title: Low-intensity case management increases contact with primary care in recently released prisoners: a single-blinded, multisite, randomised controlled trial.
abstract: The world prison population is large and growing. Poor health outcomes after release from prison are common, but few programmes to improve health outcomes for ex-prisoners have been rigorously evaluated. The aim of this study was to evaluate the impact of individualised case management on contact with health services during the first 6 months post-release.
  
  
  
  Single-blinded, randomised, controlled trial. Baseline assessment with N=1325 adult prisoners in Queensland, Australia, within 6 weeks of expected release; follow-up interviews 1, 3 and 6 months post-release. The intervention consisted of provision of a personalised booklet ('Passport') at the time of release, plus up to four brief telephone contacts in the first 4 weeks post-release.
  
  
  
  Of 1179 eligible participants, 1003 (85%) completed ≥1 follow-up interview. In intention-to-treat analyses, 53% of the intervention group and 41% of the control group reported contacting a general practitioner (GP) at 1 month post-release (difference=12%, 95% CI 5% to 19%). Similar effects were observed for GP contact at 3 months (difference=9%, 95% CI 2% to 16%) and 6 months (difference=8%, 95% CI 1% to 15%), and for mental health (MH) service contact at 6 months post release (difference=8%, 95% CI 3% to 14%).
  
  
  
  Individualised case management in the month after release from prison increases usage of primary care and MH services in adult ex-prisoners for at least 6 months post-release. Given the poor health profile of ex-prisoners, there remains an urgent need to develop and rigorously evaluate interventions to increase health service contact in this profoundly marginalised population.
  
  
  
  ACTRN12608000232336.
authors.affiliation: Griffith Criminology Institute & Menzies Health Institute Queensland, Griffith University, Brisbane, Australia Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia Queensland Centre for Intellectual and Developmental Disability, Mater Research Institute-UQ, The University of Queensland, Brisbane, Australia.
authors.forename: Stuart A
authors.identifier: 0000-0003-3956-5343
authors.initials: SA
authors.lastname: Kinner
authors.affiliation: School of Public Health, University of Queensland, Brisbane, Australia.
authors.forename: Rosa
authors.initials: R
authors.lastname: Alati
authors.affiliation: Drug and Alcohol Services South Australia, Adelaide, Australia.
authors.forename: Marie
authors.initials: M
authors.lastname: Longo
authors.affiliation: Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Spittal
authors.affiliation: School of Public Health, University of Queensland, Brisbane, Australia.
authors.forename: Frances M
authors.initials: FM
authors.lastname: Boyle
authors.affiliation: School of Public Health, University of Queensland, Brisbane, Australia.
authors.forename: Gail M
authors.initials: GM
authors.lastname: Williams
authors.affiliation: Queensland Centre for Intellectual and Developmental Disability, Mater Research Institute-UQ, The University of Queensland, Brisbane, Australia.
authors.forename: Nicholas G
authors.initials: NG
authors.lastname: Lennox
mesh_terms: D001315:Australia; D019090:Case Management; D006801:Humans; D010342:Patient Acceptance of Health Care; D011320:Primary Health Care; D011329:Prisoners; D011793:Queensland
keywords: ACCESS TO HLTH CARE; Health inequalities; MENTAL HEALTH; PRIMARY HEALTH CARE; RANDOMISED TRIALS