Faculty of Health and Medicine, The University of Newcastle, Callaghan, New South Wales, Australia.
Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia.
BMJ Open. 2019 Jul 24;9(7):e030546. doi: 10.1136/bmjopen-2019-030546.
The rising rate of incarceration in Australia, driven by high reoffending, is a major public health problem. Problematic drug use is associated with increasing rates of reoffending and return to custody of individuals. Throughcare provides support to individuals during imprisonment through to post-release, improving both the transition to community and health outcomes post-incarceration. The aim of this study is to evaluate the Connections Programme (CP) that utilises a throughcare approach for release planning of people in prison with a history of problematic drug use. The study protocol is described.
Population-based retrospective cohort study. The study will use record linkage of the Connections dataset with 10 other New South Wales (NSW) population datasets on offending, health service utilisation, opioid substitution therapy, pregnancy, birth and mortality. The study includes all patients who were eligible to participate in the CP between January 2008 and December 2015 stratified by patients who were offered CP and eligible patients who were not offered the programme (non-CP (NCP)). Propensity-score matching will be used to appropriately adjust for the observable differences between CP and NCP. The differences between two groups will be examined using appropriate univariate and multivariate analyses. A generalised estimating equation approach, which can deal with repeat outcomes for individuals will be used to examine recidivism, mortality and other health outcomes, including perinatal and infant outcomes. Survival analysis techniques will be used to examine the effect of the CP by sex and Indigenous status on the 'time-to' health-related outcomes after adjusting for potential confounders.
Ethical approval was received from the NSW Population and Health Services Research Ethics Committee, the Justice Health and Forensic Mental Health Network Human Research Ethics Committee, the Aboriginal Health and Medical Research Council Ethics Committee, the Corrective Services NSW Ethics Committee and the University of Technology Sydney Human Research Ethics Committee.
在高累犯率的推动下，澳大利亚的监禁率不断上升，这是一个主要的公共卫生问题。有问题的药物使用与累犯率的上升以及有问题的药物使用个人返回拘留所有关。出狱后护理通过在监禁期间向个人提供支持，改善监禁后的过渡和健康结果。本研究的目的是评估 Connections 计划（CP），该计划利用出狱后护理方法为有问题的药物使用史的囚犯制定出狱计划。描述了研究方案。
基于人群的回顾性队列研究。该研究将使用 Connections 数据集与新南威尔士州（NSW）的 10 个其他人群数据集进行记录链接，这些数据集涉及犯罪、卫生服务利用、阿片类药物替代疗法、怀孕、分娩和死亡率。该研究包括 2008 年 1 月至 2015 年 12 月期间有资格参加 CP 的所有患者，按接受 CP 的患者和未接受该计划（非 CP（NCP））的合格患者进行分层。将使用倾向评分匹配适当调整 CP 和 NCP 之间的可观察差异。将使用适当的单变量和多变量分析检查两组之间的差异。广义估计方程方法可用于处理个人的重复结果，以检查累犯、死亡率和其他健康结果，包括围产期和婴儿结果。生存分析技术将用于根据潜在的混杂因素调整后，按性别和土著地位检查 CP 对健康相关结果的“时间到”的影响。
新南威尔士州人口和卫生服务研究伦理委员会、司法卫生和法医心理健康网络伦理委员会、土著卫生和医学研究委员会伦理委员会、新南威尔士州惩教服务局伦理委员会和悉尼科技大学伦理委员会均批准了该研究。
