Community reentry for older adults leaving prison with and without health limitations

有或没有健康限制的出狱老年人重返社区

• 批准号: 10741029
• 负责人: Annie Lu Nguyen
• 金额: $ 38.04万
• 依托单位: TULANE UNIVERSITY OF LOUISIANA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-15 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10741029
• 关键词: Activities of Daily Living; Adaptive Behaviors; Address; Adult; Affect; Age; Attenuated; Automobile Driving; Black Populations; Caregivers; Case Management; Chronic; Cognition; Communities; Community Services; Deterioration; Disparity; Educational Curriculum; Elderly; Employment; Environment; Ethnic Origin; Evidence based intervention; Face; Family; Financial Hardship; Funding; Future; General Population; Health; Health Resources; Health Status; Home; Homelessness; Housing; Impaired cognition; Imprisonment; Independent Living; Individual; Infrastructure; Interdisciplinary Study; Intervention; Interview; Lead; Left; Medical Care Costs; Mental Depression; Minority; Modeling; Outcome; Perception; Persons; Polypharmacy; Population; Prisons; Probability; Program Development; Program Sustainability; Race; Reporting; Research; Resources; Risk; Risk Factors; Services; Support System; Testing; Time; Vulnerable Populations; Wisconsin; adverse outcome; black men; burden of illness; caregiving; community living; community organizations; community reentry; community-level factor; comorbidity; comparative; correctional system; ethnic minority; health care availability; high risk; housing instability; innovation; medical vulnerability; member; men; programs; protective factors; racial minority; racial minority population; recidivism; recruit; service providers; social; social factors; success; therapy development

ABSTRACT/SUMMARY Older adults are the fastest growing segment among incarcerated populations. The vast majority of older adults currently serving time in US prisons are men and racial/ethnic minorities, particularly Black men. Older adults in prison are a medically vulnerable group as time spent in prison amplifies and introduces new disease burdens due to highly restrictive environments and scarce resources. People in prison consistently report declines in health. Compared to the general population, older adults in prison have greater health limitations such as problems with mobility, cognitive impairment, polypharmacy, multiple comorbidities, and geriatric conditions, which can threaten their ability to live independently. These health challenges create burdens not only on correctional systems but also to the communities where these individuals will return. People returning to the community from prison face formidable challenges and the inability to reintegrate successfully into community living is one of the main drivers for recidivism. Yet, little is known about the health status of older adults leaving prison and how it impacts their transition during this critical reentry period. It is known that older adults leaving prison will face greater challenges than their younger counterparts but existing studies have not examined the added risk of having health limitations. Older adults may be returning to environments characterized by limited access to healthcare resources and caregivers, unstable housing, and challenging financial and family circumstances, particularly if incarceration was lengthy and social support systems have deteriorated over time. Poor health may compound these existing challenges. The specific aims of this study are to: (1) investigate the factors and disparities associated with successful reentry among older adults leaving prison (N=80); (2) elicit narratives about health, social, and community factors that impede or facilitate reentry among older adults with health limitations (N=30); and (3) adapt findings for a reentry case management program to develop specific modules to meet the needs of older adults leaving prison. Findings will be adapted to the evidence-based intervention, Project START+, a reentry case management model developed by members of the research team. Our study is innovative in that we study the critical reentry period for a medically vulnerable, high need, but under-characterized population. Research questions and hypotheses are theoretically grounded and results will provide practical findings for implementation. As a result of this project, we will develop an intervention that can be tested with future funding. The partnership with the Wisconsin Department of Corrections and Wisconsin Community Services, the largest community-based organization in Wisconsin that provides reentry services for people leaving prison, is a key strength.

摘要/总结 老年人是被监禁人口中增长最快的群体。绝大多数 目前在美国监狱服刑的老年人是男性和种族/少数民族，特别是黑人男性。 监狱中的老年人是一个医疗弱势群体，因为在监狱中度过的时间会放大并引入新的 疾病负担，由于高度限制性的环境和稀缺的资源。监狱里的人 报告健康状况下降。与普通人群相比，监狱中的老年人健康状况更好。 局限性，如移动性问题、认知障碍、多种药物、多种合并症，以及 老年病，这可能威胁到他们独立生活的能力。这些健康挑战 这不仅给惩教系统带来负担，也给这些人返回的社区带来负担。 从监狱返回社区的人面临着巨大的挑战，无法重新融入社会 成功融入社区生活是累犯的主要驱动力之一。然而，人们对健康状况知之甚少。 老年人离开监狱的状况以及这一状况如何影响他们在这一关键的重返监狱期间的过渡。是 知道老年人离开监狱将面临比年轻人更大的挑战， 研究还没有检查健康限制的额外风险。老年人可能会回到 环境的特点是获得医疗资源和护理人员的机会有限，住房不稳定， 具有挑战性的经济和家庭环境，特别是如果监禁时间很长， 系统随着时间的推移而恶化。健康状况不佳可能加剧这些现有挑战。具体目标 本研究的目的是：（1）探讨老年人成功重返社会的相关因素和差异 成年人离开监狱（N=80）;（2）引出关于健康，社会和社区因素的叙述，这些因素阻碍或 促进有健康限制的老年人（N=30）重返;（3）调整重返病例的结果 该方案旨在制定具体的模块，以满足出狱老年人的需要。结果 将适应循证干预，START+项目，一个重返社会的病例管理模式 由研究团队的成员开发。我们的研究是创新的，因为我们研究的关键再入期 针对医学上脆弱、需求高但特征不明显的人群。研究问题和假设 理论上有根据，结果将为执行工作提供实际结果。由于这种 项目，我们将开发一种干预措施，可以用未来的资金进行测试。与 威斯康星州惩教署和威斯康星州社区服务，最大的社区为基础的 威斯康星州的一个为出狱者提供重返社会服务的组织是一个关键力量。