title: Randomised controlled trial of a service brokerage intervention for ex-prisoners in Australia.
abstract: BACKGROUND
  Health outcomes after release from prison are typically poor with elevated rates of morbidity and mortality widely documented. Under-utilisation of health services contributes to these outcomes, but interventions to increase health service utilisation in ex-prisoners are in their infancy and few have been rigorously evaluated.
  
  
  METHODS
  Single-blinded randomised controlled trial of a service brokerage intervention (the 'Passports study') for N = 1325 adult ex-prisoners in Queensland, Australia. Participants in the intervention group received a personalised booklet summarising their health status and identifying appropriate community health services; trained workers made weekly telephone contact in the first 4 weeks post-release to identify health needs and facilitate health service utilisation. Participants in the control arm received usual care. Baseline data were collected within 6 weeks of expected release from custody with follow-up telephone interviews 1, 3 and 6 months post-release. Participant identities were linked with federal health service utilisation records, a national death register and corrective services records, two years post-release. The primary outcome was self-reported health service utilisation in the first 6 months post-release.
  
  
  RESULTS
  Between 2008 and 2010 1976 prisoners were screened for eligibility, 1665 met eligibility criteria and 1325 were recruited; 665 were randomised to the intervention and 660 to the control condition. Participants were broadly representative of adults being released from prison in Queensland except that women were intentionally oversampled (21% vs. 11%).
  
  
  CONCLUSIONS
  Outcomes from this large RCT will provide the first robust evidence of the effect of service brokerage on health service utilisation and health outcomes for ex-prisoners.
authors.affiliation: Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC 3010, Australia. s.kinner@unimelb.edu.au
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Kinner
authors.forename: Nicholas
authors.initials: N
authors.lastname: Lennox
authors.forename: Gail M
authors.initials: GM
authors.lastname: Williams
authors.forename: Megan
authors.initials: M
authors.lastname: Carroll
authors.forename: Brendan
authors.initials: B
authors.lastname: Quinn
authors.forename: Frances M
authors.initials: FM
authors.lastname: Boyle
authors.forename: Rosa
authors.initials: R
authors.lastname: Alati
mesh_terms: D000328:Adult; D001315:Australia; D003266:Continuity of Patient Care / Q000458:organization & administration*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000458:organization & administration; D011330:Prisons / Q000706:statistics & numerical data*; D011793:Queensland; D012107:Research Design; D016037:Single-Blind Method
keywords: Health service utilisation; Primary care; Prisoners; Randomised controlled trial; Re-entry