Background: Justice-involved women (JIW) experience complex, chronic, and comorbid physical and mental health conditions that are exacerbated by incarceration and often go unaddressed post-release. Yet, there is a dearth of patient-centered outcomes research and comparative clinical effectiveness research (PCOR/CER) focused on interventions that can effectively meet the needs of JIW, even though the number of JIW in the United States has grown at a staggering rate over the past four decades.

Proposed Solution to the Problem: The project team will develop a women’s justice-health alliance (WJHA) that is prepared to conduct PCOR/CER that JIW and the organizations that serve them are able and willing to participate in because (1) the topics align with their priorities and (2) the design of the PCOR/CER that results will minimize barriers to their participation. By the end of the project, the WJHA will be a robust network of individuals and organizations that are educated about PCOR/CER principles and well-prepared to collaboratively execute all phases of PCOR/CER including (1) identifying high-impact topics and questions and (2) planning, designing, and executing PCOR/CER.

Objectives:

This project’s objectives are to:

• Establish a WJHA in Arkansas
• Determine the PCOR/CER priorities among WJHA stakeholders
• Build consensus on the ways to reduce barriers to JIW’s participation in PCOR/CER

Activities:

To reach these objectives the project team will:

• Engage JIW and stakeholder organizations
• Establish a virtual learning collaborative to increase skills and knowledge on PCOR/CER and JIW’s health issues
• Use an evidence-based method to identify PCOR/CER priorities of JIW and stakeholders
• Hold virtual retreats for focused work

Projected Outcomes and Outputs:

Short-term outcomes during the project period include:

• Engagement of WJHA members in capacity-building
• Completion of project deliverables including a PCOR/CER agenda to inform future activities and summaries of barriers JIW face to participation in PCOR/CER and recommendations to overcome barriers

Medium-term outcomes (0-2 years post-project period) include:

• Improved PCOR/CER capacity of WJHA members at the end of the project
• Continued operation of the WJHA

Long-term outcomes (3+ years post-project period) include:

• Collaborative execution of PCOR/CER by WJHA members
• Expanded WJHA membership
• Improved health and access to relevant and effective services for JIW

Patient and Stakeholder Engagement Plan: The project team’s plan to engage diverse JIW and stakeholders centers on reciprocal relationships, co-learning, partnerships, transparency, honesty, and trust. In planning for this application, Health and the Legal System (HEALS) Lab’s Community Advisory Board (H-CAB) and HEALS identified more than 50 possible organizations and stakeholders to invite to join the WJHA. HEALS, Magdalene Serenity House (MSH), and H-CAB were all involved in the development of this proposal and will be key and equal partners during the project. JIW and WJHA members will be active participants and equitable partners, including via project co-leadership, oversight, feedback, and co-facilitation.

Project Collaborators: The team comprises academic, community, and directly-impacted experts with a history of jointly advancing research on and advocacy for the healthcare needs of JIW. Researchers at UAMS will co-lead this project with MSH, a community nonprofit serving JIW re-entering society after incarceration. The H-CAB, whose members are all women with lived experience of incarceration, will provide project oversight.