Individuals released from correctional facilities have high rates of hospitalization and death, especially in the weeks following release. Disproportionately poor and of racial and ethnic minority groups, they are already a high-risk group for poor health outcomes. The transition back to the community is marked with additional difficulties navigating the healthcare, community correctional, and social service systems and structural barriers to obtaining healthcare, housing, and employment. Individuals released from correctional facilities must engage with many providers, which presents challenges organizing and acting on information received from various organizations. Personal health information technologies are untapped resources which could improve the transition from corrections to the community and mitigate health risks. There is an urgent need to develop personal health information technologies in partnership with formerly incarcerated individuals and test their efficacy in improving health outcomes. Using these technologies, formerly incarcerated individuals could organize, understand and act on various sources of information, leading to improved self-efficacy and improved health outcomes. Yet, there has not been a personal health information technology designed to meet the needs and preferences of this population, which is critical for its acceptance and use. The long-term goal is to improve the health of formerly incarcerated people, facilitated by their use of personal health information technologies. The overall objective of this proposal is to develop and test strategies, in partnership with formerly incarcerated people, to increase acceptance and use of a personal health library (PerHL) mobile app. Preliminary data indicate that using a participatory health informatics approach to engage people with histories of incarceration can lead to acceptance and use of a health technology. The central hypothesis of our study is that developing and refining PerHL in partnership with formerly incarcerated people will increase its acceptance and use. To test this hypothesis, we propose three aims: (1) Assess the facilitators and barriers of the development and use of personal health information technology for formerly incarcerated individuals, (2) Develop and refine PerHL for formerly incarcerated individuals, and (3) Conduct a pilot randomized trial to test the acceptance and use of PerHL among formerly incarcerated individuals. We will leverage the expertise and infrastructure of Transitions Clinic Network, a national network of primary care clinics for formerly incarcerated people, and a multidisciplinary team of informaticists, clinical providers, formerly incarcerated individuals, and criminal justice leaders, creating a best-case scenario for developing PerHL. This study represents a new and substantial departure from the status quo by incorporating a participatory health informatics approach and state of the art informatics tools into the development and refinement of a personal health information technology for people recently released from correctional facilities.
Ten million individuals, who are disproportionately of racial/ethnic minority groups, low socioeconomic status, and have a high burden of chronic conditions are released from jails and prisons annually. At release, they are at heightened risk of poor health outcomes given the abrupt change in environment and structural barriers to healthcare, housing, and employment and the lack of access to their own health information and social resources. The proposed study will develop and refine a person health library mobile app in partnership with formerly incarcerated individuals and establish the evidence to test its efficacy to improve health outcomes.
