A Systematic Evaluation of Barriers and Facilitators to the Provision of Services for Justice-Involved Women
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ORIGINAL PAPER
A Systematic Evaluation of Barriers and Facilitators to the Provision of Services for Justice‑Involved Women Sharla Smith1 · Joi Wickliffe1 · Ivonne Rivera‑Newberry2 · Michelle Redmond3 · Patricia J. Kelly4 · Megha Ramaswamy1
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract The community health delivery system (CHDS) are vital agencies to the success of integration and the provision of services to improve the health and well-being of justice-involved women. Many agencies face barriers and challenges in providing services to vulnerable populations, such as justice-involved women, and, as a result, often offer individual rather than coordinator care. Thus, it is necessary to explore CHDS systemic barriers and challenges to identify opportunities for coordinated care. We conducted semi-structured interviews with 26 CHDS directors or designees to identify systemic barriers and challenges, organizational processes, experiences with vulnerable populations, services and programs, and care coordination and perceived women’s barriers and challenges to the provision of services including decision-making processes and access. Qualitative analyses were used to construct thematic descriptions in five areas: (1) mental health as an unmet need, (2) financial constraints, (3) limited organizational capacity, (4) implicit bias, and (5) minimal cultural support of vulnerable populations. Keywords Community health delivery system · Justice-involved women · Implicit bias · Structural competence
Introduction In 2017, women made up 7% of the total prison population—an increase of more than 100 prisoners from 2015 in the U.S [1–3]. The number of women incarcerated for more Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10900-020-00894-w) contains supplementary material, which is available to authorized users. * Sharla Smith [email protected] Patricia J. Kelly [email protected] 1
Department of Population Health, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mailstop 1008, Kansas City, KS 66160, USA
2
Family Planning Clinical Consultant, Kansas Department of Environmental Health, KDHE Wichita District Office, Wichita, KS, USA
3
Department of Population Health, University of Kansas School of Medicine, 1010 N. Kansas Street, Wichita, KS 67214, USA
4
College of Nursing, Thomas Jefferson University, Philadelphia, PA, USA
than 1 year increased by more than 700 prisoners in 2016 in the U.S [4, 5]. Kansas and Missouri similar to many other states have a reputation of incarcerating women, especially mothers dealing with drug or alcohol addictions and property crimes [6]. The Kansas incarceration rate for women is 137 per 100,000 and the Missouri incarceration rate for women is 176 per 100,000, compared to the U.S. incarceration rate of 133 per 100,000 [7, 8]. About two-thirds of these incarcerated women will be released into their communities, over 100,000 women reintegrating into Kansas and Missouri communities
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