Search

Background: Between 2012–2022 opioid-related overdose deaths in the United States, including Washington State, have risen dramatically. Opioid use disorder (OUD) is a complex, chronic, and criminalized illness with biological, environmental, and social causes. One-fifth of people with OUD have recent criminal-legal system involvement; > 50% pass through WA jails annually. Medications for Opioid Use Disorder (MOUD) can effectively treat OUD. WA has prioritized improving access to MOUD, including for those in jails. As patients in jail settings are systematically marginalized due to incarceration, it is critical to foster connections to MOUD services upon release, an acknowledged period of high overdose risk. Currently, there is insufficient focus on developing strategies to foster linkages between jail-based MOUD and referral services. The Systems Analysis and Improvement Approach (SAIA), an evidence-based implementation strategy, may optimize complex care cascades like MOUD provision and improve linkages between jail- and community-based providers. SAIA bundles systems engineering tools into an iterative process to guide care teams to visualize cascade drop-offs and prioritize steps for improvement; identify modifiable organization-level bottlenecks; and propose, implement, and evaluate modifications to overall cascade performance. The SAIA-MOUD study aims to strengthen the quality and continuity of MOUD care across jail and referral clinics in King County, WA, and ultimately reduce recidivism and mortality. Methods: We will conduct a quasi-experimental evaluation of SAIA effectiveness on improving MOUD care cascade quality and continuity for patients receiving care in jail and exiting to referral clinics; examine determinants of SAIA-MOUD adoption, implementation, and sustainment; and determine SAIA-MOUD's cost and cost-effectiveness. Clinic teams with study team support will deliver the SAIA-MOUD intervention at the jail-based MOUD program and three referral clinics over a two-year intensive phase, followed by a one-year sustainment phase where SAIA implementation will be led by King County Jail MOUD staff without study support to enable pragmatic evaluation of sustained implementation. Discussion: SAIA packages user-friendly systems engineering tools to guide decision-making by front-line care providers to identify low-cost, contextually appropriate health care improvement strategies. By integrating SAIA into MOUD care provision in jail and linked services, this pragmatic trial is designed to test a model for national scale-up. Trial registration: ClinicalTrials.gov NCT06593353 (registered 09/06/2024; https://register.clinicaltrials.gov/prs/beta/studies/S000EVJR00000029/recordSummary). [ABSTRACT FROM AUTHOR]

US courts regularly assess fines, fees, and costs against criminal defendants. Courtrelated debt can cause continuing court involvement and incarceration, not because of new crimes, but because of unpaid financial obligations. We conducted an experiment with 606 people found guilty of misdemeanors in Oklahoma County, Oklahoma. Study participants were randomly selected to receive relief from all current and prior fines and fees assessed for criminal charges in the county. Fee relief reduced jail bookings 21 mo after randomization and the effect persisted over 44 mo of follow-up. Although fee relief reduced incarceration, financial sanctions had no effect on indicators of lawbreaking. Instead, the control group (who obtained no relief from fines and fees) were rearrested at significantly higher rates because of open arrest warrants for nonpayment. These results indicate the long-term and criminalizing effects of legal debt, supporting claims that financial sanctions disproportionately harm low-income defendants while contributing little to public safety. [ABSTRACT FROM AUTHOR]

Background: Opioid-related overdose is a leading cause of death for criminal legal-involved individuals and, although naloxone distribution and medications for opioid use disorder (MOUD) are effective means for reducing post-release overdose death risk, jail-based availability is limited. This case report describes the challenges faced by three Ohio communities as they implemented evidence-based practices (EBPs) in jails to combat post-release opioid overdose deaths. Method: We present case examples of how barriers were overcome to implement jail-based EBPs in three Ohio communities (two urban and one rural) as part of the HEALing Communities Study (UM1DA049417; ClinicalTrials.gov Identifier: NCT04111939). Of the 18 participating Ohio HEALing Communities Study counties, we highlight 3 communities for the novelty of their EBPs implemented, the challenges that they faced, and their rural/urban status. We present descriptive data regarding the EBPs that they implemented and discuss the challenges identified by HEALing Communities Study staff with first-hand experience facilitating their implementation. Results: Newly implemented interventions included overdose education and direct provision of naloxone to incarcerated individuals upon release (2 of 3 communities), initiating MOUD prior to release (3 of 3), linkage to ongoing MOUD treatment in the community (2 of 3), peer support-facilitated treatment retention efforts (2 of 3) and emergency housing (1 of 3) in the immediate post-incarceration period. Common challenges that emerged included skepticism about the need and feasibility of implementing EBPs to reduce overdose and death, lack of knowledge about the options available and whether external agencies may assist, and difficulty engaging stakeholders to overcome inertia. Conclusions: Creative flexibility, calm persistence, technical facilitation, and collaboration with community service providers were assets that helped these Ohio jails implement evidence-based strategies that combat the opioid epidemic and reduce the likelihood of post-incarceration overdose and death in a high risk, formerly incarcerated population. [ABSTRACT FROM AUTHOR]

In the United States, suicide is a leading cause of death in prisons and jails, with incarcerated individuals being nine times more likely to die by suicide than the general population. Identifying vulnerabilities at each stage of custody (prebooking, jail, prison) and factors that increase suicide risk can improve prevention efforts. A hierarchical binary logistic regression was conducted on data from the Texas Justice Initiative's Deaths in Custody Report. Variables included race/ethnicity, sex, age at death, days in custody, classification of crime as violent or nonviolent, and custody type of prebooking, jail, or prison. Among main effects, when compared to suicide rates in prison, jail suicide deaths were over three and a half times more likely (OR = 3.61), and the period of prebooking emerged as a period of staggering risk of suicide death, with suicides being over 5,000% more likely than at other stages of custody (OR = 50.86). When interactions were entered, Latinx individuals were at a particularly increased risk of suicide death (OR = 10.46), likelihood of suicide death decreased with each year of age (OR =.89), nonviolent offenders were just under three and a half times more likely to die by suicide when compared to violent offenders (OR = 3.45), and each stage of custody was shown to affect the relationship between age-related rates of suicide in different ways. Results call for further investigation into suicide among understudied populations in corrections, such as Latinx individuals, juveniles in the prison system, and nonviolent offenders, to identify the groups at the highest risk of premature death in correctional systems. [ABSTRACT FROM AUTHOR]

This study evaluates the Middle Tennessee Rural Reentry (MTRR) program. MTRR is a rural reentry program funded by the Bureau of Justice Assistance that uses non-clinical case managers. Specifically, the program provided non-clinical case management and services to 144 medium and high-risk offenders released from a rural county correctional facility for up to 12 months after incarceration. Fully 56.9% of offenders completed the program, with 52.8% recidivating (i.e., arrest and revocation of supervision). Program completion did not have a statistically significant impact on recidivism. Moreover, females who participated in the program had a significantly lower overall likelihood of recidivism than when compared to male participants. Additional findings and policy implications for rural jail programs are also discussed. [ABSTRACT FROM AUTHOR]

Background: Incarcerated individuals face high rates of mental illness, substance use disorders and communicable diseases including HIV, with increased health complications and mortality in the early post-release period. Multiple re-entry interventions linking justice-involved individuals to community resources via peer navigation have emerged, though limited data exist on the mechanics and personal impact of these approaches. This paper quantifies and evaluates a pilot study of a combined Community Health Worker (CHW)-re-entry intervention for individuals released from jail who use substances and have HIV to inform future large-scale applications. Methods: A mixed-methods analysis of a CHW-re-entry intervention utilized in a pilot randomized controlled trial involving people with HIV who have a history of substance (stimulant, opioid or alcohol) use in Dallas, TX was conducted using an explanatory sequential design. Quantitative assessments of the intervention measured interaction types, time spent, and topics discussed and explored associations between the "dose" of intervention and patient outcomes. Qualitative analyses of CHW field notes and end-of-study participant interviews were triangulated with quantitative findings to elucidate the intervention's impact. Results: Of the 17/31 participants assigned to the intervention, 16 interacted with the CHW on at least one occasion, and 6 successfully completed a visit with the re-entry organization. Most CHW interactions occurred by phone (66%) or in person (28%). Frequently discussed topics included substance use, housing, and physical health. On average, participants spent 7.65 h (range 0-37.18, SD = 9.33) engaged with the intervention over 6 months. Intervention dose was associated with improved HIV control, decreased stimulant use, higher rates of recidivism, and improved clinical appointment show rate. Qualitative analyses revealed key intervention components, paralleling benefits of study participation alone: outreach, nonjudgmental approach, motivation and accountability. Conclusions: A CHW-re-entry intervention, while resource-intensive, shows preliminary promise in improving HIV and some substance use outcomes. Frequent telephone and in-person contact, with an empathetic yet goal-oriented approach, fostered participant support and motivation to address HIV and substance use. Participants reported that engagement in research provided accountability and a sense of purpose. Future studies should focus on optimizing implementation of CHW-based interventions to enhance impact on vulnerable populations. [ABSTRACT FROM AUTHOR]

Background: People who use psychoactive substances that are illicit have increased chances of coming into contact with the law enforcement and criminal justice systems for different reasons. The problem statement in terms of the need for healthcare services for such people is yet to be defined and quantified in India. Methods: We used the data collected by the National Crimes Record Bureau for the years 1986 to 2021. We assessed the profile of offences registered under the Narcotic Drugs and Psychotropic Substances Act (NDPS), 1985 over the successive years in India. We also made comparisons between the offences for possession for personal use/consumption and for trafficking of narcotic drugs and psychotropic substances at the national level and at the level of states and union territories in the country. Results: The percentage of these arrests, charge sheets and convictions as part of total Special and Local Laws (SLL) has increased over the years, showing a positive monotonic trend. A large percentage of those arrested were males. A higher percentage of females were arrested and charge-sheeted for trafficking than for personal use or consumption. The percentage of total persons arrested, charge-sheeted and convicted for possession of drugs for personal use/consumption was greater than that of those arrested for possession of drugs for trafficking for all years from 2017 to 2021. There were significant associations between gender and the types of offense. The highest rates of offences were reported from some north-western states, north-eastern states and Kerala. Conclusion: The findings help us make a strong argument in favour of strengthening the health sector response for people who use psychoactive substances and are in contact with the law enforcement and criminal justice systems in the country. [ABSTRACT FROM AUTHOR]

Individuals who are incarcerated are often stressed, hopeless, and overwhelmed by this challenging life circumstance. Unfortunately, jails offer little treatment to assist in enhancing coping and fostering hope and resilience. This research study in a rural Pennsylvania jail provided four six-week coping and stress reduction groups, two with and two without therapy dogs. Findings indicate that all group participants experienced significant reductions in stress, improved resilience, and an increased sense of hope as measured by standardized scales. All four groups rated the interventions as very helpful. [ABSTRACT FROM AUTHOR]

Background: Previous non-fatal overdose may increase risk of overdose fatality for women reentering the community following incarceration, but pre-incarceration overdose experiences are understudied. This study describes the prevalence and correlates of non-fatal overdose prior to jail among women with opioid use disorder (OUD). Methods: Women (N = 700) were randomly selected from eight Kentucky jails, screened for OUD, and interviewed as part of the NIDA-funded Kentucky Justice Community Opioid Innovation Network (JCOIN) trial. Descriptive statistics were used to examine women's prior overdose experiences, while bivariate analyses and logistic regression were used to identify correlates of overdose in the 90 days prior to jail. Results: Analyses found that 55.4% of women had overdosed in their lifetime, and 21.4% overdosed in the 90 days prior to jail. Of those who overdosed in the 90 days prior to jail, heroin (80.7%) was the most-commonly used drug prior to overdose, 35.2% received emergency, medically-attended services post-overdose, and 92.4% were administered naloxone – primarily by acquaintances. Overdosing in the 90 days prior to jail was positively correlated with identifying as a sexual minority, being from an urban community, childhood victimization, as well as recent heroin, fentanyl, and injection drug use. Conclusions: Findings indicate that prior overdose is common among jailed women with OUD, and although naloxone was often administered, few women received medically-attended services post-overdose. Results highlight the importance of distributing naloxone to community members and women reentering the community from jail, and suggest additional research is needed to understand factors inhibiting medical care following an overdose. [ABSTRACT FROM AUTHOR]

Abstract Background Opioid-related overdose is a leading cause of death for criminal legal-involved individuals and, although naloxone distribution and medications for opioid use disorder (MOUD) are effective means for reducing post-release overdose death risk, jail-based availability is limited. This case report describes the challenges faced by three Ohio communities as they implemented evidence-based practices (EBPs) in jails to combat post-release opioid overdose deaths. Method We present case examples of how barriers were overcome to implement jail-based EBPs in three Ohio communities (two urban and one rural) as part of the HEALing Communities Study (UM1DA049417; ClinicalTrials.gov Identifier: NCT04111939). Of the 18 participating Ohio HEALing Communities Study counties, we highlight 3 communities for the novelty of their EBPs implemented, the challenges that they faced, and their rural/urban status. We present descriptive data regarding the EBPs that they implemented and discuss the challenges identified by HEALing Communities Study staff with first-hand experience facilitating their implementation. Results Newly implemented interventions included overdose education and direct provision of naloxone to incarcerated individuals upon release (2 of 3 communities), initiating MOUD prior to release (3 of 3), linkage to ongoing MOUD treatment in the community (2 of 3), peer support-facilitated treatment retention efforts (2 of 3) and emergency housing (1 of 3) in the immediate post-incarceration period. Common challenges that emerged included skepticism about the need and feasibility of implementing EBPs to reduce overdose and death, lack of knowledge about the options available and whether external agencies may assist, and difficulty engaging stakeholders to overcome inertia. Conclusions Creative flexibility, calm persistence, technical facilitation, and collaboration with community service providers were assets that helped these Ohio jails implement evidence-based strategies that combat the opioid epidemic and reduce the likelihood of post-incarceration overdose and death in a high risk, formerly incarcerated population.

BACKGROUND: Improving access to high-quality healthcare for individuals in correctional settings is critical to advancing health equity in the United States. Compared to the general population, criminal-legal involved individuals experience higher rates of chronic health conditions and poorer health outcomes. Implementation science frameworks and strategies offer useful tools to integrate health interventions into criminal-legal settings and to improve care. A review of implementation science in criminal-legal settings to date is necessary to advance future applications. This systematic review summarizes research that has harnessed implementation science to promote the uptake of effective health interventions in adult criminal-legal settings. METHODS: A systematic review of seven databases (Academic Search Premier, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Social Work Abstracts, ProQuest Criminal Justice Database, ProQuest Sociological Abstracts, MEDLINE/PubMed) was conducted. Eligible studies used an implementation science framework to assess implementation outcomes, determinants, and/or implementation strategies in adult criminal-legal settings. Qualitative synthesis was used to extract and summarize settings, study designs, sample characteristics, methods, and application of implementation science methods. Implementation strategies were further analyzed using the Pragmatic Implementation Reporting Tool. RESULTS: Twenty-four studies met inclusion criteria. Studies implemented interventions to address infectious diseases (n=9), substance use (n=6), mental health (n=5), co-occurring substance use and mental health (n=2), or other health conditions (n=2). Studies varied in their operationalization and description of guiding implementation frameworks/taxonomies. Sixteen studies reported implementation determinants and 12 studies measured implementation outcomes, with acceptability (n=5), feasibility (n=3), and reach (n=2) commonly assessed. Six studies tested implementation strategies. Systematic review results were used to generate recommendations for improving implementation success in criminal-legal contexts. CONCLUSIONS: The focus on implementation determinants in correctional health studies reflects the need to tailor implementation efforts to complex organizational and inter-agency contexts. Future studies should investigate policy factors that influence implementation success, design, and test implementation strategies tailored to determinants, and investigate a wider array of implementation outcomes relevant to criminal-legal settings, health interventions relevant to adult and juvenile populations, and health equity outcomes. TRIAL REGISTRATION: A study protocol (CRD42020114111) was registered with Prospero.

Despite high suicide mortality in U.S. jails, there is limited research into precursors for suicide in this population, such as suicidal ideation. The current study examined the prevalence and correlates of lifetime and jail-specific suicidal ideation among a sample of 196 individuals (137 men) in custody in a U.S. jail. Nearly half the sample had reported lifetime suicidal ideation (45%), whereas 30% had reported jail-specific suicidal ideation. Adjusted correlates of lifetime suicidal ideation included a history of mental illness (OR = 2.79) and drug use (OR = 2.70). Adjusted correlates of jail-specific suicidal ideation included a history of mental illness (OR = 2.74), drug use (OR = 3.16), and a dehumanizing custodial environment (OR = 3.74). Some theoretically and empirically relevant factors were not significantly associated with suicidal ideation. Both expected and unexpected findings are discussed within the context of suicide theory and research, and practical implications are explored. [ABSTRACT FROM AUTHOR]

Mentoring can positively influence the mentee, the mentor, and the organization in which both are employed. Mentoring can help employees to overcome workplace challenges, including barriers to advancement, while increasing job satisfaction, enhancing career development, and producing a greater sense of value within the organization, often leading to increased productivity. While mentoring clearly has a multitude of benefits, women have traditionally had difficulty establishing mentorships in the workplace, which appear especially problematic in traditionally male-dominated careers, such as corrections. Based on surveys and interviews with members of the Association of Women Executives in Corrections (AWEC), this study investigates the role of mentorship in women's advancement within corrections departments. Data show that support, particularly from one's supervisor, is critical as women consider advancement, regardless of the supervisor's gender. These results imply that when there are few women in the administrative ranks, limiting the opportunity for female mentorship, women can find equally effective mentorship from male superiors. Moreover, mentorships do not necessarily have to be formalized to be effective and can develop from outside one's department when none exist within. Corrections agencies interested in diversifying their administrative ranks should plan to establish more opportunities to foster mentoring relationships, which would benefit all employees. [ABSTRACT FROM AUTHOR]

This study aims to test the psychometric properties of the Violent Risk Scale (VRS) in a sample of Portuguese remand prisoners. A total of 133 subjects participated in the present study. We carried out a Confirmatory Factor Analysis (CFA) to test the originally proposed two factor structure. Results showed evidence to support the VRS's psychometric qualities. The CFA tested the two-factor structure and showed evidence of the goodness of fit of the original two-factor model. Also, our findings indicated acceptable internal consistency for both subscales. The correlational analyses supported both convergent and discriminant validity of the VRS. Finally, this study also tested known-groups validity. The VRS score showed a satisfactory postdictive accuracy, which means that it is able to demonstrate distinctive scores for groups known to vary on the variables being measured. We consider this work represents an essential support for decision-makers to evaluate the appropriateness of different judicial measures. [ABSTRACT FROM AUTHOR]

Incarceration is associated with adverse health outcomes, including higher rates of infectious diseases. Poor health literacy in this population is a likely contributing factor, making health education a potential tool to help address these health disparities. This article aims to describe the implementation of a novel medical student-led educational initiative in the jail setting as a tool to promote health literacy and decrease the infectious disease burden in the correctional setting. A four-part infectious disease health education curriculum was developed and tailored to a carceral context. The course was offered on a voluntary basis to members of a reentry program at a local county jail. Pre- and postcourse surveys were used to evaluate the course effectiveness. The results demonstrated a statistically significant increase in the participants' reported confidence for recognizing the symptoms of and seeking appropriate treatment for common infections, including sexually transmitted, respiratory, and blood-borne infections. To the authors' knowledge, this is one of the first medical student-led programs of its kind to be described in existing literature. This program hopes to continue refining its curricular offerings and serve as a model for medical schools across the country to increase trainee engagement. [ABSTRACT FROM AUTHOR]

Borrowing insights from Cullen's Theory of Social Support to explain the association between women's instrumental social supports and health risks over time, we analyzed data collected from 254 women who completed all waves (completers) or some but not all waves (non-completers) of follow-up data collection at 0, 12, 24, and 36 months. Trajectory and mixed model analyses showed that after release from jail, women had improvements in employment and transportation and reductions in exchange of sex for resources, alcohol use, hard drug use, and substance dependence. We provide a framework from which in-jail and community-based programs can draw from. [ABSTRACT FROM AUTHOR]

Preventing escapes from custody is an essential function of prisons and jails. Yet, when these incidents occur, little is known about how often or quickly escapees are recaptured. Drawing on the routine activities framework, this study examines a dataset of 610 prison and jail escapees collected through a comprehensive open-source search protocol. The study uses logistic and Cox regression techniques to determine which factors are associated with being recaptured and the time-to-recapture. Findings indicate that more than 91 percent of escapees were recaptured within 1 year and very few remained on the lam for more than a few days. People who escape from nonsecure facilities (often called walkaways) were less likely to be recaptured and remained out of custody for longer durations than those who escaped from secure facilities or while outside under secure (e.g., transport) or nonsecure (e.g., work release) settings. Jail escapees were also less likely to be recaptured, and were apprehended more slowly, than those who fled from a prison. [ABSTRACT FROM AUTHOR]

Quantitative evidence that poverty and economic inequality impact incarceration are presented. Three samples are examined, a panel of U.S. states and cross-sections of U.S. state and county prisons. In all three, incarceration is shown to rise as local poverty and/or inequality increase. Estimated impacts are found much stronger within relatively low-incarceration areas. Geographically, the relationship between inequality and incarceration is found to be statistically significant across the nation, but the relationship between poverty and incarceration appears more regional. However, the impact of poverty is shown to have increased during the early 21st century, while the opposite is true for inequality. [ABSTRACT FROM AUTHOR]

Opioid overdose death is significantly increased immediately following incarceration. Evidence-based medications are underutilized in rural jails and detention centers. We have reported our efforts to address this gap through telemedicine-based medications for opioid use disorder treatment (tele-MOUD) for incarcerated patients. Staff acceptance and perceptions are critically important factors in the assurance of program validation. We assessed tele-MOUD acceptability and perceptions of effectiveness and stigma in one detention center. Overall, we found that jail staff's general acceptability of the program was rather low, as was perceived effectiveness of MOUD, while stigmatizing beliefs were present. Furthermore, tele-MOUD acceptability was positively correlated with perceptions of MOUD effectiveness and negatively correlated with stigmatizing notions of MOUD (p's < 0.001). Findings suggest the need for educational interventions. Future research investigating the potential moderating effects of training on staff acceptability of jail-based tele-MOUD will support the implementation and sustainability of these life-saving programs. [ABSTRACT FROM AUTHOR]

Summary: Background: Incarcerated people are at high risk of blood-borne virus infections, particularly HCV, and a priority population for elimination efforts. This national bio-behavioural survey evaluated blood-borne virus prevalence and HCV testing-and-treatment uptake amongst people in Australian prisons. Methods: Randomly-selected participants from 23 representative prisons nationally were offered point-of-care testing for HIV and HCV (anti-HCV) antibodies, hepatitis B surface antigen (HBsAg), and HCV RNA (if anti-HCV positive). Demographic data and previous HCV testing and treatment were collected by structured interview. Findings: 1599 individuals participated (98% participation; 89%male; median age 35 years; 49% ever injected drugs). Prevalence estimates were: 31.7% (95% CI:28.8–34.8) for anti-HCV; 8.0%for HCV RNA (95% CI:6.4–9.9); 0.5% (95% CI:0.2–1.1) for HBsAg, and 0.8% (95% CI: 0.4–1.7) for HIV antibody. Among participants who had ever injected drugs (n = 787), HCV RNA prevalence was highest among those injecting and sharing needles/syringes within the past month [27.9%; adjusted odds ratio (aOR):4.54 (95% CI:2.65–7.77). Among participants (n = 1599), 70.4% (95% CI: 67.4–73.2) had ever been tested for HCV (62.6% in prison). The highest likelihood of having had HCV testing was observed among participants who injected drugs in the past month (aOR = 10.37, 95% CI:5.72–0.18.78). Among those eligible (n = 318), 84.6% (95% CI:79.2–88.7) had ever received HCV treatment (75.0% in prison), and 67.8% (95% CI:61.7–73.4) were cured. The likelihood of HCV treatment was higher among those previously imprisoned, (aOR = 2.67, 95% CI:1.20–5.93). Interpretation: Despite high overall HCV testing and treatment uptake, the lower uptake and substantial ongoing HCV disease burden in some sub-populations highlights the need for continued prison-based elimination efforts with population-specific interventions. Funding: The AusHep study was funded by the Australian Government Department of Health and Aged Care.

Introduction Tuberculosis is a major cause of mortality worldwide. Prisoners in Guiana have multiple risk factors. The primary objective of this study was to describe tuberculosis occurring in prison and after release in French Guiana between 2008 and 2020. Secondary objectives were to identify tuberculosis risk factors and determine annual incidences.Methods: A retrospective cohort study of tuberculosis cases was carried out at the Guiana prison between 2008 and 2020. Data were collected from prison registers and cross-referenced with the list of tuberculosis notifications in French Guiana.Results: A total of 36 cases of tuberculosis were studied. Incidence was high, at 263/100,000 per year, higher than elsewhere in France and comparable to that in Brazil. Despite visibly effective screening on entry, with little evidence of intra-prison circulation of tuberculosis, 39% of patients were diagnosed within two years of leaving prison (76% were symptomatic). This could be explained by the high prevalence of latent forms (LTI).Discussion Continued screening on entry, in combination with annual radiological and clinical screening, and reinforced follow-up on release seem indicated to improve patient management and the search for possible LTI.

Government rules is allowed female prisoners to carry her children in a jail (RUTAN) for a maximum 2 years. This study aims to observe and analyze the concerned for every children rights of female prisoners who lived inside the jail. The type of research used empirical juridical method by taking the research area in the Class IIA Women's Penitentiary Surabaya and used qualitative descriptive as an analysis method. The results found : 1.) Class II A Women's Penitentiary appllied law regulation on PP No.58 tahun 1999 Government Rules about procedure of policy authority and prisoners cares responsibility that contain the rights of children born to female prisoners such as breastfeeding, immunization, nutrition foods, nursery room, health center, playground, additional needs. 2.) Based on 7 rights, only 3 had already work and the rest is still cannot managed well and became struggles such as less immunization, child needs are not provide properly, health rights policy which not related to regulation on PP No.58 Th 1999, no proper places for kids, Psychology for mom and kid are needed. 3.) Jail administrator still working on progress to provide any necessary to minimize the struggles.

Cognitive impairments are associated with poor outcomes for persons in criminal justice. Traumatic brain injury (TBI) causes cognitive impairments, but cognitive impairments are also associated with other behavioral health comorbidities like mental illness, substance abuse, trauma history and suicidality. Research has not yet quantified the relative risk for cognitive impairments conferred by behavioral health and traditional brain injury-related vulnerabilities. This study examined clinical interview and computerized cognitive test data from 156 men in the criminal legal system with a reported history of traumatic brain injury that included a loss of consciousness (LOC). To identify which factors best predicted cognition, three hierarchical linear regressions were conducted with measures of learning, attention and inhibition as the independent variables. Age, history of mental illness and history of suicide attempt emerged as significant predictors of poor performance on measures of learning and attention. Men with a history of mental illness exhibited poorer impulse control. Overall, behavioral health comorbidities were significant predictors of cognitive outcomes and outperformed brain injury-related characteristics. Results from this study suggest that, while TBI is a risk factor for cognitive impairment, the adverse behavioral health comorbidities associated with TBI are even more critical. In this way, behavioral health is critical to brain health. Importantly, this group of vulnerable men is characterized by a history of substance abuse (97.1%), mental illness (77.6%) and attempts to die by suicide (37.8%) which is almost 10 times higher than the general population base rate of suicidal behavior. Understanding the vulnerabilities of these men, including the contributions of behavioral health comorbidities to cognitive impairment, can help prioritize interventions in systems where resources and staff time are limited.

AbstractIncarcerated women are confined in institutions designed to punish. These sites often ignore the complex mental and physical health needs of people who are incarcerated. Despite the World Health Organization stressing the need for access to reproductive healthcare in carceral institutions, stigma surrounding abortion care and health inequalities create contextually specific issues for incarcerated people seeking to access these services. There is also a dearth of research conducted directly with incarcerated women, trans men and non-binary people to examine their experiences of abortion. A systematic review of international peer-reviewed and grey literature was completed to summarise existing evidence from research conducted on the experiences of needing abortion care whilst incarcerated. Various experiences were identified including: conditions of confinement shaping abortion decisions; bureaucratic obstacles to accessing abortion services; incarcerated women, carceral staff and carceral healthcare staff’s lack of understanding of abortion rights and procedures; and a scarcity of support and empathy, including experiences of stigmatisation and lack of confidentiality. There exists a significant gap in research examining the experiences of incarcerated people who may need an abortion, emphasising the need for international collaboration and advocacy to address systemic issues that extend beyond local contexts. [ABSTRACT FROM AUTHOR]

Background: Opioid-related overdose is the leading cause of death for people recently released from incarceration, however treatment with medications for opioid use disorder (MOUD) during incarceration can reduce the mortality risk. This study seeks to qualitatively analyze perceptions of post-release overdose risk from the perspectives of people who received MOUD while incarcerated in one of eight Massachusetts jails during 2021–2022 using the Risk Environment Framework to guide analyses. Methods: N = 38 participants with lived experience of MOUD treatment during incarceration who are now living in the community were interviewed on factors that may contribute to or protect against post-release overdose risk. Themes were identified inductively and deductively using the Risk Environment Framework and its domains, which organizes themes along physical, social, economic, and policy environments on both the micro- and macro- scales. Results: The physical risk environment included loss of opioid tolerance during incarceration, polysubstance use, and the toxicity of the regional drug supply as key producers of increased risk for post-release overdose. Social drivers of risk included peer group risk norms—including peer-driven harm reduction practices and interpersonal relationships between drug sellers and buyers—as well as macro-level social determinants of health such as housing insecurity and availability of mental health services. Economic drivers of post-release overdose risk included lack of income generation during incarceration and employment challenges. Participants discussed several aspects of policy that contribute to post-release overdose risk, including availability of harm reduction supplies, public health services, and broader policy around MOUD. Conclusions: The perspectives of people with lived experience are vital to understanding the disproportionate risks of overdose for those recently released from incarceration. Our results highlight the intersectional factors that produce and reproduce the post-release overdose risk environment, providing support for interventions across each domain of the Risk Environment Framework. By capturing perspectives from people with lived experience of OUD and incarceration during this critical period of risk, we can better identify interventions that target and mitigate overdose-related harm in this population. [ABSTRACT FROM AUTHOR]

Aims: We estimated the prevalence of substance use disorders (SUDs) in the Norwegian, Danish and Swedish prison populations and compared the prevalence of SUDs in the national prison populations with country‐specific general population prevalence rates. Design: A multi‐national cohort study using data from the National Prison Registries linked to the National Patient Registries in Norway, Denmark and Sweden. Setting and participants: We used data from the PriSUD‐Nordic study, including national prison populations aged 19 years and older in Norway (2010–19), Denmark (2010–18) and Sweden (2010–13). A total of 119 507 Individuals (108 971 men and 10 536 women) contributing to 191 549 incarcerations were included in the study (Norway: 45432 men; 5429 women, Denmark: 42 162 men; 3370 women, Sweden: 21 377 men; 1737 women). Measurement: We calculated a study prevalence and prevalence at entry to prison for all types of SUDs before imprisonment each consecutive year of observation in each prison population. We also extracted country‐specific 1‐year prevalence rates from the Global Burden of Diseases database to calculate comparative national prevalence ratios. Findings The study prevalence of any SUD was approximately 40% [Norway: 44.0%, 95% confidence interval (CI) = 43.6–44.5%; Denmark: 39.9%, CI = 39.5–40.4%; Sweden: 39.1%, CI = 38.4–39.7%] in all three countries. Women had a significantly higher study prevalence of any SUD compared with men (Norway: 55.8 versus 42.6%, P < 0.001; Denmark 43.1 versus 39.7%, P = 0.004; Sweden: 51.7 versus 38.0%, P < 0.001). Prevalence estimates were higher for SUDs among people in prison than in the general population. We observed an increasing proportion of people with SUDs entering prison in Norway (P = 0.003), while the proportion was more stable in Denmark and Sweden. Conclusions: Substance use disorders (SUDs) appear to be highly prevalent among the Scandinavian prison populations compared with the general population, especially among women. In Norway, there was a relative increase in SUDs from 2010 to 2019. [ABSTRACT FROM AUTHOR]

Research Summary Policy Implications: The average length of jail stays is increasing despite national efforts to reduce these populations. The current study examines variations in lengths of stay, differentiating between short and long pretrial stays. Using data from two large jails in metropolitan jurisdictions, we take an intersectional perspective and model potential differences among race, gender, and residing in a high‐poverty area. In both locations, we find that Black men are the most likely to have long lengths of stay, but that length of stay varies depending on the intersection of gender, race, and neighborhood poverty.The human costs of pretrial detention are paid unequally by different groups of people. Given the downstream costs of pretrial detention, this work suggests that focusing policy efforts on the barriers to release among people of color, particularly Black men, would be fruitful. There is evidence that bail reform can reduce some barriers to release without increases in crime. Further, attending to obstacles to case processing could lead to pretrial system reform. This work also highlights another area of the criminal legal system where Black males, compared to their White counterparts, are disparately affected and denotes the continuing need for intersectional perspectives on reform. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic brought unprecedented problems to correctional facilities globally, increasing issues of overcrowding and public health. This study delves into the lived experiences of jail officers during the pandemic, focusing on their experiences with high congestion rates among persons deprived of liberty. Twelve participants were given detailed semi structured interviews to investigate their lived experiences, and the data was analyzed utilizing interpretative phenomenological analysis. This study exposes the many challenges that these jail officers encountered as they reached an intricate setting where health, safety, and justice all intersected. Findings discuss the emotional experiences, health risks, and personal problems experienced by jail officers while upholding their duty of care. Moreover, this study emphasizes the importance of lawmakers actions and reform within the criminal justice system to ensure the safety of both jail officials and inmates as well as following public health crises. The experiences of jail officers, who were first hand witnesses of the pandemic's outcome on the prison population, provide light on important facets of our society's behavior to these unprecedented conditions. This study informs concerning future readiness and change in the criminal justice system and helps us understand the intricate dynamics that existed within correctional facilities throughout the epidemic. [ABSTRACT FROM AUTHOR]

The current study utilizes a dataset of 1,300 individuals who have been released from a Pennsylvania county jail between 2015 to 2017 to assess the competing risks of returning to jail on a probation violation versus committing a new offense. The study also examines differences between males and females. The findings suggest that while traditional predictors of recidivism help to explain male behavior, they do not allow for an understanding of women's recidivism. Future research must continue to explore gender-specific factors to provide more clarity on the experiences of men and women upon release. [ABSTRACT FROM AUTHOR]

Suicides, and related self-injurious thoughts and behaviors (SITBs), are among the leading public health concerns in American jails. Despite suicide being the leading cause of death in jails, there is little information about the prevalence of SITBs among incarcerated individuals. The Self-Injurious Thoughts and Behaviors Interview (SITBI) was developed to assess the presence, frequency, and characteristics of self-injurious thoughts and behaviors. The SITBI has been implemented and validated in a variety of clinical and research settings, but not among incarcerated individuals. With survey data collected from two samples of incarcerated individuals from Florida and Texas, single-item reliability, graded item response modeling, and validity tests are used to evaluate the psychometric properties of an adapted version of the SITBI, the SITBI-J (Self-Injurious Thoughts and Behaviors Interview – Jail). The SITBI-J demonstrated strong single-item coefficients (coefficient range from rx =.33–.99).: The SITBI-J showed strong construct validity when assessed using convergent tests with Beck's Hopelessness Scale, and discriminate validity against a theoretically dissimilar measure. Results demonstrate the potential of the SITBI-J for correctional settings. Future research should continue to test and validate the SITBI-J in other jail facilities. [ABSTRACT FROM AUTHOR]

Copyright of Foro Revista de Derecho is the property of Universidad Andina Simon Bolivar, Sede Ecuador and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Foro Revista de Derecho is the property of Universidad Andina Simon Bolivar, Sede Ecuador and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Guided by the premise that an individual's safety may be more at risk when their routines, personal attributes, or lack of guardianship influence their opportunity for exposure to violence, we examined the factors that influenced victimization risks and safety perceptions among a representative sample of respondents incarcerated at a large Midwestern jail. Results showed that vulnerable individuals such as those who were victimized prior to their incarceration, and those who antagonized others such as those who perpetrated assault, were threatened more often, were more at risk of assault victimization, and perceived more dangerous conditions. Conversely, females and individuals with greater self-control were less likely to have experienced victimization and generally felt safer in jail. Our results illustrate the importance of identifying and protecting individuals who might experience greater safety risks during jail incarceration and should be interpreted alongside research and policy aimed at improving safety and welfare within correctional institutions. [ABSTRACT FROM AUTHOR]

Body-worn cameras (BWC) have become ubiquitous in law enforcement but are nascent in correctional settings. There is little research on the attitudes of the corrections personnel expected to wear these devices, even though their buy-in is critical for successful implementation. We address this gap by examining the perceptions of deputies from the Loudoun County, Virginia Adult Detention Center (LCADC) who participated in a 12-month BWC pilot program. We survey LCADC deputies at three periods (pre-, mid-, and post-implementation) and analyze mean changes in their perceptions of BWCs and staff-resident relationships. We find that LCADC deputies were neutral or did not agree that BWCs would improve efficiency and accuracy, have a civilizing effect on incarcerated residents, or lead to work-related disruptions. These attitudes remain largely consistent across the three survey periods. We also find that deputies had more negative perceptions of their relationships with residents at both the mid- and post-implementation periods, compared to the pre-implementation period. The results suggest that, when developing a BWC program, corrections officials should involve front-line personnel early in the planning process. Officials should also ensure policies are tailored to the unique needs of their correctional agency, rather than merely adapting policies created for law enforcement. [ABSTRACT FROM AUTHOR]

Jail programming is rarely informed by site-specific health needs, diagnostic-specific screening tools that are validated, or the input of incarcerated individuals. Using the community needs assessment (CNA) framework, we aimed to fill these gaps among people incarcerated in the Pulaski County Regional Detention Facility (PCRDF), Arkansas' largest jail. Participants were 179 adults at the PCRDF who completed surveys and open-ended questions focused on (a) their mental and behavioral health and (b) programming needs at the facility. Using a concurrent transformative mixed-methods design, we descriptively analyzed surveys and conducted content analysis of the open-ended questions. Over half of participants reported clinically significant anxiety (62.6%), post-traumatic stress disorder (53.1%), and/or depression (50.3%) symptoms; positive substance use disorder screening was especially common (91.7%). Nearly all (97%) individuals queried desired more programming, with the most desired being mental health and substance use programs. Other desired programs included physical health, education, community reintegration, family support, recreation, nutrition, religious/spiritual services, and meditation. Our CNA ensured the input of those directly impacted during program-focused decision making and identified strategies to effectively implement and sustain jail-based programs. Such assessments can be a potential mechanism for addressing the burden of mental and behavioral health problems in jail populations. [ABSTRACT FROM AUTHOR]

People experiencing incarceration (PEI) have poorer COVID-19 clinical outcomes compared with the general population. Many interventions were implemented in incarceration facilities to mitigate the burden of COVID-19. This systematic review seeks to analyze the effectiveness of these interventions. Twenty-two studies were included. Reduction of the incarcerated population/interfacility transfers, cohorting of new and infectious incarcerated people, mass asymptomatic testing (despite often low uptake), hygiene measures, and prioritization of PEI in vaccine policy had some evidence of effectiveness at reducing transmission and risk of COVID-19 in incarceration facilities. Visitation suspension had conflicting evidence of effectiveness. Studies were of low or medium quality. Inadequate control of confounding variables limited the reliability and validity of conclusions drawn. Many studies relied on retrospective, third-party data. Higher quality research is required. [ABSTRACT FROM AUTHOR]

Pretrial assessment instruments provide courtroom actors with information about the likelihood that someone who has been charged with a criminal offense would engage in criminal behavior if released prior to trial. Although prior research supports the ability of pretrial instruments to predict pretrial outcomes, there are concerns that pretrial instruments may inadvertently exacerbate racial-ethnic and sex disparities found in the larger criminal legal system. In the current study, we conduct multi-site predictive bias tests of a widely used pretrial instrument—the Public Safety Assessment (PSA)— across six racial-ethnic and sex groups (i.e., White males, White females, Black males, Black females, Hispanic males, and Hispanic females). Study results support the PSA as a valid and consistent predictor of failure to appear, new criminal activity, and new violent criminal activity across these six racial-ethnic and sex groups. These findings support the use of the PSA and identify several areas for future research. [ABSTRACT FROM AUTHOR]

This study proposes and analyzes a deterministic mathematical model to describe the dynamics of corruption transmission. We began by proving that the solution to the model is bounded and positive. The next-generation matrix approach is used to compute the basic reproduction number (TZQ) in relation to corruption-free equilibrium. The Jacobian and Lyapunov functions are used to show that corruption-free equilibrium is asymptotically stable in both locally and globally when TZQ < 1, and otherwise, an endemic corruption equilibrium develops. Furthermore, the sensitivity of the model's parameters was investigated. The findings demonstrate that religious precepts govern public education. The two sectors most susceptible to corruption controlare education and corrections. The study recommends investing more in the provision of public education to citizens by creating awareness among all and including it in the education curriculum and religious leaders to teach their followers seriously about the impact of corruption as well as the use of jail as punishment. The numerical simulation results agreed with the analytical results. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This article uses the concept of a progressive jail assemblage to think about the focus on jails as both a target of social justice organizing and a tool for advancing social justice goals. Drawing on ethnographic research conducted among formerly incarcerated organizers and their allies in Western Massachusetts (New England), I explore how the sheriffs who operate jails in this region, along with their collaborators, have increasingly sought to redefine the figure of the criminal as not just a danger to others but also a danger to themselves, someone in need of rehabilitative treatment and even care. In doing so, these sheriffs have attempted to reinvent their role, from the quintessentially American crime fighting figure, to one who is also a provider of care. Social justice activism has helped to expand the "caring" role of the jail, through increased addiction treatment, re-entry support, and community outreach - even to the extent of incarcerating individuals dealing with addiction who have not been charged with a crime. As progressive jails have been reconfigured as providers of care, abolitionists are confronted with the ongoing dilemma of how to remain a figure opposed to the use of prisons and jails without being seen as against care. [ABSTRACT FROM AUTHOR]

Background: Buprenorphine maintenance treatment remains unavailable in most jails in the US. We provide data on a four-day rapid sublingual buprenorphine (SL-B) induction strategy followed by a weekly dose of extended-release injectable buprenorphine (XR-B) with incarcerated individuals with opioid use disorder (OUD) who were not opioid tolerant. Methods: Between October 2020 to April 2024, N = 65 individuals with an opioid use disorder in jails participating in a larger randomized, controlled trial received SL-B and XR-B prior to release. Primary outcomes included completing the proposed dose induction and any reported adverse events (AEs). Results: Sixty-five individuals received SL-B dose induction from our team’s medical staff, 53 (81.5 %) completed the four-day SL-B dose induction and received their first weekly XR‑B injection on day 5. Of the 65 individuals, 10 (15.38 %) participants reported AEs during the dosing period and/or in the week following the dosing period. All but one of the AEs were rated as mild. One participant experienced a serious adverse event in the week following dose induction. The study medical team determined that this was unlikely to be related to the intervention. Discussion: Overall, our study findings demonstrate the feasibility of implementing a four-day sublingual dose induction followed by a weekly XR-B injection with incarcerated individuals who are not opioid tolerant. This study provides important data to illustrate a dose induction strategy that might assist in reducing illicit diversion in jails, which is a main barrier to buprenorphine delivery cited by correctional administrators.

UNLABELLED: In this study, the authors explore how young adults navigated the dual challenges of the COVID-19 pandemic and jail reentry in a large urban environment. Fifteen young adults (aged 18-25) participated in up to nine monthly semi-structured interviews to discuss their experiences of reentry during the height of the COVID-19 pandemic (i.e., spring and summer 2020). Participants held mixed attitudes and beliefs about COVID-19. Several participants viewed the pandemic as a hoax, while others took the pandemic more seriously, particularly if their friends and family members had contracted the virus. Yet nearly all participants viewed the pandemic as having a relatively minimal impact on their lives compared to the weight of their reentry challenges and probation requirements. Young adults described COVID-19 stay-at-home orders as limiting their exposure to negative influences and facilitating compliance with probation requirements. However, resource closures due to COVID-19, including schools, employment programs, and social services presented barriers to reentry success. The authors draw upon these findings to pose implications for interventions supporting young adult reentry. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12103-022-09683-8.

Correctional facilities house millions of residents in communities throughout the United States. Such congregate settings are critical for national infection prevention and control (IPC) efforts. Carceral settings can be sites where infectious diseases are detected in patient populations who may not otherwise have access to health care services, and as highlighted by the COVID-19 pandemic, where outbreaks of infectious diseases may result in spread to residents, correctional staff, and the community at large. Correctional IPC, while sharing commonalities with IPC in other settings, is unique programmatically and operationally. In this article, we identify common challenges with correctional IPC program implementation and recommend action steps for advancing correctional IPC as a national public health priority.

Institution-level wastewater-based surveillance was implemented during the COVID-19 pandemic, including in carceral facilities. We examined the relationship between COVID-19 diagnostic test results of residents in a jail in Atlanta, Georgia, USA (average population ≈2,700), and quantitative reverse transcription PCR signal for SARS-CoV-2 in weekly wastewater samples collected during October 2021‒May 2022. The jail offered residents rapid antigen testing at entry and periodic mass screenings by reverse transcription PCR of self-collected nasal swab specimens. We aggregated individual test data, calculated the Spearman correlation coefficient, and performed logistic regression to examine the relationship between strength of SARS-CoV-2 PCR signal (cycle threshold value) in wastewater and percentage of jail population that tested positive for COVID-19. Of 13,745 nasal specimens collected, 3.9% were COVID-positive (range 0%–29.5% per week). We observed a strong inverse correlation between diagnostic test positivity and cycle threshold value (r = −0.67; p

Abstract Background A previous scoping review of legal-involved veterans’ health and healthcare (1947–2017) identified studies and their limitations. Given the influx of literature published recently, this study aimed to update the previous review and map articles to the Veterans-Sequential Intercept Model (V-SIM) – a conceptual model used by key partners, including Veterans Health Administration, veteran advocates, criminal justice practitioners, and local governments to identify intercept points in the criminal legal system where resources and programming can be provided. Developing an updated resource of literature is essential to inform current research, discover gaps, and highlight areas for future research. Methods A systematic search of 5 databases identified articles related to legal-involved veterans’ health and healthcare published between December 2017 through December 2022. The first and senior authors conducted abstract reviews, full-text reviews, and data extraction of study characteristics. Finally, each article was sorted by the various intercept points from the V-SIM. Results Of 903 potentially relevant articles, 107 peer-reviewed publications were included in this review, most related to mental health (66/107, 62%) and used an observational quantitative study design (95/107, 89%). Although most articles did not explicitly use the V-SIM to guide data collection, analyses, or interpretation, all could be mapped to this conceptual model. Half of the articles (54/107, 50%) collected data from intercept 5 (Community Corrections and Support Intercept) of the V-SIM. No articles gathered data from intercepts 0 (Community and Emergency Services Intercept), 1 (Law Enforcement Intercept), or 2 (Initial Detention and Court Hearings Intercept). Conclusions There were 107 articles published in the last five years compared to 190 articles published in 70 years covered in the last review, illustrating the growing interest in legal-involved veterans. The V-SIM is widely used by front-line providers and clinical leadership, but not by researchers to guide their work. By clearly tying their research to the V-SIM, researchers could generate results to help guide policy and practice at specific intercept points. Despite the large number of publications, research on prevention and early intervention for legal-involved veterans is lacking, indicating areas of great need for future studies.

Abstract Background Implementation of medications for opioid use disorder (MOUD) in jails varies by facility and across states. Organizational climate, including staff attitudes toward change and exposure to education, can influence perceptions of innovations like MOUD in jails. Using a mixed methods design, we aimed to understand the association between organizational climate and jail staff perceptions of MOUD. Methods Jail staff (n = 111) who operate MOUD programs in 6 Massachusetts jails completed surveys that included the Organizational Readiness for Implementing Change (ORIC) survey. Random effects logistic regression models assessed associations between organizational climate and several outcomes of perceived MOUD efficacy, acceptability, and knowledge, while controlling for covariates. Jail staff (N = 61) participated in qualitative interviews and focus groups focused on organizational climate and knowledge diffusion, which we analyzed using inductive and deductive methods. Results The results indicate that organizational change readiness on the ORIC was associated with positive perceptions of MOUD, and educational resources facilitated MOUD implementation. Greater ORIC was associated with higher perception of methadone as highly acceptable for jail populations (Odds ratio [OR] 2.3, 95% Confidence Interval [CI] 1.2 to 4.4), and high knowledge of methadone (OR 2.3, 95% CI 1.1 to 4.9), with similar magnitude of effects for buprenorphine. High levels of training for jail staff on methadone and buprenorphine were also associated with higher knowledge of these medications (Methadone: OR 7.2, 95% CI 2.2 to 23.2; Buprenorphine: OR 3.4, 95% CI 1.2 to 9.5). Qualitative results point towards the importance of organizational climate and elucidate educational strategies to improve staff perceptions of MOUD. Conclusion Results underscore the importance of organizational climate for successful implementation of jail MOUD programs and provide support for medication-specific educational resources as a facilitator of successful MOUD implementation in jail settings. Findings highlight implementation strategies that may improve jail staff perceptions of MOUD.