Low-intensity case management increases contact with primary care in recently released prisoners: a single-blinded, multisite, randomised controlled trial

Kinner, Stuart A., Alati, Rosa, Longo, Marie, Spittal, Matthew J., Boyle, Frances M., Williams, Gail M. and Lennox, Nicholas G. (2016) Low-intensity case management increases contact with primary care in recently released prisoners: a single-blinded, multisite, randomised controlled trial. Journal of Epidemiology and Community Health, 70 7: 683-688. doi:10.1136/jech-2015-206565


Author Kinner, Stuart A.
Alati, Rosa
Longo, Marie
Spittal, Matthew J.
Boyle, Frances M.
Williams, Gail M.
Lennox, Nicholas G.
Title Low-intensity case management increases contact with primary care in recently released prisoners: a single-blinded, multisite, randomised controlled trial
Journal name Journal of Epidemiology and Community Health   Check publisher's open access policy
ISSN 0143-005X
1470-2738
Publication date 2016-01-19
Year available 2016
Sub-type Article (original research)
DOI 10.1136/jech-2015-206565
Open Access Status DOI
Volume 70
Issue 7
Start page 683
End page 688
Total pages 6
Place of publication London, United Kingdom
Publisher B M J Group
Language eng
Subject 2713 Epidemiology
2739 Public Health, Environmental and Occupational Health
Abstract Background The world prison population is large and growing. Poor health outcomes after release from prison are common, but few programmes to improve health outcomes for ex-prisoners have been rigorously evaluated. The aim of this study was to evaluate the impact of individualised case management on contact with health services during the first 6 months postrelease. Methods Single-blinded, randomised, controlled trial. Baseline assessment with N=1325 adult prisoners in Queensland, Australia, within 6 weeks of expected release; follow-up interviews 1, 3 and 6 months postrelease. The intervention consisted of provision of a personalised booklet ('Passport') at the time of release, plus up to four brief telephone contacts in the first 4 weeks post-release. Results Of 1179 eligible participants, 1003 (85%) completed ≥1 follow-up interview. In intention-to-treat analyses, 53% of the intervention group and 41% of the control group reported contacting a general practitioner (GP) at 1 month post-release (difference=12%, 95% CI 5% to 19%). Similar effects were observed for GP contact at 3 months (difference=9%, 95% CI 2% to 16%) and 6 months (difference=8%, 95% CI 1% to 15%), and for mental health (MH) service contact at 6 months post release (difference=8%, 95% CI 3% to 14%). Conclusions Individualised case management in the month after release from prison increases usage of primary care and MH services in adult ex-prisoners for at least 6 months post-release. Given the poor health profile of ex-prisoners, there remains an urgent need to develop and rigorously evaluate interventions to increase health service contact in this profoundly marginalised population. Trial registration number ACTRN12608000232336.
Formatted abstract
Background: The world prison population is large and growing. Poor health outcomes after release from prison are common, but few programmes to improve health outcomes for ex-prisoners have been rigorously evaluated. The aim of this study was to evaluate the impact of individualised case management on contact with health services during the first 6 months post-release.

Methods: Single-blinded, randomised, controlled trial. Baseline assessment with N=1325 adult prisoners in Queensland, Australia, within 6 weeks of expected release; follow-up interviews 1, 3 and 6 months post-release. The intervention consisted of provision of a personalised booklet (‘Passport’) at the time of release, plus up to four brief telephone contacts in the first 4 weeks post-release.

Results: Of 1179 eligible participants, 1003 (85%) completed ≥1 follow-up interview. In intention-to-treat analyses, 53% of the intervention group and 41% of the control group reported contacting a general practitioner (GP) at 1 month post-release (difference=12%, 95% CI 5% to 19%). Similar effects were observed for GP contact at 3 months (difference=9%, 95% CI 2% to 16%) and 6 months (difference=8%, 95% CI 1% to 15%), and for mental health (MH) service contact at 6 months post release (difference=8%, 95% CI 3% to 14%).

Conclusions: Individualised case management in the month after release from prison increases usage of primary care and MH services in adult ex-prisoners for at least 6 months post-release. Given the poor health profile of ex-prisoners, there remains an urgent need to develop and rigorously evaluate interventions to increase health service contact in this profoundly marginalised population.
Keyword Public, Environmental & Occupational Health
Public, Environmental & Occupational Health
Q-Index Code C1
Q-Index Status Provisional Code
Grant ID 409966
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Mater Research Institute-UQ (MRI-UQ)
HERDC Pre-Audit
School of Public Health Publications
 
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Created: Sat, 23 Jan 2016, 00:13:08 EST by Dr Fran Boyle on behalf of School of Public Health