Structural Conditions and Health After Release From Prison

NCT05989282 — Active not recruiting, 508 participants, Kaiser Permanente

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Healthcare Organizational Structural Conditions and the Health of People Recently Released From Prison

Registry	NCT05989282, acronym SCHARP
Status	Active not recruiting
Study type	Observational
Enrollment	508 (Actual)
Sponsor	Kaiser Permanente (Other); collaborators: University of Colorado, Denver, Denver Health and Hospital Authority, National Heart, Lung, and Blood Institute (NHLBI)
Conditions	Cardiovascular Diseases, Health Care Utilization
Dates	start 2023-08-05, primary completion 2027-06-30 (estimated), completion 2028-06-30 (estimated), first posted 2023-08-14, last updated 2026-08-14
Locations	1 site in United States

-Summary

People released from prison experience two times higher cardiovascular (CV) mortality than the general population, have a high prevalence of poor CV health and increased risk of CV events within 2 years of release. Access to high quality healthcare following release from prison is key to preventing poor health and CV outcomes. Our study team will investigate facilitators and barriers to health care access experienced by people released from prison.

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+Detailed description

Upon release from prison, people face numerous challenges including unstable housing, limited employment, stigma, and poor health. Structural conditions in healthcare systems, including policies, practices and attitudes around healthcare access, transition programs, culture, support of social determinants of health, and specialized services for people released from prison, may influence access and health outcomes for people released from prison. We will enroll people released from prison into a prospective cohort study to examine the association between exposure to structural conditions and 12-month primary outcomes of healthcare utilization (clinic visits, emergency visits, hospitalization) and secondary outcomes of CV hospitalization and all-cause mortality. Moderation by participant characteristics such as self-reported race, ethnicity, gender, age and baseline CV health will be tested.

+Arms and interventions

Arm	Type	Interventions	Description
Exposure to structural conditions			Using a survey, we will measure participant exposure to organizational: access policies, transition programs, culture, support for social determinants of health and specialized services.

+Outcome measures

Primary outcomes

Healthcare utilization [12 months]: Clinic visits, emergency visits, hospitalization

Secondary outcomes

Cardiovascular hospitalization [12 months]: Hospitalization for a cardiovascular condition
Death [12 months]: All-cause death

+Eligibility

Sex: All, ages: 18 Years to any, accepts healthy volunteers

Inclusion Criteria:

* Recenlty released from state prison into the Denver/Aurora Colorado metro area
* Age 18 and older
* Ability to understand study procedures in English or Spanish
* No plans to leave the area for six months

Exclusion Criteria:

* On "current inmate" status or still under correctional observation (i.e., under locked confinement part of the day or night)
* Plans to leave area within six months
* Unable to consent

+Locations (1)

Facility	City	Country	Status
Kaiser Permanente Institute for Health Research	Aurora, Colorado	United States

+Investigators

Stacie Daugherty, Principal investigator, Kaiser Permanente Institute for Health Research

+Funding

NIH grants: R01HL164106