Connell Catriona, Birken Mary, Carver Hannah, Brown Tamara, Greenhalgh Jessica
Salvation Army Centre for Addiction Services and Research, University of Stirling, Stirling, UK.
Division of Psychiatry, University College London, London, UK.
Health Justice. 2023 Mar 14;11(1):17. doi: 10.1186/s40352-023-00217-w.
People released from prison experience complex health challenges in addition to challenges resettling into the community. Consequently, employment rates are low. Participating in good quality employment can support good health and is protective against future reoffending. Multiple interventions are provided to support people into employment on release. The effectiveness of interventions for improving employment outcomes has not previously been evaluated in a meta-analysis.
Our objective was to examine the effectiveness of interventions to improve employment following release from prison.
We searched seven databases and three trial registries for peer reviewed randomised controlled trials (RCTs), published since 2010, that included adults and measured an employment outcome(s). We conducted meta-analysis using random effects models with sub-group and sensitivity analyses. We appraised bias risk per outcome, and incorporated this into an assessment of the certainty estimates for each outcome. A group of people with experience of imprisonment met with us throughout the project to inform our search strategy and interpretation of results.
We included 12 RCTs (2,875 participants) which were all conducted in the USA. Few outcomes were of low risk of bias. Intervention participants were 2.5 times more likely to work at least one day (95% CI:1.82-3.43) and worked more days over 12 months (MD = 59.07, 95% CI:15.83-102.32) compared to controls. There was no effect on average employment status or employment at study end. There is moderate certainty in these estimates.
Interventions can improve some employment outcomes for people released from prison. More evidence is required to establish effective interventions for sustaining quality employment, particularly outside the USA, and which consider outcomes for different groups of people released, such as women or those with health or substance use needs.
刑满释放人员除了在重新融入社区方面面临挑战外，还经历着复杂的健康问题。因此，他们的就业率很低。参与高质量就业有助于保持健康，并能预防未来再次犯罪。目前提供了多种干预措施来帮助刑满释放人员就业。此前尚未通过荟萃分析评估这些干预措施对改善就业结果的有效性。
我们的目标是研究旨在改善刑满释放人员就业情况的干预措施的有效性。
我们检索了7个数据库和3个试验注册库，以查找自2010年以来发表的、纳入了成年人且测量了就业结果的同行评审随机对照试验（RCT）。我们使用随机效应模型进行荟萃分析，并进行亚组分析和敏感性分析。我们评估了每个结果的偏倚风险，并将其纳入对每个结果确定性估计的评估中。在整个项目过程中，一组有监禁经历的人与我们会面，为我们的检索策略和结果解读提供信息。
我们纳入了12项RCT（2875名参与者），所有试验均在美国进行。很少有结果的偏倚风险较低。与对照组相比，干预组参与者至少工作一天的可能性高出2.5倍（95%置信区间：1.82 - 3.43），并且在12个月内工作的天数更多（平均差 = 59.07，95%置信区间：15.83 - 102.32）。对平均就业状况或研究结束时的就业情况没有影响。这些估计结果具有中等确定性。
干预措施可以改善刑满释放人员的一些就业结果。需要更多证据来确定有效的干预措施，以维持高质量就业，特别是在美国以外的地区，并且要考虑到不同刑满释放人群的结果，如女性或有健康或物质使用需求的人群。
