Journal of Correctional Health Care
Article Abstracts
Volume 10, Issue 2 — Summer 2003
·
Psychological Distress, Prisoner
Characteristics, and System Experience in a Prison
Population William T. Edwards, MA; Roberto Hugh Potter, PhD Studies of psychological symptoms and disorders among prison
populations have yielded inconsistent findings. Whether
psychological distress is “imported” into prison or develops
as a result of “deprivation” remains a key question. This
study examined psychological distress in relation to
sociodemographic and legal processing characteristics of
prisoners, with special attention paid to
adjustment/deterioration over the length of incarceration. A
one-time, cross-sectional survey design was used to collect data
from a nonprobability sample of 263 prisoners (16% of
institution population) in a medium security state prison in
eastern Kentucky. Dependent variables included Brief Symptom
Inventory (BSI) scores. This analysis examined the bivariate
relationships among sociodemographic and legal processing
variables and BSI inventory scores. Levels of psychological
distress were generally high among the respondents. Being white
and younger were positively correlated with reported distress
levels. Length of adult life spent in prison and length of time
served in current sentence were inversely related to distress
levels. Findings suggest that low numbers of years spent behind
bars and shorter length of time served made younger offenders
particularly vulnerable to significant psychological distress.
Implications for transitional programming are discussed.
·
Evaluation of an HIV Peer Education
Program in Texas Prisons Deborah P. Scott, MPH; Amy Jo Harzke, MPH; Michael B. Mizwa;
Michael Pugh, PhD;
Michael W. Ross, PhD, MPH
The following evaluates a pilot HIV education program conducted
in five Texas prison facilities that used male and female
prisoners as peer educators. Quantitative data, collected via
pre- and post-surveys from 242 prisoners, indicated
statistically significant increases in knowledge about HIV/AIDS
and nonsignificant improvements in attitudes and beliefs about
HIV/AIDS prevention. Qualitative data were collected via
interviews with wardens and program coordinators and through
focus groups with trained peer educators and their students.
These data indicated that program implementation and
effectiveness were influenced by a range of common factors
including the roles of program coordinators and security staff
in program implementation and maintenance, the selection of peer
educators and students, curricular content, program promotion
and benefits, and logistical considerations (i.e., space, time,
and scheduling). Qualitative data also suggested a diffusion of
knowledge to other prisoners and facility staff, as well as to
family members and friends outside the facility. These data
suggest that such a peer-based, risk-reduction education program
is both feasible and beneficial in a prison population.
·
Physical Health of Women in Prison:
Relationship to Oppression Michele J. Eliason, PhD, RN; Janette Y. Taylor, PhD, RN;
Rachel Williams, PhD This article examines the health of women in prison, taking
into account social structures such as racism, classism, sexism,
and the stigma of drug addiction in their daily lives. Women are
the fastest growing segment of the criminal justice system and
are entering the system with far greater health problems than
men, but with less access to health services. Incarcerated women
are disproportionately poor women of color who have experienced
years of minority stress, drug addiction, violence, and abuse.
The article identifies the need for better prison health
services, increased access to substance abuse treatment, and a
reconsideration of current drug policy and laws. There is a
critical need to create broader community-health-oriented
responses to the epidemic of drug addiction in our society. Such
responses extend beyond individual risk factors for disease and
address wider societal issues.
·
Breast Cancer and Women in Prison:
Preventive Attitudes and Risk Factors Anjali Mascarenhas Noble, DO; Sonia A. Alemagno, PhD This paper presents findings from a pilot study of 50 female
prison inmates in Florida. A nurse administered a questionnaire
to assess inmates’ risk factors and attitudes about preventive
health care for breast cancer. Findings indicate that these
women are at high risk for poor health and the development of
breast cancer. Only half of the women reported that they perform
breast self-exams and many reported they did not know the proper
technique for performing a breast self-exam. The inmates were
found to have minimal knowledge of risk factors for breast
cancer and poor compliance with screening recommendations. This
pilot project demonstrates that female prison inmates could
benefit from health education activities, especially as they
relate to breast cancer.
·
Low Sensitivity of the Leukocyte
Esterase Test (LET) in Detecting Chlamydia trachomatis
Infections in Asymptomatic Men Entering a County Jail Sylvie Ratelle, MD, MPH; Meeta S. Nguyen, MD, MPH; Yuren
Tang, MD, MPH; Michael
Whelan, BS, MS; Paul Etkind, DrPH; Thomas
Lincoln, MD; William Dumas Objectives: To
determine the test performance characteristics of the leukocyte
esterase test (LET) in detecting Chlamydia trachomatis (CT)
infections in asymptomatic men entering a county jail. Methods:
First-void urine of 2,176 men was simultaneously tested for
urethral inflammation by the LET and for CT by the ligase chain
reaction (LCR). Results: Using the LCR as reference standard,
the sensitivity, specificity, and positive and negative
predictive values of the LET with confidence intervals were 6.1%
(2.7, 12.7), 98.5% (97.9, 99.0), 18.4% (8.3, 34.9), and 95.1%
(94.0, 95.9), respectively. Conclusion: The LET lacks
sensitivity in detecting asymptomatic chlamydial infection among
men entering a correctional facility. Alternatives should be
sought as cost-saving strategies.
·
Drug Switching: The Bottom Line
Isn’t Always What It Seems David L. Whaley, PharmD; Curtis M. Warren, RPh; David L.
Thomas, MD, JD Objectives: To
study the clinical effects and costs of a formulary conversion
from omeprazole to lansoprazole in the Florida prison system.
Methods: Drug utilization patterns were studied before and after
the conversion to determine whether the switch reduced drug
acquisition cost. In addition, the charts of 29 patients from
six sites were reviewed to evaluate the clinical consequences of
the conversion. Results: The switch significantly increased (p =
0.006) the need for twice-daily administration, total daily dose
from 24.8 mg to 30 mg, and the need for add-on medications to
control acid-related symptoms (p = 0.043). Drug acquisition
costs rose by nearly $24,000. Conclusions: Formulary conversions
based solely on anticipated reductions in drug acquisition costs
may not achieve the intended financial savings.
·
Understanding Health Care
Utilization in Custody: Situation of Canadian Penitentiaries Dominique Robert, PhD
Studies reveal that people under correctional supervision suffer
from health problems in proportionally greater numbers than the
general population and that their use of health services is
extensive. However, very few studies shed light on this
phenomenon. The poor health status of inmates is neither the
only nor the most important factor in the understanding of
health services utilization in custody. Organization of
services, health professional practices, and users’
perceptions are all important variables in understanding health
care consumption. This review of the literature, mostly Canadian
studies, aims at documenting some factors that could help us
understand the practices of health care utilization behind the
walls.
·
Juvenile Correctional System Health
Care Cost: A Five-Year Comparison Debra H. Tennyson, PhD Correctional facilities continue to experience increasing health care
demands while resources decrease and costs for services
increase. This paper shows changes in health care expenditures
over a five-year period, highlighting services vulnerable to
fluctuation. Health care costs of a long-term juvenile
correctional system housing approximately 525 juveniles were
compared between fiscal years 1995 and 2000. Health care
expenditure increased 17% over the study period, even with
concerted efforts to control spending. This longitudinal
comparison suggests that juvenile correctional facilities’
health care budgets are highly vulnerable to large fluctuations
due to youths’ unexpected medical costs.
