title: A syndemic model of women incarcerated in community jails.
abstract: OBJECTIVE
  The purpose of this study was to test whether variations in substance abuse, mental health diagnoses, individual experiences of violence, community experiences of violence, and incarceration history may be reduced to a single underlying syndemic factor for a sample of women incarcerated in three Midwestern U.S. jails.
  
  
  METHODS
  Secondary data analysis of a cross-sectional study of a medical utilization survey; initial confirmatory factor analysis tested fit of model; modification indexes provided confirmatory fit. 290 women incarcerated in three urban Midwestern U.S. jails.
  
  
  METHODS
  Demographics and variables associated with women's criminal justice experience and sexual health risk were assessed. The analysis included women's mental health, drug dependence, childhood sexual and physical abuse, and partner violence.
  
  
  RESULTS
  The final model had four variables with significant pathways: childhood sexual abuse, childhood physical abuse, domestic violence, and mental health diagnoses. The fit of this model was very good (χ(2) (1) = 0.6; CFI = 1.00; standardized RMR = 0.0147), strongly suggesting the intertwined nature of the variables.
  
  
  CONCLUSIONS
  Clarification of the specific components in a syndemic model for this population will allow for the implementation of interventions with the appropriate inclusion of content. In interventions and clinical practice, public health nurses should consider these interrelationships.
authors.affiliation: School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO.
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Kelly
authors.forename: An-Lin
authors.initials: AL
authors.lastname: Cheng
authors.forename: Elaine
authors.initials: E
authors.lastname: Spencer-Carver
authors.forename: Megha
authors.initials: M
authors.lastname: Ramaswamy
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D017579:Domestic Violence / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis*; D015146:Midwestern United States; D008960:Models, Psychological; D011329:Prisoners / Q000523:psychology* / Q000706:statistics & numerical data; D011330:Prisons / Q000706:statistics & numerical data; D011637:Public Health Nursing; D012111:Residence Characteristics; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000175:diagnosis
keywords: incarcerated women; syndemic; women's health