NAU publications by CHER
Faculty & staff publications
NAU faculty and staff have the opportunity to publish their findings and knowledge as authors. CHER has many researchers that have been cited multiple times in major publications for their great work. The Center for Health Equity Research has accumulated all faculty publications into one, easy to navigate database.
Please type in a key word or author LAST name to search
Ricky Camplain, PhD ; Lauren Hale, PhD ; Carolyn Camplain, JD ; Rita Stageman, MSW ; Julie A. Baldwin, PhD Changes in sleep quality and housing status among individuals incarcerated in jail Journal Article Sleep Health, 8 (6), 2022. @article{Camplain2022g, title = {Changes in sleep quality and housing status among individuals incarcerated in jail}, author = {Ricky Camplain, PhD and Lauren Hale, PhD and Carolyn Camplain, JD and Rita Stageman, MSW and Julie A. Baldwin, PhD}, doi = {10.1016/j.sleh.2022.08.006}, year = {2022}, date = {2022-10-10}, journal = {Sleep Health}, volume = {8}, number = {6}, abstract = {Objective To investigate sleep quality among individuals incarcerated in a rural county jail, by housing status before incarceration. Methods Using cross-sectional survey methods, 194 individuals incarcerated in jail reported sleep quality prior to and during incarceration on a Likert scale and pre-incarceration housing status (ie, house, apartment, motel, group living, or homeless). Prevalence ratios (PR) were estimated using log binomial regression to determine associations between housing status before incarceration and changes in sleep quality. Results Participants in non-permanent housing before incarceration had a lower prevalence of worsening sleep quality while incarcerated (compared to stable or improving) compared to those in permanent housing before incarceration (PR = 1.69, 95% CI: 1.03, 2.77). Conclusions Pre-incarceration housing is associated with change in sleep quality among individuals incarcerated in jail. Jail may be an important point of intervention to improve sleep quality during incarceration and through connecting individuals to more stable living conditions.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Objective To investigate sleep quality among individuals incarcerated in a rural county jail, by housing status before incarceration. Methods Using cross-sectional survey methods, 194 individuals incarcerated in jail reported sleep quality prior to and during incarceration on a Likert scale and pre-incarceration housing status (ie, house, apartment, motel, group living, or homeless). Prevalence ratios (PR) were estimated using log binomial regression to determine associations between housing status before incarceration and changes in sleep quality. Results Participants in non-permanent housing before incarceration had a lower prevalence of worsening sleep quality while incarcerated (compared to stable or improving) compared to those in permanent housing before incarceration (PR = 1.69, 95% CI: 1.03, 2.77). Conclusions Pre-incarceration housing is associated with change in sleep quality among individuals incarcerated in jail. Jail may be an important point of intervention to improve sleep quality during incarceration and through connecting individuals to more stable living conditions. |
Lopez, Nanette V; Spilkin, Ary; Brauer, Julianne; Phillips, Rachelle; Kuss, Bonnie; Delio, Gabrielle; Camplain, Ricky Nutritional adequacy of meals and commissary items provided to individuals incarcerated in a southwest, rural county jail in the United States Journal Article BMC Nutrition, 8 (96), 2022. @article{Lopez2022b, title = {Nutritional adequacy of meals and commissary items provided to individuals incarcerated in a southwest, rural county jail in the United States}, author = {Nanette V. Lopez and Ary Spilkin and Julianne Brauer and Rachelle Phillips and Bonnie Kuss and Gabrielle Delio and Ricky Camplain }, doi = {10.1186/s40795-022-00593-w}, year = {2022}, date = {2022-09-03}, journal = {BMC Nutrition}, volume = {8}, number = {96}, abstract = {Background Poor diet may contribute to deleterious chronic health among individuals incarcerated. Yet, limited research has evaluated the nutritional content of menus and commissary items provided in jails. Thus, this study assessed the macronutrient distribution, caloric composition, and diet quality of the seven-day cycle menu and commissary items provided in a southwest, rural county jail in the United States. Methods Daily and mean availability of calories and macronutrients for the seven-day cycle menu and commissary items were estimated using NutritionCalc Plus®. Diet quality (i.e., Healthy Eating Index-2015 [HEI-2015]) was assessed. Macronutrients and calories were compared to the Acceptable Macronutrient Distribution Range (AMDR) and the 2020–2025 Dietary Guidelines for Americans (DGA). Protein and carbohydrate were compared to the Dietary Reference Intake (DRI). HEI-2015 was compared to the average U.S. diet. Results Daily caloric provisions exceeded DGA recommendations. Daily available (16.2%-25.2% kcal/day) and mean protein met the AMDR recommendations, yet exceeded the DRI. Mean protein with commissary packs exceeded the AMDR recommendations and DRI. Daily available carbohydrate met AMDR recommendations for all but two days of the seven-day cycle menu, which exceeded recommendations (52.5%-66.4% kcal/day). Mean carbohydrate met the AMDR recommendations and exceeded the DRI, and with the commissary packs, exceeded the AMDR recommendations and DRI. Daily available total fat for the seven-day cycle menu (79.5–146.7 g), mean total fat alone and with the commissary packs exceeded AMDR recommendations. Daily available saturated fat for the seven-day cycle menu (16.7–47.7 g) exceeded AMDR recommendations for all but one day of the seven-day cycle menu, while mean saturated fat alone and with the commissary packs exceeded AMDR recommendations. Daily available added sugars for the seven-day cycle menu (8.4–14.2 g), mean added sugars alone and with the commissary packs all met AMDR recommendations. HEI-2015 scores for the seven-day cycle menu ranged from 49.3–74.5 (mean = 62.2, SD = 9.4), and increased with the commissary packs. Conclusions Exceeding caloric and saturated fat recommendations may contribute to weight gain, regardless of high diet quality. Increasing nutrient-dense foods available in jail may reduce chronic disease among incarcerated populations.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Background Poor diet may contribute to deleterious chronic health among individuals incarcerated. Yet, limited research has evaluated the nutritional content of menus and commissary items provided in jails. Thus, this study assessed the macronutrient distribution, caloric composition, and diet quality of the seven-day cycle menu and commissary items provided in a southwest, rural county jail in the United States. Methods Daily and mean availability of calories and macronutrients for the seven-day cycle menu and commissary items were estimated using NutritionCalc Plus®. Diet quality (i.e., Healthy Eating Index-2015 [HEI-2015]) was assessed. Macronutrients and calories were compared to the Acceptable Macronutrient Distribution Range (AMDR) and the 2020–2025 Dietary Guidelines for Americans (DGA). Protein and carbohydrate were compared to the Dietary Reference Intake (DRI). HEI-2015 was compared to the average U.S. diet. Results Daily caloric provisions exceeded DGA recommendations. Daily available (16.2%-25.2% kcal/day) and mean protein met the AMDR recommendations, yet exceeded the DRI. Mean protein with commissary packs exceeded the AMDR recommendations and DRI. Daily available carbohydrate met AMDR recommendations for all but two days of the seven-day cycle menu, which exceeded recommendations (52.5%-66.4% kcal/day). Mean carbohydrate met the AMDR recommendations and exceeded the DRI, and with the commissary packs, exceeded the AMDR recommendations and DRI. Daily available total fat for the seven-day cycle menu (79.5–146.7 g), mean total fat alone and with the commissary packs exceeded AMDR recommendations. Daily available saturated fat for the seven-day cycle menu (16.7–47.7 g) exceeded AMDR recommendations for all but one day of the seven-day cycle menu, while mean saturated fat alone and with the commissary packs exceeded AMDR recommendations. Daily available added sugars for the seven-day cycle menu (8.4–14.2 g), mean added sugars alone and with the commissary packs all met AMDR recommendations. HEI-2015 scores for the seven-day cycle menu ranged from 49.3–74.5 (mean = 62.2, SD = 9.4), and increased with the commissary packs. Conclusions Exceeding caloric and saturated fat recommendations may contribute to weight gain, regardless of high diet quality. Increasing nutrient-dense foods available in jail may reduce chronic disease among incarcerated populations. |
Camplain, Ricky; Williamson, Heather J; Pinn, Travis A; Shuman, Sara; Robinson, Bethany M; Evans, Maribeth; Luna, Crystal Barriers and facilitators to attending and being physically active during recreation time among women incarcerated Journal Article BMC Women's Health, 22 (239), 2022. @article{Camplain2022e, title = {Barriers and facilitators to attending and being physically active during recreation time among women incarcerated}, author = {Ricky Camplain and Heather J. Williamson and Travis A. Pinn and Sara Shuman and Bethany M. Robinson and Maribeth Evans and Crystal Luna}, url = {https://doi.org/10.1186/s12905-022-01831-w}, doi = {10.1186/s12905-022-01831-w}, year = {2022}, date = {2022-06-17}, journal = {BMC Women's Health}, volume = {22}, number = {239}, abstract = {Of the more than 20 million adult Americans that have been or are currently incarcerated, more men are incarcerated compared to women. However, the rate of growth for women's imprisonment has outpaced men by more than double with a 700% increase since 1980 [1,2,3,4,5]. Although there has been a substantial increase in incarceration among women, because most people incarcerated are men, women’s health has been overlooked. Most women incarcerated in jail are not physically active and do not attend recreation time (rec-time), a time dedicated to being physically active, outside. The purpose of this study was to determine barriers and facilitators to attending and being physically active during rec-time among women incarcerated in jail. We recruited and distributed a cross-sectional questionnaire to 100 women incarcerated at the Coconino County Detention Facility (CCDF) in Flagstaff, Arizona from March to July 2020. Women were asked about their experience with rec-time at CCDF, including if they had ever attended, how often they attended, if they exercised at rec-time, activities they participated in, and facilitators, barriers, and benefits to attend rec-time. Among 99 women who completed the questionnaire, 89% had ever attended rec-time. Most women identified environmental- and health-related facilitators to attending rec-time including enjoying natural light (74%), getting fresh air (83%), a change in environment (62%), and to move around and exercise (72%). Many women indicated environmental-, equipment-, clothing, and motivation-related barriers to attending rec-time. Specifically, women believed there was a lack of equipment (56%) and limited access to proper footwear (49%).}, keywords = {}, pubstate = {published}, tppubtype = {article} } Of the more than 20 million adult Americans that have been or are currently incarcerated, more men are incarcerated compared to women. However, the rate of growth for women's imprisonment has outpaced men by more than double with a 700% increase since 1980 [1,2,3,4,5]. Although there has been a substantial increase in incarceration among women, because most people incarcerated are men, women’s health has been overlooked. Most women incarcerated in jail are not physically active and do not attend recreation time (rec-time), a time dedicated to being physically active, outside. The purpose of this study was to determine barriers and facilitators to attending and being physically active during rec-time among women incarcerated in jail. We recruited and distributed a cross-sectional questionnaire to 100 women incarcerated at the Coconino County Detention Facility (CCDF) in Flagstaff, Arizona from March to July 2020. Women were asked about their experience with rec-time at CCDF, including if they had ever attended, how often they attended, if they exercised at rec-time, activities they participated in, and facilitators, barriers, and benefits to attend rec-time. Among 99 women who completed the questionnaire, 89% had ever attended rec-time. Most women identified environmental- and health-related facilitators to attending rec-time including enjoying natural light (74%), getting fresh air (83%), a change in environment (62%), and to move around and exercise (72%). Many women indicated environmental-, equipment-, clothing, and motivation-related barriers to attending rec-time. Specifically, women believed there was a lack of equipment (56%) and limited access to proper footwear (49%). |
Trotter, Robert T; Camplain, Ricky ; Eaves, Emery R; Fofanov, Viacheslav Y; Dmitrieva, Natalia O; Hepp, Crystal M; Warren, Meghan ; Barrios, Brianna A; Pagel, Nicole ; Mayer, Alyssa ; Baldwin, Julie A Health Disparities and Converging Epidemics in Jail Populations: Protocol for a Mixed-Methods Study Journal Article Journal of Medical Internet Research, 7 (10), 2019. @article{Trotter2019, title = {Health Disparities and Converging Epidemics in Jail Populations: Protocol for a Mixed-Methods Study}, author = {Trotter, Robert T and Camplain, Ricky and Eaves, Emery R and Fofanov, Viacheslav Y and Dmitrieva, Natalia O and Hepp, Crystal M and Warren, Meghan and Barrios, Brianna A and Pagel, Nicole and Mayer, Alyssa and Baldwin, Julie A }, doi = {10.2196/10337}, year = {2019}, date = {2019-08-05}, journal = {Journal of Medical Internet Research}, volume = {7}, number = {10}, keywords = {}, pubstate = {published}, tppubtype = {article} } |
Camplain, Ricky; Baldwin, Julie A; Warren, Meghan; Camplain, Carolyn Physical Activity in People Who Are Incarcerated: A Social Justice Issue Journal Article Journal of Physical Activity and Health, 16 (5), pp. 306-307, 2019. @article{Camplain2019, title = {Physical Activity in People Who Are Incarcerated: A Social Justice Issue}, author = {Ricky Camplain and Julie A Baldwin and Meghan Warren and Carolyn Camplain}, url = {https://journals.humankinetics.com/doi/full/10.1123/jpah.2019-0055}, year = {2019}, date = {2019-05-05}, journal = {Journal of Physical Activity and Health}, volume = {16}, number = {5}, pages = {306-307}, abstract = {Every year, approximately 12 million Americans cycle in and out of jail (ie, short-term facilities that hold individuals awaiting trial and/or sentenced to a term of less than 1 y).1 Although jails allow incarcerated individuals’ recreation time to engage in physical activity,2 it is not clear to what extent these opportunities are utilized. This potential lack of engagement in physical activity is concerning, especially as some of the benefits of physical activity are immediate and may improve the day-to-day life for those who are incarcerated. For example, a single bout of moderate to vigorous physical activity will reduce blood pressure, improve insulin sensitivity, improve sleep and cognition, and reduce symptoms of anxiety symptoms and anger.3 Unfortunately, use of recreation time in the jail setting has not been described previously, thereby precluding an important area for policy intervention.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Every year, approximately 12 million Americans cycle in and out of jail (ie, short-term facilities that hold individuals awaiting trial and/or sentenced to a term of less than 1 y).1 Although jails allow incarcerated individuals’ recreation time to engage in physical activity,2 it is not clear to what extent these opportunities are utilized. This potential lack of engagement in physical activity is concerning, especially as some of the benefits of physical activity are immediate and may improve the day-to-day life for those who are incarcerated. For example, a single bout of moderate to vigorous physical activity will reduce blood pressure, improve insulin sensitivity, improve sleep and cognition, and reduce symptoms of anxiety symptoms and anger.3 Unfortunately, use of recreation time in the jail setting has not been described previously, thereby precluding an important area for policy intervention. |
Camplain, Ricky; Warren, Meghan; Baldwin, Julie; Camplain, Carolyn; Fofanov, Viacheslav Y; Trotter, Robert T Epidemiology of incarceration Characterizing jail incarceration for public health research Journal Article Epidemiology, 2019. @article{Camplain2019d, title = {Epidemiology of incarceration Characterizing jail incarceration for public health research}, author = {Ricky Camplain and Meghan Warren and Julie Baldwin and Carolyn Camplain and Viacheslav Y Fofanov and Robert T Trotter}, url = {https://journals.lww.com/epidem/Abstract/2019/07000/Epidemiology_of_Incarceration__Characterizing_Jail.14.aspx}, doi = {10.1097/EDE.0000000000001021}, year = {2019}, date = {2019-04-08}, journal = {Epidemiology}, abstract = {Background: Each year, 9 million individuals cycle in and out of jails. The under-characterization of incarceration as an exposure poses substantial challenges to understanding how varying levels of exposure to jail may affect health. Thus, we characterized levels of jail incarceration including recidivism, number of incarcerations, total and average number of days incarcerated, and time to re-incarceration. Methods: We created a cohort of 75,203 individuals incarcerated at the Coconino County Detention Facility in Flagstaff, Arizona, from 2001-2018 from jail intake and release records. Results: The median number of incarcerations during the study period was 1 (Interquartile range (IQR) 1, 2). Forty percent of individuals had >1 incarceration. The median length of stay for first observed incarcerations was 1 day (IQR 0, 5). The median total days incarcerated was 3 (IQR 1, 23). Average length of stay increased by number of incarcerations. By 18 months, 27% of our sample had been re-incarcerated. Conclusion: Characteristics of jail incarceration have been largely left out of public health research. A better understanding of jail incarcerations can help design analyses to assess health outcomes of individuals incarcerated in jail. Our study is an early step in shaping an understanding of jail incarceration as an exposure for future epidemiologic research.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Background: Each year, 9 million individuals cycle in and out of jails. The under-characterization of incarceration as an exposure poses substantial challenges to understanding how varying levels of exposure to jail may affect health. Thus, we characterized levels of jail incarceration including recidivism, number of incarcerations, total and average number of days incarcerated, and time to re-incarceration. Methods: We created a cohort of 75,203 individuals incarcerated at the Coconino County Detention Facility in Flagstaff, Arizona, from 2001-2018 from jail intake and release records. Results: The median number of incarcerations during the study period was 1 (Interquartile range (IQR) 1, 2). Forty percent of individuals had >1 incarceration. The median length of stay for first observed incarcerations was 1 day (IQR 0, 5). The median total days incarcerated was 3 (IQR 1, 23). Average length of stay increased by number of incarcerations. By 18 months, 27% of our sample had been re-incarcerated. Conclusion: Characteristics of jail incarceration have been largely left out of public health research. A better understanding of jail incarcerations can help design analyses to assess health outcomes of individuals incarcerated in jail. Our study is an early step in shaping an understanding of jail incarceration as an exposure for future epidemiologic research. |
Green, Shana M; Turner, DeAnne; Baldwin, Julie A; Walsh-Buhi, Eric R; Vamos, Cheryl A; Dagne, Getachew; Marhefka, Stephanie L AIDS and Behavior, 2018. @article{Green2018, title = {Towards an Information Motivation and Behavioral Skills Model for New Sex Partners: Results of a Study of Condom Use as an HIV Prevention Method for Emerging Adults Who Met Partners on Dating and Sex-Seeking Platforms or Offline}, author = {Shana M Green and DeAnne Turner and Julie A Baldwin and Eric R Walsh-Buhi and Cheryl A Vamos and Getachew Dagne and Stephanie L Marhefka}, url = {https://link.springer.com/article/10.1007/s10461-018-2349-1#citeas}, year = {2018}, date = {2018-12-01}, journal = {AIDS and Behavior}, abstract = {The information, motivation, behavioral Skills (IMB) model was used to identify factors that affect condom use with new sex partners that were met offline or online. Mixed methods data were collected from adults between the ages of 18 and 29 years who reported a new sex partner. A model was composed of participants’ IMB scale scores to determine the effect of these variables on condom use. A subset of 20 survey participants completed interviews exploring how IMB model elements may have influenced their condom use. Mixed methods results showed condom use skills were influential for condom use during the first sexual encounter between new partners. Qualitative findings suggest the information and motivation may also influence condom use with new sex partners. The IMB model for new partners may be relevant model for the development of interventions that encourage emerging adults to use condoms at first sex with new sex partners.}, keywords = {}, pubstate = {published}, tppubtype = {article} } The information, motivation, behavioral Skills (IMB) model was used to identify factors that affect condom use with new sex partners that were met offline or online. Mixed methods data were collected from adults between the ages of 18 and 29 years who reported a new sex partner. A model was composed of participants’ IMB scale scores to determine the effect of these variables on condom use. A subset of 20 survey participants completed interviews exploring how IMB model elements may have influenced their condom use. Mixed methods results showed condom use skills were influential for condom use during the first sexual encounter between new partners. Qualitative findings suggest the information and motivation may also influence condom use with new sex partners. The IMB model for new partners may be relevant model for the development of interventions that encourage emerging adults to use condoms at first sex with new sex partners. |
II, Robert Trotter T; Camplain, Ricky; Eaves, Emery R; Fofanov, Viacheslav Y; Dmitrieva, Natalia O; Hepp, Crystal M; Warren, Meghan; Barrios, Brianna A; Pagel, Nicole; Mayer, Alyssa; Baldwin, Julie A Health Disparities and Converging Epidemics in Jail Populations: Protocol for a Mixed-Methods Study Journal Article JMIR Res Protoc, 7 (10), 2018. @article{II2018b, title = {Health Disparities and Converging Epidemics in Jail Populations: Protocol for a Mixed-Methods Study}, author = {Robert Trotter T II and Ricky Camplain and Emery R Eaves and Viacheslav Y Fofanov and Natalia O Dmitrieva and Crystal M Hepp and Meghan Warren and Brianna A Barrios and Nicole Pagel and Alyssa Mayer and Julie A Baldwin}, editor = {Gunther Eysenbach and Nicola Kuter}, url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231773/}, year = {2018}, date = {2018-10-24}, journal = {JMIR Res Protoc}, volume = {7}, number = {10}, abstract = {Background Incarcerated populations have increased in the last 20 years and >12 million individuals cycle in and out of jails each year. Previous research has predominately focused on the prison population. However, a substantial gap exists in understanding the health, well-being, and health care utilization patterns in jail populations. Objective This pilot study has 5 main objectives: (1) define recidivists of the jail system, individuals characterized by high incarceration rates; (2) describe and compare the demographic and clinical characteristics of incarcerated individuals; (3) identify jail-associated health disparities; (4) estimate associations between incarceration and health; and (5) describe model patterns in health care and jail utilization. Methods The project has two processes—a secondary data analysis and primary data collection—which includes a cross-sectional health survey and biological sample collection to investigate infectious disease characteristics of the jail population. This protocol contains pilot elements in four areas: (1) instrument validity and reliability; (2) individual item assessment; (3) proof of concept of content and database accessibility; and (4) pilot test of the “honest broker” system. Secondary data analysis includes the analysis of 6 distinct databases, each covered by a formal memorandum of agreement between Northern Arizona University and the designated institution: (1) the Superior Court of Arizona Public Case Finder database; (2) North Country Health Care; (3) Health Choice Integrated Care; (4) Criminal Justice Information Services; (5) Correctional Electronic Medical Records; and (6) iLEADS. We will perform data integration processes using an automated honest broker design. We will administer a cross-sectional health survey, which includes questions about health status, health history, health care utilization, substance use practices, physical activity, adverse childhood events, and behavioral health, among 200 Coconino County Detention Facility inmates. Concurrent with the survey administration, we will collect Methicillin-resistant and Methicillin-sensitive Staphylococcus aureus (samples from the nose) and dental microbiome (Streptococcus sobrinus and Streptococcus mutans samples from the mouth) from consenting participants. Results To date, we have permission to link data across acquired databases. We have initiated data transfer, protection, and initial assessment of the 6 secondary databases. Of 199 inmates consented and enrolled, we have permission from 97.0% (193/199) to access and link electronic medical and incarceration records to their survey responses, and 95.0% (189/199) of interviewed inmates have given nasal and buccal swabs for analysis of S. aureus and the dental microbiome. Conclusions This study is designed to increase the understanding of health needs and health care utilization patterns among jail populations, with a special emphasis on frequently incarcerated individuals. Our findings will help identify intervention points throughout the criminal justice and health care systems to improve health and reduce health disparities among jail inmates. International Registered Report Identifier (IRRID) RR1-10.2196/10337}, keywords = {}, pubstate = {published}, tppubtype = {article} } Background Incarcerated populations have increased in the last 20 years and >12 million individuals cycle in and out of jails each year. Previous research has predominately focused on the prison population. However, a substantial gap exists in understanding the health, well-being, and health care utilization patterns in jail populations. Objective This pilot study has 5 main objectives: (1) define recidivists of the jail system, individuals characterized by high incarceration rates; (2) describe and compare the demographic and clinical characteristics of incarcerated individuals; (3) identify jail-associated health disparities; (4) estimate associations between incarceration and health; and (5) describe model patterns in health care and jail utilization. Methods The project has two processes—a secondary data analysis and primary data collection—which includes a cross-sectional health survey and biological sample collection to investigate infectious disease characteristics of the jail population. This protocol contains pilot elements in four areas: (1) instrument validity and reliability; (2) individual item assessment; (3) proof of concept of content and database accessibility; and (4) pilot test of the “honest broker” system. Secondary data analysis includes the analysis of 6 distinct databases, each covered by a formal memorandum of agreement between Northern Arizona University and the designated institution: (1) the Superior Court of Arizona Public Case Finder database; (2) North Country Health Care; (3) Health Choice Integrated Care; (4) Criminal Justice Information Services; (5) Correctional Electronic Medical Records; and (6) iLEADS. We will perform data integration processes using an automated honest broker design. We will administer a cross-sectional health survey, which includes questions about health status, health history, health care utilization, substance use practices, physical activity, adverse childhood events, and behavioral health, among 200 Coconino County Detention Facility inmates. Concurrent with the survey administration, we will collect Methicillin-resistant and Methicillin-sensitive Staphylococcus aureus (samples from the nose) and dental microbiome (Streptococcus sobrinus and Streptococcus mutans samples from the mouth) from consenting participants. Results To date, we have permission to link data across acquired databases. We have initiated data transfer, protection, and initial assessment of the 6 secondary databases. Of 199 inmates consented and enrolled, we have permission from 97.0% (193/199) to access and link electronic medical and incarceration records to their survey responses, and 95.0% (189/199) of interviewed inmates have given nasal and buccal swabs for analysis of S. aureus and the dental microbiome. Conclusions This study is designed to increase the understanding of health needs and health care utilization patterns among jail populations, with a special emphasis on frequently incarcerated individuals. Our findings will help identify intervention points throughout the criminal justice and health care systems to improve health and reduce health disparities among jail inmates. International Registered Report Identifier (IRRID) RR1-10.2196/10337 |
2022 |
Ricky Camplain, PhD ; Lauren Hale, PhD ; Carolyn Camplain, JD ; Rita Stageman, MSW ; Julie A. Baldwin, PhD Changes in sleep quality and housing status among individuals incarcerated in jail Journal Article Sleep Health, 8 (6), 2022. @article{Camplain2022g, title = {Changes in sleep quality and housing status among individuals incarcerated in jail}, author = {Ricky Camplain, PhD and Lauren Hale, PhD and Carolyn Camplain, JD and Rita Stageman, MSW and Julie A. Baldwin, PhD}, doi = {10.1016/j.sleh.2022.08.006}, year = {2022}, date = {2022-10-10}, journal = {Sleep Health}, volume = {8}, number = {6}, abstract = {Objective To investigate sleep quality among individuals incarcerated in a rural county jail, by housing status before incarceration. Methods Using cross-sectional survey methods, 194 individuals incarcerated in jail reported sleep quality prior to and during incarceration on a Likert scale and pre-incarceration housing status (ie, house, apartment, motel, group living, or homeless). Prevalence ratios (PR) were estimated using log binomial regression to determine associations between housing status before incarceration and changes in sleep quality. Results Participants in non-permanent housing before incarceration had a lower prevalence of worsening sleep quality while incarcerated (compared to stable or improving) compared to those in permanent housing before incarceration (PR = 1.69, 95% CI: 1.03, 2.77). Conclusions Pre-incarceration housing is associated with change in sleep quality among individuals incarcerated in jail. Jail may be an important point of intervention to improve sleep quality during incarceration and through connecting individuals to more stable living conditions.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Objective To investigate sleep quality among individuals incarcerated in a rural county jail, by housing status before incarceration. Methods Using cross-sectional survey methods, 194 individuals incarcerated in jail reported sleep quality prior to and during incarceration on a Likert scale and pre-incarceration housing status (ie, house, apartment, motel, group living, or homeless). Prevalence ratios (PR) were estimated using log binomial regression to determine associations between housing status before incarceration and changes in sleep quality. Results Participants in non-permanent housing before incarceration had a lower prevalence of worsening sleep quality while incarcerated (compared to stable or improving) compared to those in permanent housing before incarceration (PR = 1.69, 95% CI: 1.03, 2.77). Conclusions Pre-incarceration housing is associated with change in sleep quality among individuals incarcerated in jail. Jail may be an important point of intervention to improve sleep quality during incarceration and through connecting individuals to more stable living conditions. |
Lopez, Nanette V; Spilkin, Ary; Brauer, Julianne; Phillips, Rachelle; Kuss, Bonnie; Delio, Gabrielle; Camplain, Ricky Nutritional adequacy of meals and commissary items provided to individuals incarcerated in a southwest, rural county jail in the United States Journal Article BMC Nutrition, 8 (96), 2022. @article{Lopez2022b, title = {Nutritional adequacy of meals and commissary items provided to individuals incarcerated in a southwest, rural county jail in the United States}, author = {Nanette V. Lopez and Ary Spilkin and Julianne Brauer and Rachelle Phillips and Bonnie Kuss and Gabrielle Delio and Ricky Camplain }, doi = {10.1186/s40795-022-00593-w}, year = {2022}, date = {2022-09-03}, journal = {BMC Nutrition}, volume = {8}, number = {96}, abstract = {Background Poor diet may contribute to deleterious chronic health among individuals incarcerated. Yet, limited research has evaluated the nutritional content of menus and commissary items provided in jails. Thus, this study assessed the macronutrient distribution, caloric composition, and diet quality of the seven-day cycle menu and commissary items provided in a southwest, rural county jail in the United States. Methods Daily and mean availability of calories and macronutrients for the seven-day cycle menu and commissary items were estimated using NutritionCalc Plus®. Diet quality (i.e., Healthy Eating Index-2015 [HEI-2015]) was assessed. Macronutrients and calories were compared to the Acceptable Macronutrient Distribution Range (AMDR) and the 2020–2025 Dietary Guidelines for Americans (DGA). Protein and carbohydrate were compared to the Dietary Reference Intake (DRI). HEI-2015 was compared to the average U.S. diet. Results Daily caloric provisions exceeded DGA recommendations. Daily available (16.2%-25.2% kcal/day) and mean protein met the AMDR recommendations, yet exceeded the DRI. Mean protein with commissary packs exceeded the AMDR recommendations and DRI. Daily available carbohydrate met AMDR recommendations for all but two days of the seven-day cycle menu, which exceeded recommendations (52.5%-66.4% kcal/day). Mean carbohydrate met the AMDR recommendations and exceeded the DRI, and with the commissary packs, exceeded the AMDR recommendations and DRI. Daily available total fat for the seven-day cycle menu (79.5–146.7 g), mean total fat alone and with the commissary packs exceeded AMDR recommendations. Daily available saturated fat for the seven-day cycle menu (16.7–47.7 g) exceeded AMDR recommendations for all but one day of the seven-day cycle menu, while mean saturated fat alone and with the commissary packs exceeded AMDR recommendations. Daily available added sugars for the seven-day cycle menu (8.4–14.2 g), mean added sugars alone and with the commissary packs all met AMDR recommendations. HEI-2015 scores for the seven-day cycle menu ranged from 49.3–74.5 (mean = 62.2, SD = 9.4), and increased with the commissary packs. Conclusions Exceeding caloric and saturated fat recommendations may contribute to weight gain, regardless of high diet quality. Increasing nutrient-dense foods available in jail may reduce chronic disease among incarcerated populations.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Background Poor diet may contribute to deleterious chronic health among individuals incarcerated. Yet, limited research has evaluated the nutritional content of menus and commissary items provided in jails. Thus, this study assessed the macronutrient distribution, caloric composition, and diet quality of the seven-day cycle menu and commissary items provided in a southwest, rural county jail in the United States. Methods Daily and mean availability of calories and macronutrients for the seven-day cycle menu and commissary items were estimated using NutritionCalc Plus®. Diet quality (i.e., Healthy Eating Index-2015 [HEI-2015]) was assessed. Macronutrients and calories were compared to the Acceptable Macronutrient Distribution Range (AMDR) and the 2020–2025 Dietary Guidelines for Americans (DGA). Protein and carbohydrate were compared to the Dietary Reference Intake (DRI). HEI-2015 was compared to the average U.S. diet. Results Daily caloric provisions exceeded DGA recommendations. Daily available (16.2%-25.2% kcal/day) and mean protein met the AMDR recommendations, yet exceeded the DRI. Mean protein with commissary packs exceeded the AMDR recommendations and DRI. Daily available carbohydrate met AMDR recommendations for all but two days of the seven-day cycle menu, which exceeded recommendations (52.5%-66.4% kcal/day). Mean carbohydrate met the AMDR recommendations and exceeded the DRI, and with the commissary packs, exceeded the AMDR recommendations and DRI. Daily available total fat for the seven-day cycle menu (79.5–146.7 g), mean total fat alone and with the commissary packs exceeded AMDR recommendations. Daily available saturated fat for the seven-day cycle menu (16.7–47.7 g) exceeded AMDR recommendations for all but one day of the seven-day cycle menu, while mean saturated fat alone and with the commissary packs exceeded AMDR recommendations. Daily available added sugars for the seven-day cycle menu (8.4–14.2 g), mean added sugars alone and with the commissary packs all met AMDR recommendations. HEI-2015 scores for the seven-day cycle menu ranged from 49.3–74.5 (mean = 62.2, SD = 9.4), and increased with the commissary packs. Conclusions Exceeding caloric and saturated fat recommendations may contribute to weight gain, regardless of high diet quality. Increasing nutrient-dense foods available in jail may reduce chronic disease among incarcerated populations. |
Camplain, Ricky; Williamson, Heather J; Pinn, Travis A; Shuman, Sara; Robinson, Bethany M; Evans, Maribeth; Luna, Crystal Barriers and facilitators to attending and being physically active during recreation time among women incarcerated Journal Article BMC Women's Health, 22 (239), 2022. @article{Camplain2022e, title = {Barriers and facilitators to attending and being physically active during recreation time among women incarcerated}, author = {Ricky Camplain and Heather J. Williamson and Travis A. Pinn and Sara Shuman and Bethany M. Robinson and Maribeth Evans and Crystal Luna}, url = {https://doi.org/10.1186/s12905-022-01831-w}, doi = {10.1186/s12905-022-01831-w}, year = {2022}, date = {2022-06-17}, journal = {BMC Women's Health}, volume = {22}, number = {239}, abstract = {Of the more than 20 million adult Americans that have been or are currently incarcerated, more men are incarcerated compared to women. However, the rate of growth for women's imprisonment has outpaced men by more than double with a 700% increase since 1980 [1,2,3,4,5]. Although there has been a substantial increase in incarceration among women, because most people incarcerated are men, women’s health has been overlooked. Most women incarcerated in jail are not physically active and do not attend recreation time (rec-time), a time dedicated to being physically active, outside. The purpose of this study was to determine barriers and facilitators to attending and being physically active during rec-time among women incarcerated in jail. We recruited and distributed a cross-sectional questionnaire to 100 women incarcerated at the Coconino County Detention Facility (CCDF) in Flagstaff, Arizona from March to July 2020. Women were asked about their experience with rec-time at CCDF, including if they had ever attended, how often they attended, if they exercised at rec-time, activities they participated in, and facilitators, barriers, and benefits to attend rec-time. Among 99 women who completed the questionnaire, 89% had ever attended rec-time. Most women identified environmental- and health-related facilitators to attending rec-time including enjoying natural light (74%), getting fresh air (83%), a change in environment (62%), and to move around and exercise (72%). Many women indicated environmental-, equipment-, clothing, and motivation-related barriers to attending rec-time. Specifically, women believed there was a lack of equipment (56%) and limited access to proper footwear (49%).}, keywords = {}, pubstate = {published}, tppubtype = {article} } Of the more than 20 million adult Americans that have been or are currently incarcerated, more men are incarcerated compared to women. However, the rate of growth for women's imprisonment has outpaced men by more than double with a 700% increase since 1980 [1,2,3,4,5]. Although there has been a substantial increase in incarceration among women, because most people incarcerated are men, women’s health has been overlooked. Most women incarcerated in jail are not physically active and do not attend recreation time (rec-time), a time dedicated to being physically active, outside. The purpose of this study was to determine barriers and facilitators to attending and being physically active during rec-time among women incarcerated in jail. We recruited and distributed a cross-sectional questionnaire to 100 women incarcerated at the Coconino County Detention Facility (CCDF) in Flagstaff, Arizona from March to July 2020. Women were asked about their experience with rec-time at CCDF, including if they had ever attended, how often they attended, if they exercised at rec-time, activities they participated in, and facilitators, barriers, and benefits to attend rec-time. Among 99 women who completed the questionnaire, 89% had ever attended rec-time. Most women identified environmental- and health-related facilitators to attending rec-time including enjoying natural light (74%), getting fresh air (83%), a change in environment (62%), and to move around and exercise (72%). Many women indicated environmental-, equipment-, clothing, and motivation-related barriers to attending rec-time. Specifically, women believed there was a lack of equipment (56%) and limited access to proper footwear (49%). |
2019 |
Trotter, Robert T; Camplain, Ricky ; Eaves, Emery R; Fofanov, Viacheslav Y; Dmitrieva, Natalia O; Hepp, Crystal M; Warren, Meghan ; Barrios, Brianna A; Pagel, Nicole ; Mayer, Alyssa ; Baldwin, Julie A Health Disparities and Converging Epidemics in Jail Populations: Protocol for a Mixed-Methods Study Journal Article Journal of Medical Internet Research, 7 (10), 2019. @article{Trotter2019, title = {Health Disparities and Converging Epidemics in Jail Populations: Protocol for a Mixed-Methods Study}, author = {Trotter, Robert T and Camplain, Ricky and Eaves, Emery R and Fofanov, Viacheslav Y and Dmitrieva, Natalia O and Hepp, Crystal M and Warren, Meghan and Barrios, Brianna A and Pagel, Nicole and Mayer, Alyssa and Baldwin, Julie A }, doi = {10.2196/10337}, year = {2019}, date = {2019-08-05}, journal = {Journal of Medical Internet Research}, volume = {7}, number = {10}, keywords = {}, pubstate = {published}, tppubtype = {article} } |
Camplain, Ricky; Baldwin, Julie A; Warren, Meghan; Camplain, Carolyn Physical Activity in People Who Are Incarcerated: A Social Justice Issue Journal Article Journal of Physical Activity and Health, 16 (5), pp. 306-307, 2019. @article{Camplain2019, title = {Physical Activity in People Who Are Incarcerated: A Social Justice Issue}, author = {Ricky Camplain and Julie A Baldwin and Meghan Warren and Carolyn Camplain}, url = {https://journals.humankinetics.com/doi/full/10.1123/jpah.2019-0055}, year = {2019}, date = {2019-05-05}, journal = {Journal of Physical Activity and Health}, volume = {16}, number = {5}, pages = {306-307}, abstract = {Every year, approximately 12 million Americans cycle in and out of jail (ie, short-term facilities that hold individuals awaiting trial and/or sentenced to a term of less than 1 y).1 Although jails allow incarcerated individuals’ recreation time to engage in physical activity,2 it is not clear to what extent these opportunities are utilized. This potential lack of engagement in physical activity is concerning, especially as some of the benefits of physical activity are immediate and may improve the day-to-day life for those who are incarcerated. For example, a single bout of moderate to vigorous physical activity will reduce blood pressure, improve insulin sensitivity, improve sleep and cognition, and reduce symptoms of anxiety symptoms and anger.3 Unfortunately, use of recreation time in the jail setting has not been described previously, thereby precluding an important area for policy intervention.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Every year, approximately 12 million Americans cycle in and out of jail (ie, short-term facilities that hold individuals awaiting trial and/or sentenced to a term of less than 1 y).1 Although jails allow incarcerated individuals’ recreation time to engage in physical activity,2 it is not clear to what extent these opportunities are utilized. This potential lack of engagement in physical activity is concerning, especially as some of the benefits of physical activity are immediate and may improve the day-to-day life for those who are incarcerated. For example, a single bout of moderate to vigorous physical activity will reduce blood pressure, improve insulin sensitivity, improve sleep and cognition, and reduce symptoms of anxiety symptoms and anger.3 Unfortunately, use of recreation time in the jail setting has not been described previously, thereby precluding an important area for policy intervention. |
Camplain, Ricky; Warren, Meghan; Baldwin, Julie; Camplain, Carolyn; Fofanov, Viacheslav Y; Trotter, Robert T Epidemiology of incarceration Characterizing jail incarceration for public health research Journal Article Epidemiology, 2019. @article{Camplain2019d, title = {Epidemiology of incarceration Characterizing jail incarceration for public health research}, author = {Ricky Camplain and Meghan Warren and Julie Baldwin and Carolyn Camplain and Viacheslav Y Fofanov and Robert T Trotter}, url = {https://journals.lww.com/epidem/Abstract/2019/07000/Epidemiology_of_Incarceration__Characterizing_Jail.14.aspx}, doi = {10.1097/EDE.0000000000001021}, year = {2019}, date = {2019-04-08}, journal = {Epidemiology}, abstract = {Background: Each year, 9 million individuals cycle in and out of jails. The under-characterization of incarceration as an exposure poses substantial challenges to understanding how varying levels of exposure to jail may affect health. Thus, we characterized levels of jail incarceration including recidivism, number of incarcerations, total and average number of days incarcerated, and time to re-incarceration. Methods: We created a cohort of 75,203 individuals incarcerated at the Coconino County Detention Facility in Flagstaff, Arizona, from 2001-2018 from jail intake and release records. Results: The median number of incarcerations during the study period was 1 (Interquartile range (IQR) 1, 2). Forty percent of individuals had >1 incarceration. The median length of stay for first observed incarcerations was 1 day (IQR 0, 5). The median total days incarcerated was 3 (IQR 1, 23). Average length of stay increased by number of incarcerations. By 18 months, 27% of our sample had been re-incarcerated. Conclusion: Characteristics of jail incarceration have been largely left out of public health research. A better understanding of jail incarcerations can help design analyses to assess health outcomes of individuals incarcerated in jail. Our study is an early step in shaping an understanding of jail incarceration as an exposure for future epidemiologic research.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Background: Each year, 9 million individuals cycle in and out of jails. The under-characterization of incarceration as an exposure poses substantial challenges to understanding how varying levels of exposure to jail may affect health. Thus, we characterized levels of jail incarceration including recidivism, number of incarcerations, total and average number of days incarcerated, and time to re-incarceration. Methods: We created a cohort of 75,203 individuals incarcerated at the Coconino County Detention Facility in Flagstaff, Arizona, from 2001-2018 from jail intake and release records. Results: The median number of incarcerations during the study period was 1 (Interquartile range (IQR) 1, 2). Forty percent of individuals had >1 incarceration. The median length of stay for first observed incarcerations was 1 day (IQR 0, 5). The median total days incarcerated was 3 (IQR 1, 23). Average length of stay increased by number of incarcerations. By 18 months, 27% of our sample had been re-incarcerated. Conclusion: Characteristics of jail incarceration have been largely left out of public health research. A better understanding of jail incarcerations can help design analyses to assess health outcomes of individuals incarcerated in jail. Our study is an early step in shaping an understanding of jail incarceration as an exposure for future epidemiologic research. |
2018 |
Green, Shana M; Turner, DeAnne; Baldwin, Julie A; Walsh-Buhi, Eric R; Vamos, Cheryl A; Dagne, Getachew; Marhefka, Stephanie L AIDS and Behavior, 2018. @article{Green2018, title = {Towards an Information Motivation and Behavioral Skills Model for New Sex Partners: Results of a Study of Condom Use as an HIV Prevention Method for Emerging Adults Who Met Partners on Dating and Sex-Seeking Platforms or Offline}, author = {Shana M Green and DeAnne Turner and Julie A Baldwin and Eric R Walsh-Buhi and Cheryl A Vamos and Getachew Dagne and Stephanie L Marhefka}, url = {https://link.springer.com/article/10.1007/s10461-018-2349-1#citeas}, year = {2018}, date = {2018-12-01}, journal = {AIDS and Behavior}, abstract = {The information, motivation, behavioral Skills (IMB) model was used to identify factors that affect condom use with new sex partners that were met offline or online. Mixed methods data were collected from adults between the ages of 18 and 29 years who reported a new sex partner. A model was composed of participants’ IMB scale scores to determine the effect of these variables on condom use. A subset of 20 survey participants completed interviews exploring how IMB model elements may have influenced their condom use. Mixed methods results showed condom use skills were influential for condom use during the first sexual encounter between new partners. Qualitative findings suggest the information and motivation may also influence condom use with new sex partners. The IMB model for new partners may be relevant model for the development of interventions that encourage emerging adults to use condoms at first sex with new sex partners.}, keywords = {}, pubstate = {published}, tppubtype = {article} } The information, motivation, behavioral Skills (IMB) model was used to identify factors that affect condom use with new sex partners that were met offline or online. Mixed methods data were collected from adults between the ages of 18 and 29 years who reported a new sex partner. A model was composed of participants’ IMB scale scores to determine the effect of these variables on condom use. A subset of 20 survey participants completed interviews exploring how IMB model elements may have influenced their condom use. Mixed methods results showed condom use skills were influential for condom use during the first sexual encounter between new partners. Qualitative findings suggest the information and motivation may also influence condom use with new sex partners. The IMB model for new partners may be relevant model for the development of interventions that encourage emerging adults to use condoms at first sex with new sex partners. |
II, Robert Trotter T; Camplain, Ricky; Eaves, Emery R; Fofanov, Viacheslav Y; Dmitrieva, Natalia O; Hepp, Crystal M; Warren, Meghan; Barrios, Brianna A; Pagel, Nicole; Mayer, Alyssa; Baldwin, Julie A Health Disparities and Converging Epidemics in Jail Populations: Protocol for a Mixed-Methods Study Journal Article JMIR Res Protoc, 7 (10), 2018. @article{II2018b, title = {Health Disparities and Converging Epidemics in Jail Populations: Protocol for a Mixed-Methods Study}, author = {Robert Trotter T II and Ricky Camplain and Emery R Eaves and Viacheslav Y Fofanov and Natalia O Dmitrieva and Crystal M Hepp and Meghan Warren and Brianna A Barrios and Nicole Pagel and Alyssa Mayer and Julie A Baldwin}, editor = {Gunther Eysenbach and Nicola Kuter}, url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231773/}, year = {2018}, date = {2018-10-24}, journal = {JMIR Res Protoc}, volume = {7}, number = {10}, abstract = {Background Incarcerated populations have increased in the last 20 years and >12 million individuals cycle in and out of jails each year. Previous research has predominately focused on the prison population. However, a substantial gap exists in understanding the health, well-being, and health care utilization patterns in jail populations. Objective This pilot study has 5 main objectives: (1) define recidivists of the jail system, individuals characterized by high incarceration rates; (2) describe and compare the demographic and clinical characteristics of incarcerated individuals; (3) identify jail-associated health disparities; (4) estimate associations between incarceration and health; and (5) describe model patterns in health care and jail utilization. Methods The project has two processes—a secondary data analysis and primary data collection—which includes a cross-sectional health survey and biological sample collection to investigate infectious disease characteristics of the jail population. This protocol contains pilot elements in four areas: (1) instrument validity and reliability; (2) individual item assessment; (3) proof of concept of content and database accessibility; and (4) pilot test of the “honest broker” system. Secondary data analysis includes the analysis of 6 distinct databases, each covered by a formal memorandum of agreement between Northern Arizona University and the designated institution: (1) the Superior Court of Arizona Public Case Finder database; (2) North Country Health Care; (3) Health Choice Integrated Care; (4) Criminal Justice Information Services; (5) Correctional Electronic Medical Records; and (6) iLEADS. We will perform data integration processes using an automated honest broker design. We will administer a cross-sectional health survey, which includes questions about health status, health history, health care utilization, substance use practices, physical activity, adverse childhood events, and behavioral health, among 200 Coconino County Detention Facility inmates. Concurrent with the survey administration, we will collect Methicillin-resistant and Methicillin-sensitive Staphylococcus aureus (samples from the nose) and dental microbiome (Streptococcus sobrinus and Streptococcus mutans samples from the mouth) from consenting participants. Results To date, we have permission to link data across acquired databases. We have initiated data transfer, protection, and initial assessment of the 6 secondary databases. Of 199 inmates consented and enrolled, we have permission from 97.0% (193/199) to access and link electronic medical and incarceration records to their survey responses, and 95.0% (189/199) of interviewed inmates have given nasal and buccal swabs for analysis of S. aureus and the dental microbiome. Conclusions This study is designed to increase the understanding of health needs and health care utilization patterns among jail populations, with a special emphasis on frequently incarcerated individuals. Our findings will help identify intervention points throughout the criminal justice and health care systems to improve health and reduce health disparities among jail inmates. International Registered Report Identifier (IRRID) RR1-10.2196/10337}, keywords = {}, pubstate = {published}, tppubtype = {article} } Background Incarcerated populations have increased in the last 20 years and >12 million individuals cycle in and out of jails each year. Previous research has predominately focused on the prison population. However, a substantial gap exists in understanding the health, well-being, and health care utilization patterns in jail populations. Objective This pilot study has 5 main objectives: (1) define recidivists of the jail system, individuals characterized by high incarceration rates; (2) describe and compare the demographic and clinical characteristics of incarcerated individuals; (3) identify jail-associated health disparities; (4) estimate associations between incarceration and health; and (5) describe model patterns in health care and jail utilization. Methods The project has two processes—a secondary data analysis and primary data collection—which includes a cross-sectional health survey and biological sample collection to investigate infectious disease characteristics of the jail population. This protocol contains pilot elements in four areas: (1) instrument validity and reliability; (2) individual item assessment; (3) proof of concept of content and database accessibility; and (4) pilot test of the “honest broker” system. Secondary data analysis includes the analysis of 6 distinct databases, each covered by a formal memorandum of agreement between Northern Arizona University and the designated institution: (1) the Superior Court of Arizona Public Case Finder database; (2) North Country Health Care; (3) Health Choice Integrated Care; (4) Criminal Justice Information Services; (5) Correctional Electronic Medical Records; and (6) iLEADS. We will perform data integration processes using an automated honest broker design. We will administer a cross-sectional health survey, which includes questions about health status, health history, health care utilization, substance use practices, physical activity, adverse childhood events, and behavioral health, among 200 Coconino County Detention Facility inmates. Concurrent with the survey administration, we will collect Methicillin-resistant and Methicillin-sensitive Staphylococcus aureus (samples from the nose) and dental microbiome (Streptococcus sobrinus and Streptococcus mutans samples from the mouth) from consenting participants. Results To date, we have permission to link data across acquired databases. We have initiated data transfer, protection, and initial assessment of the 6 secondary databases. Of 199 inmates consented and enrolled, we have permission from 97.0% (193/199) to access and link electronic medical and incarceration records to their survey responses, and 95.0% (189/199) of interviewed inmates have given nasal and buccal swabs for analysis of S. aureus and the dental microbiome. Conclusions This study is designed to increase the understanding of health needs and health care utilization patterns among jail populations, with a special emphasis on frequently incarcerated individuals. Our findings will help identify intervention points throughout the criminal justice and health care systems to improve health and reduce health disparities among jail inmates. International Registered Report Identifier (IRRID) RR1-10.2196/10337 |