Lifestyle and mood correlates of cardiometabolic risk in people with serious mental illness on second-generation antipsychotic medications.

Introduction: Cardiovascular morbidity and mortality are high in people with serious mental illness (SMI). This problem is mediated, at least in part, by metabolic side effects of second-generation antipsychotics (SGAs) and by unhealthy lifestyle behaviors. We asked whether oral glucose tolerance testing (oGTT) or hemoglobin A1c (HbA1c) is superior in identifying people with SMI at high cardiometabolic risk and whether this risk is shaped by mood, cognition, or lifestyle habits.

Motivation and accessing care among drug treatment court involved women: A sequential, mixed-methods approach.

Drug treatment courts (DTC) address substance use disorders (SUD) but not cooccurrencing HIV or hepatitis C virus (HCV). This pilot explored feasibility and preliminary outcomes of the Women's Initiative Supporting Health (WISH) intervention and health-related motivation, both based in self-determination theory (SDT) regarding HIV/HCV and SUD treatment. WISH feasibility study: 79 DTC women completed a one-time survey regarding motivation and willingness to engage in future interventions.

HIV/STI/HCV Risk Clusters and Hierarchies Experienced by Women Recently Released from Incarceration.

This study examines cross-sectional clusters and longitudinal predictions using an expanded SAVA syndemic conceptual framework-SAVA MH + H (substance use, intimate partner violence, mental health, and homelessness leading to HIV/STI/HCV risks)-among women recently released from incarceration (WRRI) (n = 206) participating in the WORTH Transitions (WT) intervention. WT combines two evidence-based interventions: the Women on the Road to Health HIV intervention, and Transitions Clinic. Cluster analytic and logistic regression methods were utilized.

Female Opioid Court Participants' Narratives of Siloed Medical, Legal, and Social Service Sector Interactions to Inform Future Integrated Interventions.

A gap exists regarding how to design gender-specific interventions for women charged with opioid use disorder (OUD)-related crimes. National recent efforts include opioid courts. Treatment courts present opportunities for earlier intervention for women under judicial supervision.

Trauma, Mental Health Distress, and Infectious Disease Prevention Among Women Recently Released From Incarceration.

Background: U.S. women recently released from incarceration experience significantly higher rates of trauma and exacerbation of mental health conditions, and the period following release has been identified as a window of heightened risk for mental health distress and human immunodeficiency virus (HIV), sexually transmitted infections (STI) and hepatitis C (HCV) transmissions.

FOCUS on women: Program evaluation of a pilot probation and primary care transitions clinic collaboration.

Gender-specific probation programs are needed for rising numbers of women on probation, as women's paths to probation differ from men's and are not as frequently addressed. Substance use, mental illness, health disparities, and barriers to treatment can contribute to women clients' unsuccessful completion of probation. The current study describes a process evaluation of the pilot Female Offenders Can Ultimately Succeed (FOCUS) program, which aimed to meet women probation clients' complex needs and improve their probation outcomes.

Women's Motivators to Engage in Opioid Use Disorder Treatment While Enrolled in an Opioid Intervention Court.

To address the rising presence of opioid use disorder in the United States, states have begun to implement specialized opioid intervention courts to provide immediate support for individuals at risk of opioid overdose. The present study sought to understand the motivations of women to engage in treatment while enrolled in an opioid intervention court. We conducted 31 in-depth, qualitative interviews with women enrolled in an opioid intervention court in Buffalo, NY, to better understand their motivation regarding opioid use treatment.

"I was 15 when I started doing drugs with my dad": Victimization, Social Determinants of Health, and Criminogenic Risk Among Women Opioid Intervention Court Participants.

The presence and severity of childhood and adult victimization increase the likelihood of substance use disorder (SUD), crimes, antisocial behaviors, arrests, convictions, and medical and psychiatric disorders among women more than men. These problems are compounded by the impact of social determinants of health (SDH) challenges, which include predisposition to the understudied, dramatic increase in opioid dependence among women. This study examined victimization, related SDH challenges, gender-based criminogenic risk factors for female participants, and public health opportunities to address these problems.

Empathy and boundary turbulence in cancer communication.

Objectives: To describe and deepen our understanding of patient-centeredness, empathy, and boundary management in challenging conversations. Previous studies show frequent physician self-disclosure, while empathy and boundary management are infrequent.

Methods: Three standardized patients (SPs) portrayed cancer patients consulting a new community-based physician, resulting in 39 audio-recorded SP visits to 19 family physicians and 20 medical oncologists.

The Transitions Clinic Network: Post Incarceration Addiction Treatment, Healthcare, and Social Support (TCN-PATHS): A hybrid type-1 effectiveness trial of enhanced primary care to improve opioid use disorder treatment outcomes following release from jail.

Background: In 2016, at least 20% of people with opioid use disorder (OUD) were involved in the criminal justice system, with the majority of individuals cycling through jails. Opioid overdose is the leading cause of death and a common cause of morbidity after release from incarceration. Medications for OUD (MOUD) are effective at reducing overdoses, but few interventions have successfully engaged and retained individuals after release from incarceration in treatment.

"I think everybody should take it if they're doing drugs, doing heroin, or having sex for money": a qualitative study exploring perceptions of pre-exposure prophylaxis among female participants in an opioid intervention court program.

Background: Women's rise in opioid use disorder has increased their presence in the criminal justice system and related risk behaviors for HIV infection. Although pre-exposure prophylaxis (PrEP) is an effective biomedical HIV prevention treatment, uptake among this high-risk population has been particularly low. Considerably little is known about the interplay between justice-involved women with opioid use disorder and HIV prevention.

Perceived Discrimination Based on Criminal Record in Healthcare Settings and Self-Reported Health Status among Formerly Incarcerated Individuals.

Perceived discrimination based on criminal record is associated with social determinants of health such as housing and employment. However, there is limited data on discrimination based on criminal record within health care settings. We examined how perceived discrimination based on criminal record within health care settings, among individuals with a history of incarceration, was associated with self-reported general health status.

"They didn't give up on me": a women's transitions clinic from the perspective of re-entering women.

Background: Women recently released from incarceration have increased rates of co-occurring substance use, physical health, and mental health disorders. During re-entry, they face challenges navigating needed health services and social services stemming from these problems. Women's Initiative Supporting Health Transitions Clinic (WISH-TC) is a primary care program that facilitates treatment access for re-entering women.

Corrections for Academic Medicine: The Importance of Using Person-First Language for Individuals Who Have Experienced Incarceration.

This Invited Commentary addresses the use of labels and their impact on people involved in the criminal justice system. There are 2.2 million adults incarcerated in the United States and close to 6.

A Qualitative Analysis of Family Dynamics and Motivation in Sessions With 15 Women in Drug Treatment Court.

Women with substance use disorders (SUDs) often experience inadequate health care, mental and physical health problems, trauma, lack of social support, and undermining of support for psychological needs of autonomy, competence, and relatedness needed for motivation and well-being. For women with SUD trying to reclaim sobriety and a healthy life, family can present both barriers and support. The aim of this study is to gain a deeper understanding of the intersection of family relationships with motivation of women in Drug Treatment Court (DTC) to attain their health goals.

Outcomes among pregnant recently incarcerated women attending a reentry transitions clinic.

This mixed methods retrospective case series and qualitative descriptive study describes pregnancy outcomes during the postincarceration period. A retrospective case series via electronic medical record chart review from a subset of women attending a postincarceration primary care clinic with a condition of interest (pregnancy) described demographics, substance use, diagnoses, and pregnancy outcomes. We compared 27 pregnant to 79 nonpregnant women and contextualized quantitative data with qualitative descriptive vignettes.

IDENTIFYING PREDICTORS OF SUBSTANCE USE AND RECIDIVISM OUTCOME TRAJECTORIES AMONG DRUG TREATMENT COURT CLIENTS.

Drug treatment court (DTC) is a diversion program for individuals with drug-related crimes. However, the DTC literature is conflicting with regard to substance use and recidivism outcomes. This study examines factors associated with improved client outcome trajectories among a multisite, national DTC sample.

Does a Primary Health Clinic for Formerly Incarcerated Women Increase Linkage to Care?

Objective: This study examined a primary care-based program to address the health needs of women recently released from incarceration by facilitating access to primary medical, mental health, and substance use disorder (SUD) treatment.

Study Design: Peer community health workers recruited women released from incarceration within the past 9 months into the Women's Initiative Supporting Health Transitions Clinic (WISH-TC). Located within an urban academic medical center, WISH-TC uses cultural, gender, and trauma-specific strategies grounded in the self-determination theory of motivation.

"Our commonality is our past:" a qualitative analysis of re-entry community health workers' meaningful experiences.

Background: Re-entry community health workers (CHWs) are individuals who connect diverse community residents at risk for chronic health issues such as Hepatitis C virus and cardiovascular disease with post-prison healthcare and re-entry services. While the utilization of CHWs has been documented in other marginalized populations, there is little knowledge surrounding the work of re-entry CHWs with individuals released from incarceration. Specifically, CHWs' experiences and perceptions of the uniqueness of their efforts to link individuals to healthcare have not been documented systematically.

Finding the loopholes: a cross-sectional qualitative study of systemic barriers to treatment access for women drug court participants.

Background: Therapeutic diversion courts seek to address justice-involved participants' underlying problems leading to their legal system involvement, including substance use disorder, psychiatric illness, and intimate partner violence. The courts have not addressed systemic hurdles, which can contribute to a cycle of substance use disorder and recidivism, which in turn hinder health and wellness. The study purpose is to explore the systemic issues faced by women participants in drug treatment court from multiple perspectives to understand how these issues may relate to health and wellness in their lives.

Does gender matter? Exploring mental health recovery court legal and health outcomes.

Background: Based upon therapeutic justice principles, mental health courts use legal leverage to improve access and compliance to treatment for defendants who are mentally ill. Justice-involved women have a higher prevalence of mental illness than men, and it plays a greater role in their criminal behavior. Despite this, studies examining whether women respond differently than men to mental health courts are lacking.

Meeting health and psychological needs of women in drug treatment court.

We explored healthcare-related experiences of women drug court participants through combining context from the socio-ecological model with motivation needs for health behavior as indicated by self-determination theory. Five focus groups with 8 women drug court participants, 8 court staff, and 9 community service providers were examined using qualitative framework analysis. Themes emerged across the socio-ecological model and were cross-mapped with self-determination theory-defined motivation needs for autonomy, relatedness, and competence.

Physicians criticizing physicians to patients.

Background: Teamwork is critical to providing excellent healthcare, and effective communication is essential for teamwork. Physicians often discuss patient referrals from other physicians, including referrals from outside their primary institution. Sharing conflicting information or negative judgments of other physicians to patients may be unprofessional.

"They told me to leave": how health care providers address intimate partner violence.

Background: Intimate partner violence (IPV) victims frequently seek medical treatment, though rarely for IPV. Recommendations for health care providers (HCPs) include IPV screening, counseling, and safety referral. The objective of this study was to report women's experiences discussing IPV with HCPs.

"An effect that is deeper than beating": family violence in Jordanian women.

This study informs health care approaches to gender-based family violence through focus groups with Jordanian women. The authors conducted a thematic qualitative analysis of 12 focus groups among 70 married, divorced, or widowed women about their experiences and beliefs regarding family violence. Five themes relevant to health care providers were identified.