Health and Justice最新文献

{"title":"Differences in opioid use and overdose among younger and older justice-impacted adults.","authors":"Meghan M O'Neil, Wayne Kepner, Garland Gerber, Thomas Wojciekowski, Debra Pinals","doi":"10.1186/s40352-025-00367-z","DOIUrl":"10.1186/s40352-025-00367-z","url":null,"abstract":"<p><strong>Background: </strong>Justice-impacted persons aged 40 and up with substance use disorders (SUD) demonstrate increased health risks and health disparities relative to general population peers. Persons with SUD are less likely to age out of criminal behavior, appearing on criminal dockets, in jails, prisons, and under community supervision throughout the life course, with greater community-level cost burdens as they age. Justice system involvement presents health risks that compound with SUD to undermine well-being, which is amplified as people age and experience age-related health decline. Propensity for premature mortality from overdose is startlingly high for this population, highlighting demand for targeted policies to better meet the needs of this vulnerable group. To better understand justice-impacted older adults in treatment for SUD and inform policy, we examined opioid use outcomes among 357 low-income justice-impacted adults in SUD treatment in the Midwest, USA, including a natural oversampling of Black and American Indian or Alaska Native (AIAN) persons. We explored patterns among persons in their 40s, 50s, and 60s, relative to those under 40, conceptualizing life-course risk factors and using logistic regression to assess overdose, opioid use, and opioid agonist medication use.</p><p><strong>Results: </strong>Significant differences in opioid use by age were observed, with older persons less likely to report opioid prescription misuse or illicit opioid use. Differences were not significant once controlling for user preferences, race/ethnicity, gender, family, childhood, and life course experiences. Overdose history was also significantly less likely for the 40 and older SUD patient, though this was no longer significant when controlling for demographic covariates. Opioid agonist medication use did not significantly differ by age.</p><p><strong>Conclusions: </strong>Justice-involved patients aged 40 and up in SUD treatment were less likely to have experienced overdose or report opioid use, relative to their younger peers, but this variation dissipated when considering demographic, family and/or life course factors. Targeted treatment services for gender and racial minorities may be beneficial for patients 40 and up. We identify preference for one substance, versus two, as protective against overdose and opioid use among older persons who use drugs.</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":"13 1","pages":"63"},"PeriodicalIF":2.6,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12574194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145410243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Latinas' perception of law enforcement who respond to intimate partner violence calls: a qualitative inquiry.","authors":"Sharon Gandarilla-Javier, Dasha J Rhodes, Kelsey Greenfield","doi":"10.1186/s40352-025-00374-0","DOIUrl":"10.1186/s40352-025-00374-0","url":null,"abstract":"<p><p>This qualitative study explores the lived experiences of undocumented Latina survivors of intimate partner violence (IPV) and their interactions with law enforcement. Existing literature identifies Latina immigrants as disproportionately affected by IPV, but limited research has focused on how undocumented status intersects with survivors’ seeking help and police interactions. Using semi-structured interviews with 17 women from Central and South America, thematic analysis reveals deep mistrust of police and a lack of cultural competency among officers. Findings underscore the need for trauma-informed, culturally responsive policing to ensure the safety and dignity of undocumented IPV survivors.</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":"13 1","pages":"61"},"PeriodicalIF":2.8,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12533431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145303827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of harm reduction strategies in criminal-legal systems: a scoping review of the literature.","authors":"Kiersten L Johnson, Sheila V Patel, Jessica Cance, Ivette Rodriguez Borja, Mia-Cara Christopher, Jennifer Counts, Monica Desjardins, Sarah M Philbrick, Leo Beletsky, Bradley Ray","doi":"10.1186/s40352-025-00369-x","DOIUrl":"10.1186/s40352-025-00369-x","url":null,"abstract":"<p><strong>Background: </strong>Harm reduction is a public health approach that emphasizes strategies to reduce the negative consequences of drug use. Rising overdose deaths in the United States have prompted integration of harm reduction strategies within criminal-legal systems (CLS), which have historically emphasized deterrence. However, the scope and nature of these strategies across the CLS remain poorly understood.</p><p><strong>Methods: </strong>We conducted a scoping review, in accordance with PRISMA guidelines, to identify harm reduction strategies targeting illicit drug use that have been implemented within CLS settings in the United States. We searched seven databases for peer-reviewed articles published in the last 10 years. Eligible articles reported on implementation of a harm reduction strategy focused on reaching PWUD in a CLS setting. Using the Sequential Intercept Model as a guiding framework, we mapped strategies to law enforcement, initial detention/court hearings, jails and courts, reentry, and community corrections settings. We used DistillerSR to screen articles and abstract data.</p><p><strong>Results: </strong>From 455 records, 99 articles met inclusion criteria, representing 51 discrete instances of harm reduction strategy implementation. Implementation was most common in custody settings (e.g., jails and courts) and frequently included initiation of medication for opioid use disorder, naloxone distribution, and CLS referral/diversion. Fewer instances of implementation were documented in early stage or community-based settings. CLS staff were directly involved in delivering over 75% of the harm reduction strategies, and one-third included partnerships with non-CLS government agencies. Nearly one-third of the strategies were implemented as part of research studies.</p><p><strong>Conclusions: </strong>Harm reduction strategies have increasingly been integrated into CLS, though unevenly and often with a narrow clinical focus. Expanding harm reduction within CLS will require broader definitions, system-level buy-in, and efforts to align practice with public health evidence.</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":"13 1","pages":"62"},"PeriodicalIF":2.8,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12532404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145303812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing real-time assessments of substance use cravings, triggers, and mood: a feasibility study with justice-involved populations.","authors":"Ginnie Sawyer-Morris, McKenna Halverson, Kelly M Maher, Steven B Carswell, Michael S Gordon","doi":"10.1186/s40352-025-00372-2","DOIUrl":"10.1186/s40352-025-00372-2","url":null,"abstract":"<p><p>BACKGROUND: The Daily Progress System (DPS) is a daily mobile health monitoring tool that allows clients with opioid use disorder to track substance use, recovery-related symptoms, and recovery support activities (e.g., 12-step groups) over a 24-hour period. This pilot study explored the feasibility of equipping the DPS with an ecological momentary assessment (EMA) feature. METHODS: Thirty participants with justice involvement were recruited from an outpatient addiction treatment clinic in Maryland. Participants completed an integrated 14-day DPS + EMA protocol that assessed cravings, triggers, and mood three times per day (3–7 items; morning, afternoon, evening), and recovery-related symptoms and activities once per day (DPS, 10 items; evening). Financial incentives were provided for each survey completed. Descriptive statistics described sample characteristics and usage metrics (e.g., compliance). Friedman and Wilcoxon signed-rank tests were used to compare differences in non-normal compliance rates based on time of day and survey type. RESULTS: Overall compliance with the EMA and DPS surveys was excellent (91.9%). No significant differences in compliance were observed based on time of day or survey type. In terms of acceptability, participants reported high overall satisfaction (MEMA = 8.9/10; MDPS = 9.5/10) and reported that the surveys were easy to understand (MEMA = 4.9/5; MDPS = 4.8/5). Qualitative feedback suggested that the EMA surveys helped participants identify patterns and glean additional insights into their mood, cravings, and triggers. Participants provided suggestions for future development, such as incorporating additional opportunities to report cravings and triggers outside of the primary delivery windows. CONCLUSION: These findings suggest that equipping the DPS with real-time assessments of cravings, triggers, and mood is feasible and acceptable among individuals with justice involvement who are engaged in outpatient treatment. Further research is needed with larger samples and over longer periods of time to evaluate the long-term benefits of this approach and its potential to enhance treatment adherence, patient engagement, and downstream recovery outcomes. However, these findings support the continued development and refinement of the DPS equipped with real-time assessments. </p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":"13 1","pages":"60"},"PeriodicalIF":2.8,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12532816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145303817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the health and well-being impacts and implementation barriers and facilitators of legally-mandated non-custodial drug and alcohol treatment for justice-involved adults: a qualitative evidence synthesis.","authors":"Emma Fiona France, Louise Hoyle, Pauline Campbell, Hilda Bissozo Hernandez, Julie Cowie, Candida Fenton, Hannah Carver, Catriona Connell, Joshua Dumbrell, Rosie Hill, Fiona Blacklaw, Nihr Evidence Synthesis Scotland Initiative Nessie, Bridget Davis","doi":"10.1186/s40352-025-00361-5","DOIUrl":"10.1186/s40352-025-00361-5","url":null,"abstract":"<p><strong>Background: </strong>Non-custodial judicial treatment orders aim to reduce recidivism for justice-involved people with drug and/or alcohol use problems, but health and well-being impacts are not understood. We conducted the first qualitative evidence synthesis to explore the perceived impacts on health and well-being of treatment orders and the perceived barriers and facilitators to implementation from the perspectives of justice-involved adults, their family members/significant others, and staff delivering/ mandating the treatment.</p><p><strong>Design: </strong>We searched 14 bibliographic databases (31/10/2023-07/11/2023) and conducted supplementary searches to identify qualitative evidence. Two reviewers appraised methodological limitations using CASP and assessed confidence in review findings using GRADE-CERQual. We used framework synthesis to synthesise evidence. We integrated synthesised findings with results of a complementary quantitative review investigating health and well-being effects of treatment orders.</p><p><strong>Results: </strong>We synthesised 25 studies (29 reports); 22/29 reports had moderate or high methodological limitations. Most studies (n = 20) focused on USA drug courts; none focused on alcohol interventions. Only three studies had health and well-being as their main focus. No studies involved family members. Only one study reported a theory of how treatment orders might impact health. GRADE-CERQual assessments of 13 findings were high (n = 7/13), moderate (n = 4/13), or low (n = 2/13) confidence. Justice-involved adults perceived treatment orders to reduce mortality/morbidity risk, improve sense of self and coping with emotions, to result in feeling healthier, but also to exacerbate trauma and increase stress. Coerced treatment was perceived to interfere with \"therapeutic change,\" nonetheless it was often perceived to reduce, cease and/or stabilise illicit drug use. Justice-involved adults' challenging life circumstances were an important barrier to reducing/ ceasing substance use. Abstinence-based approaches were common but abstinence may be unrealistic. Intervention effectiveness trials rarely measured relational outcomes of importance to justice-involved adults e.g., impacts on their children, or health outcomes.</p><p><strong>Conclusions: </strong>High-quality qualitative studies are urgently needed on the health impacts of diverse treatments orders. Treatment orders should emphasise harm-reduction treatment approaches and address participants' healthcare and social needs. Theories of how treatment orders work are needed. Unintended negative health consequences of treatment orders must be researched. Future trials should measure and report health and relational outcomes. Study protocol registration: [CRD42023484923]. The National Institute for Health and Care Research (NIHR) Evidence Synthesis Programme (Grant: NIHR153425, project number NIHR162046) funded this study.</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":"13 1","pages":"58"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative study of police officers' knowledge of the relationship between police opioid seizures and subsequent risk of overdose.","authors":"Brandon Del Pozo, Erin Thompson, Alina Whiteside","doi":"10.1186/s40352-025-00368-y","DOIUrl":"10.1186/s40352-025-00368-y","url":null,"abstract":"<p><p>People who use opioids (PWUO) have asserted police opioid seizures increase risk of overdose in their proximate aftermath. Ecological studies and causal models exhibit a positive association between police opioid seizures and overdose risk. To further characterize this relationship, this qualitative study explores how police officers who conduct drug enforcement understand the relationship between their opioid seizures and overdose risk. Semi-structured interviews were conducted with officers from the Providence, Rhode Island (USA) Police Department (n = 26) who patrolled areas with highly concentrated public substance use, or who conducted narcotics investigations. Interviews explored beliefs about the effects of police opioid seizures on overdose risk, reasons why seizures may modify this risk, and the motivations for narcotics enforcement. In contrast to patrol officers, narcotics investigators and patrol supervisors with narcotics investigation experience expressed four themes: (1) police opioid seizures increase subsequent overdose risk; (2) the reasons why closely track accounts put forth by researchers, and PWUO who experience this risk firsthand; (3) this risk was one of many faced by PWUO, and (4) police narcotics work should weigh it against the perceived need to address the effects of the illicit narcotics trade on a community. This consensus across diverse study populations, supported by ecological research and causal models, suggests the overdose risks generated by police opioid enforcement should be taken seriously in formulating drug policy.</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":"13 1","pages":"59"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"U.S. Jails and fatal drug overdoses: patterns, predictors and the role of rehabilitative contexts.","authors":"Victor St John, Tasha Perdue, Jason Szkola, Mijin Kim, Katharine McGrath, Noa Glover, Josh Sugino","doi":"10.1186/s40352-025-00365-1","DOIUrl":"10.1186/s40352-025-00365-1","url":null,"abstract":"<p><p>Opioid-related fatalities in U.S. correctional facilities present a critical criminal justice and health challenge. This study examines predictors of drug- and opioid-related deaths among incarcerated individuals nationwide. In the main models, younger age increases overdose risk, females face higher odds of drug-related death than males, and shorter stays are linked to all drug-related deaths, while longer stays are associated with opioid fatalities. Geographic disparities emerge, with small metro and micropolitan areas showing higher drug death rates and large fringe metros showing significantly lower opioid death rates. Medium-security facilities and greater spatial distance from public transportation access points predict higher rates for both outcomes. Subgroup analyses reveal that conviction status predicts elevated drug-related mortality only among males and among individuals held longer than 17 days. Notably, over one-third of opioid-related deaths and more than half of other drug deaths occur within 24 h of incarceration, underscoring acute early-stage vulnerability. Findings reveal distinct and overlapping predictors shaped by both rehabilitative and punitive factors, informing policies and interventions to reduce overdose fatalities in jails.</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":"13 1","pages":"56"},"PeriodicalIF":2.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Civil society in action: insights into volunteer-based community mentoring for reentry support.","authors":"Ety Elisha","doi":"10.1186/s40352-025-00366-0","DOIUrl":"10.1186/s40352-025-00366-0","url":null,"abstract":"<p><p>This study examined YouTurn's program, a volunteer-based mentoring initiative for individuals released after completing their full prison sentences in Israel. Unlike parolees, this group generally lacks structured transitional and healthcare support, risks of adverse health outcomes, and recidivism. Drawing on semi-structured interviews with mentors, staff, and institutional partners involved in the program, the study employed thematic analysis to explore the program's strengths, challenges, and broader implications. Findings indicate that YouTurn's civilian volunteer mentors deliver holistic support that addresses emotional, social, and practical reentry needs, while fostering organizational cohesion and continuity during crisis. The program's distinctive reliance on civic volunteers offers an alternative model of support rooted in community commitments, positioning YouTurn as a strengths-based intervention that fills gaps in current rehabilitation policy. Respondents also indicated significant challenges, including participants' dropout, limited resources, and a lack of diversity among mentees. The study extends theoretical understandings of mentoring models and demonstrates the potential of civic volunteer-driven initiatives to complement peer- and professional-based approaches in offender rehabilitation.</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":"13 1","pages":"57"},"PeriodicalIF":2.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a health-related social need screener for adults soon to be, and recently released, from incarceration.","authors":"Brittany Miller, Andrea D Janota, Jacqueline Wiltshire, Christopher A Harle, Joshua R Vest","doi":"10.1186/s40352-025-00364-2","DOIUrl":"10.1186/s40352-025-00364-2","url":null,"abstract":"<p><p>BACKGROUND: A history of incarceration is associated with poor overall health and increased health care utilization and costs. The challenges facing people recently released from prison vary by age, gender, and reason for incarceration. Better identification and management of the needs facing this population is critical for both state departments of correction, tasked with ensuring effective re-entry into the community, and for the health care system, tasked with caring for a population with potentially high and costly utilization. A justice systems-focused screening tool tailored to the social needs specific to the soon-to-be released and recently released adult incarcerated population could better assist transition planning and risk assessment. METHODS: We identified social needs for a justice systems-focused screening tool through interviews and focus groups with adults incarcerated in Indiana state prisons, individuals with lived experience of past incarceration, and individuals who work professionally with the justice system. Through content and face validation, we reduced candidate needs to a relevant set and adapted language from existing screening items to be appropriate for the population. RESULTS: The finalized tool included 25 needs in the following domains: Material resources, Access to health services, Economic resources and opportunities, Competencies, and Relationship management. Needs reflecting material resources, including their availability, accessibility, and ability to be secured, were among the most frequently identified. Health services, particularly mental health and substance use services, were identified in every interview and focus group as particularly important during a person’s transition home. Individuals identified employment as a need, but also noted the importance of programs and social supports when individuals returning home did not have access to their own financial resources. Competencies included skills and abilities important to successful reentry, such as coping skills, digital literacy, health literacy, financial literacy, general literacy, knowledge of parole conditions, and job readiness. CONCLUSIONS: Individuals recently released from incarceration faced an expansive and varied set of social needs. Many needs mirrored the social needs prioritized in the health care system for all patients, but several factors were unique to those with a history of incarceration. Information about the social needs could support connection to services, identification of trends, and allocation of resources. </p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":"13 1","pages":"55"},"PeriodicalIF":2.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"It's gotta be really hard to be a mom inside right now:\" a qualitative analysis on the impacts of COVID-19 on perinatal support programs for people in prison.","authors":"Abaki Beck, Ingie Osman, Ashley Watson, Cheri Branham, Brittany Seaver, Aparea Smith, Noël L Marsh, Carolyn Sufrin, Rebecca J Shlafer","doi":"10.1186/s40352-025-00359-z","DOIUrl":"10.1186/s40352-025-00359-z","url":null,"abstract":"<p><strong>Background: </strong>Prisons are well understood to be hotspots of the COVID-19 pandemic. Yet, little is known about the impacts the COVID-19 pandemic has had on pregnant and postpartum people in prison. We conducted a secondary analysis of 63 semi-structured qualitative interviews (December 2021-May 2023) with subject matter experts, primarily perinatal program staff working in prisons, to better understand how perinatal support programs for people in prison were impacted by the COVID-19 pandemic.</p><p><strong>Results: </strong>We identified nine themes in interviews as impacting perinatal support programming for incarcerated pregnant and postpartum people during the COVID-19 pandemic: 1) prison COVID-19 preventative practices and their influences on perinatal support programs; 2) COVID-19 quarantine and confinement of pregnant and postpartum people; 3) changes in the pregnant and postpartum population and reentry support; 4) changes to birth support during incarceration; 5) lack of communication and inconsistency between the DOC and perinatal support programs; 6) DOC staffing and staff turnover; 7) lack of access to volunteer-led programming and visiting; 8) relationships between perinatal support programs and DOC healthcare providers; and 9) relationships between perinatal support programs and hospitals. Results were organized into a modified socioecological model, allowing us to view different spheres of influence, how they interact and overlap, and as we describe in the discussion section, where practitioners and policy-makers might intervene. In particular, we focused on the organizational, relational, and structural levels, with multiple themes organized into each level. All of these themes, together, help provide information on how the COVID-19 pandemic impacted perinatal support programs in prisons.</p><p><strong>Conclusions: </strong>The COVID-19 pandemic had drastic impacts on prison operations and perinatal support programs, with cascading influences on the health and wellbeing of pregnant and postpartum people who are incarcerated. We conclude with a series of recommendations, developed by the research team and a community research council of formerly incarcerated individuals, that aim to address pandemic-related health disparities and promote health equity among those disproportionately impacted by the COVID-19 pandemic.</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":"13 1","pages":"54"},"PeriodicalIF":2.6,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}