Utilizing the probation office as an opportunity to screen for cardiometabolic outcomes

Authors: DONG, KIMBERLY - Tufts University; BECKWITH, CURT - Lifespan; GROSSMAN, ANNA - Tufts University; WEINER, DANIEL - Tufts Medical Center; LICHTENSTEIN, ALICE - Jean Mayer Human Nutrition Research Center On Aging At Tufts University

Submitted to: Journal of Correctional Health Care
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/1/2021
Publication Date: 6/10/2022
Citation: Dong, K.R., Beckwith, C.G., Grossman, A., Weiner, D.E., Lichtenstein, A.H. 2022. Utilizing the probation office as an opportunity to screen for cardiometabolic outcomes. Journal of Correctional Health Care. https://doi.org/10.1089/jchc.20.11.0102.
DOI: https://doi.org/10.1089/jchc.20.11.0102

Interpretive Summary: Due to inequities in social determinants of health, adults under probation supervision may be at elevated risk for heart disease. Our goal was to determine whether using a setting of mandatory attendance to screen for heart disease may help improve the health of this vulnerable population. To accomplish this goal we used flyers in the waiting room of a probation office and by referral from probation officers to recruit English-speaking 202 adults. Collected was (i) blood pressure and other measurements (height, weight, and waist circumference) data, (ii) a finger stick blood sample for the measurement of total cholesterol, HDL-cholesterol and glucose concentrations and (iii) brief survey responses about sociodemographic characteristics, medical history and current prescribed medication regimens and adherence. Of all participants, 84% were men, with a mean age 39.6 years. The wellness screening identified 5% with high total cholesterol, 38% of men and 50% of women with low HDL-cholesterol, 70% with overweight or obese, and 31% of men and 55% of women with elevated waist circumferences. Of individuals with a history of high blood pressure, 77% had elevated blood pressure and of diabetes, 22% had elevated blood glucose concentrations. An additional 11% had stage 2 hypertension, 27% had stage 1 hypertension, 22% had elevated blood pressure, and 5% had high blood glucose concentrations, independent of whether they report being prescribed medication. These results indicate the probation office may be a reasonable setting to screen people under probation supervision for heart disease risk.

Technical Abstract: Objective: To determine whether the probation office is a feasible setting to screen adults under probation supervision for cardiometabolic risk. Methods: This was a cross-sectional study conducted between June and August 2019 in one probation office in Rhode Island. The wellness screening included blood pressure, height, weight, waist circumference, and a finger stick for the measurement of total cholesterol, HDL-cholesterol and glucose concentrations. Participants also took a brief survey to provide sociodemographic characteristics, medical history, and current prescribed medication regimens and adherence. Results: Participants (N=202) included 169 men (84%) with a mean [SD] age of 39.6 [12.1] years. The participation rate of the wellness screening was 36%. The wellness screening identified 5% with high total cholesterol, 38% of men and 50% of women with low HDL-cholesterol, 70% with overweight or obesity, and 31% of men and 55% of women with elevated waist circumferences. Of individuals with a history of high blood pressure (n=74), 77% had elevated blood pressure and of those with a history of diabetes (n=27), 22% had elevated blood glucose concentrations, independent of whether they reported being prescribed medication. The screening identified an additional 11% with stage 2 hypertension, 27% with stage 1 hypertension, 22% with elevated blood pressure, and 5% with high blood glucose concentrations. Conclusions: It is feasible to provide wellness screenings at a probation office to a population that might not have regular access to healthcare. Finding novel ways to engage people under community supervision in healthcare screenings may improve long-term health outcomes.