Kinner Stuart A, Alati Rosa, Longo Marie, Spittal Matthew J, Boyle Frances M, Williams Gail M, Lennox Nicholas G
Griffith Criminology Institute & Menzies Health Institute Queensland, Griffith University, Brisbane, Australia Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia Queensland Centre for Intellectual and Developmental Disability, Mater Research Institute-UQ, The University of Queensland, Brisbane, Australia.
School of Public Health, University of Queensland, Brisbane, Australia.
J Epidemiol Community Health. 2016 Jul;70(7):683-8. doi: 10.1136/jech-2015-206565. Epub 2016 Jan 19.
The world prison population is large and growing. Poor health outcomes after release from prison are common, but few programmes to improve health outcomes for ex-prisoners have been rigorously evaluated. The aim of this study was to evaluate the impact of individualised case management on contact with health services during the first 6 months post-release.
Single-blinded, randomised, controlled trial. Baseline assessment with N=1325 adult prisoners in Queensland, Australia, within 6 weeks of expected release; follow-up interviews 1, 3 and 6 months post-release. The intervention consisted of provision of a personalised booklet ('Passport') at the time of release, plus up to four brief telephone contacts in the first 4 weeks post-release.
Of 1179 eligible participants, 1003 (85%) completed ≥1 follow-up interview. In intention-to-treat analyses, 53% of the intervention group and 41% of the control group reported contacting a general practitioner (GP) at 1 month post-release (difference=12%, 95% CI 5% to 19%). Similar effects were observed for GP contact at 3 months (difference=9%, 95% CI 2% to 16%) and 6 months (difference=8%, 95% CI 1% to 15%), and for mental health (MH) service contact at 6 months post release (difference=8%, 95% CI 3% to 14%).
Individualised case management in the month after release from prison increases usage of primary care and MH services in adult ex-prisoners for at least 6 months post-release. Given the poor health profile of ex-prisoners, there remains an urgent need to develop and rigorously evaluate interventions to increase health service contact in this profoundly marginalised population.
ACTRN12608000232336.
全球监狱人口数量庞大且不断增长。出狱后健康状况不佳的情况很常见，但很少有改善出狱人员健康状况的项目经过严格评估。本研究的目的是评估个性化个案管理对出狱后前6个月内与医疗服务机构接触情况的影响。
单盲、随机对照试验。对澳大利亚昆士兰州1325名成年囚犯在预计出狱前6周进行基线评估；在出狱后1个月、3个月和6个月进行随访访谈。干预措施包括在出狱时提供一本个性化手册（“护照”），以及在出狱后的前4周内最多进行4次简短的电话联系。
在1179名符合条件的参与者中，1003人（85%）完成了≥1次随访访谈。在意向性分析中，干预组53%的人和对照组41%的人报告在出狱后1个月与全科医生（GP）有过接触（差异=12%，95%置信区间5%至19%）。在3个月（差异=9%，95%置信区间2%至16%）和6个月（差异=8%，95%置信区间1%至15%）时，与全科医生接触也观察到类似效果，在出狱后6个月与心理健康（MH）服务机构接触时也是如此（差异=8%，95%置信区间3%至14%）。
出狱后一个月内的个性化个案管理可增加成年出狱人员在出狱后至少6个月内对初级保健和心理健康服务的使用。鉴于出狱人员健康状况不佳，迫切需要开发并严格评估干预措施，以增加这一极度边缘化人群与医疗服务机构的接触。
ACTRN12608000232336。
