INVESTIGATING MORTALITY AMONG EX-PRISONERS IN QUEENSLAND: A DATA LINKAGE STUDY

注：在提交这个项目的NOI时，我们还没有收到关于社会劣势的平行NHMRC筹资回合的反馈。自那以后，我们收到了对我们NOI中预示的试验的非常积极的评价，并根据一位审查员的建议，我们修改了我们的申请，以通过进行记录联系研究来补充拟议的试验。与拟议项目相关的内容领域和道德问题基本保持不变。澳大利亚和其他地方的研究发现，出狱囚犯的死亡风险增加，药物过量、自杀和事故是三个主要原因。许多人在获释后不久死亡。虽然服刑人员服药过量的高发生率通常被归因于耐受性降低，但大多数致命的服药过量是多种药物共同作用的结果。详细了解刑满释放人员的死亡情况是采取循证预防战略的先决条件。拟议的研究将：(A)将1994年至2006年期间在昆士兰监狱获释的囚犯的身份与国家死亡指数联系起来。这一链接的数据库将使人们能够探索出狱囚犯死亡的发生率、时间、原因和风险因素。(B)比较已故前囚犯和已知在世的随机前囚犯的惩教记录，重点放在疑似危险因素上，包括犯罪史、在押期间的行为、健康状况、心理社会适应、社会经济地位以及吸毒史和治疗。这将使对出院后死亡的风险因素进行更详细的分析。(C)利用国家验尸官信息系统深入分析被释放囚犯的死因。关于死因和背景的信息将由一名研究助理进行编码和分析，以确定群体差异(例如，ATSI和非ATSI出狱囚犯之间的差异)。

NOTE: At the time of submitting the NOI for this project we had not yet received feedback from a submission to a parallel NHMRC funding round concerned with social disadvantage. We have since received very positive reviews for the trial foreshadowed in our NOI, and consistent with the recommendations of one reviewer, we have modified our application to complement the proposed trial by conducting a record linkage study. The content area and ethical issues associated with the proposed project remain largely unchanged. Studies in Australia and elsewhere have identified a heightened risk of death among ex-prisoners, with drug overdose, suicide and 'accidents' three major causes. Many deaths occur soon after release. Although the high incidence of 'overdose' among ex-prisoners is often attributed to reduced tolerance,most fatal drug overdoses are due to the combined effects of multiple drugs. A detailed understanding of deaths among ex-prisoners is a prerequisite for evidence-based preventive strategies. The proposed study will: (a) Link the identities of prisoners released from custody in QLD between 1994 and 2006, with the National Death Index (NDI). The linked database will permit exploration of the incidence, timing, causes and risk factors for death among ex-prisoners. (b) Compare correctional records of deceased ex-prisoners and a random sample of ex-prisoners known to be alive, focussing on suspected risk factors including criminal history, behaviour in custody, health status, psychosocial adjustment, socio-economic status, and history and treatment for drug use. This will allow more detailed analysis of risk factors for death post-release. (c) Conduct in-depth analysis of causes of death among ex-prisoners, using the National Coroners Information System (NCIS). Information regarding cause and context of death will be coded by a research assistant and analysed to identify group differences (e.g., between ATSI and non-ATSI ex-prisoners).