural barriers to successful re-entry and high risk of overdose. Few published studies investigate experiences in the immediate period (i.e., first 24 h) of re-entry among people with OUD. AIM To understand the barriers and facilitators to treatment and reintegration of people with OUD during the initial transition from carceral settings back into the community. METHODS From January-December 2017, we conducted 42 semi-structured qualitative interviews with patients with a history of incarceration who were receiving methadone at a not-for-profit, low-barrier opioid treatment program. Interviews probed participants' community re-entry experiences immediately following incarceration. Interviews were transcribed and analyzed using a Thematic Analysis approach. RESULTS The main themes described the experiences during the 24 h following release, reacclimating and navigating re-entry barriers, and re-entry preparedness and planning. Participants noted the initial 24 h to be a period of risk for returning to substance use or an opportunity to engage with OUD treatment as well as a tenuous period where many lacked basic resources such as shelter or money. When discussing the subsequent re-entry period, participants noted social challenges and persistent barriers to stable housing and employment. Participants overall described feeling unprepared for release and suggested improvements including formal transition programs, improved education, and support to combat the risk of overdose and return to substance use after incarceration. CONCLUSIONS In this study that qualitatively examines the experiences of people with incarceration histories and OUD enrolled in methadone treatment, we found that participants faced many barriers to community re-entry, particularly surrounding basic resources and treatment engagement. Participants reported feeling unprepared for release but made concrete suggestions for interventions that might improve the barriers they encountered. Future work should examine the incorporation of these perspectives of people with lived experience into the development of transition programs or re-entry classes.
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Affiliation(s)
- Kim A Hoffman
- Department of Medicine, Oregon Health and Science University, Portland, OR, USA.
- APT Foundation, New Haven, CT, USA.
| | - Emma Thompson
- APT Foundation, New Haven, CT, USA
- Rutgers New Jersey Medical School, Rutgers, Newark, NJ, USA
| | - Marina Gaeta Gazzola
- APT Foundation, New Haven, CT, USA
- Department of Emergency Medicine, New York University School of Medicine, New York, NY, USA
| | - Lindsay M S Oberleitner
- APT Foundation, New Haven, CT, USA
- Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Anthony Eller
- APT Foundation, New Haven, CT, USA
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Lynn M Madden
- APT Foundation, New Haven, CT, USA
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Ruthanne Marcus
- APT Foundation, New Haven, CT, USA
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - David E Oberleitner
- APT Foundation, New Haven, CT, USA
- Department of Psychology, University of Bridgeport, Bridgeport, CT, USA
| | - Mark Beitel
- APT Foundation, New Haven, CT, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - Declan T Barry
- APT Foundation, New Haven, CT, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Child Study Center, Yale School of Medicine, New Haven, CT, USA
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Shearer RD, Winkelman TNA, Khatri UG. State level variation in substance use treatment admissions among criminal legal-referred individuals. Drug Alcohol Depend 2022; 240:109651. [PMID: 36228467 DOI: 10.1016/j.drugalcdep.2022.109651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/25/2022] [Accepted: 09/27/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Individuals involved in the criminal legal system face unique challenges to accessing substance use disorder (SUD) treatment, yet state-level variation in referrals for treatment remains largely unknown. To address disparities in the overdose crisis among individuals with criminal legal involvement, it is important to understand variation in SUD treatment across states. METHODS We conducted a retrospective comparison of substance use treatment referrals from the criminal legal system and other sources across participating states. Using data from the 2018-2019 Treatment Episode Dataset-Admissions, we characterized treatment referral rates from the criminal legal system, the substances most commonly leading to treatment, and rates of treatment with medication for opioid use disorder (MOUD) across states. RESULTS Across all states, criminal legal referral rates were higher than non-criminal legal rates. Criminal-legal referral rates, adjusted for state overdose deaths, were highest in the Northeast and Midwest. Methamphetamine use was the most common substance leading to treatment referral from the criminal legal system in 24 states while opioid use was the most common reason for non-criminal legal referrals in 34 states. In over half the states analyzed, fewer than 10% of opioid treatment referrals from the criminal legal system received MOUD. In almost all states, MOUD was more common in treatment referred from non-criminal legal settings. CONCLUSION State-specific policies and practices shape drug policy and the SUD treatment landscape for people with criminal legal involvement. Standards and ongoing monitoring for substance use treatment referrals from the criminal-legal system should be considered by federal agencies charged with addressing the ongoing overdose crisis.
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Affiliation(s)
- Riley D Shearer
- University of Minnesota School of Public Health, 420 Delaware St SE, Mayo Building B681, Minneapolis, MN 55455, USA; Health, Homelessness, and Criminal Justice Lab, Hennepin Healthcare Research Institute, 701 Park Ave., Suite PP7.700, Minneapolis, MN 55415, USA
| | - Tyler N A Winkelman
- Health, Homelessness, and Criminal Justice Lab, Hennepin Healthcare Research Institute, 701 Park Ave., Suite PP7.700, Minneapolis, MN 55415, USA; Division of General Internal Medicine, Department of Medicine, Hennepin Healthcare, 716 S 7th St, Minneapolis, MN 55415, USA
| | - Utsha G Khatri
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1620, New York, NY 10029, USA; Institute for Health Equity Research, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1077, New York, NY 10029, USA.
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