Measuring everyday adaptation after imprisonment: The post-release living inventory for ex-prisoners (PORLI-ex)

Background: The number of ex-prisoners worldwide has constantly been increasing in recent years. Currently, little is known about post-release daily adaptation, not to mention valid and reliable instruments for post-release daily routines pertinent to mental health. Objective: This study aims to develop and validate a self-report instrument, hereafter referred to as Post Release Living Inventory for Ex-prisoners (PORLI-ex). Methods: Three separate samples of ex-prisoners were recruited to complete an online survey (N=1,277, age range=17–89 years, 53.2% male, 72% white). Results: The final model evidenced acceptable goodness-of-fit and consisted of 45 items on nine dimensions, which loaded on three second-order factors: Consolidation (three dimensions; e.g., Institutional Routines), Replacement (two dimensions; e.g., Maladaptive Behaviors), and Addition (four dimensions; e.g., Socializing with Ex-prisoner Friends) (α=.695–.915). Convergent validity was demonstrated in the positive correlations with IADL, SOLI, MLQ, GSE-6, and MSPSS. Discriminant validity was demonstrated in the weak correlations with the LEC-5 and perceived social and personal cost of punishment. Criterion-related validity was demonstrated in the correlations with psychiatric symptoms and crime-related outcomes and incremental validity in the correlations with these measures independent of the scores on IADL, SOLI, MLQ, GSE-6, and MSPSS. Conclusion: This study calls for more resources on fostering psychological strengths and resilience through regularizing basic daily life experiences on top of traditional interventions for risk management among the ex-prisoners. (AU)

Participating in a parenting intervention in prison, perceptions from incarcerated fathers and mothers-A convergent mixed-methods study.

BACKGROUND: Children of incarcerated parents run a high risk of ill-health and future delinquency, whereas positive parenting can support children's healthy development. The For Our Children's Sake (FOCS) parenting intervention for parents in prison was evaluated as a controlled trial during 2019-2021 within The Swedish Prison and Probation Service (SPPS). This study reports on the process evaluation and aimed to describe how parents perceived their participation and aspects that influenced implementation of the FOCS intervention. METHODS: This convergent mixed-methods study (QUAL + quan) included qualitative interview data after participation in the FOCS intervention group (12 parents), and quantitative questionnaire data from intervention and control groups (46 parents). Qualitative data were analysed using inductive qualitative content analysis and quantitative data using descriptive and non-parametric statistics. RESULTS: An integrated synthesis of the qualitative and quantitative results showed three joint concepts that provided an extended understanding of the importance of a child and parent focused intervention available to parents in prison, where FOCS was perceived as the only place where inmates could openly reflect, and express sensitive feelings and thoughts related to the children and being a parent. Also, that the SPPS as an organisation entails partly unsupportive organisational norms with irregular individual staff engagement, which made FOCS invisible in prisons, and the importance of engagement and motivation from all participants and group leaders in the group was essential for a successful FOCS group. CONCLUSION: This study showed that availability of a child and parent focused intervention in prison is perceived as very important, and at the same time dependent on a trustful relationship in the group to be rewarding to the participants, where organisational norms within the SPSS need amendments for successful implementation of FOCS. These findings can guide further implementation of similar interventions in prison.

Evaluation of an oral health programme targeting prison inmates in Saudi Arabia.

This paper aimed to evaluate the impact of an oral health programme targeting prisoners in eastern Saudi Arabia. The reach, effectiveness, adoption, implementation and maintenance (RE-AIM) strategy was used as the evaluation framework to assess both process and outcome. This annual programme included four stations: an interview, an educational session, dental examination and treatment. Programme indicators included the number of prisoners reached, percent improvement in oral health practices, teeth present in the mouth and percent reduction in dental treatment needs. A non-experimental pre- and post-programme evaluation design was implemented. Prisons in eastern Saudi Arabia were visited once a year from 2016 to 2019. The evaluation used primary data collected during the visits in the form of clinical examination and surveys. The number of beneficiaries increased from 270 to 634, and three cities within the Eastern province were covered. The percent of inmates who smoke and consume sugary drinks decreased by 24 and 30%, respectively; however, there was a 25% reduction in regular toothbrushing using a fluoridated toothpaste. The long-term outcomes showed an improvement in the overall oral health condition and treatment needs: periodontal treatment needs and surgical procedures were reduced by 91 and 79%, respectively. The programme was successful based on the RE-AIM framework. This is the first sustainable oral health programme targeting prison inmates in the Middle East. The findings indicate that the oral health programme had positive effects on prisoners' oral health and achieved its objectives. Such programmes can help address health disparities among populations.

US Prison Policies on Organ Donation for Individuals Who Are Incarcerated.

This cross-sectional study collects data on US prison policies concerning organ donation by incarcerated individuals.

Incarcerated Loved Ones: Building a Community to Support and Advocate on Facebook.

Individuals with an incarcerated loved one are often overlooked when discussing the impacts of incarceration. It can be difficult for these individuals to navigate the criminal justice system, as well as form meaningful connections and obtain support from others that are experiencing a similar situation. Social media allows for connections to be made between individuals in similar situations that might not be geographically close to one another. Specifically, for those with an incarcerated loved one, the Facebook group "Incarcerated Loved Ones" allows for meaningful connection to others who are navigating incarceration. Posts were collected from this Facebook group, with the themes emerging including COVID, information seeking, and advocacy. Findings, as well as future directions, will be discussed.

Defining avoidable healthcare-associated harm in prisons: A mixed-method development study.

BACKGROUND: Reducing avoidable healthcare-associated harm is a global health priority. Progress in evaluating the burden and aetiology of avoidable harm in prisons is limited compared with other healthcare sectors. To address this gap, this study aimed to develop a definition of avoidable harm to facilitate future epidemiological studies in prisons. METHODS: Using a sequential mixed methods study design we first characterised and reached consensus on the types and avoidability of patient harm in prison healthcare involving analysis of 151 serious prison incidents reported to the Strategic Executive Information System (StEIS) followed by in-depth nominal group (NG) discussions with four former service users and four prison professionals. Findings of the NG discussions and StEIS analysis were then synthesised and discussed among the research team and study oversight groups to develop an operational definition of avoidable harm in prison healthcare which was subsequently tested and validated using prison patient safety incident report data derived from the National Reporting and Learning System (NRLS). RESULTS: Analysis of StEIS incident reports and NG discussions identified important factors influencing avoidable harm which reflected the unique prison setting, including health care delivery issues and constraints associated with the secure environment which limited access to care. These findings informed the development of a new working two-tier definition of avoidable harm using appropriate and timely intervention, which included an additional assessment of harm avoidability taking into the account the prison regime and environment. The definition was compatible with the NRLS incident report narratives and illustrated how the prison environment may influence identification of avoidable harm and judgements of avoidability. CONCLUSIONS: We have developed a working definition of avoidable harm in prison health care that enables consideration of caveats associated with prison environments and systems. Our definition enables future studies of the safety of prison healthcare to standardise outcome measurement.

Crime hierarchy, victimization and coping results of a qualitative study on the older incarcerated Person's mental health in Switzerland.

BACKGROUND: Incarcerated persons rank themselves according to the crime they have committed. Due to which, those lower in this hierarchy (e.g., paedophiles) are bullied. The goal of this paper was to better knowledge on older incarcerated adults' experiences of crime and social hierarchy in prisons. METHODS: Our results comprise data from 50 semi-structured interviews with older incarcerated persons. Data was assessed following thematic analysis. RESULTS: Our research showed that crime hierarchy occurs in prison and is recognized by older incarcerated individuals. Also, a social hierarchy based on various characteristics (e.g., ethnicity, education, language, mental health) is established within detention centres. This hierarchy is put forth by all persons deprived of liberty, but mostly by the ones at the bottom of the crime hierarchy, thus using it to portray themselves as better human beings than other incarcerated adults. They use the social hierarchy to cope with bullying whilst exhibiting coping mechanisms, such as the narcissistic facade. A concept we put forth as a novel idea. DISCUSSION: Our results show that crime hierarchy prevails in prison. Also, we explain the social hierarchy based on ethnicity, education, and other characteristics. Hence, being a victim of bullies, make lower-ranked (on the crime hierarchy) persons resort to social hierarchy to portray themselves as better individuals. This should not be considered as a personality disorder, but rather a narcissistic facade.

Prevalence of skin diseases in Taiwan prisons: a population-based study.

BACKGROUND: The prevalence of skin diseases among prisoners in Taiwan has rarely been investigated. This study aimed to estimate the prevalence of skin diseases by sex in a sample of prisoners in Taiwan. METHODS: We included 83,048 participants from the National Health Insurance Program. The outcomes were measured using the clinical version of the International Classification of Diseases, Ninth Revision. For prevalence, we presented absolute values as well as percentages. We also conducted an X2 test to assess sex differences and age group differences in the percentages of skin and subcutaneous tissue diseases. RESULTS: The prevalence of skin diseases was 42.25%, higher than that in the general population. The prevalence of skin diseases among male prisoners was higher than that among female prisoners (p < 0.001), and the prevalence of skin diseases among prisoners who were ≤ 40 was higher than that among prisoners who were > 40. Among all cases diagnosed with skin disease, the top three diseases were contact dermatitis and other types of eczema, cellulitis and abscess, pruritus, and related conditions. Male prisoners had a significantly higher prevalence of all types of skin diseases than female prisoners. CONCLUSIONS: Skin diseases are common in prisoners in Taiwan. Therefore, early prevention and appropriate treatment are needed. Male-specific skin products are also needed, given the differences in the prevalence of skin diseases among male and female prisoners.

Psychometric Properties of the Child Neglect Scale and Risk Factors for Child Neglect in Chinese Young Males Who Were Incarcerated.

Child neglect is an important risk factor for juvenile delinquency, while few studies have examined child neglect in Chinese juvenile delinquents due to the lack of appropriate measurement tools. The Child Neglect Scale is a 38-item retrospective self-report scale that specifically focuses on child neglect. The current study, therefore, aimed to examine the psychometric properties of the Child Neglect Scale and risk factors for child neglect among Chinese juvenile delinquents. A total of 212 young males who were incarcerated participated in this study, and the Childhood Trauma Questionnaire, Child Neglect Scale, and basic information questionnaire were used to collect data. The results showed that the Child Neglect Scale has good reliability, and the mean inter-item correlation coefficients reach accepted standards. Moreover, it is found that child neglect is prevalent among Chinese young males who are incarcerated, with communication neglect occurring most frequently. Low levels of family monthly income and rural residency are risk factors for child neglect. The average scores of security neglect, physical neglect, and communication neglect of the participants respectively show statistically significant differences according to the type of major caregivers. Findings suggest that the Child Neglect Scale may be used to measure child neglect with four independent subscales in Chinese young males who are incarcerated.

Socioeconomic factors in the age-graded effect of incarceration on depressive symptoms in early adulthood.

Based on insights from the stress process and life-course paradigms, this study investigates the effect of incarceration on depressive symptoms during early adulthood (ages 18-40). We employed fixed-effects dynamic panel models that adjust for confounding effects due to unobserved time-invariant variables and reverse causality using data from the National Longitudinal Study of Adolescent to Adult Health (N = 11, 811). Our analysis shows that the effect of incarceration on depressive symptoms is greater when incarceration occurs after individuals have established a stable adult status (ages 32-40) as compared to incarceration that occurs at earlier stages of adulthood (ages 18-24 and ages 25-31). The age-graded effect of incarceration on depressive symptoms is partially attributable to time-varying effects of incarceration on socioeconomic factors, such as employment status and income. All these findings contribute to our understanding of the mental health consequences of incarceration.

Prevalence of and risk factors for HCV among incarcerated people at Great Tehran Prison: a cross-sectional study.

PURPOSE: Hepatitis C is one of the major health issues in both developed and developing countries. Hepatitis C virus (HCV) infection is more common in prisoners than in the general population. The purpose of this study was to determine the prevalence of HCV and its associated risk factors in Iranian male prisoners in Tehran. DESIGN/METHODOLOGY/APPROACH: In this cross-sectional study, the authors investigated the frequency and risk factors of hepatitis C infection among male prisoners in the Great Tehran Prison. Information on risk factors including the length of imprisonment, previous history of imprisonment, history of drug injection, history of tattooing, history of piercing, history of high-risk sex and family history of hepatitis C were extracted from patients' records. To evaluate HCV status, blood samples were collected and tested. FINDINGS: In this study, 179 participants were included. Nine participants (5.0%, 95% CI, 2.3-9.3) were positive for hepatitis C. HCV infection was not significantly associated with age, marital status, education, previous history of imprisonment, length of imprisonment, piercing and high-risk sex; however, there was a significant association between a history of tattooing and a history of injecting drug use and Hepatitis C. ORIGINALITY/VALUE: The prevalence of hepatitis C among male prisoners in Great Tehran Prison was 5% in this study, similar to recent studies on prisoners in Tehran. A history of drug injections as well as tattooing were the most important risk factors for hepatitis C in male prisoners.

Prevalence of and risk factors for Human Immunodeficiency Virus (HIV) infection in entrants and residents of an Ethiopian prison.

BACKGROUND: Prisoners generally have a higher prevalence of HIV infection compared to the general population from which they come. Whether this higher prevalence reflects a higher HIV prevalence in those entering prisons or intramural transmission of HIV within prisons or both is unclear. Any of these possibilities would increase the prevalence found in resident prisoners above that in the general population. Moreover, comparisons of HIV prevalence in entrants and residents and in men and women in African prisons are not well documented. The purpose of this study was to estimate and compare the prevalence and risk factors for HIV infection amongst both male as well as female and entrant and resident prisoners in a large Ethiopian Federal Prison. METHODS: We studied consenting prisoners cross-sectionally from August 2014 through November 2016. Prison entrants were screened continuously for HIV infection and its associated risk factors and residents were screened in two waves one year apart. HIV was diagnosed at the prison hospital laboratory based on the Ethiopian national HIV rapid antibody testing protocol. An external, internationally-accredited reference laboratory confirmed results. Agreement of results between the laboratories were assessed. RESULTS: A total of 10,778 participants were screened for HIV. Most participants were young (median age of 26 years, IQR: 21-33), male (84%), single (61%), literate (89%), and urban residents (91%) without prior incarceration (96%). Prevalence of HIV was 3.4% overall. Rates of HIV (p = 0.80) were similar in residents and entrants in wave 1 and in entrants in both waves, but were 1.9-fold higher (5.4% vs 2.8%) in residents than entrants in wave 2 (both p<0.001). At entrance to the prison women were more likely to be HIV+ than men (5.5% in women vs 2.5% in men, p< 0.001). In contrast resident women were less likely to be HIV+, but this difference was not statistically significant (3.2% in women vs 4.3% in men, p = 0.125). Other risk factors associated with HIV infection were increasing age (p<0.001), female gender (p<0.001), marital status (never vs other categories, p = 0.016), smaller number of rooms in their houses pre-imprisonment (p = 0.031), TB diagnosis ever (p<0.001), number of lifetime sex partners (especially having 2-10, p<0.001), and genital ulcer (p = 0.037). CONCLUSIONS: Prevalence of HIV in the residents at this large, central Ethiopian prison was higher than that estimated for the general population and lower than in many other studies from other smaller Ethiopian prisons. A higher prevalence in residents than in entrants were found only in our second wave of screening after one year of continuous screening and treatment, possibly representing increased willingness of residents at increased risk of HIV to participate in the second wave. Thus, this findings did not clearly support intramural transmission of HIV or the effectiveness of screening to reduce prevalence. Finally, the higher HIV prevalence in women than men requires that they be similarly screened and treated for HIV infection.

Transmission of tuberculosis in an incarcerated population during the subclinical period: A cross-sectional study in Qingdao, China.

Objectives: As a closed gathering place, prison is the cradle of tuberculosis (TB) outbreak. Therefore, the analysis of the prevalence rate and risk factors of latent tuberculosis infection (LTBI) in prison will be a necessary measure to intervene in the spread of tuberculosis. Methods: In this study, we consecutively recruited 506 adult prisoners in Qingdao to carry out this cross-sectional study. TB and LTBI were screened by IGRA, X-ray, X-pert, sputum smear and culture. Results: A total of 17 TB, 101 LTBI and 388 HC were identified, with an infection rate of 23.32% (118/506) and a TB incidence rate of 3282/100,000 population. Age, malnutrition and inmates living with TB prisoners were risk factors for LTBI. Additionally, most TB cases (70.59%, 12/17) were subclinical tuberculosis (STB), contributing significantly to TB transmission. Conclusion: Our results demonstrate that the transmission efficiency of asymptomatic patients is not essentially different from that of symptomatic patients, indicating that TB transmission occurs during the subclinical period. Our findings highlight the need to strengthen active case-finding strategies to increase TB case detection in this population.

[Access to health services for a group man deprived of their liberty in a penitentiary and prison of Antioquia-Colombia, 2012]. / Acceso a servicios de salud en un establecimiento penitenciario y carcelario masculino de Antioquia (Colombia), 2012.

OBJECTIVE: Identify the conditions of access to health services of persons deprived of their Liberty (PDL) in the Penitentiary and Prison La Paz in Itagüí, Antioquia in 2012. MATERIALS AND METHODS: It is a cross-sectional descriptive study based on primary information obtained from a survey applied to a sample of 126 inmates of this institution. Descriptive and inferential statistics techniques were used: means, proportions and tests of statistical significance. RESULTS: The majority qualify adequate or very adequate continuity, opportunity and integrality of care. Everyone values how good or very good the treatment received. About one-third were denied or partially given the prescription drugs. 35.7% lost medical appointments due to administrative problems and most of them did not have sufficient information about their health rights. 66.7% said that their health deteriorated or remained the same after having been treated. CONCLUSIONS: A high proportion of this people access services and qualify medical care positively, but there are still barriers to access to medicines, problems with information about rights, and negative evaluations of the impact of medical care received.

OBJETIVO: Identificar los factores que condicionan el acceso a los servicios de salud de las personas privadas de la libertad en el establecimiento penitenciario y carcelario La Paz del municipio de Itagüí, en Antioquia (Colombia), en el 2012. MATERIALES Y MÉTODOS: Estudio descriptivo transversal soportado en encuestas a una muestra de 126 privados de la libertad de dicha institución. Se aplicaron técnicas de estadística descriptiva e inferencial: medias, proporciones y pruebas de significancia estadística. RESULTADOS: La mayoría califica adecuada o muy adecuada la continuidad, oportunidad e integralidad de la atención. Todos valoran como bueno o muy bueno el trato recibido. A cerca de un tercio le fueron negados o entregados parcialmente los medicamentos recetados. El 35,7% perdió citas médicas por problemas administrativos y la mayoría manifiesta no tener información suficiente sobre sus derechos en salud. El 66,7% declara que su salud empeoró o permaneció igual luego de haber sido atendido. CONCLUSIONES: Una alta proporción logra acceder a los servicios y califica positivamente la atención médica, pero persisten barreras de acceso a medicamentos, problemas de información sobre derechos y valoraciones negativas sobre el impacto de la atención médica recibida.

The case for transitional services and programs for older adults reentering society: a narrative review of US departments of correction and recommendations.

PURPOSE: Older adults who are or have been incarcerated constitute a growing population in the USA. The complex health needs of this group are often inadequately addressed during incarceration and equally so when transitioning back to the community. The purpose of this paper is to discuss the literature on challenges older adults (age 50 and over) face in maintaining health and accessing social services to support health after an incarceration and to outline recommendations to address the most urgent of these needs. DESIGN/METHODOLOGY/APPROACH: This study conducted a narrative literature review to identify the complex health conditions and health services needs of incarcerated older adults in the USA and outline three primary barriers they face in accessing health care and social services during reentry. FINDINGS: Challenges to healthy reentry of older adults include continuity of health care; housing availability; and access to health insurance, disability and other support. The authors recommend policy changes to improve uniformity of care, development of support networks and increased funding to ensure that older adults reentering communities have access to resources necessary to safeguard their health and safety. ORIGINALITY/VALUE: This review presents a broad perspective of the current literature on barriers to healthy reentry for older adults in the USA and offers valuable system, program and policy recommendations to address those barriers.

Caring for the Rapidly Aging Incarcerated Population: The Role of Policy.

The population of incarcerated adults in the United States is aging rapidly. Incarcerated adults experience accelerated aging, the process in which exposure to incarceration speeds up biological aging. The current article highlights unique structural factors and care practices that incarcerated older adults face in correctional and community health systems. These factors and practices are often in direct opposition to age-friendly care. Opportunities exist to expand research, modify existing policies, and change current care practices. Given their expertise in health system processes, gerontological nurses in correctional and community health care systems can play a pivotal role in improving the care of this growing and vulnerable population. [Journal of Gerontological Nursing, 49(3), 7-11.].

"I feel like marijuana is the only drug that wouldn't kill me": perceptions of cannabis use in previously incarcerated Black men who have sex with other men.

BACKGROUND: Fragmented state laws have impacted cannabis uptake and perceptions in the USA. Little research has explored the attitudes, beliefs, and social network influences of young Black men who have sex with men (BMSM) who have experienced incarceration and use cannabis. While problematic cannabis use is not well defined and understudied, scholars have found that a person's social network can mediate problematic substance use and reduce recidivism rates by providing both tangible and emotional support. This analysis examines how social networks contribute to cannabis perceptions and use among BMSM with criminal legal system involvement in Chicago, IL, and Houston TX. METHODS: Researchers conducted interviews with 25 cis gender Black men informed by life course theory, with a focus on the role of social networks, incarceration, and other life experiences in substance use. All interviews were audio-recorded, de-identified, and transcribed; participants were compensated $50. A deductive-inductive thematic analysis was used to analyze all qualitative data collected. RESULTS: Twelve BMSM in Chicago and 13 BMSM in Houston (M = 26.6 years old, SD = 3.7) were interviewed. A majority identified as gay (56%), with 12 participants (48%) reporting having a high school diploma or equivalent; their average age of first substance use was 15.2 (SD = 2.9). Participants perceived cannabis usage to be categorically distinct from other intoxicating substance usage, with many describing it as not harmful and potentially beneficial. Three themes shaped their choices and attitudes regarding cannabis and "hard" drugs-social networks, need fulfillment, and knowledge of risk. CONCLUSION: Participant descriptions of cannabis use emphasize their drug-use behavior as being produced by agent decision-making and risk assessment. Future work should expand on how these decisions are made, and how social networks can be leveraged to encourage non-harmful drug consumption behaviors.

Assessing the validity of self-report of psychopathy short-form (SRP-SF) in incarcerated offenders from Chile and Uruguay.

Psychopathy remains a relatively unexplored concept in Latin America. The abbreviated Self-Report Psychopathy Scale (SRP-SF) seems promising in this under-resourced context. However, the SRP-SF should be tested for measurement invariance to achieve meaningful comparison across countries in Latin America. Therefore the aims of this study were to examine the underlying factor structure of the SRP-SF in incarcerated adult male offenders from Uruguay (n = 331) and Chile (n = 208), to examine the measurement invariance of the SRP-SF across countries, and to assess the utility of SRP-SF to classify first time offenders from offenders with criminal history. Findings showed a good fit for the four-factor model in Uruguay, and both Chile and Uruguay showed invariance. Conversely, the Interpersonal and Affective factors were not associated with criminal history in the Uruguayan sample. Therefore, more studies are needed before using the SRP-SF as screening tool to classify first-time offenders and reoffenders in different countries in Latin America.