Structural Conditions and Health After Release From Prison (SCHARP)

Healthcare Organizational Structural Conditions and the Health of People Recently Released From Prison

People released from prison experience two times higher cardiovascular (CV) mortality than the general population, have a high prevalence of poor CV health and increased risk of CV events within 2 years of release. Access to high quality healthcare following release from prison is key to preventing poor health and CV outcomes. Our study team will investigate facilitators and barriers to health care access experienced by people released from prison.

Study Overview

• Status: Recruiting
• Conditions: Cardiovascular Diseases; Health Care Utilization

Detailed Description

Upon release from prison, people face numerous challenges including unstable housing, limited employment, stigma, and poor health. Structural conditions in healthcare systems, including policies, practices and attitudes around healthcare access, transition programs, culture, support of social determinants of health, and specialized services for people released from prison, may influence access and health outcomes for people released from prison. We will enroll people released from prison into a prospective cohort study to examine the association between exposure to structural conditions and 12-month primary outcomes of healthcare utilization (clinic visits, emergency visits, hospitalization) and secondary outcomes of CV hospitalization and all-cause mortality. Moderation by participant characteristics such as self-reported race, ethnicity, gender, age and baseline CV health will be tested.

• Study Type: Observational
• Enrollment (Estimated): 400

Contacts and Locations

• Study Contact: Name: SCHARP Study; Phone Number: 1-833-660-5300; Email: SCHARP@kp.org

Study Locations

• United States
  • Colorado
    • Aurora, Colorado, United States, 80011
      • Recruiting
      • Kaiser Permanente Institute for Health Research
      • Contact: SCHARP Study Team; Email: SCHARP@kp.org
      • Principal Investigator: Ingrid Binswanger

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

We are enrolling people who were formerly in prison. People on probation or on parole are responsible for meeting their own needs for health care, in contrast to people currently in prison, who receive these services from the prison system. Thus, people recently released from prison are a high-risk group for a range of poor health outcomes and poor access to care. For these reasons, the focus of this investigation is on people recently released from prison.

Description

Inclusion Criteria:

• Recenlty released from state prison into the Denver/Aurora Colorado metro area
• Age 18 and older
• Ability to understand study procedures in English or Spanish
• No plans to leave the area for six months

Exclusion Criteria:

• On "current inmate" status or still under correctional observation (i.e., under locked confinement part of the day or night)
• Plans to leave area within six months
• Unable to consent

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Exposure to structural conditions; Using a survey, we will measure participant exposure to organizational: access policies, transition programs, culture, support for social determinants of health and specialized services.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Healthcare utilization	Clinic visits, emergency visits, hospitalization	12 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Cardiovascular hospitalization	Hospitalization for a cardiovascular condition	12 months
Death	All-cause death	12 months

Collaborators and Investigators

• Sponsor: Kaiser Permanente
• Collaborators: University of Colorado, Denver; National Heart, Lung, and Blood Institute (NHLBI); Denver Health and Hospital Authority
• Investigators: Principal Investigator: Stacie Daugherty, Kaiser Permanente Institute for Health Research

Study record dates

Study Major Dates

• Study Start (Actual): August 5, 2023
• Primary Completion (Estimated): June 30, 2027
• Study Completion (Estimated): June 30, 2028

Study Registration Dates

• First Submitted: August 3, 2023
• First Submitted That Met QC Criteria: August 3, 2023
• First Posted (Actual): August 14, 2023

Study Record Updates

• Last Update Posted (Estimated): December 7, 2023
• Last Update Submitted That Met QC Criteria: December 6, 2023
• Last Verified: December 1, 2023

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Cardiovascular Diseases
• Other Study ID Numbers: IRB# 00002931; R01HL164106 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No