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Women in Transition to Health
Abstract
The time after incarceration is widely regarded as tenuous and stressful, and for women living with chronic illness, self-management is yet another stressor. Intervening before the individual is overwhelmed is critical to ensuring success. In this article the Women in Transition to Health, a nurse-led intervention based on Lazarus and Folkman's Transactional Model of Stress and Coping, designed to improve health outcomes in women recently released from jail or prison is described. Motivational interviewing and case management are used to strengthen coping skills and encourage engagement in care. Using the stress model to address the unique needs of this population holds promise for improving health and quality of life.
... The justice agencies included are parole and probation departments, police departments, and courts including court officials-judges, administrators, prosecutors, deputies, and public and private defenders, prison and jails. Social organizations are agencies that provide a range of public services to improve the health and well-being of justice-involved women, their families, and their communities (Colbert & Durand, 2016;Huebner, DeJong, & Cobbina, 2010;Parsons & Warner-Robbins, 2002;Swavola et al., 2016;Yamatani & Spjeldnes, 2011). The social service agencies included are housing and urban development, department of children and families, welfare, workforce, substance abuse treatment centers, mental health, food pantries, local health departments, Medicaid, and faith-based organizations. ...
... The social service agencies included are housing and urban development, department of children and families, welfare, workforce, substance abuse treatment centers, mental health, food pantries, local health departments, Medicaid, and faith-based organizations. Healthcare organizations are public and private agencies that provide healthcare services to justice-involved women to prevent, alleviate, and cure illness and injuries (Colbert & Durand, 2016;Huebner et al., 2010;Parsons & Warner-Robbins, 2002;Swavola et al., 2016;Yamatani & Spjeldnes, 2011). Healthcare agencies included are substance use and mental health treatment, community health centers, and hospitals. ...
Background:
Over seven million imprisoned and jailed women are released into the community each year and many are ill-equipped to meet the challenges of re-integration. Upon release into their community, women are faced with uncertain barriers and challenges using community services to improve their health and well-being and reuniting with families. Few studies have identified and described the barriers of the community health delivery system (CHDS)- a complex set of social, justice, and healthcare organizations that provide community services aimed to improve the health and well-being (i.e. safety, health, the success of integration, and life satisfaction) of justice-involved women. We conducted a narrative review of peer-reviewed and gray literature to identify and describe the CHDS and the CHDS service delivery.
Results:
Peer-reviewed and gray literature (n = 82) describing the CHDS organizations' missions, incentives, goals, and services were coded in three domains, justice, social, and healthcare, to examine their service delivery to justice-involved women and their efforts to improve the health and well-being of justice-involved women.
Conclusions:
We found that the CHDS is fragmented, identified gaps in knowledge about the CHDS that serves justice-involved women, and offer recommendations to reduce fragmentation and integrate service delivery aimed to improve the health and well-being of justice-involved women.
... To date, in research that examines individuals' stress and coping processes, several researchers have discovered the significant applicability of Lazarus and Folkman's (1984) stress theory in explaining various coping strategies in dynamic contexts (e.g. Ermasova et al., 2020;Green et al., 2005Green et al., , 2010Kelso et al., 2005;Quine and Pahl, 1991), including those in the realm of criminology (Colbert and Durand, 2016;Ermasova et al., 2020;Giurgescu et al., 2015). This theory is thus employed to comprehend the factors that trigger stress among victims and how they cope in cases of sextortion. ...
Sextortion is the threat to distribute intimate, sexual materials unless a victim complies with particular demands. Cyber sextortion, specifically, takes advantage of the Internet’s anonymous nature and uses explicit personal images to inflict harm on victims. Despite this crime’s serious nature, there is a dearth of empirical knowledge of sextortion, particularly the process of fear management for the victims. This article employed a qualitative content analysis of the victim testimonials posted on the Reddit sextortion forum to explore the coping mechanisms of 175 cyber sextortion victims. Borrowed from the transactional model of stress and coping developed by Lazarus and Folkman, the characteristics of person–environment stimuli, ransom, appraisal and coping, revisit, and reappraisal were identified and revealed an extended model of fear and stress management applied particularly among sextortion victims. In addition, characteristics that are unique to female and male victims are also revealed in this analysis. In sum, the dynamic nature of fear and stress management among victims of sextortion implies specific crime control and prevention policies.
... In 2017, women made up 7% of the total prison population-an increase of more than 100 prisoners from 2015 in the U.S [1][2][3]. The number of women incarcerated for more than 1 year increased by more than 700 prisoners in 2016 in the U.S [4,5]. Kansas and Missouri similar to many other states have a reputation of incarcerating women, especially mothers dealing with drug or alcohol addictions and property crimes [6]. ...
The community health delivery system (CHDS) are vital agencies to the success of integration and the provision of services to improve the health and well-being of justice-involved women. Many agencies face barriers and challenges in providing services to vulnerable populations, such as justice-involved women, and, as a result, often offer individual rather than coordinator care. Thus, it is necessary to explore CHDS systemic barriers and challenges to identify opportunities for coordinated care. We conducted semi-structured interviews with 26 CHDS directors or designees to identify systemic barriers and challenges, organizational processes, experiences with vulnerable populations, services and programs, and care coordination and perceived women’s barriers and challenges to the provision of services including decision-making processes and access. Qualitative analyses were used to construct thematic descriptions in five areas: (1) mental health as an unmet need, (2) financial constraints, (3) limited organizational capacity, (4) implicit bias, and (5) minimal cultural support of vulnerable populations.
... People who experience imprisonment face a greater burden of illness on average compared to the rest of the general population, with a higher prevalence of infectious diseases, chronic diseases, and mental health and substance use disorders [8]. The period after release from prison is associated with particularly high morbidity and mortality, with several studies showing increased rates of medical-surgical hospitalization compared to the general population [9][10][11][12][13][14][15][16][17][18]. Health care access and quality may be suboptimal for this population while in prison and after prison release [13,19], with substantial impacts on individual and population health [20]. ...
We aimed to compare 30-day readmission after medical-surgical hospitalization for people who experience imprisonment and matched people in the general population in Ontario, Canada. We used linked population-based correctional and health administrative data. Of people released from Ontario prisons in 2010, we identified those with at least one medical or surgical hospitalization between 2005 and 2015 while they were in prison or within 6 months after release. For those with multiple eligible hospitalizations, we randomly selected one hospitalization. We stratified people by whether they were in prison or recently released from prison at the time of hospital discharge. We matched each person with a person in the general population based on age, sex, hospitalization case mix group, and hospital discharge year. Our primary outcome was 30-day hospital readmission. We included 262 hospitalizations for people in prison and 1,268 hospitalizations for people recently released from prison. Readmission rates were 7.7% (95%CI 4.4–10.9) for people in prison and 6.9% (95%CI 5.5–8.3) for people recently released from prison. Compared with matched people in the general population, the unadjusted HR was 0.72 (95%CI 0.41–1.27) for people in prison and 0.78 (95%CI 0.60–1.02) for people recently released from prison. Adjusted for baseline morbidity and social status, hospitalization characteristics, and post-discharge health care use, the HR for 30-day readmission was 0.74 (95%CI 0.40–1.37) for people in prison and 0.48 (95%CI 0.36–0.63) for people recently released from prison. In conclusion, people recently released from prison had relatively low rates of readmission. Research is needed to elucidate reasons for lower readmission to ensure care quality and access.
... Administrative issues may also contribute to use in prison, such as institutional requirements for a clinical assessment or to see a physician for care that is available in the community without a physician [10,13], for example over-the-counter medications. Though ambulatory care utilization decreased substantially on release, the rates in the prison release group remained high compared to the general population, which is notable given that people face many challenges on release that may compete with attending to health needs and accessing health care, including housing access, relapse to substance use, and family issues [47][48][49][50][51][52]; this suggests people may have urgent unmet health care needs at the time of release. ...
Background
Many people experience imprisonment each year, and this population bears a disproportionate burden of morbidity and mortality. States have an obligation to provide equitable health care in prison and to attend to care on release. Our objective was to describe health care utilization in prison and post-release for persons released from provincial prison in Ontario, Canada in 2010, and to compare health care utilization with the general population.
Methods
We conducted a population-based retrospective cohort study. We included all persons released from provincial prison to the community in 2010, and age- and sex-matched general population controls. We linked identities for persons released from prison to administrative health data. We matched each person by age and sex with four general population controls. We examined ambulatory care and emergency department utilization and medical-surgical and psychiatric hospitalization, both in prison and in the three months after release to the community. We compared rates with those of the general population.
Results
The rates of all types of health care utilization were significantly higher in prison and on release for people released from prison (N = 48,861) compared to general population controls (N = 195,444). Comparing those released from prison to general population controls in prison and in the 3 months after release, respectively, utilization rates were 5.3 (95% CI 5.2, 5.4) and 2.4 (95% CI 2.4, 2.5) for ambulatory care, 3.5 (95% CI 3.3, 3.7) and 5.0 (95% CI 4.9, 5.3) for emergency department utilization, 2.3 (95% CI 2.0, 2.7) and 3.2 (95% CI 2.9, 3.5) for medical-surgical hospitalization, and 21.5 (95% CI 16.7, 27.7) and 17.5 (14.4, 21.2) for psychiatric hospitalization. Comparing the time in prison to the week after release, ambulatory care use decreased from 16.0 (95% CI 15.9,16.1) to 10.7 (95% CI 10.5, 10.9) visits/person-year, emergency department use increased from 0.7 (95% CI 0.6, 0.7) to 2.6 (95% CI 2.5, 2.7) visits/person-year, and hospitalization increased from 5.4 (95% CI 4.8, 5.9) to 12.3 (95% CI 10.1, 14.6) admissions/100 person-years for medical-surgical reasons and from 8.6 (95% CI 7.9, 9.3) to 17.3 (95% CI 14.6, 20.0) admissions/100 person-years for psychiatric reasons.
Conclusions
Across care types, health care utilization in prison and on release is elevated for people who experience imprisonment in Ontario, Canada. This may reflect high morbidity and suboptimal access to quality health care. Future research should identify reasons for increased use and interventions to improve care.
... Administrative issues may also contribute to use in prison, such as institutional requirements for a clinical assessment or to see a physician for care that is available in the community without a physician [10,13], for example over-the-counter medications. Though ambulatory care utilization decreased substantially on release, the rates in the prison release group remained high compared to the general population, which is notable given that people face many challenges on release that may compete with attending to health needs and accessing health care, including housing access, relapse to substance use, and family issues [47][48][49][50][51][52]; this suggests people may have urgent unmet health care needs at the time of release. ...
Background
Many people experience imprisonment each year, and this population bears a disproportionate burden of morbidity and mortality. States have an obligation to provide equitable health care in prison and to attend to care on release. Our objective was to describe health care utilization in prison and post-release for persons released from provincial prison in Ontario, Canada in 2010, and to compare health care utilization with the general population.
Methods
We conducted a population-based retrospective cohort study. We included all persons released from provincial prison to the community in 2010, and age- and sex-matched general population controls. We linked identities for persons released from prison to administrative health data. We matched each person by age and sex with four general population controls. We examined ambulatory care and emergency department utilization and medical-surgical and psychiatric hospitalization, both in prison and in the three months after release to the community. We compared rates with those of the general population.
Results
The rates of all types of health care utilization were significantly higher in prison and on release for people released from prison (N = 48,861) compared to general population controls (N = 195,444). Comparing those released from prison to general population controls in prison and in the 3 months after release, respectively, utilization rates were 5.3 (95% CI 5.2, 5.4) and 2.4 (95% CI 2.4, 2.5) for ambulatory care, 3.5 (95% CI 3.3, 3.7) and 5.0 (95% CI 4.9, 5.3) for emergency department utilization, 2.3 (95% CI 2.0, 2.7) and 3.2 (95% CI 2.9, 3.5) for medical-surgical hospitalization, and 21.5 (95% CI 16.7, 27.7) and 17.5 (14.4, 21.2) for psychiatric hospitalization. Comparing the time in prison to the week after release, ambulatory care use decreased from 16.0 (95% CI 15.9,16.1) to 10.7 (95% CI 10.5, 10.9) visits/person-year, emergency department use increased from 0.7 (95% CI 0.6, 0.7) to 2.6 (95% CI 2.5, 2.7) visits/person-year, and hospitalization increased from 5.4 (95% CI 4.8, 5.9) to 12.3 (95% CI 10.1, 14.6) admissions/100 person-years for medical-surgical reasons and from 8.6 (95% CI 7.9, 9.3) to 17.3 (95% CI 14.6, 20.0) admissions/100 person-years for psychiatric reasons.
Conclusions
Across care types, health care utilization in prison and on release is elevated for people who experience imprisonment in Ontario, Canada. This may reflect high morbidity and suboptimal access to quality health care. Future research should identify reasons for increased use and interventions to improve care.
Objective:
To examine attachment to primary care and team-based primary care in the community for people who experienced imprisonment in Ontario, and to compare these attachment data with data for the general population.
Design:
Population-based retrospective cohort study.
Setting:
Ontario.
Participants:
All persons released from provincial prison in Ontario to the community in 2010 who were linked with provincial health administrative data, and an age- and sex-matched general population group.
Main outcome measures:
Primary care attachment and team-based primary care attachment in the 2 years before admission to provincial prison (baseline) and in the 2 years after release in 2010 (follow-up) for the prison release group, and for the corresponding periods for the general population group.
Results:
People in the prison release group (n = 48 861) were less likely to be attached to primary care compared with the age- and sex-matched general population group (n = 195 444), at 58.9% versus 84.1% at baseline (P < .001) and 63.0% versus 84.4% during follow-up (P < .001), respectively. The difference in attachment to team-based primary care was small in magnitude but statistically significant, at 14.4% versus 16.1% at baseline (P < .001) and 19.9% versus 21.6% during follow-up (P < .001), respectively.
Conclusion:
People who experience imprisonment have lower primary care attachment compared with the general population. Efforts should be made to understand barriers and to facilitate access to high-quality primary care for this population, including through initiatives to link people while in prison with primary care in the community.
Nurses who provide care in the community to women with a history of repeated incarceration may struggle to understand the full extent of the barriers faced by this population and as a result risk giving suboptimal care to an already underserved group. This narrative inquiry study of stories told by 10 women with histories of repeated incarceration fulfilled 2 purposes: to demonstrate how women's shelter-seeking stories exposed uniquely complex patterns of health opportunity and risk and to demonstrate how storytelling might serve as an informative mode of nursing health assessment for this population.
Abstract Women entering the correctional system represent a population at high risk for mental health and the body of research on the mental health needs of women offenders is growing. These mental health problems pose challenges for women at every stage of the criminal justice process, from arrest to incarceration to community reentry and reintegration. In this paper, we examined mental health status among a sample of 142 women leaving confinement and the role that mental health problems played in shaping their reentry outcomes using data collected between 2002 and 2005 in Houston Texas. In the year after leaving prison, women with mental health problems reported poorer health, more hospitalizations, more suicidal thoughts, greater difficulties securing housing and employment, more involvement in criminal behavior, and less financial support from family than women with no indication of mental health problems. However, mental health status did not increase the likelihood of substance use relapse or reincarceration. The paper concludes with a discussion of recommendations for improved policy and practice.
In the past three decades, incarceration has become an increasingly powerful force for reproducing and reinforcing social inequalities. A new wave of sociological research details the contemporary experiment with mass incarceration in the United States and its attendant effects on social stratification. This review first describes the scope of imprisonment and the process of selection into prison. It then considers the implications of the prison boom for understanding inequalities in the labor market, educational attainment, health, families, and the intergenerational transmission of inequality. Social researchers have long understood selection into prison as a reflection of existing stratification processes. Today, research attention has shifted to the role of punishment in generating these inequalities.
We sought to determine whether adding motivational interviewing to a behavioral weight control program improves weight loss outcomes and glycemic control for overweight women with type 2 diabetes.
We conducted a randomized, controlled, clinical trial in which participants all received an 18-month, group-based behavioral obesity treatment and were randomized to individual sessions of motivational interviewing or attention control (total of five sessions) as an adjunct to the weight control program. Overweight women with type 2 diabetes treated by oral medications who could walk for exercise were eligible. Primary outcomes were weight and A1C, assessed at 0, 6, 12, and 18 months.
A total of 217 overweight women (38% African American) were randomized (93% retention rate). Women in motivational interviewing lost significantly more weight at 6 months (P = 0.01) and 18 months (P = 0.04). Increased weight losses with motivational interviewing were mediated by enhanced adherence to the behavioral weight control program. African-American women lost less weight than white women overall and appeared to have a diminished benefit from the addition of motivational interviewing. Significantly greater A1C reductions were observed in those undergoing motivational interviewing at 6 months (P = 0.02) but not at 18 months.
Motivational interviewing can be a beneficial adjunct to behavioral obesity treatment for women with type 2 diabetes, although the benefits may not be sustained among African-American women.
This study explores whether being met at the gate by a case manager is associated with more health-seeking behavior during the six months post-release among HIV-infected inmates transitioning from the facility to the community. Case managers documented whether clients were met at the gate upon release. Clients (N=226) underwent a structured interview at approximately six months post-release. One hundred and four clients were met at the gate upon release (46%). Results indicate that clients who were met at the gate were more likely to participate in drug or alcohol treatment (p< or =.01) and not engage in sex exchange during the subsequent six months (p< or =.05). Health-seeking behavior prior to incarceration, facility type, and state were controlled for. Being met at the gate was not significantly associated with reduced emergency room use or using street drugs. Findings offer support for the importance of establishing early post-release contact with a case manager among HIV-infected ex-offenders.
Womens choices: Case management for women leaving jails and prisons.
- Weissman