Criminal Justice Supervision Research Articles

Current and Promising Pharmacotherapies for Substance Use Disorders among Justice-Involved Populations

Growing recognition of the biological underpinnings of substance use disorders (SUDs) has led to increased acceptance of pharmacotherapy-based treatments for general populations and, more recently, for individuals under criminal justice supervision, including those in correctional settings. This paper focuses on pharmacotherapies that have been approved by the United States Food and Drug Administration (FDA) for treatment of alcohol use disorder and opioid use disorder. For alcohol use disorder, these medications are disulfiram, naltrexone, and acamprosate; for opioid use disorder, these are methadone, buprenorphine, and naltrexone. Promising pharmacotherapies for stimulant use disorder are also briefly summarized. The paper concludes with three “lessons learned,” specifically: (1) treatment and policy should reflect the fact that substance misuse and addiction is a medical disorder, (2) interventions for SUDs should be integrated into primary care, and (3) reductions in substance use among pharmacotherapy-treated patients do not necessarily lead to concomitant reductions in crime (nor should this be the primary rationale for providing such treatment).

Assessing informed consent in an opioid relapse prevention study with adults under current or recent criminal justice supervision

Concerns persist that individuals with substance use disorders who are under community criminal justice supervision experience circumstances that might compromise their provision of valid, informed consent for research participation. These concerns include the possibilities that desire to obtain access to treatment might lead individuals to ignore important information about research participation, including information about risks, or that cognitive impairment associated with substance use might interfere with attending to important information. We report results from a consent quiz (CQ) administered in a multisite randomized clinical trial of long-acting naltrexone to prevent relapse to opioid use disorder among adults under community criminal justice supervision—a treatment option difficult to access by this population of individuals. Participants were required to answer all 11 items correctly before randomization. On average, participants answered 9.8 items correctly (89%) at baseline first attempt (n=306). At week 21 (n=212), participants scored 87% (9.5 items correct) without review. Performance was equivalent to, or better than, published results from other populations on a basic consent quiz instrument across multiple content domains. The consent quiz is an efficient method to screen for adequate knowledge of consent information as part of the informed consent process. Clinical researchers who are concerned about these issues should consider using a consent quiz with corrected feedback to enhance the informed consent process. Overall, while primarily useful as an educational tool, employing a CQ as part of the gateway to participation in research may be particularly important as the field continues to advance and tests novel experimental treatments with significant risks and uncertain potential for benefit.

An international human rights perspective on maternal criminal justice involvement in the United States.

Internationally and historically unprecedented numbers of women in the United States are under criminal justice supervision in jails, prisons, and the community. Pregnant women and mothers with minor children comprise a large proportion of this population. The rise in criminal justice oversight and

Dealing More Effectively and Humanely with Illegal Drugs

AbstractMany judge the American criminal justice system to have largely failed in its drug enforcement role, and the justice system itself has suffered a loss of community support and internal morale as a consequence. Five principles should guide improvement of drug enforcement, including that drug enforcement be viewed as a preventive activity, whose main goal is reducing drug abuse and related harms, and it should be designed for sustainability. Six more specific proposals are, first, make marijuana enforcement a minor matter for police through decriminalization of possession or outright legalization; second, induce drug users who are under criminal justice supervision to refrain from drug use by imposing appropriate monitoring and graduated sanctions programs; third, expand opioid substitution therapy for heroin- and other opioid-using offenders; fourth, reduce the average severity of sentences for drug offenses, particularly for minor functionaries who are easily replaced; fifth, base sentence length ...

Preventing Criminal Recidivism Through Mental Health and Criminal Justice Collaboration.

Criminal justice system involvement is common among persons with serious mental illness in community treatment settings. Various intervention strategies are used to prevent criminal recidivism among justice-involved individuals, including mental health courts, specialty probation, and conditional release programs. Despite differences in these approaches, most involve the use of legal leverage to promote treatment adherence. Evidence supporting the effectiveness of leverage-based interventions at preventing criminal recidivism is mixed, however, with some studies suggesting that involving criminal justice authorities in mental health treatment can increase recidivism rates. The effectiveness of interventions that utilize legal leverage is likely to depend on several factors, including the ability of mental health and criminal justice staff to work together. Collaboration is widely acknowledged as essential in managing justice-involved individuals, yet fundamental differences in goals, values, and methods exist between mental health and criminal justice professionals. This article presents a six-step conceptual framework for optimal mental health-criminal justice collaboration to prevent criminal recidivism among individuals with serious mental illness who are under criminal justice supervision in the community. Combining best practices from each field, the stepwise process includes engagement, assessment, planning and treatment, monitoring, problem solving, and transition. Rationale and opportunities for collaboration at each step are discussed.

Drug Courts - Just the Beginning: How to Get Other Areas of Public Policy in Sync? Addressing Continuing Collateral Consequences for Drug Offenders

In 2003, I prepared an article for the Middle Eastern-Mediterranean Summer Institute on Drug Use: “Drug Courts – Just the Beginning: Getting Other Areas of Public Policy in Sync” which highlighted five areas of public policy in the U.S., unconnected to the criminal justice, that imposed significant ― and generally lifetime ― sanctions on drug court graduates regardless of their successful completion of a drug court program and termination from criminal justice supervision. At that time, the extensive research corroborating the effectiveness of drug courts in reducing drug use, recidivism and promoting long term recovery was just beginning to be disseminated, along with scientific findings relating to the neurobiology of addiction, its effects on the brain and cognitive functioning ― all confirming that drug use was a symptomatic of a chronic disease and far more than a “behavioral” issue and/or moral failing. Given these extensive research findings, as well as over a decade of drug court experience at the time, it was therefore discouraging, but not unexpected, that the impact of the research had not yet affected public policy and practice in sectors not directly involved with drug offending and/or treatment. Given the commonly held premise that it takes seventeen years for research to affect practice, I prepared this “update” to determine the degree to which these research findings have now “infiltrated” practice. The intention in preparing this “Update” ten years later was to document progress made in reducing these areas of stigma ― come to be known as “collateral consequences” ― in light of the tremendous growth of drug courts since the article was first published in 2003, both in the U.S. and abroad, the widely documented effectiveness of these programs in stemming continued drug use and crime, and the growing body of research documenting addiction as a chronic disease for which treatment has proven effective and incarceration in and of itself to be counter-effective. The expectation was that progress in removing stigma associated with addiction would have been significant during these years. The results, however, have been the opposite. While there has been some progress, it has been slow and spotty, and the situation in 2014 can be characterized by continued stigma imposed by multiple sectors of public policy on individuals who have successfully completed drug court programs and which, in many instances, extend for their lifetime. Not only do the major areas of stigma described in the 2003 article continue but, in addition, the preparation of this “Update” has uncovered numerous additional “collateral consequences” that hadn’t formally surfaced in 2003 ― exclusions regarding the right to adopt children, grounds for divorce, and a host of professional license requirements.

“On papers”: perceptions of synthetic cannabinoid use among black males under criminal justice supervision

BackgroundA number of studies reveal a strong linkage between SC use and avoiding positiveurine creens. Despite this work and given the high rates of criminal justice supervision among Black men in the U.S., little is known about SC usage among Black men under criminal justice supervision.MethodsIn-depth qualitative interviews were conducted with 11 Black men under criminal justicesupervision treated by an urban ED for violent injury.ResultsThemes that emerged from the analysis include 1) prevalence of use, 2)health literacy, 3) availability and costs, 4) negative side effects, and 5) criminal justice supervision.ConclusionsCriminal justice supervision policies are a contributing factor to SC use among Black men under criminal justice supervision.

Varieties of Veterans’ Courts: A Statewide Assessment of Veterans’ Treatment Court Components

Since the mid-2000s, there has been an upsurge in the development of Veterans’ Treatment Courts (VTCs) to support justice-involved veterans’ treatment needs while also providing criminal justice supervision. Despite their prolific development in recent years, there is a dearth of scholarly research on how VTCs are structured and whether there are common components across courts. There is a need to understand how VTCs are structured and operationally implemented to inform additional program planning and evaluation. To bridge this gap in the literature, this study provides a statewide assessment of the 17 VTCs operating in Pennsylvania, identifies six common components, and highlights areas in which their implementation diverges between courts to meet the specific needs of veterans across Pennsylvania. The results of this study provide a baseline framework to aid future researchers in conducting process and outcome evaluations by documenting and examining the common components of VTCs.

The cost-effectiveness of implementing in-person and computerized interventions to enhance treatment receipt among drug-involved probationers in two US jurisdictions (Economics of SBI Symposium)

Background In the United States 1 in 45 adults is under criminal justice supervision in the community, and substance use is prevalent among this population. Treatment for this population has been shown to be generally cost-effective and cost-beneficial. Relatively little is known about the costeffectiveness of services to enhance treatment receipt among drug-involved probationers. This study assesses the relative cost and cost-effectiveness of face-to-face motivational interview (MI), a motivational computer program (MC), and probation services as usual in a controlled clinical trial. The protocol is to deliver two sessions in the MI and MC arms.

Methadone maintenance treatment may improve completion rates and delay opioid relapse for opioid dependent individuals under community corrections supervision

AimsSeveral studies have demonstrated the importance of agonist therapies such as methadone and buprenorphine for preventing relapse for individuals being released from jail or prison to the community. No studies have examined the impact of methadone for increasing the completion of community supervision requirements and preventing opioid relapse for individuals under community corrections supervision. This observational study compared the community corrections completion rate and opioid relapse rate of individuals receiving methadone maintenance therapy (MMT) to individuals who did not. MethodsOf the 2931 individuals enrolled under criminal justice supervision in the community, Treatment Accountability for Safer Communities (TASC), and who met criteria for opioid dependence, 329 (11%) individuals reported receiving MMT in the community. ResultsThe majority of participants were White (79.8%) and male (63.5%), with a mean age of 31.33years (SD=9.18), and were under supervision for 10.4months (SD=9.1). MMT participants were less likely to fail out of supervision compared to individuals not in MMT (39.0% vs. 52.9%, p<0.001), and had a lower rate of relapse (32.9%) and longer time to relapse (average days=89.7, SD=158.9) compared to the relapse rate (55.9%) and time to relapse (average days=60.5, SD=117.9) of those not on MMT. ConclusionsWhile the observational nature of this study prevents causal inferences, these results suggest that utilization of MMT in community corrections may increase the likelihood of completing supervision requirements and delay time to opioid relapse. Providing agonist therapies to opioid dependent individuals under supervision appears to be a critical strategy in this important population.

Expectancies for the effectiveness of different tobacco interventions account for racial and gender differences in motivation to quit and abstinence self-efficacy.

Racial and gender disparities for smoking cessation might be accounted for by differences in expectancies for tobacco interventions, but few studies have investigated such differences or their relationships with motivation to quit and abstinence self-efficacy. In this cross-sectional study, 673 smokers (African American: n = 443, 65.8%; women: n = 222, 33.0%) under criminal justice supervision who enrolled in a clinical smoking cessation trial in which all received bupropion and half received counseling. All participants completed pretreatment measures of expectancies for different tobacco interventions, motivation to quit, and abstinence self-efficacy. The indirect effects of race and gender on motivation to quit and abstinence self-efficacy through expectancies for different tobacco interventions were evaluated. African Americans' stronger expectancies that behavioral interventions would be effective accounted for their greater motivation to quit and abstinence self-efficacy. Women's stronger expectancies for the effectiveness of pharmacotherapy accounted for their greater motivation to quit, whereas their stronger expectancies for the effectiveness of behavioral treatments accounted for their greater abstinence self-efficacy. Findings point to the mediating role of expectancies for treatment effectiveness and suggest the importance of exploring expectancies among African Americans and women as a way to augment motivation and self-efficacy.

Relationship of Trauma Exposure and Substance Abuse to Self-Reported Violence Among Men and Women in Substance Abuse Treatment

Past research showed a relationship between substance abuse and aggression and past trauma and aggression. The nature of the relationships between substance use, trauma, and aggression is inconclusive. The current research hypothesized greater aggression among those with a history of substance abuse and trauma compared with those without such a history and an additive relationship between substance abuse and trauma on aggression. Participants were 615 individuals in a substance abuse treatment program for individuals under criminal justice supervision. Data were collected from face-to-face interviews and self-report measures. Univariate and multivariate analyses assessed the relationships among substance use, trauma, and aggression. Participants with a history of trauma and regular substance use reported the highest rates of homicidal ideation, problem behaviors, and person offenses. Participants in this group also reported greater desire for help managing their stress and tension, dealing with problems in their intimate relationships, developing healthier relationships in general, and learning prosocial approaches to express their feelings. Substance abusing participants who experienced trauma reported more externalizing behaviors and a greater desire for coping- and social-skills training than participants who abused substances but did not report a history of trauma. This suggests that participants in substance abuse treatment programs may have improved outcomes with the addition of components to address these issues.

Effects of Imprisonment and Community Supervision on Neighborhood Political Participation in North Carolina

This article considers the effect of prison, probation, and parole on neighborhood political participation in North Carolina. I analyze data from state boards of elections, departments of corrections, departments of public health, the Census Bureau, and market research firms for 2000 and 2008. Multivariate regressions reveal a complex relationship between criminal justice supervision and voter turnout. The evidence suggests that at the individual level and in the aggregate, the criminal justice system shapes neighborhood political participation.

Bridging the gap between health and justice

What does health have to do with justice? Everything! More than seven million people in the United States are currently under some form of criminal justice supervision, and control (whether in jail, prison, or on probation or parole), and they have somatic and mental health issues in rates that are much higher than those found in the general population. Ignoring these issues will contributes to health disparities and negative outcomes and this will be unjust—not only for those individuals—for the communities in which they live (or will live, upon release), and for human kind in general. As this article will show, the health needs of this population are also of paramount importance to those within specific communities, even if they are not currently involved with the criminal justice system. It is thus critically important to bridge the gap between the fields of public health and criminal justice by promoting an interdisciplinary discourse that brings together professionals and scholars from both ends of the justice and health spectrum; and thus better serve society, and address health disparities issues that affect health and justice. Criminal justice practitioners and public health workers may, at first glance, seem to be in unrelated (sometimes even opposing) fields, but in fact, they share many of the same challenges, as they both deal with human beings, environments, and public safety. Yet these two fields have long operated in parallel universes, and only recently has that approach begun to change. Scholars, practitioners, and policy makers from both sides have started to share ideas and information in an effort to create a better response to rising challenges that concern both fields. So far, most of the work has been related to incarcerated offenders and their rehabilitation and reintegration, but health-related issues are also relevant for examining and intervening with non-incarcerated criminal justice populations. As Levy (2007) states, “...public health practices inform and empower individuals and communities, and create healthy environments through the use of evidence-based

Treatment Outcomes of African American Buprenorphine Patients by Parole and Probation Status.

This secondary analysis compared outcomes of African-American adults newly-admitted to buprenorphine treatment who were on parole and probation to patients who were not under criminal justice supervision. Buprenorphine patients (N=300) were randomly assigned to receive either Intensive Outpatient Treatment (IOP) or Standard Outpatient Treatment (OP) treatment and were assessed at baseline, 3- and 6-months. There were no differences between groups in treatment retention. Among probationers/parolees, IOP was associated with lower 3-month treatment retention compared to OP, but among participants not on probation/parole the relationship was reversed (p=.004). Both conditions showed significant declines in heroin and cocaine use, illegal activity, and in meeting DSM-IV criteria for opioid and cocaine dependence. Probationers/parolees reported lower frequency of illegal activities at 3-months compared to non-probationers/parolees (p=.007). Buprenorphine treatment should be made more widely available to individuals on parole/probation as they respond as well to treatment as patients not supervised by the criminal justice system.

Looking Past The Hype: 10 Questions Everyone Should Ask About California’s Prison Realignment

DOI 10.1515/cjpp-2013-0011 Calif. J. Politics Policy 2013; 5(2): 266–306 Joan Petersilia* and Jessica Greenlick Snyder Looking Past The Hype: 10 Questions Everyone Should Ask About California’s Prison Realignment Abstract: California’s Criminal Justice Realignment Act passed in 2011 shifted vast discretion for managing lower-level offenders from the state to the county, allocated over $2 billion in the first 2 years for local programs, and altered sen- tences for more than 100,000 offenders. Despite the fact that it is the biggest penal experiment in modern history, the state provided no funding to evaluate its overall effect on crime, incarceration, justice agencies, or recidivism. We provide a frame- work for a comprehensive evaluation by raising 10 essential questions: (1) Have prison populations been reduced and care sufficiently improved to bring prison medical care up to a Constitutional standard? (2) What is the impact on victim rights and safety? (3) Will more offenders participate in treatment programs, and will recidivism be reduced? (4) Will there be equitable sentencing and treatment across counties? (5) What is the impact on jail crowding, conditions, and litiga- tion? (6) What is the impact on police, prosecution, defense, and judges? (7) What is the impact on probation and parole? (8) What is the impact on crime rates and community life? (9) How much will realignment cost? Who pays? (10) Have we increased the number of people under criminal justice supervision? Keywords: prison realignment; California corrections; criminal justice; prisons; probation and parole; Jails; victim’s rights; penology. *Corresponding author: Joan Petersilia, PhD, Adelbert H. Sweet Professor of Law at Stanford Law School, Co-Director of Stanford’s Criminal Justice Center, 559 Nathan Abbott Way, Stanford Law School, CA 94305, USA, e-mail: petersilia@law.stanford.edu Jessica Greenlick Snyder: 559 Nathan Abbott Way, Stanford Law School, CA 94305, USA 1 Introduction On April 2, 2011, Governor Jerry Brown signed into law Assembly Bill 109, the Criminal Justice Realignment Act of 2011. AB 109, commonly referred to as “rea- lignment,” took effect on October 1, 2011. AB 109 passed the legislature in a matter of hours after being introduced, and without any public input. Despite some mis- leading headlines, the law did not require the state to release anyone currently

Recidivism among Participants of a Reentry Program for Prisoners Released without Supervision

As higher numbers of individuals are released from prison and rejoin society, reentry programs can help former offenders reintegrate into society without continuing to engage in crime. This quasi-experimental study examined whether participation in reentry programming was associated with reduced recidivism among offenders who were no longer under criminal justice supervision. Offenders who completed their sentences in prison were invited to participate in Project Re-Connect (PRC), a six-month, voluntary prisoner reentry program. Following participants' release from prison, PRC provided case management and direct monetary support to participants for up to six months. Survival analysis was used to compare recidivism rates between 122 PRC participants and 158 eligible non-participants. Cox regression coefficients indicated that program participation and having a high school diploma or its equivalent were associated with reduced likelihood of new convictions, whereas substance abuse was associated with higher risk of subsequent convictions. The implications for social work policy and practice are discussed. KEY WORDS: case management; former offenders; prisoner reentry; program evaluation ********* The U.S. prison population has grown exponentially over the past 30 years, at great cost to taxpayers and offenders alike. Between 1980 and 2008, the prison population expanded by 475%, reaching 1,518,559 in 2008 (Bureau of Justice Statistics, 2010). Policy changes fueled this rapid growth, as many states adopted mandatory and determinant sentencing guidelines that resulted in more individuals serving longer prison terms. Meanwhile, stricter parole requirements returned mote ex-offenders to prison on technical parole violations (Seiter & Kadela, 2003; Zhang, Roberts, & Callanan, 2006). Parole violators who complete their sentences in prison are no longer subject to supervision once released from prison, thereby restricting society's ability to monitor and assist these individuals during reentry (Braga, Piehl, & Hureau, 2009; O'Brien, 2009; Seiter & Kadela, 2003). The number and the rate of inmates released without parole supervision have increased even over the last decade, as the number of unsupervised releases grew from 118,886 in 2000 (20.4% of all released) to 165,568 in 2008 (24.2% of all releases) (Sabol, West, & Cooper, 2009; Seiter & Kadela, 2003). Former offenders commit crimes at higher rates than the general population, so in combination with technical parole violations, many ex-offenders recidivate and return to prison within the first few years of release (Brad et al., 2009). As of 1994, more than two-thirds of state prisoners were rearrested for one or more serious crimes within three years of release. Almost half of those released returned to prison during that time frame for parole violations or new convictions (Langan & Levin, 2002). Prisoner reentry has become a critical topic as communities prepare to absorb increasing numbers of returning former offenders; 683,106 inmates were released from state or federal prisons in 2008, an increase of nearly 20% over the number released in 2000 (Petersilia, 2003; Roman & Travis, 2006; Sabol et al., 2009; Seiter & Kadda, 2003; Wilson & Davis, 2006). Reentry programs have been developed nationwide to address offender needs and smooth the transition from prison into the community. RISK FACTORS FOR REENTRY, CURRENT PRACTICE, AND EMPIRICAL EVIDENCE Several risk factors increase the likelihood that ex-offenders will return to prison on new charges. These risk factors include age, gender, race, gang membership, substance abuse, antisocial behavior, low social achievement, negative peers, length of prior criminal history, and the number of years incarcerated before release (Braga et al., 2009; Gendreau, Little, & Goggin, 1996; Huebner, Varano, & Bynum, 2007; Langan & Levin, 2002; Listwan, 2009; O'Brien, 2009; Seiter & Kadela, 2003; Wheeler & Patterson, 2008; Wilson & Davis, 2006; Yahner & Visher, 2008). …

Does mandating offenders to treatment improve completion rates?

While it is known that community-based outpatient treatment for substance abusing offenders is effective, treatment completion rates are low and much of the prior research has been conducted with offenders in residential treatment or therapeutic communities. The aim of the present study was to assess whether offenders who are mandated to community-based outpatient treatment have better completion rates compared to those who enter treatment voluntarily. The 160 research participants were a heterogeneous group of substance abusers who were under various levels of criminal justice supervision (CJS) in the community. The participants were enrolled in an intensive outpatient program and were recruited into the study between July 2007 and October 2010. All offenders received weekly therapy sessions using a cognitive problem solving framework and 45% completed the 6month treatment program. Interestingly, those who were mandated demonstrated less motivation at treatment entry, yet were more likely to complete treatment compared to those who were not court-ordered to treatment. While controlling for covariates known to be related to treatment completion, the logistic regression analyses demonstrated that court-ordered offenders were over 10 times more likely to complete treatment compared to those who entered treatment voluntarily (OR=10.9, CI=2.0–59.1, p=.006). These findings demonstrate that stipulated treatment for offenders may be an effective way to increase treatment compliance.

Reverse Social Work's Neglect of Adults Involved in the Criminal Justice System: The Intersection and an Agenda

Social work has neglected adults involved in the criminal justice system for nearly four decades. This neglect has been attributed to value conflicts between social work and criminal justice professionals, perceived limited effects of interventions with adults involved in the criminal justice system, and lack of social work training in services to those involved in the criminal justice system (Scheyett, Pettus-Davis, McCarter, & Bringham, 2012). Meanwhile, the number of adults under criminal justice supervision has increased sevenfold. Nearly 24 million people cycle through the U.S. criminal justice system each year. On any given day, 2.3 million people are held in state and federal prisons or local jails, and more than 7.2 million people are under some form of criminal justice supervision (Glaze, Bonczar, & Zhang, 2010; Sabol & West, 2010). Fear-driven and conceptually devoid policies adopted since the 1970s have turned America into a carceral state with criminal justice supervision rates higher than those in most nations in the world (Gottschalk, 2011). The reach of criminal justice involvement extends well beyond the sentence for a crime committed. During the time period that social work disengaged from the criminal justice system, policies proliferated throughout the United States to exclude justice-involved adults from conventional means of citizenry. A felony conviction permanently bans adults from a multitude of housing, employment, education, social service, and civic participation (for example, voting) opportunities. These exclusionary policies impede social mobility and propagate intergenerational transmission of inequality (Wakefield & Uggen, 2010). Despite the enormous implications for social justice, social workers remain silent. Therefore, it seems important to remind fellow social workers that almost every facet of social work intersects with criminal justice. RACIAL DISPARITIES More than 60% of prisoners in the United States are racial or ethnic minorities (Sentencing Project, 2011). Arrest rates for African Americans are double the national average (Bureau of Justice Statistics, 2011). African Americans make up half of the prison and parole populations and one-third of the probation population but only 12% of the general population (Glaze et al., 2010; Sabol & West, 2010). If current trends continue, one in three African American men and one in six Hispanic men will go to prison at some point during their lifetime, compared with one in 17 white men (Bonczar, 2003). POVERTY Nearly half of prisoners in 2004 had been in poverty in the year prior to their arrest (Wheelock & Uggen, 2006). The rate of homelessness among prisoners is four to six times the rate of homelessness among the general population (Greenberg & Rosenheck, 2008). Earning potential is severely limited by involvement in the criminal justice system. A history of incarceration reduces annual income for men by 40% (Western & Pettit, 2010). Parental incarceration imposes hardship on families and negatively affects the economic and residential stability of children (Geller, Garfinkel, Cooper, & Mincy, 2009). EDUCATION Adults involved in the criminal justice system report poor educational histories. On average, only 13% of jail inmates have more than a high school education. Two-thirds of state prisoners and 44% of jail inmates have less than a high school education. Compared with 18% of the general population, one-third of adult probationers did not complete high school (Harlow, 2003; James, 2004). CHILD WELFARE More than 2.7 million children have a parent in jail or prison (Western & Pettit, 2010). Parental incarceration is related to aggression, delinquency, anxiety, and depression in children (Wakefield & Wildeman, 2011). National data indicate that at least 12.5% of children reported to child welfare authorities had parents who had been arrested (Phillips, Burns, Wagner, & Barth, 2004). …

Risk Factors for Cervical Cancer in Criminal Justice Settings

Women in criminal justice settings have an increased prevalence of cervical cancer compared with the general population. However, little is known about abnormal cervical cancer screening results among women in jail and community-based criminal justice settings. Thus, the aims of this study were to compare the prevalence of self-reported abnormal Papanicolou (Pap) test results in women in jail and under community criminal justice supervision and to examine factors associated with abnormal Pap tests in these criminal justice settings. We analyzed data from two cross-sectional surveys of women in jails and community corrections in two Southern cities (n=380) about their history of abnormal Pap tests and risk factors for cervical cancer. Univariate analyses (analysis of variance [ANOVA] and chi-square) and a binary logistic regression analysis were conducted to test associations between a history of abnormal Pap testing and factors known to be associated with cervical cancer. Nearly half of the women surveyed (n=163, 43%) reported ever having an abnormal Pap test. There was a high prevalence of risk factors for cervical cancer among women with and without an abnormal Pap test. After controlling for age and race, there were significant associations between an abnormal Pap test and inconsistent use of barrier protection (odds ratio [OR] 2.01, 95% confidence interval [CI] 1.18-3.43), having a history of gynecologic infections (OR 1.68, 95% CI 1.05-2.67), and having a history of sexually transmitted diseases (OR 1.92, 95% CI 1.17-3.15). Women in jail and under community justice supervision reported a high prevalence of risk factors for cervical cancer. Because of their high prevalence of abnormal Pap testing, women in criminal justice settings may be appropriate targets for improved cervical cancer screening, prevention with human papillomavirus (HPV) vaccination, risk reduction education, and treatment.