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少数种族/族裔，特别是黑人男性。 监狱中的老年人是医疗上的弱势群体，因为在监狱中度过的时间增加并引入了新的 由于高度限制性的环境和稀缺的资源而造成的疾病负担。监狱里的人始终如一 报告健康状况下降。与一般人群相比，监狱中的老年人健康状况更好 限制，例如行动能力问题、认知障碍、多重用药、多种合并症，以及 老年疾病可能会威胁到他们独立生活的能力。这些健康挑战造成 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们面临着巨大的挑战并且无法重新融入社会 成功融入社区生活是累犯的主要驱动因素之一。然而，人们对健康知之甚少 老年人出狱的状况及其在这一关键的重返社会期间如何影响他们的过渡。这是 众所周知，出狱的老年人将比年轻人面临更大的挑战，但现有的 研究尚未检验健康限制带来的额外风险。老年人可能会返回 环境的特点是获得医疗资源和护理人员的机会有限、住房不稳定以及 经济和家庭环境面临挑战，特别是在长期监禁和社会支持的情况下 随着时间的推移，系统已经恶化。健康状况不佳可能会加剧这些现有的挑战。具体目标 本研究的目的是：（1）调查与老年人成功重返社会相关的因素和差异 出狱的成年人（N=80）； (2) 引出有关阻碍或阻碍的健康、社会和社区因素的叙述 促进健康状况不佳的老年人重返社会（N=30）； (3) 调整再入境案例的调查结果 管理计划开发特定模块，以满足老年人出狱的需求。发现 将适应循证干预、START+项目、再入病例管理模型 由研究团队成员开发。我们的研究具有创新性，因为我们研究了关键的再入期 针对医疗上脆弱、需求高但特征欠缺的人群。研究问题和假设 具有理论依据，结果将为实施提供实际发现。结果是 项目中，我们将开发一种可以用未来资金进行测试的干预措施。与的合作伙伴关系 威斯康星州惩教部和威斯康星州社区服务部，最大的社区服务 威斯康星州为出狱人员提供重返服务的组织是一个关键优势。