A systematic review of randomized controlled trials of interventions to improve the health of persons during imprisonment and in the year after release

The health of people who experience imprisonment is poor, and efforts can be made to improve health and health care during imprisonment and at the time of release. We systematically reviewed randomized controlled trials of interventions to improve the health of people during imprisonment or in the year after release. We searched 14 biomedical and social science databases and identified 95 studies. Most studies involved only men or a majority of men (70/83 studies in which gender distribution was specified) and only 13 studies focused on adolescents. Most studies were conducted in the USA (n=57) and very few were conducted in low or middle income countries (n=6). The risk of bias for outcomes in almost all studies was unclear or high (n=91). In 59 studies, interventions led to improved mental health, substance use, infectious diseases, or health service utilization outcomes, and in 42 of these studies, outcomes were measured in the community after release. Improving the health of people who experience imprisonment requires significant knowledge generation and translation efforts, including the adaptation and implementation of effective interventions identified in this review.This study was supported by the Centre for Research on Inner City Health (CRICH). CRICH is part of the Keenan Research Centre in the Li Ka Shing Knowledge Institute of St. Michael’s Hospital. Fiona G. Kouyoumdjian receives a Fellowship from the Canadian Institutes for Health Research. Stuart A. Kinner is supported by NHMRC Career Development Award (#1004765)