Clinical trial NCT05989282: Structural Conditions and Health After Release From Prison
Official title: Healthcare Organizational Structural Conditions and the Health of People Recently Released From Prison
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Cardiovascular Diseases
Health Care Utilization
Lead sponsor: Kaiser Permanente
Sponsor class: OTHER
Collaborators: name: University of Colorado, Denver
name: Denver Health and Hospital Authority
name: National Heart, Lung, and Blood Institute (NHLBI)
First posted: 2023-08-14
Enrollment: 400
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: We are enrolling people who were formerly in prison. People on probation or on parole are responsible for meeting their own needs for health care, in contrast to people currently in prison, who receive these services from the prison system. Thus, people recently released from prison are a high-risk group for a range of poor health outcomes and poor access to care. For these reasons, the focus of this investigation is on people recently released from prison.

Brief summary: People released from prison experience two times higher cardiovascular (CV) mortality than the general population, have a high prevalence of poor CV health and increased risk of CV events within 2 years of release. Access to high quality healthcare following release from prison is key to preventing poor health and CV outcomes. Our study team will investigate facilitators and barriers to health care access experienced by people released from prison.

Detailed description: Upon release from prison, people face numerous challenges including unstable housing, limited employment, stigma, and poor health. Structural conditions in healthcare systems, including policies, practices and attitudes around healthcare access, transition programs, culture, support of social determinants of health, and specialized services for people released from prison, may influence access and health outcomes for people released from prison. We will enroll people released from prison into a prospective cohort study to examine the association between exposure to structural conditions and 12-month primary outcomes of healthcare utilization (clinic visits, emergency visits, hospitalization) and secondary outcomes of CV hospitalization and all-cause mortality. Moderation by participant characteristics such as self-reported race, ethnicity, gender, age and baseline CV health will be tested.

Eligibility criteria: Inclusion Criteria:

* Recenlty released from state prison into the Denver/Aurora Colorado metro area
* Age 18 and older
* Ability to understand study procedures in English or Spanish
* No plans to leave the area for six months

Exclusion Criteria:

* On "current inmate" status or still under correctional observation (i.e., under locked confinement part of the day or night)
* Plans to leave area within six months
* Unable to consent

Primary outcomes:
measure: Healthcare utilization
timeFrame: 12 months
Secondary outcomes:
measure: Cardiovascular hospitalization
timeFrame: 12 months
measure: Death
timeFrame: 12 months
Other outcomes:
Locations:
city: Aurora
country: United States
facility: Kaiser Permanente Institute for Health Research
state: Colorado
Study officials:
affiliation: Kaiser Permanente Institute for Health Research
name: Stacie Daugherty
role: PRINCIPAL_INVESTIGATOR
References: