Maternal and Child Health Research Program

Advancing Applied MCH Research

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Health care access for delinquent youth

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Project Number: R40 MC 08721-03
Grantee: Indiana University
Department/Center: Adolescent Medicine/Pediatrics
Project Date: 9/1/2007

Final Report

Health care access for delinquent youth Final Report (PDF) Exit Disclaimer

Principal Investigator

Matthew Aalsma, PhD
Assistant Professor
410 W 10th St. STE 1001
Indianapolis, IN  46202-3011
Phone: (317) 274-8812
Email: maalsma@iupui.edu

Age

  • Adolescence (12-18 years)

Abstract

The primary focus of the proposed research is to understand how to improve health care access and utilization for youth in the juvenile justice system. Specific research aims will address the adequacy and success of physical health and mental health care screening and referral programs, assess the role of health care access and utilization on recidivism, and evaluate the role of Medicaid termination as a barrier to effective health care for detained youth. We will address these research aims using input from community-based youth-serving coalitions, complementary experiences and skills of the investigators, technical expertise to merge and evaluate multiple data bases, and capacity to use data developed from this project to create a model "best practices" system for youth involved in the juvenile justice system. A unique partnership was instituted in Marion County (which contains most of Indianapolis, Indiana) in 2006 which entailed providing high quality medical and mental health screening services for detained youth. We will use a combination of existing data sets to assess the effectiveness of this program. Two cohorts of youth will be identified and data will be merged from the Marion County juvenile courts, the Indiana Office of Medicaid Policy and Planning, the Regenstrief Medical Records System, and Midtown Mental Health to evaluate the program. The first group will be youth placed in the Marion County detention center from April 2006 - April 2008 (intervention group). The second group will be youth placed in the Marion County detention center from April 2004 - March 2006 (historical control group). Specific aims include the following: 1) Assessment of physical health and mental health care screening and referral programs. 2) Assess the role of health care access and utilization on recidivism (arrest, residential placement and commitment to department of corrections). 3) Explore the role of Medicaid termination as a barrier to effective health care for detained youth. This proposal directly addresses each strategic research issue of the Maternal and Child Health Research Program. We are seeking to improve the medical and mental health service to youth in the juvenile justice system through this screening and referral (through case management) to medical and mental health services (Strategic Issue #1). Health disparities (racial/ethnic and gender) in both health care access and utilization will be assessed in this application (Strategic Issue # 2). We are also seeking to improve the quality of care for this population by exploring their connection with medical and mental health care previous to and after being detained (Strategic Issue # 3). Lastly, we are seeking to improve the health of youth in the juvenile justice system that is at high-risk for early death (Strategic Issue #4). We expect data from this research to inform future policy changes in the care of marginalized youth in Marion County as well as in national efforts to provide appropraite health care for delinquent youth. Data will also be used to address current Medicaid policy in which automatic disenrollment occurs upon entry into a detention facility. The information regarding this effort will also be disseminated in medical, public health and health policy journals to reach a larger audience.

Publications

Listed is descending order by year published.

Aalsma MC, Blythe MJ, Tong Y, et al. Insurance status of urban detained adolescents. Journal of Correctional Health Care. 2012;18(4):274-284.

Aalsma MC, Tong Y, Lane K, et al. Utilization of outpatient mental health care upon community reentry for juvenile detainees: Assessing the effect of mental health screening and referral. Psychiatric Services. 2012;63:997-1003.

Aalsma MC, Wiehe SE, Blythe MJ, Tong Y, Harezlak J, Rosenman MB. Mental health screening and STI among detained youth. J Community Health. 2011 Apr;36(2):300-6.

Aalsma M, Tong Y, Wiehe S, Tu W. The impact of delinquency on young adult sexual risk behaviors and sexually transmitted infections. J Adolesc Health. 2010 Jan;46(1):17-24.

Keywords

Screening, Access to Health Care, Medicaid SCHIP & Health Insurance, Mental Health & Wellbeing, Health Care Utilization, Incarceration

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