The Relationship between Family Functioning & the Crime Types in Incarcerated Children

AIM:

We assessed to investigate the relationship between the family functioning crime types in incarcerated children.

METHODS:

One hundred eighty two incarcerated children aged between 13-18 years who were confined in child-youth prisons and child correctional facilities were enrolled into this descriptive study. Participants completed demographic questions and the McMaster Family Assessment Device (Epstein, Baldwin, & Bishop, 1983) (FAD) with face to face interviews.

RESULTS:

The crime types were; theft, assault (bodily injury), robbery, sexual assault, drug trafficker and murder. The socio-demographic characteristics were compared by using FAD scale, and growing up in a nuclear family had statistically significant better scores for problem solving and communication subscales and the children whose parents had their own house had significantly better problem solving scores When we compared the crime types of children by using problem solving, communication and general functioning subscales of FAD, we found statistical lower scores in assault (bodily injury) group than in theft, sexual assault, murder groups and in drug trafficker group than in murder group, also we found lower scores in drug trafficker group than in theft group for problem solving and general functioning sub-scales, also there were lower scores in bodily injury assault group than in robbery, theft groups and in drug trafficker than in theft group for problem solving subscale.

CONCLUSION:

The communication and problem solving sub-scales of FAD are firstly impaired scales for the incarcerated children. We mention these sub-scales are found with unplanned and less serious crimes and commented those as cry for help of the children.

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By:  Teker K1, Topçu S, Başkan S, Şimşek Orhon F, Ulukol B.

• 1Ankara Sami Ulus Child Hospital, Ankara, Turkey - drsedatopcu@gmail.com. 
• Minerva Pediatr. 2016 Mar 17. 

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Substance Use, Disordered Eating, and Weight Gain: Describing the Prevention and Treatment Needs of Incarcerated Women

Weight-related concerns are associated with women's substance use and treatment relapse. The prevalence of overweight, obesity, disordered eating behavior, and substance abuse history was assessed among female inmates incarcerated for 6 to 24 months at an Oregon state prison, using a self-administered survey and physical measurements. 

Average weight gain was 20 pounds, 87% of women were overweight (39%) or obese (48%), and 24% reported using one or more unhealthy strategies to lose weight in the past 6 months. Women who used tobacco and illicit substances before incarceration gained more weight. 

Integrating nutrition and weight gain issues into substance abuse treatment could benefit incarcerated women-both soon after entering prison to prevent weight gain and close to release to prevent relapse into substance use.

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By:  Drach LL1, Maher JE2, Braun MJ3, Murray SL4, Sazie E5.

• 1Program Design and Evaluation Services, Multnomah County Health Department and Oregon Public Health Division, Portland, OR, USA linda.drach@state.or.us.
• 2Program Design and Evaluation Services, Multnomah County Health Department and Oregon Public Health Division, Portland, OR, USA.
• 3Oregon Youth Authority, Portland, OR, USA Oregon Department of Corrections (formerly), Portland, OR, USA.
• 4Oregon Public Health Division, Portland, OR, USA.
• 5Oregon Department of Corrections (formerly), Portland, OR, USA. 
• J Correct Health Care. 2016 Apr;22(2):139-45. doi: 10.1177/1078345816634692.

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The Impact of Motivational Interviewing on Delinquent Behaviors in Incarcerated Adolescents

Highlights

• Depression moderated the effects of MI on delinquent behaviors 3 months after treatment.
• Compared to meditation, MI is better at reducing predatory aggression when depressive symptoms are low.
• Compared to meditation, MI is better at reducing alcohol-related predatory aggression when depressive symptoms are low.

The impact of Motivational Interviewing (MI) on risky behaviors of incarcerated adolescents and adults has been investigated with promising results. Findings suggest that MI reduces substance use, improves motivation and confidence to reduce use, and decreases risky behaviors. 

The current study investigated the impact of MI on general, alcohol-related, and marijuana-related delinquent behaviors in incarcerated adolescents. Participants in the study were incarcerated adolescents in a state correctional facility in the Northeast region and were assessed as part of a larger randomized clinical trial. Adolescents were randomly assigned to receive MI or relaxation therapy (RT) (N = 189) treatment. Delinquent behaviors and depressive symptomatology were measured using the Delinquent Activities Scale (DAS; Reavy, Stein, Paiva, Quina, & Rossi, 2012) and the Center for Epidemiological Studies—Depression scale (CES-D; Radloff, 1991) respectively. 

Findings indicate that depression moderated treatment effects. Compared to RT, MI was better at reducing predatory aggression and alcohol-related predatory aggression 3 months post-release when depressive symptoms were low. Identifying an efficacious treatment for these adolescents may benefit society in that it may decrease crimes against persons (i.e., predatory aggression) post release.

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By:   Mary Clair-Michaud, Ph.D., Rosemarie A. Martin, Ph.D., Linda A.R. Stein, Ph.D., Shayna Bassett, M.S., Rebecca Lebeau, Ph.D., Charles Golembeske, Ph.D.

Affiliations

Cancer Prevention Research Center, University of Rhode Island (http://web.uri.edu/cprc/), 130 Flagg Rd., Kingston, RI 02881

The Rhode Island Training School, 300 New London Avenue, Cranston, RI 02920

Correspondence

Corresponding author at: Cancer Prevention Research Center, University of Rhode Island, 130 Flagg Rd., Kingston, RI, 02881. Tel.: +1 401 874 4013; fax: +1 401 874 5562.

mclair@uri.edu

DOI: http://dx.doi.org/10.1016/j.jsat.2015.09.003

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Incarcerated Intravenous Heroin Users: Predictors of Post-Release Utilization of Methadone Maintenance Treatment

BACKGROUND:

Incarcerated intravenous heroin users (IIHUs) have more problematic patterns of heroin use but are less likely to access methadone maintenance treatment (MMT) by their own initiative than heroin users in the community.

OBJECTIVE:

The present study examined predictors for receiving MMT postrelease among IIHUs within a 24-month period.

DESIGN/METHODS:

This cohort study recruited 315 IIHUs detained in four prisons in southern Taiwan and followed up within 24-month period postrelease. Cox proportional hazards regression analysis was applied to determine the predictive effects of the sociodemographic and drug-use characteristics, attitude toward MMT, HIV serostatus, perceived family support, and depression for access to MMT after release.

RESULTS:

Two hundred and ninety five (93.7%) IIHUs were released and entered the follow-up phase of the study. During the 24-month follow-up period, 50.8% of them received MMT. After controlling for the effects of the detainment period before and after recruitment by Cox proportional hazards regression analysis, IIHUs who had positive HIV serostatus (HR = 2.85, 95% CI = 1.80-4.52, p < .001) and had ever received MMT before committal (HR = 1.94, 95% CI = 1.23-3.05, p < .01) were more likely to enter MMT within the 24-month follow-up period.

DISCUSSION:

Positive HIV serostatus with fully subsidized treatment and previous MMT experiences predicted access of MMT postrelease. Strategies for getting familiar with MMT during detainment including providing MMT prior to release and lowering economic burden of receiving treatment may facilitate entry of MMT for IIHUs.

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By:   Lin HC1,2, Wang PW1,2, Tsai JJ3,4,5, Yen CF1,2.

• 1 Department of Psychiatry , Kaohsiung , Taiwan.
• 2 Department of Psychiatry , School of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University , Kaohsiung , Taiwan.
• 3 Department of Infectious Diseases , Kaohsiung Medical University Hospital , Kaohsiung , Taiwan.
• 4 Tropical Medicine Center, Kaohsiung Medical University Hospital , Kaohsiung , Taiwan.
• 5 Department of Internal Medicine , School of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University , Kaohsiung , Taiwan. 

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Incarcerated Women’s Relationship-based Strategies to Avoid Drug Use After Community Re-Entry

While recent research has stressed the supportive role that family and friends play for incarcerated persons as they re-enter the community, drug-using incarcerated women re-entering the community often have to rely on family, community, and intimate relationships that have played a role in their substance abuse and criminalization. 

This study conducted qualitative analysis of clinical sessions with rural, drug-using women (N = 20) in a larger prison-based HIV risk reduction intervention in Kentucky during 2012-2014 to examine incarcerated women’s perceptions of the role of their family, community, and intimate relationships in their plans to decrease their substance abuse upon community re-entry. 

Women stressed the obstacles to receiving support in many of their family and drug-using relationships after community re-entry. Nonetheless, they asserted that changes in their relationships could support their desires to end their substance abuse by setting limits on and using their positive relationships, particularly with their children, to motivate them to change. Interventions to promote incarcerated women’s health behavior changes—including substance abuse—must acknowledge the complex social environments in which they live.

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By:  Claire Snell-Rood PhD^a*, Michele Staton-Tindall PhD, MSW^b &Grant Victor MSW^b

• ^a University of Kentucky College of Medicine, Department of Behavioral Science, 108 Medical Behavioral Science Building, Lexington, KY 40536-0086
• ^b University of Kentucky College of Social Work, 619 Patterson Office Tower, Lexington, Kentucky, 40506-0027 

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PTSD among Aboriginal & Torres Strait Islander People in Custody in Australia: Prevalence & Correlates

Mental disorder and trauma experiences are highly prevalent among individuals in custody; however, the impact of posttraumatic stress disorder (PTSD) on functioning is rarely considered. Indigenous Australians are incarcerated at 13 times the rate of nonindigenous Australians and report high levels of trauma exposure and psychological distress. 

In analysis of the largest systematic study of mental disorder among indigenous Australians in custody (N = 396), we found that the 12-month prevalence of PTSD was high in both men (12.1%) and women (32.3%). Having PTSD was also associated with high rates of co-occurring mental disorders (anxiety 31.2%, depression 32.8%, psychosis 24.6%, and substance use, 75.4%), lifetime suicidal ideation (50.1%), and suicide attempts (34.4%). Individuals with PTSD, compared to those without, were more likely to experience other mental disorders, OR = 2.42, 95% CI [1.12, 5.80], p = .022; lifetime suicide thoughts, OR= 2.43, 95% CI [1.34, 4.39], p = .001, and attempts, OR = 2.56, 95% CI [1.33, 4.83], p = .002; and high rates of intoxication at the time of arrest. Despite this, most (58.9%) had not accessed any form of mental health care prior to incarceration. These findings highlight the need to identify and manage PTSD in community and custodial populations.

Spanish Abstracts by the Asociacion Chilena de Estres Traumatico

TEPT en Indígenas Australianos en Prisión

Los trastornos mentales y las experiencias de trauma son altamente prevalentes en los individuos en prisión, sin embargo, el impacto del TEPT es considerado raramente. Los indígenas australianos son encarcelados a una tasa que es 13 veces la tasa de australianos no indígenas y reportan altos niveles de exposición a trauma y estrés psicológico. En un análisis más detallado del estudio sistemático más grande sobre los trastornos mentales en los indígenas australianos en prisión (N = 396), encontramos que la prevalencia a los 12 meses del TEPT era alta tanto en hombres (12.1%) como en mujeres (32.3%). Tener TEPT también se asoció con altas tasas de trastornos mentales comórbidos (ansiedad 31.2%, depresión 32.8%, psicosis 24.6% y consumo de sustancias 75.4%), ideación suicida a lo largo de la vida (50.1%) e intentos suicidas (34.4%). Los individuos con TEPT, en comparación con los individuos sin TEPT, tenían más probabilidad de sufrir otro trastorno mental OR = 2.42, 95% IC [1.12, 5.80], p = ,022 y pensamientos suicidas en algún momento de la vida OR = 2.56, 95% IC [1.33, 4.83], p = ,002 y altas tasas de intoxicación al momento del arresto. A pesar de esto, la mayoría (58.9%) no había accedido a ninguna forma de atención en salud mental antes del encarcelamiento. Estos hallazgos destacan la necesidad de identificar y manejar el TEPT en las poblaciones de la comunidad y carcelarias.

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By:  

Edward Heffernan^1,*, 

Kimina Andersen²,

Fiona Davidson² and

Stuart A. Kinner^1,3

1. 1 School of Medicine, University of Queensland, Brisbane, Queensland, Australia
2. 2 Metro North Hospital and Health Service, Brisbane, Queensland, Australia
3. 3 Centre for Mental Health, Melbourne School of Population & Global Health, University of Melbourne

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Incarceration and Current Tobacco Smoking among Black and Caribbean Black Americans in the National Survey of American Life

We examined the relationship between having a history of incarceration and being a current smoker using a national sample of noninstitutionalized Black adults living in the United States.

With data from the National Survey of American Life collected between February 2001 and March 2003, we calculated individual propensity scores for having a history of incarceration. To examine the relationship between prior incarceration and current smoking status, we ran gender-specific propensity-matched fitted logistic regression models.

A history of incarceration was consistently and independently associated with a higher risk of current tobacco smoking in men and women. Formerly incarcerated Black men had 1.77 times the risk of being a current tobacco smoker than did their counterparts without a history of incarceration (95% confidence interval [CI] = 1.20, 2.61) in the propensity score-matched sample. The results were similar among Black women (prevalence ratio = 1.61; 95% CI = 1.00, 2.57).

Mass incarceration likely contributes to the prevalence of smoking among US Blacks. Future research should explore whether the exclusion of institutionalized populations in national statistics obscures Black-White disparities in tobacco smoking.

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By: Bailey ZD1, Okechukwu C1, Kawachi I1, Williams DR1.

• 1Zinzi D. Bailey, Cassandra Okechukwu, Ichiro Kawachi, and David R. Williams are with the Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA. Zinzi D. Bailey is also with the Montreal Health Equity Research Consortium, Institute of Health and Social Policy, McGill University, Montreal, Canada.  

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Prevalence & Factors Associated with Smoking Tobacco among Men Recently Released from Prison in California

Over 1.5 million people are incarcerated in state and federal correctional facilities in the United States. Formerly incarcerated men have significantly higher rates of mortality and morbidity than the general population, disparities that have been partially attributed to higher rates of tobacco smoking-related illnesses such as cardiovascular disease, pulmonary disease and cancer.

We compared the prevalence of smoking tobacco in a sample of 172 men who were released from California state prisons to Oakland and San Francisco between 2009 and 2011 to sub-populations of respondents to the 2009 California Health Interview Survey (CHIS). Using logistic regression, we analyzed the association between lifetime history of incarceration and self-reported smoking status.

Seventy-four percent of men recently released from prison reported being current tobacco smokers. The prevalence of smoking in a demographically similar group of men in the CHIS was 24%. We found in bivariate analysis that each additional five years of history of incarceration was associated with 1.32 times greater odds of smoking (95% CI 1.02 to 1.71). Illicit substance use was associated with a 2.47 higher adjusted odds of smoking (95% CI 1.29 to 5.39). In the multivariate model adjusting for age, income, substance use and mental health, every five years ofincarceration was associated with 1.23 greater odds of smoking (95% CI 0.94 to 1.63) which was not statistically significant.

Given the high prevalence of smoking tobacco among former prisoners and the underlying high tobacco-related mortality rates, these findings suggest that a history of incarceration may be an important determinant of smoking. Prison and parole systems may be important potential settings for smoking-cessation interventions.

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By: Howell BA1, Guydish J2, Kral AH3, Comfort M4.

• 1Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.
• 2Philip R Lee Health Policy Institute, University of San Francisco, San Francisco, CA, USA.
• 3Behavioral and Urban Health Program, RTI International, San Francisco, CA, USA.
• 4Behavioral and Urban Health Program, RTI International, San Francisco, CA, USA. Electronic address: mcomfort@rti.org.  

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Factors Associated with Premature Exits from Supported Housing

Many homeless consumers who enroll in supported housing programs-which offer subsidized housing and supportive services-disengage prematurely, before placement in permanent community-based housing. This study explored factors associated with exiting a supported housing program before achieving housing placement.

With the use of administrative data, a roster was obtained for consumers enrolled in the Veterans Affairs (VA) Greater Los Angeles supported housing program from 2011 to 2012. Fewer (4%) consumers exited this program before achieving housing ("exiters") compared with consumers described in national VA figures (18%). Exiters with available demographic data (N=51) were matched 1:1 on age, gender, marital status, and race-ethnicity with consumers housed through this program ("stayers," N=51). Medical records were reviewed to compare diagnoses, health care utilization, housing histories, vocational history, and criminal justice involvement of exiters versus stayers. Exiters' housing outcomes were identified. Recursive partitioning identified variables that best differentiated exiters from stayers.

Several factors were associated with premature exits from this supported housing program: residing in temporary housing on hospital grounds during program enrollment, poor adherence to outpatient care, substance use disorders, hepatitis C, chronic pain, justice involvement, frequent emergency department utilization, and medical-surgical admissions. The first of these factors and poor adherence to outpatient medical-surgical care best differentiated exiters from stayers. Moreover, >50% of exiters became street homeless or incarcerated after leaving the program.

In that diverse social factors, diagnoses, and health care utilization patterns were associated with premature disengagement from supported housing, future research is needed to implement and evaluate rehabilitative services that address these factors, adapted to the context of supported housing.

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By: Gabrielian S1, Burns AV1, Nanda N1, Hellemann G1, Kane V1, Young AS1.

• 1Dr. Gabrielian, Dr. Hellemann, and Dr. Young are with the Desert Pacific Mental Illness Research, Education and Clinical Center, West Los Angeles Veterans Affairs (VA) Healthcare Center, Los Angeles (e-mail: sonya.gabrielian@va.gov ). Dr. Gabrielian and Dr. Young are also with the Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at the University of California, Los Angeles (UCLA), where Dr. Burns is affiliated. Dr. Hellemann is also with SiStat, Semel Institute for Neuroscience and Human Behavor, David Geffen School of Medicine at UCLA. Ms. Nanda is with the RAND Corporation, Pittsburgh, Pennsylvania. Mr. Kane is with Homeless Services for the Secretary of the VA and with the Lebanon VA Medical Center, Lebanon, Pennsylvania.  

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Mothering at a Distance: What Incarcerated Mothers Value About a Parenting Program

Children with incarcerated mothers experience a range of adverse health, social, emotional and economic circumstances, and are a particularly vulnerable group within the Australian community. Mothers in custody face significant challenges to their capacity to parent their children. This study presents findings from a mixed-methods evaluation of a parenting support program for incarcerated mothers in NSW Australia. It examines responses to open and closed questions on a questionnaire to identify participants' views on the program's impact on their parenting role. 

Quantitative data indicated that participants found the program worthwhile and relevant, and that it helped build their parenting knowledge and confidence. Qualitative responses highlighted the aspects of the program which participants valued, specifically gaining support for their parenting role in complicated circumstances, a greater understanding of child development and perspectives, and a range of practical strategies for enhancing relationships with their children during their incarceration. Respondents reported feeling validated as mothers due to improved self-perception and feeling more confident and hopeful in their mothering role.

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By: Rossiter C1, Power T1, Fowler C1,2, Jackson D3,4, Hyslop D5, Dawson A1.

• 1a Faculty of Health , University of Technology Sydney , Australia.
• 2b Tresillian Family Care Centres.
• 3c Oxford Brookes University , UK.
• 4d University of New England , NSW , Australia.
• 5e Corrective Services New South Wales.  

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Feasibility of an HIV/STI Risk-Reduction Program for Incarcerated Women Who Have Experienced Interpersonal Violence

HIV and other sexually transmitted infections (STIs) and interpersonal violence (IV; e.g., childhood abuse, partner violence, and rape) victimization are significant and interconnected public health problems facing incarcerated women. We adapted a best-evidence HIV-prevention intervention for women (the Women's CoOp) to address sexual safety among incarcerated women with histories of interpersonal violence victimization. 

The standard Women's CoOp teaches safe sex, substance use harm reduction, and violence prevention information and skills needed to empower women to make more intentional decisions about their safety. We also incorporated strategies to increase affect management, social support, and access to community resources. This resulted in the first trauma-focused HIV-prevention intervention for women that directly addresses the sequelae of IV (such as affect dysregulation in sexual situations) within the context of HIV harm reduction. 

This manuscript describes the rationale, feasibility, acceptability, and pre-post outcomes of this intervention among 14 women nearing release from prison in two state prison systems. Assessments took place at baseline, prior to release, and at 2-, 5-, and 8 months after release. The intervention overall and each of its components were feasible and acceptable. Participants' number of unprotected sexual occasions, post-traumatic stress disorder symptoms, and depressive symptoms decreased significantly from baseline to post-release. Effectiveness in obtaining resources increased significantly from baseline to post-release. 

Because pre-post measurements of outcomes are confounded with incarceration and subsequent release in this preliminary study, a randomized controlled trial is needed to establish the efficacy of this tailored intervention.

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By:  Johnson JE1, Peabody ME2, Wechsberg WM3, Rosen RK4, Fernandes K2, Zlotnick C5.

• 1Brown University, Providence, RI, USA
• 2Brown University, Providence, RI, USA.
• 3RTI International, Durham, NC, USA.
• 4Brown University, Providence, RI, USA Miriam Hospital, Providence, RI, USA.
• 5Brown University, Providence, RI, USA Butler Hospital, Providence, RI, USA Women and Infants Hospital, Providence, RI, USA University of Cape Town, South Africa. 

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Do Young Women Engage in Greater Sexual Risk Behaviour with Biological Fathers of Their Children?

Qualitative research suggests that young women's relationships with the biological fathers of their children (BFRs), known colloquially as 'baby daddy' relationships, enable risk for pregnancy and STI/HIV. Our study compared partner characteristics and sexual risk within dyads based on BFR, among a sample of young women in Baltimore, Maryland, USA.

We conducted secondary analysis of survey data collected in 2011-2013 from heterosexually experienced youth ages 15-24 in Baltimore, Maryland, USA. Analyses are limited to women with at least one recent (past 6 months) sex partner (n=171 participants, reporting on 271 relationships). Using generalised estimating equations with logit function for correlated binary responses, we evaluate associations of BFR with partner characteristics, sexual risk behaviour and contraceptive non-use.

• At least one BFR partner was reported by 25.2%. 
• Male partners in BFRs were more likely to have been incarcerated or arrested. 
• BFRs were more often characterised by women as 'main' versus 'casual' partners. 
• In adjusted analyses, BFR was associated with 
• condom non-use for vaginal and anal intercourse. 
• While BFR was associated with contraceptive non-use, this association attenuated to non-significance after adjusting for partnership type.

While few differences in BFR partner characteristics emerged, significantly greater risk for unprotected intercourse was identified within BFR relationships. Findings suggest that the relationship context of a shared child heightens sexual risk for the young women most affected by STI.

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By: Decker MR1, Chung SE2, Ellen JM3, Sherman SG4.

• 1Department of Population, Family & Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
• 2Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA Center for Child and Community Health Research, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
• 3Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA All Childrens Hospital, Johns Hopkins Medicine, St Petersburg, Florida, USA.
• 4Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.

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Psychological Distress among Victimized Women on Probation and Parole: A Latent Class Analysis

Below:  Standardized mean scores of three subgroups of victimized women on probation and parole across nine latent class indicator variables

Latent class analysis was used to identify subgroups of victimized women (N=406) on probation and parole differentiated by levels of general psychological distress. The nine primary symptom dimensions from the Brief Symptom Inventory (BSI) were used individually as latent class indicators (Derogatis, 1993). Results identified three classes of women characterized by increasing levels of psychological distress; classes were further differentiated by posttraumatic stress disorder symptoms, cumulative victimization, substance use and other domains of psychosocial functioning (i.e., sociodemographic characteristics; informal social support and formal service utilization; perceived life stress; and resource loss). The present research was effective in uncovering important heterogeneity in psychological distress using a highly reliable and easily accessible measure of general psychological distress. Differentiating levels of psychological distress and associated patterns of psychosocial risk can be used to develop intervention strategies targeting the needs of different subgroups of women. Implications for treatment and future research are presented.

Women are among the fastest growing segment of the correctional population. At present, over 200,000 women are incarcerated and more than 1 million women are on probation (Ajinkya, 2012). Approximately one out of every 89 women in the U.S. is involved in the criminal justice system and over 85% are sanctioned within the community...

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Health Priorities among Women Recently Released from Jail

Below:  Priorities among Women Recently Released from Jail

Five out of 28 women listed health as their top post-release priority. However, many women had competing priorities after release, including housing, employment, and children. We found that women described several reasons why health was not a priority; however, participants reported regular use of the healthcare system upon release from jail, indicating that health was important to them to some degree.

Our findings may inform intervention efforts that connect women to healthcare resources and increase health-promoting behavior during the transition from jail to community.

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