title: The role of primary health care services to better meet the needs of Aboriginal Australians transitioning from prison to the community.
abstract: BACKGROUND
  Aboriginal Australians are more likely than other Australians to cycle in and out of prison on remand or by serving multiple short sentences-a form of serial incarceration and institutionalisation. This cycle contributes to the over-representation of Aboriginal Australians in prison and higher rates of recidivism. Our research examined how primary health care can better meet the health care and social support needs of Aboriginal Australians transitioning from prison to the community.
  
  
  METHODS
  Purposive sampling was used to identify 30 interviewees. Twelve interviews were with Aboriginal people who had been in prison; ten were with family members and eight with community service providers who worked with former inmates. Thematic analysis was conducted on the interviewees' description of their experience of services provided to prisoners both during incarceration and on transition to the community.
  
  
  RESULTS
  Interviewees believed that effective access to primary health care on release and during transition was positively influenced by providing appropriate healthcare to inmates in custody and by properly planning for their release. Further, interviewees felt that poor communication between health care providers in custody and in the community prior to an inmate's release, contributed to a lack of comprehensive management of chronic conditions. System level barriers to timely communication between in-custody and community providers included inmates being placed on remand which contributed to uncertainty regarding release dates and therefore difficulties planning for release, cycling in and out of prison on short sentences and being released to freedom without access to support services.
  
  
  CONCLUSIONS
  For Aboriginal former inmates and family members, release from prison was a period of significant emotional stress and commonly involved managing complex needs. To support their transition into the community, Aboriginal former inmates would benefit from immediate access to culturally- responsive community -primary health care services. At present, however, pre-release planning is not always available, especially for Aboriginal inmates who are more likely to be on remand or in custody for less than six months.
authors.affiliation: Centre for Primary Health Care and Equity, Faculty of Medicine, University of New South Wales, Sydney, Australia. j.lloyd@unsw.edu.au.
authors.forename: Jane E
authors.initials: JE
authors.lastname: Lloyd
authors.affiliation: Aboriginal Medical Service Western Sydney, Sydney, Australia. Dea@amsws.org.au.
authors.forename: Dea
authors.initials: D
authors.lastname: Delaney-Thiele
authors.affiliation: Department of General Practice, Faculty of Medicine, University of Western Sydney, Sydney, Australia. P.Abbott@uws.edu.au.
authors.forename: Penny
authors.initials: P
authors.lastname: Abbott
authors.affiliation: School of Social Sciences, Faculty of Arts and Social Sciences, University of New South Wales, Sydney, Australia. e.baldry@unsw.edu.au.
authors.forename: Eileen
authors.initials: E
authors.lastname: Baldry
authors.affiliation: School of Social Sciences, Faculty of Arts and Social Sciences, University of New South Wales, Sydney, Australia. emcentyre50@gmail.com.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: McEntyre
authors.affiliation: Department of General Practice, Faculty of Medicine, University of Western Sydney, Sydney, Australia. J.Reath@uws.edu.au.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Reath
authors.affiliation: Australian Prevention Partnership Centre, University of Sydney, Sydney, Australia. d.indig@unsw.edu.au.
authors.forename: Devon
authors.initials: D
authors.lastname: Indig
authors.affiliation: National Centre for Cultural Competence, University of Sydney, Sydney, Australia. juanita.sherwood@sydney.edu.au.
authors.forename: Juanita
authors.initials: J
authors.lastname: Sherwood
authors.affiliation: Centre for Primary Health Care and Equity, Faculty of Medicine, University of New South Wales, Sydney, Australia. m.f.harris@unsw.edu.au.
authors.forename: Mark F
authors.initials: MF
authors.lastname: Harris
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D001315:Australia; D003153:Community Health Services / Q000458:organization & administration*; D005190:Family; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration*; D006301:Health Services Needs and Demand; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000458:organization & administration*; D011329:Prisoners; D011788:Quality of Life; D012944:Social Support; D013315:Stress, Psychological