International Journal of Prisoner HealthTable of Contents for International Journal of Prisoner Health. List of articles from the current issue, including Just Accepted (EarlyCite)https://www.emerald.com/insight/publication/issn/1744-9200/vol/19/iss/4?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestInternational Journal of Prisoner HealthEmerald Publishing LimitedInternational Journal of Prisoner HealthInternational Journal of Prisoner Healthhttps://www.emerald.com/insight/proxy/containerImg?link=/resource/publication/journal/b5d5b6aa702bcb8662d1d4bc4a98a9f9/urn:emeraldgroup.com:asset:id:binary:ijph.cover.jpghttps://www.emerald.com/insight/publication/issn/1744-9200/vol/19/iss/4?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestEditorialhttps://www.emerald.com/insight/content/doi/10.1108/IJPH-12-2023-120/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestEditorialEditorial
Tali Ziv, Ruth Shefner,  Carolyn Sufrin
International Journal of Prisoner Health, Vol. 19, No. 4, pp.489-491]]>
Editorial10.1108/IJPH-12-2023-120International Journal of Prisoner Health2023-11-28© 2023 Emerald Publishing LimitedTali ZivRuth Shefner Carolyn SufrinInternational Journal of Prisoner Health1942023-11-2810.1108/IJPH-12-2023-120https://www.emerald.com/insight/content/doi/10.1108/IJPH-12-2023-120/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2023 Emerald Publishing Limited
Prevalence of sexually transmitted infections (STIs) and related factors among female prisoners in Tehran, Iranhttps://www.emerald.com/insight/content/doi/10.1108/IJPH-09-2022-0055/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestSexually transmitted infections (STIs) can be transferred from one person to another through sexual contact. STIs lead to substantial morbidity and mortality and affect many different aspects of human life, including quality of life, sexual health, reproductive health and even the health of newborns and children. Despite of high rates of STIs in prisons, there are not sufficient screening, prevention and treatment programs to control STIs transmission among prisoners in Iran. This study aims to evaluate the prevalence of STIs among incarcerated women in Iran for the first time, using the active case finding strategy. This is a cross-sectional study conducted on 438 incarcerated women in a prison in Tehran, Iran, from 2017 to 2018. A total of 438 prisoners were screened by active case findings for STI symptoms, then evaluated by complete genital and anal examination, followed by molecular testing. A total of 189 (43.2%) prisoners announced vaginal discharge, while 194 (44.3%) individuals had vaginal discharge in the genital examination. In the cervical examination, 137 individuals (31.3%) had abnormal findings, of which 83 (18.9%) individuals had cervicitis, 40 (9.1%) individuals had cervical erosion, 38 (8.7%) individuals had cervical prolapse and 17 (3.9%) individuals had bleeding originated from the cervix. This study showed that it is possible to set up a system in which the diagnosis, follow-up and treatment of prisoners with STIs can be actively performed. Educating prisoners about signs and symptoms, risk behaviors and prevention routes of STIs, as much as regular screening of prisoners, and adequate treatment can help control the STIs prevalence among prisoners and in the general population.Prevalence of sexually transmitted infections (STIs) and related factors among female prisoners in Tehran, Iran
Behnam Farhoudi, Elnaz Shahmohamadi, SeyedAhmad SeyedAlinaghi, Zohreh Rostam Afshar, Zohal Parmoon, Pegah Mirzapour, SeyedAlireza Nadji, Fatemeh Golsoorat Pahlaviani, Mehrzad Tashakorian
International Journal of Prisoner Health, Vol. 19, No. 4, pp.492-500

Sexually transmitted infections (STIs) can be transferred from one person to another through sexual contact. STIs lead to substantial morbidity and mortality and affect many different aspects of human life, including quality of life, sexual health, reproductive health and even the health of newborns and children. Despite of high rates of STIs in prisons, there are not sufficient screening, prevention and treatment programs to control STIs transmission among prisoners in Iran. This study aims to evaluate the prevalence of STIs among incarcerated women in Iran for the first time, using the active case finding strategy.

This is a cross-sectional study conducted on 438 incarcerated women in a prison in Tehran, Iran, from 2017 to 2018. A total of 438 prisoners were screened by active case findings for STI symptoms, then evaluated by complete genital and anal examination, followed by molecular testing.

A total of 189 (43.2%) prisoners announced vaginal discharge, while 194 (44.3%) individuals had vaginal discharge in the genital examination. In the cervical examination, 137 individuals (31.3%) had abnormal findings, of which 83 (18.9%) individuals had cervicitis, 40 (9.1%) individuals had cervical erosion, 38 (8.7%) individuals had cervical prolapse and 17 (3.9%) individuals had bleeding originated from the cervix.

This study showed that it is possible to set up a system in which the diagnosis, follow-up and treatment of prisoners with STIs can be actively performed. Educating prisoners about signs and symptoms, risk behaviors and prevention routes of STIs, as much as regular screening of prisoners, and adequate treatment can help control the STIs prevalence among prisoners and in the general population.

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Prevalence of sexually transmitted infections (STIs) and related factors among female prisoners in Tehran, Iran10.1108/IJPH-09-2022-0055International Journal of Prisoner Health2022-12-29© 2022 Emerald Publishing LimitedBehnam FarhoudiElnaz ShahmohamadiSeyedAhmad SeyedAlinaghiZohreh Rostam AfsharZohal ParmoonPegah MirzapourSeyedAlireza NadjiFatemeh Golsoorat PahlavianiMehrzad TashakorianInternational Journal of Prisoner Health1942022-12-2910.1108/IJPH-09-2022-0055https://www.emerald.com/insight/content/doi/10.1108/IJPH-09-2022-0055/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2022 Emerald Publishing Limited
Intensified pulmonary tuberculosis case finding among HIV-infected new entrants of a prison in Malaysia: implications for a holistic approach to control tuberculosis in prisonshttps://www.emerald.com/insight/content/doi/10.1108/IJPH-01-2022-0001/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestThis intensified case finding study aimed to evaluate the prevalence of tuberculosis (TB) disease among people with HIV entering the largest prison in Malaysia. The study was conducted in Kajang prison, starting in July 2013 in the men’s prison and June 2015 in the women’s prison. Individuals tested positive for HIV infection, during the mandatory HIV testing at the prison entry, were consecutively recruited over five months at each prison. Consented participants were interviewed using a structured questionnaire and asked to submit two sputum samples that were assessed using GeneXpert MTB/RIF (Xpert) and culture, irrespective of clinical presentation. Factors associated with active TB (defined as a positive result on either Xpert or culture) were assessed using regression analyses. Overall, 214 incarcerated people with HIV were recruited. Most were men (84.6%), Malaysians (84.1%) and people who inject drugs (67.8%). The mean age was 37.5 (SD 8.2) years, and median CD4 lymphocyte count was 376 cells/mL (IQR 232–526). Overall, 27 (12.6%) TB cases were identified, which was independently associated with scores of five or more on the World Health Organization clinical scoring system for prisons (ARR 2.90 [95% CI 1.48–5.68]). Limited data exists about the prevalence of TB disease at prison entry, globally and none from Malaysia. The reported high prevalence of TB disease in the study adds an important and highly needed information to design comprehensive TB control programmes in prisons.Intensified pulmonary tuberculosis case finding among HIV-infected new entrants of a prison in Malaysia: implications for a holistic approach to control tuberculosis in prisons
Haider Al-Darraji, Philip Hill, Katrina Sharples, Frederick L. Altice, Adeeba Kamarulzaman
International Journal of Prisoner Health, Vol. 19, No. 4, pp.501-511

This intensified case finding study aimed to evaluate the prevalence of tuberculosis (TB) disease among people with HIV entering the largest prison in Malaysia.

The study was conducted in Kajang prison, starting in July 2013 in the men’s prison and June 2015 in the women’s prison. Individuals tested positive for HIV infection, during the mandatory HIV testing at the prison entry, were consecutively recruited over five months at each prison. Consented participants were interviewed using a structured questionnaire and asked to submit two sputum samples that were assessed using GeneXpert MTB/RIF (Xpert) and culture, irrespective of clinical presentation. Factors associated with active TB (defined as a positive result on either Xpert or culture) were assessed using regression analyses.

Overall, 214 incarcerated people with HIV were recruited. Most were men (84.6%), Malaysians (84.1%) and people who inject drugs (67.8%). The mean age was 37.5 (SD 8.2) years, and median CD4 lymphocyte count was 376 cells/mL (IQR 232–526). Overall, 27 (12.6%) TB cases were identified, which was independently associated with scores of five or more on the World Health Organization clinical scoring system for prisons (ARR 2.90 [95% CI 1.48–5.68]).

Limited data exists about the prevalence of TB disease at prison entry, globally and none from Malaysia. The reported high prevalence of TB disease in the study adds an important and highly needed information to design comprehensive TB control programmes in prisons.

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Intensified pulmonary tuberculosis case finding among HIV-infected new entrants of a prison in Malaysia: implications for a holistic approach to control tuberculosis in prisons10.1108/IJPH-01-2022-0001International Journal of Prisoner Health2023-01-11© 2022 Emerald Publishing LimitedHaider Al-DarrajiPhilip HillKatrina SharplesFrederick L. AlticeAdeeba KamarulzamanInternational Journal of Prisoner Health1942023-01-1110.1108/IJPH-01-2022-0001https://www.emerald.com/insight/content/doi/10.1108/IJPH-01-2022-0001/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2022 Emerald Publishing Limited
Looked after children in prison as adults: life adversity and neurodisabilityhttps://www.emerald.com/insight/content/doi/10.1108/IJPH-08-2022-0051/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestLooked after children (LAC) are criminalised at five times the rate of children in the general population. Children in contact with both child welfare and child justice systems have higher rates of neurodisability and substance use problems, and LAC in general have high rates of school exclusion, homelessness and unemployment. This study aims to understand whether these factors persist in LAC who are in prison as adults. Administrative data collected by the Do-IT profiler screening tool in a prison in Wales, UK, were analysed to compare sentenced prisoners who were LAC (n = 631) to sentenced prisoners who were not LAC (n = 2,201). The sample comprised all prisoners who were screened on entry to prison in a two-year period. Prisoners who were LAC scored more poorly on a functional screener for neurodisability (effect size = 0.24), and on four self-report measures capturing traits of dyslexia (0.22), attention-deficit hyperactivity disorder (0.40), autism spectrum disorders (0.34) and developmental co-ordination disorder (0.33). Prisoners who were LAC were more likely to have been to a pupil referral unit (0.24), have substance use problems (0.16), be homeless or marginally housed (0.18) and be unemployed or unable to work due to disability (0.13). This study uniquely contributes to our understanding of prisoners who were LAC as a target group for intervention and support with re-integration into the community upon release. LAC in prison as adults may require additional interventions to help with employment, housing and substance use. Education programmes in prison should screen for neurodisability, to develop strategies to support engagement.Looked after children in prison as adults: life adversity and neurodisability
Hope Kent, Amanda Kirby, George Leckie, Rosie Cornish, Lee Hogarth, W. Huw Williams
International Journal of Prisoner Health, Vol. 19, No. 4, pp.512-523

Looked after children (LAC) are criminalised at five times the rate of children in the general population. Children in contact with both child welfare and child justice systems have higher rates of neurodisability and substance use problems, and LAC in general have high rates of school exclusion, homelessness and unemployment. This study aims to understand whether these factors persist in LAC who are in prison as adults.

Administrative data collected by the Do-IT profiler screening tool in a prison in Wales, UK, were analysed to compare sentenced prisoners who were LAC (n = 631) to sentenced prisoners who were not LAC (n = 2,201). The sample comprised all prisoners who were screened on entry to prison in a two-year period.

Prisoners who were LAC scored more poorly on a functional screener for neurodisability (effect size = 0.24), and on four self-report measures capturing traits of dyslexia (0.22), attention-deficit hyperactivity disorder (0.40), autism spectrum disorders (0.34) and developmental co-ordination disorder (0.33). Prisoners who were LAC were more likely to have been to a pupil referral unit (0.24), have substance use problems (0.16), be homeless or marginally housed (0.18) and be unemployed or unable to work due to disability (0.13).

This study uniquely contributes to our understanding of prisoners who were LAC as a target group for intervention and support with re-integration into the community upon release. LAC in prison as adults may require additional interventions to help with employment, housing and substance use. Education programmes in prison should screen for neurodisability, to develop strategies to support engagement.

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Looked after children in prison as adults: life adversity and neurodisability10.1108/IJPH-08-2022-0051International Journal of Prisoner Health2023-01-24© 2022 Emerald Publishing LimitedHope KentAmanda KirbyGeorge LeckieRosie CornishLee HogarthW. Huw WilliamsInternational Journal of Prisoner Health1942023-01-2410.1108/IJPH-08-2022-0051https://www.emerald.com/insight/content/doi/10.1108/IJPH-08-2022-0051/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2022 Emerald Publishing Limited
Nigerian prisoners’ experience: prison circumstances, family support and sleep qualityhttps://www.emerald.com/insight/content/doi/10.1108/IJPH-09-2021-0096/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestThis study aims to determine the association between prison circumstances, perceived family support and sleep quality among male inmates at the Ibara prison, Ogun State. It was a cross-sectional study of 300 male inmates interviewed with socio-demographic proforma and Pittsburgh sleep quality index. While all respondents described the prison as being overcrowded, half of them used inappropriate sleeping materials daily and 41.4% decried a very noisy environment at night. Twenty-seven percent of the respondents described poor family support while 47.3% experienced poor sleep quality. Though nature of sleeping material and self-awareness of sleep problem were associated with poor sleep quality, no predictor of the latter was identified. The study was conducted among males only because of the relative dominance of the male gender in the prison population. This makes analysis of gender difference impossible. Furthermore, sleep studies may be preferred over reports by some sleep experts. Findings from this study may culminate in taking steps to improve the Nigerian prison conditions as well as the prisoner’s welfare. Developing support group for relatives of inmates may be a focus of social intervention for these inmates. Also, inmates with good sleep quality are likely to partake effectively in the prison reformation programmes and may not self-medicate with sedatives. This study provides a scholarly documentation of the state of Nigerian prisons; inmates’ perception of family support; prevalence and correlates of poor sleep quality among a group of male inmates.Nigerian prisoners’ experience: prison circumstances, family support and sleep quality
Omokehinde Olubunmi Fakorede, Peter Olutunde Onifade, Oluyinka Emmanuel Majekodunmi, Adefunke Omosefe DadeMatthews
International Journal of Prisoner Health, Vol. 19, No. 4, pp.524-535

This study aims to determine the association between prison circumstances, perceived family support and sleep quality among male inmates at the Ibara prison, Ogun State.

It was a cross-sectional study of 300 male inmates interviewed with socio-demographic proforma and Pittsburgh sleep quality index.

While all respondents described the prison as being overcrowded, half of them used inappropriate sleeping materials daily and 41.4% decried a very noisy environment at night. Twenty-seven percent of the respondents described poor family support while 47.3% experienced poor sleep quality. Though nature of sleeping material and self-awareness of sleep problem were associated with poor sleep quality, no predictor of the latter was identified.

The study was conducted among males only because of the relative dominance of the male gender in the prison population. This makes analysis of gender difference impossible. Furthermore, sleep studies may be preferred over reports by some sleep experts.

Findings from this study may culminate in taking steps to improve the Nigerian prison conditions as well as the prisoner’s welfare.

Developing support group for relatives of inmates may be a focus of social intervention for these inmates. Also, inmates with good sleep quality are likely to partake effectively in the prison reformation programmes and may not self-medicate with sedatives.

This study provides a scholarly documentation of the state of Nigerian prisons; inmates’ perception of family support; prevalence and correlates of poor sleep quality among a group of male inmates.

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Nigerian prisoners’ experience: prison circumstances, family support and sleep quality10.1108/IJPH-09-2021-0096International Journal of Prisoner Health2023-10-18© 2023 Emerald Publishing LimitedOmokehinde Olubunmi FakoredePeter Olutunde OnifadeOluyinka Emmanuel MajekodunmiAdefunke Omosefe DadeMatthewsInternational Journal of Prisoner Health1942023-10-1810.1108/IJPH-09-2021-0096https://www.emerald.com/insight/content/doi/10.1108/IJPH-09-2021-0096/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2023 Emerald Publishing Limited
Prevalence of and risk factors for HCV among incarcerated people at Great Tehran Prison: a cross-sectional studyhttps://www.emerald.com/insight/content/doi/10.1108/IJPH-09-2022-0059/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestHepatitis C is one of the major health issues in both developed and developing countries. Hepatitis C virus (HCV) infection is more common in prisoners than in the general population. The purpose of this study was to determine the prevalence of HCV and its associated risk factors in Iranian male prisoners in Tehran. In this cross-sectional study, the authors investigated the frequency and risk factors of hepatitis C infection among male prisoners in the Great Tehran Prison. Information on risk factors including the length of imprisonment, previous history of imprisonment, history of drug injection, history of tattooing, history of piercing, history of high-risk sex and family history of hepatitis C were extracted from patients’ records. To evaluate HCV status, blood samples were collected and tested. In this study, 179 participants were included. Nine participants (5.0%, 95% CI, 2.3-9.3) were positive for hepatitis C. HCV infection was not significantly associated with age, marital status, education, previous history of imprisonment, length of imprisonment, piercing and high-risk sex; however, there was a significant association between a history of tattooing and a history of injecting drug use and Hepatitis C. The prevalence of hepatitis C among male prisoners in Great Tehran Prison was 5% in this study, similar to recent studies on prisoners in Tehran. A history of drug injections as well as tattooing were the most important risk factors for hepatitis C in male prisoners.Prevalence of and risk factors for HCV among incarcerated people at Great Tehran Prison: a cross-sectional study
SeyedAhmad SeyedAlinaghi, Behnam Farhoudi, Elnaz Shahmohamadi, Mehrnaz Rasoolinejad, Maliheh Hasannezhad, Mohammad Rasool Rashidi, Omid Dadras, Ali Moradi, Zohal Parmoon, Hooman Ebrahimi, Ali Asadollahi-Amin
International Journal of Prisoner Health, Vol. 19, No. 4, pp.536-544

Hepatitis C is one of the major health issues in both developed and developing countries. Hepatitis C virus (HCV) infection is more common in prisoners than in the general population. The purpose of this study was to determine the prevalence of HCV and its associated risk factors in Iranian male prisoners in Tehran.

In this cross-sectional study, the authors investigated the frequency and risk factors of hepatitis C infection among male prisoners in the Great Tehran Prison. Information on risk factors including the length of imprisonment, previous history of imprisonment, history of drug injection, history of tattooing, history of piercing, history of high-risk sex and family history of hepatitis C were extracted from patients’ records. To evaluate HCV status, blood samples were collected and tested.

In this study, 179 participants were included. Nine participants (5.0%, 95% CI, 2.3-9.3) were positive for hepatitis C. HCV infection was not significantly associated with age, marital status, education, previous history of imprisonment, length of imprisonment, piercing and high-risk sex; however, there was a significant association between a history of tattooing and a history of injecting drug use and Hepatitis C.

The prevalence of hepatitis C among male prisoners in Great Tehran Prison was 5% in this study, similar to recent studies on prisoners in Tehran. A history of drug injections as well as tattooing were the most important risk factors for hepatitis C in male prisoners.

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Prevalence of and risk factors for HCV among incarcerated people at Great Tehran Prison: a cross-sectional study10.1108/IJPH-09-2022-0059International Journal of Prisoner Health2023-02-13© 2023 Emerald Publishing LimitedSeyedAhmad SeyedAlinaghiBehnam FarhoudiElnaz ShahmohamadiMehrnaz RasoolinejadMaliheh HasannezhadMohammad Rasool RashidiOmid DadrasAli MoradiZohal ParmoonHooman EbrahimiAli Asadollahi-AminInternational Journal of Prisoner Health1942023-02-1310.1108/IJPH-09-2022-0059https://www.emerald.com/insight/content/doi/10.1108/IJPH-09-2022-0059/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2023 Emerald Publishing Limited
General and reproductive healthcare experiences of formerly incarcerated women in the United States: a qualitative studyhttps://www.emerald.com/insight/content/doi/10.1108/IJPH-09-2021-0094/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestThe US prison population has recently reached an all-time high, with women representing the fastest growing subpopulation. Correctional health-care system in the USA remains fragmented and nonuniform in practice, particularly in women’s health care, with poor transitions between incarceration and release. This study aims to examine the qualitative health-care experiences of women while incarcerated and their transition into the community health-care setting. Additionally, this study also examined the experiences of a subset of women who were pregnant while incarcerated. After obtaining institutional review board approval, adult, English-speaking women with a history of incarceration within the past 10 years were interviewed using a semi-structured interview tool. Interview transcripts were analyzed using inductive content analysis. The authors completed 21 full interviews and identified six themes that were both the most significant and most novel: “feeling stigmatized and insignificant,” “care as punishment,” “delay in care,” “exceptions to the rule,” “fragmentation of care” and “obstetric trauma and resilience.” Women face numerous barriers and hardships when accessing basic and reproductive health-care services while incarcerated. This hardship is particularly challenging for women with substance use disorders. The authors were able to describe for the first time, partially through their own words, novel challenges described by women interacting with incarceration health care. Community providers should understand these barriers and challenges so as to effectively reengage women in care upon release and improve the health-care status of this historically marginalized group.General and reproductive healthcare experiences of formerly incarcerated women in the United States: a qualitative study
Sarah K. O’Connor, Rachna Vanjani, Rachel Cannon, Mary Beth Dawson, Rebecca Perkins
International Journal of Prisoner Health, Vol. 19, No. 4, pp.545-564

The US prison population has recently reached an all-time high, with women representing the fastest growing subpopulation. Correctional health-care system in the USA remains fragmented and nonuniform in practice, particularly in women’s health care, with poor transitions between incarceration and release. This study aims to examine the qualitative health-care experiences of women while incarcerated and their transition into the community health-care setting. Additionally, this study also examined the experiences of a subset of women who were pregnant while incarcerated.

After obtaining institutional review board approval, adult, English-speaking women with a history of incarceration within the past 10 years were interviewed using a semi-structured interview tool. Interview transcripts were analyzed using inductive content analysis.

The authors completed 21 full interviews and identified six themes that were both the most significant and most novel: “feeling stigmatized and insignificant,” “care as punishment,” “delay in care,” “exceptions to the rule,” “fragmentation of care” and “obstetric trauma and resilience.”

Women face numerous barriers and hardships when accessing basic and reproductive health-care services while incarcerated. This hardship is particularly challenging for women with substance use disorders. The authors were able to describe for the first time, partially through their own words, novel challenges described by women interacting with incarceration health care. Community providers should understand these barriers and challenges so as to effectively reengage women in care upon release and improve the health-care status of this historically marginalized group.

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General and reproductive healthcare experiences of formerly incarcerated women in the United States: a qualitative study10.1108/IJPH-09-2021-0094International Journal of Prisoner Health2023-05-19© 2023 Emerald Publishing LimitedSarah K. O’ConnorRachna VanjaniRachel CannonMary Beth DawsonRebecca PerkinsInternational Journal of Prisoner Health1942023-05-1910.1108/IJPH-09-2021-0094https://www.emerald.com/insight/content/doi/10.1108/IJPH-09-2021-0094/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2023 Emerald Publishing Limited
The incidence and profile of self-harm among prisoners: findings from the Self-Harm Assessment and Data Analysis Project 2017–2019https://www.emerald.com/insight/content/doi/10.1108/IJPH-02-2023-0012/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestInternationally, rates of suicide and lifetime self-harm are higher in prisoners compared to the general population. This study aims to identify specific characteristics of self-harming behaviour and to establish a profile of prisoners who engage in self-harm. Data from the Self-Harm Assessment and Data Analysis Project (SADA) on self-harm episodes in prisons in the Republic of Ireland during 2017–2019 was used. Annual rates per 1,000 were calculated by age and gender. The rate of self-harm between 2017 and 2019 was 31 per 1,000 prisoners for men and six times higher at 184 per 1,000 prisoners for women. The rate of self-harm was twice as high among prisoners on remand than sentenced prisoners (60.5 versus 31.3 per 1,000). The highest rates of self-harm among sentenced prisoners were observed among 18–29-year-old men (45 per 1,000) and women (125 per 1,000). The rate of self-harm was higher among women prisoners in all age groups. Contributory factors associated with self-harm were mainly related to mental health but also linked to a prisoner’s environment and relationships. There is a need to ensure access to timely and suitable mental health services, including both appropriate referral and provision of evidence-based mental health interventions to address the needs of these cohorts. To the best of the authors’ knowledge, this is the first national study to systematically examine incidence and patterns of self-harm among the prison population in Ireland. The recording of severity/intent of each episode is novel when assessing self-harm among the prison population.The incidence and profile of self-harm among prisoners: findings from the Self-Harm Assessment and Data Analysis Project 2017–2019
Niall McTernan, Eve Griffin, Grace Cully, Enda Kelly, Sarah Hume, Paul Corcoran
International Journal of Prisoner Health, Vol. 19, No. 4, pp.565-577

Internationally, rates of suicide and lifetime self-harm are higher in prisoners compared to the general population. This study aims to identify specific characteristics of self-harming behaviour and to establish a profile of prisoners who engage in self-harm.

Data from the Self-Harm Assessment and Data Analysis Project (SADA) on self-harm episodes in prisons in the Republic of Ireland during 2017–2019 was used. Annual rates per 1,000 were calculated by age and gender.

The rate of self-harm between 2017 and 2019 was 31 per 1,000 prisoners for men and six times higher at 184 per 1,000 prisoners for women. The rate of self-harm was twice as high among prisoners on remand than sentenced prisoners (60.5 versus 31.3 per 1,000). The highest rates of self-harm among sentenced prisoners were observed among 18–29-year-old men (45 per 1,000) and women (125 per 1,000). The rate of self-harm was higher among women prisoners in all age groups. Contributory factors associated with self-harm were mainly related to mental health but also linked to a prisoner’s environment and relationships.

There is a need to ensure access to timely and suitable mental health services, including both appropriate referral and provision of evidence-based mental health interventions to address the needs of these cohorts.

To the best of the authors’ knowledge, this is the first national study to systematically examine incidence and patterns of self-harm among the prison population in Ireland. The recording of severity/intent of each episode is novel when assessing self-harm among the prison population.

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The incidence and profile of self-harm among prisoners: findings from the Self-Harm Assessment and Data Analysis Project 2017–201910.1108/IJPH-02-2023-0012International Journal of Prisoner Health2023-05-03© 2023 Niall McTernan, Eve Griffin, Grace Cully, Enda Kelly, Sarah Hume and Paul Corcoran.Niall McTernanEve GriffinGrace CullyEnda KellySarah HumePaul CorcoranInternational Journal of Prisoner Health1942023-05-0310.1108/IJPH-02-2023-0012https://www.emerald.com/insight/content/doi/10.1108/IJPH-02-2023-0012/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2023 Niall McTernan, Eve Griffin, Grace Cully, Enda Kelly, Sarah Hume and Paul Corcoran.
Implementation strategies to screen, refer and link women involved in the carceral system to PrEP for HIV preventionhttps://www.emerald.com/insight/content/doi/10.1108/IJPH-06-2022-0037/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestWomen involved in the carceral system (CS) experience several conditions that increase their risk for HIV (e.g. high rates of substance use, psychiatric disorders, histories of victimization). The purpose of this study is to explore perspectives on potential strategies to connect women in the CS to pre-exposure prophylaxis (PrEP) services. This study conducted in-depth interviews with 27 women involved in the CS eligible for PrEP. Using vignettes, interviews explored attitudes, barriers and facilitators toward PrEP screening, referral and linkage facilitated via a CS stakeholder, an mHealth application or providing PrEP service referrals during detention via a navigator. Most women were, on average, 41.3 years, from racial and ethnic minority groups (56% black/African American; 19% Latinx). Inductive thematic analysis revealed CS involved women expressed mostly positive attitudes toward CS-based PrEP implementation. Younger women were more accepting of and interested in mHealth interventions. Implementation facilitators included leveraging relationships with trusted allies (e.g. “peers”) and existing systems collaborations. Recommended implementation strategies included providing HIV and PrEP-specific education and training for system stakeholders and addressing issues related to privacy, system mistrust and stigma. Results provide a critical foundation for the implementation of interventions to improve PrEP access for women involved in the CS and have important implications for implementation strategies for all adults involved in the CS. Improving access to PrEP among this population may also support progress toward addressing national disparities in PrEP uptake, where women, black and Latinx populations have substantial unmet need.Implementation strategies to screen, refer and link women involved in the carceral system to PrEP for HIV prevention
Emily Dauria, Christopher Rodriguez, Sarah Bauerle Bass, Marina Tolou-Shams, Katerina Christopoulos
International Journal of Prisoner Health, Vol. 19, No. 4, pp.578-590

Women involved in the carceral system (CS) experience several conditions that increase their risk for HIV (e.g. high rates of substance use, psychiatric disorders, histories of victimization). The purpose of this study is to explore perspectives on potential strategies to connect women in the CS to pre-exposure prophylaxis (PrEP) services.

This study conducted in-depth interviews with 27 women involved in the CS eligible for PrEP. Using vignettes, interviews explored attitudes, barriers and facilitators toward PrEP screening, referral and linkage facilitated via a CS stakeholder, an mHealth application or providing PrEP service referrals during detention via a navigator.

Most women were, on average, 41.3 years, from racial and ethnic minority groups (56% black/African American; 19% Latinx). Inductive thematic analysis revealed CS involved women expressed mostly positive attitudes toward CS-based PrEP implementation. Younger women were more accepting of and interested in mHealth interventions. Implementation facilitators included leveraging relationships with trusted allies (e.g. “peers”) and existing systems collaborations. Recommended implementation strategies included providing HIV and PrEP-specific education and training for system stakeholders and addressing issues related to privacy, system mistrust and stigma.

Results provide a critical foundation for the implementation of interventions to improve PrEP access for women involved in the CS and have important implications for implementation strategies for all adults involved in the CS. Improving access to PrEP among this population may also support progress toward addressing national disparities in PrEP uptake, where women, black and Latinx populations have substantial unmet need.

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Implementation strategies to screen, refer and link women involved in the carceral system to PrEP for HIV prevention10.1108/IJPH-06-2022-0037International Journal of Prisoner Health2023-05-01© 2023 Emerald Publishing LimitedEmily DauriaChristopher RodriguezSarah Bauerle BassMarina Tolou-ShamsKaterina ChristopoulosInternational Journal of Prisoner Health1942023-05-0110.1108/IJPH-06-2022-0037https://www.emerald.com/insight/content/doi/10.1108/IJPH-06-2022-0037/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2023 Emerald Publishing Limited
Sexual and reproductive history of female prisoners in Iran: a health care needs analysishttps://www.emerald.com/insight/content/doi/10.1108/IJPH-12-2022-0076/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestAccording to estimates, there are approximately 714,000 female prisoners in the world. A considerable proportion are pregnant, of childbearing age at the time of incarceration and may experience numerous reproductive health concerns. The purpose of this study is to examine the demographics and sexual and reproductive history of female prisoners in Iran. Four hundred and thirty-four female prisoners (mean age: 39.0 ± 9.9) serving sentences at Qarchak prison, Iran, completed a questionnaire. The participants were recruited between October 2017 and September 2018 using a convenient sampling method. The questionnaire captured sociodemographic characteristics and sexual and reproductive history. Most respondents had 7–12 years of formal education, were housewives (69.9%), were either married (41.6%) or divorced (41.8%) and were literate (91.3%). History of drug use among the respondents was 34.7%. Most respondents had regular menstruation (63.5%) and were pre-menopausal (86.1%). Natural birth control was preferred (39.7%) compared to other methods, such as condoms (18%) and oral contraceptive pills (8.4%). Spontaneous and induced abortions were reported by 17.8% and 16.4% of respondents, respectively. There was 5.9% of respondents that reported having a history of sexually transmitted infections (STIs) before incarceration, with HPV the most common (12.7%). This study has limitations, including the problem of following up with prisoners to shorten the average length of their imprisonment, which can leave many issues in the field of women’s health and their follow-up incomplete. Prison health care workers should also follow up on women’s health and pregnancy hygiene after their release because there is usually a high prevalence of STIs in prisoners. The findings highlight the importance of improving the quality of women’s health care and pregnancy-related care in prisons. Additionally, the importance of having a health protocol for incarcerated women in Iran. Other programs should also be implemented for women prisoners to eliminate the discrimination they may face in prison. The international community has attempted to develop care guidelines for pregnant prisoners, particularly for prenatal and mental health services. However, currently in Iran no such guidelines have been developed. To date no research has explored the sexual health among female prisoners of this country. The aim of the present study was to examine the demographics and sexual and reproductive history of female prisoners in Iran. A secondary aim was to identify the health care needs of female prisoners in Iran.Sexual and reproductive history of female prisoners in Iran: a health care needs analysis
Behnam Farhoudi, Elnaz Shahmohamadi, SeyedAhmad SeyedAlinaghi, Zohreh Rostam Afshar, Pegah Mirzapour, SeyedAlireza Nadji, Fatemeh Golsoorat Pahlaviani, Mehrzad Tashakorian, Daniel Hackett
International Journal of Prisoner Health, Vol. 19, No. 4, pp.591-598

According to estimates, there are approximately 714,000 female prisoners in the world. A considerable proportion are pregnant, of childbearing age at the time of incarceration and may experience numerous reproductive health concerns. The purpose of this study is to examine the demographics and sexual and reproductive history of female prisoners in Iran.

Four hundred and thirty-four female prisoners (mean age: 39.0 ± 9.9) serving sentences at Qarchak prison, Iran, completed a questionnaire. The participants were recruited between October 2017 and September 2018 using a convenient sampling method. The questionnaire captured sociodemographic characteristics and sexual and reproductive history.

Most respondents had 7–12 years of formal education, were housewives (69.9%), were either married (41.6%) or divorced (41.8%) and were literate (91.3%). History of drug use among the respondents was 34.7%. Most respondents had regular menstruation (63.5%) and were pre-menopausal (86.1%). Natural birth control was preferred (39.7%) compared to other methods, such as condoms (18%) and oral contraceptive pills (8.4%). Spontaneous and induced abortions were reported by 17.8% and 16.4% of respondents, respectively. There was 5.9% of respondents that reported having a history of sexually transmitted infections (STIs) before incarceration, with HPV the most common (12.7%).

This study has limitations, including the problem of following up with prisoners to shorten the average length of their imprisonment, which can leave many issues in the field of women’s health and their follow-up incomplete. Prison health care workers should also follow up on women’s health and pregnancy hygiene after their release because there is usually a high prevalence of STIs in prisoners.

The findings highlight the importance of improving the quality of women’s health care and pregnancy-related care in prisons. Additionally, the importance of having a health protocol for incarcerated women in Iran. Other programs should also be implemented for women prisoners to eliminate the discrimination they may face in prison.

The international community has attempted to develop care guidelines for pregnant prisoners, particularly for prenatal and mental health services. However, currently in Iran no such guidelines have been developed. To date no research has explored the sexual health among female prisoners of this country. The aim of the present study was to examine the demographics and sexual and reproductive history of female prisoners in Iran. A secondary aim was to identify the health care needs of female prisoners in Iran.

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Sexual and reproductive history of female prisoners in Iran: a health care needs analysis10.1108/IJPH-12-2022-0076International Journal of Prisoner Health2023-05-08© 2023 Emerald Publishing LimitedBehnam FarhoudiElnaz ShahmohamadiSeyedAhmad SeyedAlinaghiZohreh Rostam AfsharPegah MirzapourSeyedAlireza NadjiFatemeh Golsoorat PahlavianiMehrzad TashakorianDaniel HackettInternational Journal of Prisoner Health1942023-05-0810.1108/IJPH-12-2022-0076https://www.emerald.com/insight/content/doi/10.1108/IJPH-12-2022-0076/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2023 Emerald Publishing Limited
Prevalence and characteristics of mental and physical disorders among female prisoners: a mixed-methods systematic reviewhttps://www.emerald.com/insight/content/doi/10.1108/IJPH-12-2022-0080/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestThis study aims to provide an overview and quality appraisal of the current scientific evidence concerning the prevalence and characteristics of mental and physical disorders among sentenced female prisoners. A mixed-methods systematic literature review. A total of 4 reviews and 39 single studies met the inclusion criteria for the review. Mental disorders were the main area of investigation in the majority of single studies, with substance abuse, particularly drug abuse, as the most consistently gender biased disorder, with higher prevalence among women than men in prison. The review identified a lack of updated systematic evidence on the presence of multi-morbidity. This study provides an up-to-date overview and quality appraisal of the current scientific evidence concerning the prevalence and characteristics of mental and physical disorders among female prisoners.Prevalence and characteristics of mental and physical disorders among female prisoners: a mixed-methods systematic review
Christine Friestad, Unn Kristin Haukvik, Berit Johnsen, Solveig Karin Vatnar
International Journal of Prisoner Health, Vol. 19, No. 4, pp.599-627

This study aims to provide an overview and quality appraisal of the current scientific evidence concerning the prevalence and characteristics of mental and physical disorders among sentenced female prisoners.

A mixed-methods systematic literature review.

A total of 4 reviews and 39 single studies met the inclusion criteria for the review. Mental disorders were the main area of investigation in the majority of single studies, with substance abuse, particularly drug abuse, as the most consistently gender biased disorder, with higher prevalence among women than men in prison. The review identified a lack of updated systematic evidence on the presence of multi-morbidity.

This study provides an up-to-date overview and quality appraisal of the current scientific evidence concerning the prevalence and characteristics of mental and physical disorders among female prisoners.

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Prevalence and characteristics of mental and physical disorders among female prisoners: a mixed-methods systematic review10.1108/IJPH-12-2022-0080International Journal of Prisoner Health2023-05-10© 2023 Emerald Publishing LimitedChristine FriestadUnn Kristin HaukvikBerit JohnsenSolveig Karin VatnarInternational Journal of Prisoner Health1942023-05-1010.1108/IJPH-12-2022-0080https://www.emerald.com/insight/content/doi/10.1108/IJPH-12-2022-0080/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2023 Emerald Publishing Limited
“Overcrowded but lonely”: exploring mental health and well-being among young prisoners in Cambodiahttps://www.emerald.com/insight/content/doi/10.1108/IJPH-02-2023-0011/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestYoung prisoners are one of the most vulnerable groups in society for mental health problems and ill-being. Therefore, there is a crucial need to understand their physical, psychological and social situations. This study aims to explore young Cambodian prisoners’ experiences and perceptions of mental health and well-being, their determinants and their coping strategies. Six focus group discussions were carried out in three prisons with a total of 48 young prisoners between the ages of 15 and 24 years (50% women, 50% men). Semi-structured questions guided the discussions, and thematic analysis was applied to analyse the data. Young prisoners reported multifaceted experiences of mental health and well-being. The majority described adverse mental health experiences, while some revealed better well-being, partly influenced by the socio-economic support from outside the prisons and previous involvement or not in drug abuse. The experience of physical overcrowding without emotional attachment among the fellow prisoners was perceived as the overarching determinant of loneliness and mental health problems, while socio-emotional support and rituals were described as the most important coping mechanisms. This pioneering study from Cambodia gives young prisoners an opportunity to voice their experiences and perceptions of mental health and well-being in the prison setting. The findings in this study underline the importance of prison authorities tackling overcrowding to promote well-being and reduce mental health problems. Also, the coping mechanisms outlined by the participants should be considered when planning psychosocial interventions.“Overcrowded but lonely”: exploring mental health and well-being among young prisoners in Cambodia
Puthy Pat, Kerstin Edin, Bhoomikumar Jegannathan, Miguel San Sebastian, Linda Richter Sundberg
International Journal of Prisoner Health, Vol. 19, No. 4, pp.628-640

Young prisoners are one of the most vulnerable groups in society for mental health problems and ill-being. Therefore, there is a crucial need to understand their physical, psychological and social situations. This study aims to explore young Cambodian prisoners’ experiences and perceptions of mental health and well-being, their determinants and their coping strategies.

Six focus group discussions were carried out in three prisons with a total of 48 young prisoners between the ages of 15 and 24 years (50% women, 50% men). Semi-structured questions guided the discussions, and thematic analysis was applied to analyse the data.

Young prisoners reported multifaceted experiences of mental health and well-being. The majority described adverse mental health experiences, while some revealed better well-being, partly influenced by the socio-economic support from outside the prisons and previous involvement or not in drug abuse. The experience of physical overcrowding without emotional attachment among the fellow prisoners was perceived as the overarching determinant of loneliness and mental health problems, while socio-emotional support and rituals were described as the most important coping mechanisms.

This pioneering study from Cambodia gives young prisoners an opportunity to voice their experiences and perceptions of mental health and well-being in the prison setting. The findings in this study underline the importance of prison authorities tackling overcrowding to promote well-being and reduce mental health problems. Also, the coping mechanisms outlined by the participants should be considered when planning psychosocial interventions.

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“Overcrowded but lonely”: exploring mental health and well-being among young prisoners in Cambodia10.1108/IJPH-02-2023-0011International Journal of Prisoner Health2023-06-28© 2023 Puthy Pat, Kerstin Edin, Bhoomikumar Jegannathan, Miguel San Sebastian and Linda Richter Sundberg.Puthy PatKerstin EdinBhoomikumar JegannathanMiguel San SebastianLinda Richter SundbergInternational Journal of Prisoner Health1942023-06-2810.1108/IJPH-02-2023-0011https://www.emerald.com/insight/content/doi/10.1108/IJPH-02-2023-0011/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2023 Puthy Pat, Kerstin Edin, Bhoomikumar Jegannathan, Miguel San Sebastian and Linda Richter Sundberg.http://creativecommons.org/licences/by/4.0/legalcode
Prisoners with reduced criminal responsibility stand out based on their rates of hospitalisation during their sentenceshttps://www.emerald.com/insight/content/doi/10.1108/IJPH-05-2022-0032/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestGlobally, health problems are very common among prisoners. A mental state examination aims to help in recognising psychiatric problems among offenders and the possible association of these psychiatric issues with their committed crime. The legal-medical term “reduced criminal responsibility” refers to a weakened sense of reality and the ability to control one’s behaviour because of compromised mental health and without an evaluated need for forensic psychiatric hospitalisation. However, little is known about the actual need for the health care of prisoners with reduced criminal responsibility (PRCR). The purpose of this study was to explore treatment-related visits to prison by PRCR in Finland. The research data comprise information on PRCR’s treatment-related visits and that of a matched control group (n = 222). Descriptive cross-tabulation with X²- and nonparametric Mann–Whitney U-tests and Cox regression analyses are applied. The results show that almost every PRCR had at least one treatment-related visit during their sentences. Visits to a psychiatric hospital for prisoners, to the prison hospital and especially to a civil hospital are more common among PRCR. The need for treatment appears significantly earlier in their sentences. These findings demonstrate the PRCR’s greater need for access to health services and the need for further development between the Health Care Services for Prisoners, Prison and Probation Service of Finland and public health and social services in Finland. More exploration of the medical reasons and locational distribution of the vast amount of civil hospitalisation is needed.Prisoners with reduced criminal responsibility stand out based on their rates of hospitalisation during their sentences
Miisa Törölä, Mika Rautanen
International Journal of Prisoner Health, Vol. 19, No. 4, pp.641-652

Globally, health problems are very common among prisoners. A mental state examination aims to help in recognising psychiatric problems among offenders and the possible association of these psychiatric issues with their committed crime. The legal-medical term “reduced criminal responsibility” refers to a weakened sense of reality and the ability to control one’s behaviour because of compromised mental health and without an evaluated need for forensic psychiatric hospitalisation. However, little is known about the actual need for the health care of prisoners with reduced criminal responsibility (PRCR). The purpose of this study was to explore treatment-related visits to prison by PRCR in Finland.

The research data comprise information on PRCR’s treatment-related visits and that of a matched control group (n = 222). Descriptive cross-tabulation with X²- and nonparametric Mann–Whitney U-tests and Cox regression analyses are applied.

The results show that almost every PRCR had at least one treatment-related visit during their sentences. Visits to a psychiatric hospital for prisoners, to the prison hospital and especially to a civil hospital are more common among PRCR. The need for treatment appears significantly earlier in their sentences.

These findings demonstrate the PRCR’s greater need for access to health services and the need for further development between the Health Care Services for Prisoners, Prison and Probation Service of Finland and public health and social services in Finland. More exploration of the medical reasons and locational distribution of the vast amount of civil hospitalisation is needed.

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Prisoners with reduced criminal responsibility stand out based on their rates of hospitalisation during their sentences10.1108/IJPH-05-2022-0032International Journal of Prisoner Health2023-07-25© 2023 Miisa Törölä and Mika Rautanen.Miisa TöröläMika RautanenInternational Journal of Prisoner Health1942023-07-2510.1108/IJPH-05-2022-0032https://www.emerald.com/insight/content/doi/10.1108/IJPH-05-2022-0032/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2023 Miisa Törölä and Mika Rautanen.http://creativecommons.org/licences/by/4.0/legalcode
Attentional impulsivity accounts for the association of antisociality with craving and mental health problems in incarcerated individuals with substance dependencehttps://www.emerald.com/insight/content/doi/10.1108/IJPH-03-2022-0023/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestPrisoners with substance use disorder (SUD) are at risk of mental health problems. Given the common co-occurring of psychopathic traits with SUDs, probably because of underlying impulsive traits (Ellingson et al., 2018), this study aims to examine the relation between psychopathy (impulsive antisociality and fearless dominance) and the functioning of incarcerated individuals with SUD. The authors investigated whether impulsivity (motor, nonplanning and attentional) can account for the relationship between one psychopathy facet (impulsive antisociality) and craving and mental health problems. The authors assessed self-reported impulsivity, psychopathy, craving and mental health problems in 121 male incarcerated individuals with SUD and calculated cross-sectional linear regression analyses and mediation models. Impulsive antisociality was positively related to all impulsivity facets, craving and mental health problems. Attentional impulsivity mediated the relationship of impulsive antisociality with craving and mental health problems. Fearless dominance was related to lower attentional and nonplanning impulsivity, craving and mental health problems. Future studies should investigate these relations in longitudinal studies and evaluate tailored approaches, for example, mindfulness interventions. Interventions to reduce craving and improve mental health might be important for those who display self-centered, antisocial behavior but are less relevant for those with fearless, dominant interpersonal behavior. Addressing attentional impulsivity may be of special interest in this regard. To the best of the authors’ knowledge, this study was the first to investigate the mediating role of different impulsivity facets for the association of impulsive antisociality with craving and with mental health problems in incarcerated individuals with SUD.Attentional impulsivity accounts for the association of antisociality with craving and mental health problems in incarcerated individuals with substance dependence
Daniela Reichl, Bruno Heindl, Anette Lea Distler, Sabine Steins-Loeber
International Journal of Prisoner Health, Vol. 19, No. 4, pp.653-667

Prisoners with substance use disorder (SUD) are at risk of mental health problems. Given the common co-occurring of psychopathic traits with SUDs, probably because of underlying impulsive traits (Ellingson et al., 2018), this study aims to examine the relation between psychopathy (impulsive antisociality and fearless dominance) and the functioning of incarcerated individuals with SUD. The authors investigated whether impulsivity (motor, nonplanning and attentional) can account for the relationship between one psychopathy facet (impulsive antisociality) and craving and mental health problems.

The authors assessed self-reported impulsivity, psychopathy, craving and mental health problems in 121 male incarcerated individuals with SUD and calculated cross-sectional linear regression analyses and mediation models.

Impulsive antisociality was positively related to all impulsivity facets, craving and mental health problems. Attentional impulsivity mediated the relationship of impulsive antisociality with craving and mental health problems. Fearless dominance was related to lower attentional and nonplanning impulsivity, craving and mental health problems.

Future studies should investigate these relations in longitudinal studies and evaluate tailored approaches, for example, mindfulness interventions.

Interventions to reduce craving and improve mental health might be important for those who display self-centered, antisocial behavior but are less relevant for those with fearless, dominant interpersonal behavior. Addressing attentional impulsivity may be of special interest in this regard.

To the best of the authors’ knowledge, this study was the first to investigate the mediating role of different impulsivity facets for the association of impulsive antisociality with craving and with mental health problems in incarcerated individuals with SUD.

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Attentional impulsivity accounts for the association of antisociality with craving and mental health problems in incarcerated individuals with substance dependence10.1108/IJPH-03-2022-0023International Journal of Prisoner Health2023-07-24© 2023 Emerald Publishing LimitedDaniela ReichlBruno HeindlAnette Lea DistlerSabine Steins-LoeberInternational Journal of Prisoner Health1942023-07-2410.1108/IJPH-03-2022-0023https://www.emerald.com/insight/content/doi/10.1108/IJPH-03-2022-0023/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2023 Emerald Publishing Limited
Psychometric properties of the WHOQOL-BREF in a population of older adults in prison: measuring quality of life in a carceral settinghttps://www.emerald.com/insight/content/doi/10.1108/IJPH-07-2022-0042/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestValid and reliable measurement is critical to the assessment and evaluation of health interventions. However, few scholars have examined the psychometric properties of “gold standard” measures in carceral settings, and no research has explored the reliability, validity and factor structure of the 26-item World Health Organization Quality of Life (WHOQOL) BREF among older adults incarcerated in prison, a large and growing population marked by substantial chronic and life-limiting illness. This study aims to examine the reliability, validity and factor structure of the WHOQOL-BREF. Secondary data from a large-scale study with older adults (age 45+) incarcerated in a Midwestern state were used (N = 499). Floor and ceiling effects were examined, as was the reliability of the measure (Cronbach's alpha). The structural validity of a four-factor and second-order four-factor model of the WHOQOL-BREF was examined using confirmatory factor analysis. Model data fit was examined using chi-square, standardized root mean square residual, comparative fit indices, Akaike information criterion and the Bayesian Information Criterion. Pearson product-moment correlation coefficients were also used to assess validity. Results indicate adequate construct validity and reliability for the WHOQOL-BREF using the current sample. Model-data fit indexes also reveal adequate structure of the measure relative to other older adult samples. Non-random data and item exclusion are noteworthy limits, and future researchers are encouraged to co-conceptualize and operationalize life quality with older adults who are incarcerated. To the best of the authors’ knowledge, this is the first study to explore the psychometric properties of the WHOQOL-BREF among older adults incarcerated in prison.Psychometric properties of the WHOQOL-BREF in a population of older adults in prison: measuring quality of life in a carceral setting
Adrian J. Archuleta, Stephanie Grace Prost, Seana Golder
International Journal of Prisoner Health, Vol. 19, No. 4, pp.668-681

Valid and reliable measurement is critical to the assessment and evaluation of health interventions. However, few scholars have examined the psychometric properties of “gold standard” measures in carceral settings, and no research has explored the reliability, validity and factor structure of the 26-item World Health Organization Quality of Life (WHOQOL) BREF among older adults incarcerated in prison, a large and growing population marked by substantial chronic and life-limiting illness. This study aims to examine the reliability, validity and factor structure of the WHOQOL-BREF.

Secondary data from a large-scale study with older adults (age 45+) incarcerated in a Midwestern state were used (N = 499). Floor and ceiling effects were examined, as was the reliability of the measure (Cronbach's alpha). The structural validity of a four-factor and second-order four-factor model of the WHOQOL-BREF was examined using confirmatory factor analysis. Model data fit was examined using chi-square, standardized root mean square residual, comparative fit indices, Akaike information criterion and the Bayesian Information Criterion. Pearson product-moment correlation coefficients were also used to assess validity.

Results indicate adequate construct validity and reliability for the WHOQOL-BREF using the current sample. Model-data fit indexes also reveal adequate structure of the measure relative to other older adult samples. Non-random data and item exclusion are noteworthy limits, and future researchers are encouraged to co-conceptualize and operationalize life quality with older adults who are incarcerated.

To the best of the authors’ knowledge, this is the first study to explore the psychometric properties of the WHOQOL-BREF among older adults incarcerated in prison.

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Psychometric properties of the WHOQOL-BREF in a population of older adults in prison: measuring quality of life in a carceral setting10.1108/IJPH-07-2022-0042International Journal of Prisoner Health2023-07-25© 2023 Emerald Publishing LimitedAdrian J. ArchuletaStephanie Grace ProstSeana GolderInternational Journal of Prisoner Health1942023-07-2510.1108/IJPH-07-2022-0042https://www.emerald.com/insight/content/doi/10.1108/IJPH-07-2022-0042/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2023 Emerald Publishing Limited
Sport in prison: social and subjective health outcomes of different sport programshttps://www.emerald.com/insight/content/doi/10.1108/IJPH-10-2022-0062/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestThe purpose of this study is to examine the effects of four different sport programs on various social and subjective health outcomes among prisoners. Four different sport programs (endurance, strength, dance-like martial arts, soccer) were provided in 2020 and 2021 in a German prison. Participants completed paper-pencil surveys before and after the sport programs (n = 134 observations), including questions about potential social health (enjoyment of physical activity, interpersonal exchange, interpersonal trust, self-efficacy) and subjective health outcomes (health status, health satisfaction, well-being). Further information such as prisoner characteristics were added to the data. Results of regression analyses show that the endurance program had a significant positive effect on interpersonal trust, while the soccer program had a negative effect. Subjective well-being increased significantly after the strength and the soccer program. The weekly sport hours before imprisonment had a positive association with enjoyment of physical activity and interpersonal exchange while being negatively related to health status and health satisfaction. Furthermore, the number of months of imprisonment before the survey, being a young offender, the prisoners’ body mass index, educational level and migration background were significantly associated with several social and subjective health outcomes. This study analyzed the effects of different sport programs for prisoners on various social and subjective health outcomes, revealing differences across programs and outcomes. The findings suggest that sport can be a way to enhance prisoners’ social and subjective health, ultimately facilitating their rehabilitation process.Sport in prison: social and subjective health outcomes of different sport programs
Elisa Herold, Pamela Wicker, Uta Czyrnick-Leber, Bernd Gröben, Milan Dransmann
International Journal of Prisoner Health, Vol. 19, No. 4, pp.682-698

The purpose of this study is to examine the effects of four different sport programs on various social and subjective health outcomes among prisoners.

Four different sport programs (endurance, strength, dance-like martial arts, soccer) were provided in 2020 and 2021 in a German prison. Participants completed paper-pencil surveys before and after the sport programs (n = 134 observations), including questions about potential social health (enjoyment of physical activity, interpersonal exchange, interpersonal trust, self-efficacy) and subjective health outcomes (health status, health satisfaction, well-being). Further information such as prisoner characteristics were added to the data.

Results of regression analyses show that the endurance program had a significant positive effect on interpersonal trust, while the soccer program had a negative effect. Subjective well-being increased significantly after the strength and the soccer program. The weekly sport hours before imprisonment had a positive association with enjoyment of physical activity and interpersonal exchange while being negatively related to health status and health satisfaction. Furthermore, the number of months of imprisonment before the survey, being a young offender, the prisoners’ body mass index, educational level and migration background were significantly associated with several social and subjective health outcomes.

This study analyzed the effects of different sport programs for prisoners on various social and subjective health outcomes, revealing differences across programs and outcomes. The findings suggest that sport can be a way to enhance prisoners’ social and subjective health, ultimately facilitating their rehabilitation process.

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Sport in prison: social and subjective health outcomes of different sport programs10.1108/IJPH-10-2022-0062International Journal of Prisoner Health2023-08-04© 2023 Emerald Publishing LimitedElisa HeroldPamela WickerUta Czyrnick-LeberBernd GröbenMilan DransmannInternational Journal of Prisoner Health1942023-08-0410.1108/IJPH-10-2022-0062https://www.emerald.com/insight/content/doi/10.1108/IJPH-10-2022-0062/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2023 Emerald Publishing Limited
Prevalence of HIV among inmates in four states of north India: findings from the 16th round of HIV sentinel surveillancehttps://www.emerald.com/insight/content/doi/10.1108/IJPH-03-2022-0021/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestPrisoners are at a higher risk of HIV infection compared to the general population. The purpose of this study is to estimate the prevalence of HIV and related risk behaviours among inmates of the Central Prisons in four states of North India. The HIV sentinel surveillance was conducted in seven Central Prisons in four states of North India from February to April 2019. Four hundred inmates were included from each prison. The interviews were conducted at the Integrated Counselling and Testing Centre located within the prison premises. The Ethics Committee of the National AIDS Control Organization, New Delhi, granted ethical approval before the start of the surveillance. Overall, 2,721 inmates were enrolled in this study. The mean (SD) age was 38.9 (13.9) years. One-third of prison inmates had comprehensive knowledge about HIV/AIDS. The proportion of convict (54%) and undertrial (46%) inmates was almost equal. The overall prevalence of HIV infection among inmates was 0.96% (95% CI 0.65–1.40). The odds of being HIV positive were significantly higher in never married inmates, undertrials, inmates who were in the prison for more than three months to one year, inmates incarcerated for multiple times, inmates with history of injecting drug use and inmates with history of intercourse with a commercial sex worker. The findings from the very first HIV sentinel surveillance in central prisons in North India have been presented in this paper. This has huge implications for future policy decisions.Prevalence of HIV among inmates in four states of north India: findings from the 16th round of HIV sentinel surveillance
Shreya Jha, Shashi Kant, Nishakar Thakur, Pradeep Kumar, Sanjay Rai, Partha Haldar, Priyanka Kardam, Puneet Misra, Kiran Goswami, Shobini Rajan
International Journal of Prisoner Health, Vol. 19, No. 4, pp.699-708

Prisoners are at a higher risk of HIV infection compared to the general population. The purpose of this study is to estimate the prevalence of HIV and related risk behaviours among inmates of the Central Prisons in four states of North India.

The HIV sentinel surveillance was conducted in seven Central Prisons in four states of North India from February to April 2019. Four hundred inmates were included from each prison. The interviews were conducted at the Integrated Counselling and Testing Centre located within the prison premises. The Ethics Committee of the National AIDS Control Organization, New Delhi, granted ethical approval before the start of the surveillance.

Overall, 2,721 inmates were enrolled in this study. The mean (SD) age was 38.9 (13.9) years. One-third of prison inmates had comprehensive knowledge about HIV/AIDS. The proportion of convict (54%) and undertrial (46%) inmates was almost equal. The overall prevalence of HIV infection among inmates was 0.96% (95% CI 0.65–1.40). The odds of being HIV positive were significantly higher in never married inmates, undertrials, inmates who were in the prison for more than three months to one year, inmates incarcerated for multiple times, inmates with history of injecting drug use and inmates with history of intercourse with a commercial sex worker.

The findings from the very first HIV sentinel surveillance in central prisons in North India have been presented in this paper. This has huge implications for future policy decisions.

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Prevalence of HIV among inmates in four states of north India: findings from the 16th round of HIV sentinel surveillance10.1108/IJPH-03-2022-0021International Journal of Prisoner Health2023-07-31© 2023 Emerald Publishing LimitedShreya JhaShashi KantNishakar ThakurPradeep KumarSanjay RaiPartha HaldarPriyanka KardamPuneet MisraKiran GoswamiShobini RajanInternational Journal of Prisoner Health1942023-07-3110.1108/IJPH-03-2022-0021https://www.emerald.com/insight/content/doi/10.1108/IJPH-03-2022-0021/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2023 Emerald Publishing Limited
Health status and health-care utilization among men recently released from a superjail: a matched prospective cohort studyhttps://www.emerald.com/insight/content/doi/10.1108/IJPH-01-2023-0004/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestContinuity of care and access to primary care have been identified as important contributors to improved health outcomes and reduced reincarceration among people who are justice-involved. While the disproportionate burden of health concerns among incarcerated populations is well documented, less is known about their health service utilization, limiting the potential for effective improvements to current policy and practice. This study aims to examine health status and health care utilization among men recently released from a superjail in a large metropolitan area to better understand patterns of use, risk factors and facilitators. Participants included adult men (n = 106) matched to a general population group (n = 530) in Ontario, Canada, linked to medical records (88.5% linkage) to examine baseline health status and health utilization three-months post-release. The authors compared differences between the groups in baseline health conditions and estimated the risk of emergency department, primary care, inpatient hospitalization and specialist ambulatory care visits. Superjail participants had a significantly higher prevalence of respiratory conditions, mental illness, substance use and injuries. Substance use was a significant risk factor for all types of visits and emergency department visits were over three times higher among superjail participants. This empirical case is illustrative of an emerging phenomenon in some regions of the world where emergency departments serve as de facto “walk-in clinics” for those with criminal justice involvement. Strategic approaches to health services are required to meet the complex social and health needs and disparities in access to care experienced by men released from custody.Health status and health-care utilization among men recently released from a superjail: a matched prospective cohort study
Flora I. Matheson, Arthur McLuhan, Ruth Croxford, Tara Hahmann, Max Ferguson, Cilia Mejia-Lancheros
International Journal of Prisoner Health, Vol. 19, No. 4, pp.709-723

Continuity of care and access to primary care have been identified as important contributors to improved health outcomes and reduced reincarceration among people who are justice-involved. While the disproportionate burden of health concerns among incarcerated populations is well documented, less is known about their health service utilization, limiting the potential for effective improvements to current policy and practice. This study aims to examine health status and health care utilization among men recently released from a superjail in a large metropolitan area to better understand patterns of use, risk factors and facilitators.

Participants included adult men (n = 106) matched to a general population group (n = 530) in Ontario, Canada, linked to medical records (88.5% linkage) to examine baseline health status and health utilization three-months post-release. The authors compared differences between the groups in baseline health conditions and estimated the risk of emergency department, primary care, inpatient hospitalization and specialist ambulatory care visits.

Superjail participants had a significantly higher prevalence of respiratory conditions, mental illness, substance use and injuries. Substance use was a significant risk factor for all types of visits and emergency department visits were over three times higher among superjail participants.

This empirical case is illustrative of an emerging phenomenon in some regions of the world where emergency departments serve as de facto “walk-in clinics” for those with criminal justice involvement. Strategic approaches to health services are required to meet the complex social and health needs and disparities in access to care experienced by men released from custody.

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Health status and health-care utilization among men recently released from a superjail: a matched prospective cohort study10.1108/IJPH-01-2023-0004International Journal of Prisoner Health2023-09-05© 2023 Emerald Publishing LimitedFlora I. MathesonArthur McLuhanRuth CroxfordTara HahmannMax FergusonCilia Mejia-LancherosInternational Journal of Prisoner Health1942023-09-0510.1108/IJPH-01-2023-0004https://www.emerald.com/insight/content/doi/10.1108/IJPH-01-2023-0004/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2023 Emerald Publishing Limited
What are the factors of parental incarceration that may increase risk of poor emotional and mental health in children of prisoners?https://www.emerald.com/insight/content/doi/10.1108/IJPH-05-2022-0031/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatestGlobally millions of children have a parent who is imprisoned. Research suggests that this has an adverse impact on the child and imprisonment of a parent is considered to be an adverse childhood experience (ACE). Parental incarceration will not only affect the child but the entire household and may result in further ACEs such as household dysfunction and parental separation making this group of children particularly vulnerable. This scoping review aims to adopt an international perspective to comprehensively examine the extent range and nature of literature both published and grey relating to parental incarceration and the potential impact on children’s emotional and mental health. In this scoping review, the five stages identified by Arksey and O’Malley (2005) were used including identifying the research question, identifying relevant studies, study selection, charting data, collating, summarising and reporting results. In addition, the included studies were appraised for quality using methodology-specific tools. A critical narrative synthesis was adopted to present findings and discussion. Nine studies met the inclusion criteria. Of the included studies, eight were retrieved from peer-reviewed journals and one from grey literature searching. Five categories with subcategories were identified affecting children’s mental health: 1) Relationships: parent and incarcerated child relationship; facilitators and barriers to maintaining contact; 2) Family structure; maternal or paternal incarceration; living arrangements during parental incarceration; 3) Children’s emotions: emotional recognition and regulation; resilience; 4) Prison stigma: social stigma; shame and secrecy; 5) Structural disadvantages: poverty; race/ethnicity. This scoping review has highlighted how the imprisonment of a parent negatively affects their children’s emotional and mental health. Factors negatively impacting children’s emotional and mental health are interrelated and complex. Further research is required, including differences between paternal and maternal incarceration; impact of gender and age of child; poverty as an ACE and prison exacerbating this; and effects of ethnicity and race. An important policy direction is in developing an effective way of capturing the parental status of a prisoner to ensure that the child and family receive needed support.What are the factors of parental incarceration that may increase risk of poor emotional and mental health in children of prisoners?
Matthew Charles Thorne, Nick de Viggiani, Emma Plugge
International Journal of Prisoner Health, Vol. 19, No. 4, pp.724-742

Globally millions of children have a parent who is imprisoned. Research suggests that this has an adverse impact on the child and imprisonment of a parent is considered to be an adverse childhood experience (ACE). Parental incarceration will not only affect the child but the entire household and may result in further ACEs such as household dysfunction and parental separation making this group of children particularly vulnerable. This scoping review aims to adopt an international perspective to comprehensively examine the extent range and nature of literature both published and grey relating to parental incarceration and the potential impact on children’s emotional and mental health.

In this scoping review, the five stages identified by Arksey and O’Malley (2005) were used including identifying the research question, identifying relevant studies, study selection, charting data, collating, summarising and reporting results. In addition, the included studies were appraised for quality using methodology-specific tools. A critical narrative synthesis was adopted to present findings and discussion.

Nine studies met the inclusion criteria. Of the included studies, eight were retrieved from peer-reviewed journals and one from grey literature searching. Five categories with subcategories were identified affecting children’s mental health: 1) Relationships: parent and incarcerated child relationship; facilitators and barriers to maintaining contact; 2) Family structure; maternal or paternal incarceration; living arrangements during parental incarceration; 3) Children’s emotions: emotional recognition and regulation; resilience; 4) Prison stigma: social stigma; shame and secrecy; 5) Structural disadvantages: poverty; race/ethnicity.

This scoping review has highlighted how the imprisonment of a parent negatively affects their children’s emotional and mental health. Factors negatively impacting children’s emotional and mental health are interrelated and complex. Further research is required, including differences between paternal and maternal incarceration; impact of gender and age of child; poverty as an ACE and prison exacerbating this; and effects of ethnicity and race. An important policy direction is in developing an effective way of capturing the parental status of a prisoner to ensure that the child and family receive needed support.

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What are the factors of parental incarceration that may increase risk of poor emotional and mental health in children of prisoners?10.1108/IJPH-05-2022-0031International Journal of Prisoner Health2023-09-26© 2023 Emerald Publishing LimitedMatthew Charles ThorneNick de ViggianiEmma PluggeInternational Journal of Prisoner Health1942023-09-2610.1108/IJPH-05-2022-0031https://www.emerald.com/insight/content/doi/10.1108/IJPH-05-2022-0031/full/html?utm_source=rss&utm_medium=feed&utm_campaign=rss_journalLatest© 2023 Emerald Publishing Limited