A Multi-component Intervention For Smoking Cessation Among Australian Male Prison Inmates
Funder
National Health and Medical Research Council
Funding Amount
$551,500.00
Summary
The prevalence of smoking amongst the Australian prison population is much higher than that in the general community. Despite a perception that prison inmates are unlikely to give up smoking while in prison, a recent survey has found that many inmates have attempted to quit or have reduced the amount they smoke. The same survey reported that almost a quarter of male inmates were planning to give up smoking within the next three months. Depression and anxiety are common among prison inmates. Rese ....The prevalence of smoking amongst the Australian prison population is much higher than that in the general community. Despite a perception that prison inmates are unlikely to give up smoking while in prison, a recent survey has found that many inmates have attempted to quit or have reduced the amount they smoke. The same survey reported that almost a quarter of male inmates were planning to give up smoking within the next three months. Depression and anxiety are common among prison inmates. Research has shown that people with depression or anxiety problems are less likely to quit, and more likely to relapse, than smokers without these symptoms. For this reason there has been interest in incorporating antidepressant medications into quit strategies. As a group with a high prevalence of depression and anxiety, prisoners may benefit from an intervention strategy that includes an antidepressant medication. Prisoners are often poorly educated, on a low income or benefits, or from a lower socioeconomic or an indigenous background. Members of this disadvantaged group have been shown to be less likely to use preventive health services, such as smoking cessation programs. This research proposal represents the first large scale randomised controlled trial of a multi-component intervention for tobacco dependence amongst a prisoner population in the world. This project will compare the effectiveness of adding an antidepressant medication to counselling, nicotine replacement therapy, a coping with change package and referral to a Quitline. The proposed research follows a small pilot study of the feasibility of a similar intervention. It brings together the expertise of several people across Australia with experience in tobacco dependence and prison research. The results will inform future smoking interventions for prison inmates and offers a real opportunity to impact upon the health and well-being of some of the most marginalised groups in Australian society.Read moreRead less
An Examination Of The Causes Of Mortality Following Imprisonment In New South Wales Using Data-linkage.
Funder
National Health and Medical Research Council
Funding Amount
$205,500.00
Summary
Prisoner populations are characterised by poor health status including infectious diseases, injury, risk taking behaviours (eg. smoking and self-harm), mental illness, and substance abuse. Serosurveys of blood borne viruses such as hepatitis C and hepatitis B conducted in Australian and overseas prison settings have found that over one third of inmates have been exposed to these viruses with higher rates detected in injecting drug users and female inmates. Few attempts have been made to examine ....Prisoner populations are characterised by poor health status including infectious diseases, injury, risk taking behaviours (eg. smoking and self-harm), mental illness, and substance abuse. Serosurveys of blood borne viruses such as hepatitis C and hepatitis B conducted in Australian and overseas prison settings have found that over one third of inmates have been exposed to these viruses with higher rates detected in injecting drug users and female inmates. Few attempts have been made to examine the causes of mortality among prisoners following release from detention. Most interest has focused on overdoses in the period immediately following release; the aim of this study will examine all causes of death among individuals exposed to the correctional environment and compare these to death rates for NSW. Correctional centres house a largely male (94% in NSW) population with backgrounds of disadvantage in all areas, including Indigenous Australians, people of lower socio-economic status, those with a mental illness, and the intellectually disabled. There are currently over 21,000 (June 2001) prisoners detained in Australian correctional centres with approximately 39% housed in NSW. Fifteen percent of the NSW prisoners are Indigenous but comprise only 2% of the general population. The aims of this project will be to: (1) Identify all causes of death among ex-prisoners in NSW for the period 1985 to 2001; (2). Compare death rates in the study group with those in the NSW community; (3) Correlate pre-release health information contained in medical records with specific causes of death; (4) Compare causes of mortality among various sub-groups eg. injecting drug users, the mentally ill, violent offenders, and the intellectually disabled; (5) Examine causes of mortality between Indigenous and non-Indigenous inmates; and (6) use this information to develop pre-release programmes aimed at reducing excess mortality among this group.Read moreRead less
INVESTIGATING MORTALITY AMONG EX-PRISONERS IN QUEENSLAND: A DATA LINKAGE STUDY
Funder
National Health and Medical Research Council
Funding Amount
$716,801.00
Summary
NOTE: At the time of submitting the NOI for this project we had not yet received feedback from a submission to a parallel NHMRC funding round concerned with social disadvantage. We have since received very positive reviews for the trial foreshadowed in our NOI, and consistent with the recommendations of one reviewer, we have modified our application to complement the proposed trial by conducting a record linkage study. The content area and ethical issues associated with the proposed project rema ....NOTE: At the time of submitting the NOI for this project we had not yet received feedback from a submission to a parallel NHMRC funding round concerned with social disadvantage. We have since received very positive reviews for the trial foreshadowed in our NOI, and consistent with the recommendations of one reviewer, we have modified our application to complement the proposed trial by conducting a record linkage study. The content area and ethical issues associated with the proposed project remain largely unchanged. Studies in Australia and elsewhere have identified a heightened risk of death among ex-prisoners, with drug overdose, suicide and 'accidents' three major causes. Many deaths occur soon after release. Although the high incidence of 'overdose' among ex-prisoners is often attributed to reduced tolerance,most fatal drug overdoses are due to the combined effects of multiple drugs. A detailed understanding of deaths among ex-prisoners is a prerequisite for evidence-based preventive strategies. The proposed study will: (a) Link the identities of prisoners released from custody in QLD between 1994 and 2006, with the National Death Index (NDI). The linked database will permit exploration of the incidence, timing, causes and risk factors for death among ex-prisoners. (b) Compare correctional records of deceased ex-prisoners and a random sample of ex-prisoners known to be alive, focussing on suspected risk factors including criminal history, behaviour in custody, health status, psychosocial adjustment, socio-economic status, and history and treatment for drug use. This will allow more detailed analysis of risk factors for death post-release. (c) Conduct in-depth analysis of causes of death among ex-prisoners, using the National Coroners Information System (NCIS). Information regarding cause and context of death will be coded by a research assistant and analysed to identify group differences (e.g., between ATSI and non-ATSI ex-prisoners).Read moreRead less
Investigating The Association Between Incarceration While Pregnant And Maternal And Infant Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$307,500.00
Summary
The number of women incarcerated within Australian prisons has doubled over the last ten years. Prisons contain large numbers of women from Indigenous backgrounds, women with a mental illness, women with violent partners and women with substance abuse problems. As such they constitute one of the most disadvantaged groups within Australian society and their children are unlikely to experience a healthy start to life. At any one time around 5-10% of women inside Australian prisons are pregnant. Th ....The number of women incarcerated within Australian prisons has doubled over the last ten years. Prisons contain large numbers of women from Indigenous backgrounds, women with a mental illness, women with violent partners and women with substance abuse problems. As such they constitute one of the most disadvantaged groups within Australian society and their children are unlikely to experience a healthy start to life. At any one time around 5-10% of women inside Australian prisons are pregnant. There has been no Australian research into the effect incarceration has upon pregnant women or their babies. Some believe that women who are incarcerated during their pregnancy may have better outcomes as they are outside their normal milieu with restricted access to alcohol and illicit drugs and separated from abusive partners. Others argue that the stress of incarceration and separation from family and friends could result in poorer pregnancy outcomes. This study will investigate whether being imprisoned while pregnant results in better or worse pregnancy and birth outcomes for Australian women and their babies.Read moreRead less
Hepatitis C, Prisons And Treatment Opportunities (HePATO)
Funder
National Health and Medical Research Council
Funding Amount
$460,778.00
Summary
Despite the availability of an effective treatment for hepatitis C and the high prevalence of infection among Australian prisoners treatment uptake is extremely low. Using survey data and qualitative interviews with prisoners and prison health staff this project will investigate the structural and cultural barriers which limit access to treatment and care. The project will also estimate the public health benefits which would result if the uptake of treatment was to reach its full potential.
A Survey Of The Sexual Behaviour And Sexual Health Of Australian Prisoners
Funder
National Health and Medical Research Council
Funding Amount
$591,000.00
Summary
The Australian Study of Health and Relationships telephone survey recently reported on the sexual attitudes, knowledge, health and behaviour of over 19,000 Australians. One of the groups that was omitted from that survey was prisoners. Yet prisoners are a high-risk group for sexual ill health. Prisoners are mostly drawn from the most disadvantaged groups in society: they are more likely to be unemployed, they have less education and lower incomes than other Australians, and many suffer from mino ....The Australian Study of Health and Relationships telephone survey recently reported on the sexual attitudes, knowledge, health and behaviour of over 19,000 Australians. One of the groups that was omitted from that survey was prisoners. Yet prisoners are a high-risk group for sexual ill health. Prisoners are mostly drawn from the most disadvantaged groups in society: they are more likely to be unemployed, they have less education and lower incomes than other Australians, and many suffer from minor intellectual disabilities and-or mental illness. This proposed survey of inmates in Australian prisons will fill in this missing data. Prisoners are the forgotten population in many countries. Only a few surveys of prisoners' health have been performed. There are some surveys of sexual behaviour in particular prisons overseas, though most of them concentrate on HIV risks and do not explore the sexual lives of prisoners in the same way as the major national sex surveys in the US, the UK and France did for people living outside prison. Prison is itself a dangerous place for people's sexual health. In prison, much of the sex that occurs is not voluntary. Sexual assault in prisons can lead to serious physical injury as well as risk of sexually transmitted diseases including HIV-AIDS. Although some of these injuries can be sufficiently serious to require surgery, only a small proportion are reported to the authorities. Younger prisoners (aged 18-25) and those who are small, slightly built or gay, are at higher risk of being assaulted. This study will explore the factors surrounding sexual assault in prison and make recommendations for preventing it.Read moreRead less
Using Mathematical Models To Assess The Impact Of Interventions To Reduce Sexually Transmitted Infections In Australia
Funder
National Health and Medical Research Council
Funding Amount
$562,276.00
Summary
Sexually transmitted infections (STIs) are an increasing public health problem in Australia. Australia's recent National Transmissible Infections Strategy identified chlamydia control, STI prevention in gay men and STIs in Aboriginal and Torres Strait Islander communities as priority areas. We propose to develop mathematical models of STI transmission and use these to help understand and identify the most cost-effective interventions to reduce the impact of STIs on Australian populations.
Blue Mountains Cohort Study: Long-term (15-year) Incidence Of Eye Disease, Hearing Loss And Other Public Health Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$837,919.00
Summary
The Blue Mountains Eye Study 15-year study will re-examine survivors of the 3,654 persons who participated in baseline BMES exams, to determine the long-term development and progression of sensory problems, including vision and hearing loss and eye diseases like macular degeneration, glaucoma, cataract or diabetic eye damage. The project will assess whether vascular conditions like high blood pressure, chronic medical conditions, medications, smoking, diet, blood, family and genetic factors pred ....The Blue Mountains Eye Study 15-year study will re-examine survivors of the 3,654 persons who participated in baseline BMES exams, to determine the long-term development and progression of sensory problems, including vision and hearing loss and eye diseases like macular degeneration, glaucoma, cataract or diabetic eye damage. The project will assess whether vascular conditions like high blood pressure, chronic medical conditions, medications, smoking, diet, blood, family and genetic factors predict the risk or age at onset of eye disease or hearing loss. We will assess impacts of vision and hearing loss on independence, falls, quality of life and development of memory loss and depression. This information will help to develop services, and to plan interventions to prevent and treat these conditions. Because of the exponential age-related increase in frequency of these diseases, this long follow-up will provide more disease events, and a longer interval to assess impacts from the exposures we measured when we started the BMES in 2002. It will enable us to estimate the strength of risk factors for eye disease and hearing loss with greater precision, essential to understand their evolution. Surviving participants from the original BMES will be invited to attend follow-up exams at our Katoomba clinic, or to attend mobile- nursing home exams. We will conduct similar exams to those previously to detect new or worsened eye disease or hearing loss. In 2002-4, we saw 82% of the population of 2 Blue Mountains postcodes aged 50 or older. At the 5- and 10-year exams we saw 75% of people still living. We expect the same proportion to participate this time. The BMES is one of Australia's main cohort studies with over 200 publications. It has yielded key findings on the frequency and causes of the major diseases threatening vision and hearing. Longer follow-up will greatly increase our power to detect predictors of these key age-dependent conditions.Read moreRead less
A Population-based Longitudinal Study Of Cancer Survivors' Psychosocial And Physical Well Being
Funder
National Health and Medical Research Council
Funding Amount
$454,600.00
Summary
Cancer control is a National Health Priority Area. About 345,000 new cases of cancer are diagnosed in Australia each year. It is the second highest cause of death accounting for 27% of all deaths in Australia each year. Improvements in diagnosis and treatment have resulted in a growing number of people living with a history of cancer and for longer periods. Many cancer survivors report experiencing negative effects of cancer such as fatigue, anxiety, depression, and disrupted family and social r ....Cancer control is a National Health Priority Area. About 345,000 new cases of cancer are diagnosed in Australia each year. It is the second highest cause of death accounting for 27% of all deaths in Australia each year. Improvements in diagnosis and treatment have resulted in a growing number of people living with a history of cancer and for longer periods. Many cancer survivors report experiencing negative effects of cancer such as fatigue, anxiety, depression, and disrupted family and social relationships well after treatment has finished. Despite the large burden of this disease, little is known about the later effects that cancer and its treatment has on cancer survivors, their ongoing concerns, how the issues they face change over time and the type of support they need. This will be the first population-based longitudinal survey of the physical and psychosocial effects that cancer has on adult cancer survivors to be undertaken in Australia. It will follow cancer survivors for the first five years from diagnosis to provide data on important outcomes including anxiety, depression, quality of life and unmet needs. It will also provide the first population-based data on the predictors of these outcomes, including social support, coping style and patient demographic, treatment and disease characteristics. Given the large-scale cancer survivorship initiatives underway internationally, it is timely for high quality and comprehensive Australian data to be obtained. These data will provide new information on how the physical, social and emotional impact of cancer changes with time since diagnosis and a better understanding of the support desired by cancer survivors at various stages of recovery or disease progression. This information will help guide the development of policies and services that are tailored to the needs of Australian cancer survivors.Read moreRead less