Media attention relevant to law enforcement use of force in the last decade finally alerted the scientific community to the need for more research regarding law enforcement discretion and decision making. The purpose of this study was to synthesize the existing literature to explore the motivating factors for law enforcement use of force. This study will utilize a social-ecological framework to systematically examine factors that impact officer decisions to use force at the individual and community levels. The paper includes recommendations for research and practice through an equity lens that highlights the disparate use of force against men of color in particular. Interventions, trainings, education, and research to stop the promotion of perceived safety over justice will be highlighted.

Objective: The purpose is to determine whether a facilitated local change team (LCT) intervention improves linkage to medication for opioid use disorder (MOUD) and implementation outcomes, and whether participant-level outcomes are further enhanced by use of peer support specialists (PSS). Methods: This Type 1 hybrid implementation-effectiveness study involves a pre-post design (implementation study) followed by a randomized trial of PSS (effectiveness study). Participants are at least 114 justice and service staff from 7 sites in three states: probation officers, community treatment providers, a supervisor from each agency, and key stakeholders. The study will recruit up to 680 individuals on probation from seven adult community probation offices; eligible individuals will be recently committed, English speakers, with opioid use disorder (OUD). Core Implementation Study: The study will use the exploration, preparation, implementation, sustainability (EPIS) framework to guide system-change through facilitated LCTs of probation and community treatment staff given a core set of implementation strategies to set goals. The study will collect program-level and staff survey data at the end of each EPIS stage. Implementation outcomes: Organizational engagement in MOUD (primary), plus changes in staff knowledge/attitudes and organizational outcomes (secondary). Effectiveness Study of PSS: After completing implementation, the study will randomize adults on probation to receive PSS vs. treatment as usual, with assessments at baseline, 3, 6 and 12 months. Effectiveness outcomes include participant engagement in MOUD (primary), probation revocation, illicit opioid use, and overdoses. Other aims include identifying barriers and facilitators, and cost-benefit analysis of PSS. Adaptations in response to COVID-19 included moving many procedures to remote methods.

In The Lancet Public Health, Paul Simpson and colleagues report their use of a citizens' jury research method to identify health research priorities directly from people who are incarcerated. This type of community-engaged research helps mitigate the disenfranchisement of a systematically marginalised group of individuals to better address their needs. Indeed, as Simpson and colleagues state, “if endeavours in research priority setting are to consider health equity goals, the views of our most health affected citizens need to be included.” Although people in prison are considered a vulnerable group, rarely are their voices heard in guiding future research. The majority of health-care trials and data have not included incarcerated populations.Recent literature has called for their greater participation in research, particularly in the time of COVID-19. The USA, in particular, should heed this call and employ similar attempts to understand the primary needs of people in prison from their perspective.

Few settings have been as dramatically affected by the COVID-19 pandemic as jails and prisons across the United States. The majority of the largest national outbreaks of COVID-19 have taken place in carceral facilities with some reporting positive testing rates of over 70%. The FDA has granted emergency use authorization for two SARS-CoV-2 vaccines that demonstrate near 95% efficiency, offering a life-saving tool to prevent future infections and outbreaks. Vaccine allocation, particularly among incarcerated individuals, remains a controversial topic. Yet there are very clear reasons why incarcerated people should be prioritized for vaccination efforts. First, incarcerated individuals are at high risk for Covid-19 transmission and severe disease. Congregate living settings, including jails and prisons, facilitate rapid spread of infection. Those in jails and prisons have a 5-fold greater likelihood of infection and 3-fold greater likelihood of death from Covid-19. Vaccine allocation should follow the epidemiology and be deployed in settings that will have the most impact: where there have been the most cases and more severe disease. Jails and prisons certainly meet these criteria.

Individuals involved in the criminal justice (CJ) system continue to be at disproportionate risk for HIV infection, and often have a greater prevalence of substance use and sexual related risk behaviors relative to their non-CJ involved peers. Pre-exposure prophylaxis (PrEP), a once daily antiretroviral medicine, is an evidence-based approach for reducing the risk of contracting HIV but limited data exist regarding the use of PrEP among CJ populations, especially in the U.S. South. This study was conducted at the Pulaski County Regional Detention Facility (PCRDF) in Little Rock, Arkansas (AR), the largest county jail in the state. We explored knowledge about PrEP and HIV, perceptions about PrEP feasibility in both the jail and community settings and barriers to PrEP program implementation, through in-depth qualitative interviews with 21 jail detainees. We purposively sampled individuals based on specific self-reported risk behavior, including sexual risk (both heterosexual and same-sex) and drug related risk (e.g. IDU), among all eligible individuals. We identified five primary themes from the interviews: 1) accessing healthcare during community reentry was a low priority; 2) perception of risk and interaction with people with HIV was low; 3) there are many barriers to disclosing HIV risk behaviors in jail settings; 4) knowledge of PrEP is low but willingness to use is high; and 5) multiple barriers exist to PrEP uptake post-release. Our findings are contextually unique and therefore have important implications for future implementation of PrEP access either within jail settings or linkage to PrEP post release.