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 Passports to advantage: Health and capacity building as a basis for social integration

Funding - $1,445,000 from the National Health and Medical Research Council (NHMRC), 2007-2011.
Project Team
Chief Investigators:
Dr Stuart Kinner *, Dr Rosa Alati *, Prof Nick Lennox Ω, Prof Konrad Jamrozik Ω, Dr Melissa Haswell-Elkins Ω, Prof Gail Williams, Fran Boyle, Ms Coralie Ober *, Dr Susan Vlack Ω, Dr Alun Richards Ω,
Project Manager:
Dr Marie Longo*
Ms Wendy Arnold*, Ms Tina Belovic*, Ms Elizabeth Clarke*, Ms Heather Clarke*, Ms Judith Cochrane*, Ms Lorraine Connelly*, Mr David Cummins*.Ms Ingrid Elvy*, Mr Simon Forsyth, Ms Teresa Gibson*, Mr Andrew Harnden*, Mr Phillipp Ihme*, Ms Rebecca Jenkinson , Ms Erin Mallon*, Ms Lucy Marsh-Bibb*, Ms Fairlie McIlwraith*, Ms Judith McPhee*, Ms Kylie Osborne*, Mr William Parry*, Ms Lenora Rasmussen*, Ms Meg Richardson*, Ms Helen Taylor*, Ms Rachael Wargent*, Ms Karen White*, Ms Patricia Whipple*
RHD Students:
Ms Kate van Dooren*, Ms Megan Williams, Ms Georgia Sakrzewski*
* QADREC; Burnet Institute, Melbourne; ‡ School of Population Health; Ω External collaborator
Collaborating organisations: Queensland Corrective Services; The Macfarlane Burnet Institute for Medical Research and Public Health.
Prisoners as a group are characterised by chronic social disadvantage, high rates of risky drug use, and poor physical and mental health. Many prisoners enter custody with these problems, and despite the existence of intervention programs in prison, many leave prison with the same problems. This is particularly true of women and Indigenous prisoners.
Little is known about what happens to prisoners once they return to the community – what we do know is that the majority will re-offend at some point in their life, and that almost a third will return to prison within two years of release. In the weeks following release, ex-prisoners also face a massively increased risk of premature death due to drug overdose, accidents, suicide and other causes. Despite this, the few post-release programs that do exist for ex-prisoners in Australia are fragmented, under-funded and based on limited evidence.
The Passports project is conducting a randomised, controlled trial of a health-based post-release intervention for adult prisoners in Queensland. Participants will undergo a comprehensive health assessment prior to release, and before release will receive a ‘health passport’ which will encourage and empower them to seek out appropriate health and psychosocial support in their local community. Participants will also receive telephone support from trained support staff, in the first four weeks following release. These four weeks are known to be a critical time for the reintegration of ex-prisoners.
The impact of the Passports intervention will be assessed through telephone interviews 1, 3 and 6 months post-release, and by accessing correctional and health (Medicare Australia) records for participants two years post-release. The findings of the study will inform the development of evidence-based post-release interventions for prisoners in Australia and elsewhere, as well as providing an unprecedented insight into the post-release experiences of prisoners in Queensland. 

2010 highlights

Baseline data collection was completed on 2 July 2010 with N=1328 participants recruited into the cohort. Cleaning of the baseline data is now complete. The project also involves follow-up interviews approximately one, three and six months post-release. One- and three-month follow-up interviews have been completed, including for those who have returned to custody during this time. The final, six-month follow-up interviews have been completed for the vast majority of the cohort, and the remainder will be completed by mid 2011.

Project stakeholders have been updated on progress through a series of regular newsletters, and through community consultations. The most recent round of community consultations occurred in August and September 2010 in Brisbane, Townsville and Cairns; preliminary baseline data were presented and their policy implications discussed. The project continues to be the subject of invited presentations at national and international meetings, including as the only international presentation at a juvenile justice policy briefing at Capitol Hill in Washington DC, USA. Reflecting the policy relevance of the project, CI Kinner was also invited to present preliminary findings to the Director General of Queensland Corrective Services.

Now that baseline data are collected and cleaned, a large number of papers (based on cross-sectional data) are in preparation, including one on risk factors for alcohol dependence among Indigenous prisoners that will be the subject of a plenary address at the 37th Annual Alcohol Epidemiology Symposium of the Kettil Bruun Society in April 2011. Two additional PhD students have been attracted to the project, one focusing on estimating and managing biased attrition, the other funded by a scholarship from NHMRC.

CIs Kinner and Lennox, along with other investigators, were awarded a large NHMRC project grant (#1002463) to build on the Passports project through prospective record linkage and abstraction of prison health records, and to establish a similar cohort (N=1000) in Western Australia. This new project will be the world’s largest and most comprehensive cohort of ex-prisoners ever studied.

2011 aims

·         Completion of follow-up interviews

·         Analyses to examine impact of the intervention on health, social and criminal justice outcomes

·         Dissemination of project findings through peer-reviewed papers and conference presentations. 

  • Kinner, S., Lennox, N., Taylor, M. (2009). Randomised controlled trial of a post-release intervention for prisoners with and without an intellectual disability. Journal on Developmental Disabilities, 15(2), 72-76.
  • Spencer, B. Landmark prisoner study has links to past. Mater News 2nd March 2009.
  • Kinner, S. (2009). Queensland study looks at improving health and wellbeing outcomes for prisoners post release. Anex Bulletin, 7(5), 3.