The justice-involved population is a high-needs, health disparity population.1 Individuals released from jails and prisons have a disproportionately high incidence of chronic health conditions, infectious diseases, sexually transmitted infections, substance use disorders, and medical and mental health co-morbidity.2 Since 70 to 90 percent of individuals released from jails and prisons have no health insurance, they are frequent users of high-cost local emergency medical services.3 Lack of health insurance coverage and lack of continuity of health care in the community upon release are associated with increased rates of recidivism, high health care costs, poor health outcomes and a 12-fold increase in the risk of death in the first two weeks after release.4 Poor health within the justice-involved population is a public health issue, a public safety issue and costly for taxpayers. The current project aims to engage justice-involved individuals with health information to enhance their knowledge and use of health services and resources. In this way, the project will empower participants toward improved health literacy, health insurance literacy, self-care management skills, health care decision- making and overall quality of life. The proposed project will make health-related modules available to justice- involved individuals incarcerated in 4 participating correctional facilities. The modules will be deployed using an existing, secure, tablet-based education system. The project has 4 specific aims: 1) Conduct a health needs assessment using the secure tablet platform to determine the health coverage eligibility status and special health information needs of justice involved individuals preparing for reentry into the community; 2) Deliver the health information curricula and training modules through the secure tablet platform; 3) Using pre- and post-training surveys, measure the impact of health information training on the level of health literacy and confidence to improve self-care management skills of incarcerated individuals preparing for reentry into the community; 4) Follow a sample of participants for 6 months after release from incarceration to collect post-release outcomes including: eligibility and status of health care coverage; frequency of visits to a health care provider; frequency of emergency room visits and/or hospitalizations; level of involvement in treatment programs for chronic health conditions, mental health or substance use disorder; level of compliance with medications; and frequency of return to incarceration. Positive results from this project could improve post-release outcomes for study participants, and facilitate the expansion of such programs throughout the criminal justice system.
PROJECT RELEVANCE TO PUBLIC HEALTH The proposed research will examine the impact of a tablet based health information resource in a justice-involved population during incarceration and post release. Health-based programming deployed on a secure, tablet-based system within correctional facilities will be designed to improve individual's health literacy, health insurance literacy, self-care management skills, health care decision-making and overall quality of life. Positive results from this project could not only benefit the justice-involved individuals participating in the study but could also advance the facilitation of such programs within the justice system.