Conclusions Targeted interventions in treatment and rehabilitation programs could help prevent unnecessary ED use and reduce the use of EDs through drug treatment during incarceration and after release. Previous work has indicated that these variables are associated with health services usage among at-risk individuals in Los Angeles County Erlyana, et al. Sex trade involvement was associated with having abscesses among injection drug users Lloyd-Smith et al. A single mediator model determines whether the relationship of the independent variable to the dependent variable was mediated by another third variable. Prevalence of substance use and dependence was higher among prisoners than the general population, particularly among drug using women Fazel et al. The poor health status of reentry populations also led to use of high-cost health services Leukefeld et al.
The ED serves as an entry point for inpatient admissions and is a common setting for acute care. Most of the Cooperative Agreement data used a 6-month follow-up period, but did not find any differences between conditions at follow-up. We also hypothesized that those who traded sex for drugs or money were also more likely to use an ED. This study investigates whether the impact of history of incarceration on ED use is mediated by opiate use and sex trading for drugs or money, two current public health problems with substantial risks to individual health. A z score is then calculated to determine the statistical significance of the mediated or indirect effect. In this meta-analysis, it was found that the reliabilities for most sex behaviors and most drug use were better with the shorter recall period. The literature also suggests that only heavy illicit drug users were reported to use EDs rather than non-drug users French et al. Among women, stigma caused by drug use and incarceration increases the need for health and social services, but restricts access to those services van Olphen et al. Prisons may be high-risk environments for the initiation and use of heroin and other drugs Boys et al. Therefore, it is important to investigate patterns of ED use by reentry populations, particularly factors that mediate the use of EDs among individuals with a history of incarceration. Each client was interviewed using two different instruments: A single mediator model determines whether the relationship of the independent variable to the dependent variable was mediated by another third variable. The poor health status of reentry populations also led to use of high-cost health services Leukefeld et al. Statistical analysis This study utilized mediation analysis to investigate factors that mediated the relationship between history of incarceration and ED use. Other information collected included age, gender, sexual orientation, race, marital status, educational attainment, living arrangements, homelessness, and income. Mediation models are developed through a series of regression models where the direct effect of the independent variable are assessed by regression coefficients and standard errors; the effect of the mediator variable is also assessed by regression coefficients and standard errors; and the indirect or mediated effect is of the independent variable on the outcome variable via the mediator variable is then calculated. The findings suggested that the effect of history of incarceration on ED use was exacerbated when the individuals were male and opiate users. All analyses were conducted in SAS 9. Conclusions Targeted interventions in treatment and rehabilitation programs could help prevent unnecessary ED use and reduce the use of EDs through drug treatment during incarceration and after release. Challenges in accessing health care and medication and risk factors for HIV and hepatitis C infection HCV were more prevalent among former inmates, especially immediately after release Adams et al. In addition to being an ongoing challenge for corrections, drug abuse may predispose an individual to misuse or underutilize health services Leukefeld et al. The RBA elicits information on drug utilization use of any type of drugs in the last month, use of injected drugs, and frequency of use , sex trading practices, and history of incarceration including length of time in jail or prison. Other barriers to receiving health care include structural poverty, homelessness and individual factors such as drug use, fear of violent victimization, and mental illness Kurtz et al. The sample also consisted of participants recruited through snowball sampling, as many participants refer others into testing. Use of mediation analysis explains the mechanism through which the independent variable affects the dependent variable MacKinnon, Previous work has indicated that these variables are associated with health services usage among at-risk individuals in Los Angeles County Erlyana, et al.
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