RESUMO
The United States (US) has experienced a surge of anti-immigrant policies and rhetoric, raising concerns about the influence on health outcomes for immigrants living in the US. We conducted qualitative interviews (n = 20) with health care and social service providers, attorneys, and legal/policy experts in California to understand how agencies were maintaining access to HIV care and prevention for immigrant clients. We conducted a thematic analysis to describe the role of medical-legal partnerships (MLPs) and document best practices. Informants reported high demand for legal services. Referrals were facilitated by case managers, medical providers, and pre-existing relationships between clinics and legal agencies. Informants identified a need for additional funding and further guidance on screening for and supporting patients with legal needs. MLPs have the capacity to create sustainable, efficient, comprehensive structural changes that minimize barriers to HIV prevention and treatment and improve health outcomes among immigrant populations.
Assuntos
Continuidade da Assistência ao Paciente/organização & administração , Emigrantes e Imigrantes/estatística & dados numéricos , Infecções por HIV/terapia , Acessibilidade aos Serviços de Saúde/organização & administração , Serviços Jurídicos/organização & administração , Atitude do Pessoal de Saúde , California/epidemiologia , Continuidade da Assistência ao Paciente/economia , Infecções por HIV/etnologia , Infecções por HIV/prevenção & controle , Pessoal de Saúde/organização & administração , Acessibilidade aos Serviços de Saúde/economia , Humanos , Relações Interinstitucionais , Entrevistas como Assunto , Serviços Jurídicos/economia , Avaliação de Programas e Projetos de Saúde , Pesquisa Qualitativa , Serviço Social/organização & administração , Estados Unidos/epidemiologiaRESUMO
Juvenile drug court (JDC) programs are an increasingly popular option for rehabilitating juvenile offenders with substance problems, but research has found inconsistent evidence regarding their effectiveness and economic impact. While assessing client outcomes such as reduced substance use and delinquency is necessary to gauge program effectiveness, a more comprehensive understanding of program success and sustainability can be attained by examining program costs and economic benefits. As part of the National Cross-Site Evaluation of JDC and Reclaiming Futures (RF), an economic analysis of five JDC/RF programs was conducted from a multisystem and multiagency perspective. The study highlights the direct and indirect costs of JDC/RF and the savings generated from reduced health problems, illegal activity, and missed school days. Results include the average (per participant) cost of JDC/RF, the total economic benefits per JDC/RF participant, and the net savings of JDC/RF relative to standard JDC.