Abstract：
BACKGROUND: People released from prison experience complex health challenges in addition to challenges resettling into the community. Consequently, employment rates are low. Participating in good quality employment can support good health and is protective against future reoffending. Multiple interventions are provided to support people into employment on release. The effectiveness of interventions for improving employment outcomes has not previously been evaluated in a meta-analysis.
OBJECTIVE: Our objective was to examine the effectiveness of interventions to improve employment following release from prison.
METHODS: We searched seven databases and three trial registries for peer reviewed randomised controlled trials (RCTs), published since 2010, that included adults and measured an employment outcome(s). We conducted meta-analysis using random effects models with sub-group and sensitivity analyses. We appraised bias risk per outcome, and incorporated this into an assessment of the certainty estimates for each outcome. A group of people with experience of imprisonment met with us throughout the project to inform our search strategy and interpretation of results.
RESULTS: We included 12 RCTs (2,875 participants) which were all conducted in the USA. Few outcomes were of low risk of bias. Intervention participants were 2.5 times more likely to work at least one day (95% CI:1.82-3.43) and worked more days over 12 months (MD = 59.07, 95% CI:15.83-102.32) compared to controls. There was no effect on average employment status or employment at study end. There is moderate certainty in these estimates.
CONCLUSIONS: Interventions can improve some employment outcomes for people released from prison. More evidence is required to establish effective interventions for sustaining quality employment, particularly outside the USA, and which consider outcomes for different groups of people released, such as women or those with health or substance use needs.
OBJECTIVE: Our objective was to examine the effectiveness of interventions to improve employment following release from prison.
METHODS: We searched seven databases and three trial registries for peer reviewed randomised controlled trials (RCTs), published since 2010, that included adults and measured an employment outcome(s). We conducted meta-analysis using random effects models with sub-group and sensitivity analyses. We appraised bias risk per outcome, and incorporated this into an assessment of the certainty estimates for each outcome. A group of people with experience of imprisonment met with us throughout the project to inform our search strategy and interpretation of results.
RESULTS: We included 12 RCTs (2,875 participants) which were all conducted in the USA. Few outcomes were of low risk of bias. Intervention participants were 2.5 times more likely to work at least one day (95% CI:1.82-3.43) and worked more days over 12 months (MD = 59.07, 95% CI:15.83-102.32) compared to controls. There was no effect on average employment status or employment at study end. There is moderate certainty in these estimates.
CONCLUSIONS: Interventions can improve some employment outcomes for people released from prison. More evidence is required to establish effective interventions for sustaining quality employment, particularly outside the USA, and which consider outcomes for different groups of people released, such as women or those with health or substance use needs.
摘要：
背景：从监狱释放的人除了重新进入社区的挑战外，还会遇到复杂的健康挑战。因此,就业率很低。参与高质量的就业可以支持身体健康，并防止未来的再犯。提供了多种干预措施，以支持人们在获释后就业。以前尚未在荟萃分析中评估干预措施改善就业结果的有效性。
目的：我们的目的是检查从监狱释放后改善就业的干预措施的有效性。
方法：我们搜索了7个数据库和3个试验注册中心，寻找同行评审的随机对照试验(RCT)。自2010年以来出版，其中包括成年人，并衡量了就业结果。我们使用随机效应模型和亚组和敏感性分析进行了荟萃分析。我们评估了每个结果的偏差风险，并将其纳入对每个结果的确定性估计的评估中。在整个项目中，一群有监禁经验的人与我们会面，以告知我们的搜索策略和结果解释。
结果：我们纳入了12项RCT（2,875名参与者），均在美国进行。很少有结果具有低偏倚风险。与对照组相比，干预参与者至少工作一天的可能性增加2.5倍（95％CI：1.82-3.43），并且在12个月内工作更多（MD=59.07，95％CI：15.83-102.32）。对研究结束时的平均就业状况或就业没有影响。这些估计有适度的确定性。
结论：干预措施可以改善出狱人员的一些就业结果。需要更多的证据来建立有效的干预措施，以维持高质量的就业，特别是在美国以外，考虑到不同人群的结果，例如妇女或有健康或物质使用需要的人。
目的：我们的目的是检查从监狱释放后改善就业的干预措施的有效性。
方法：我们搜索了7个数据库和3个试验注册中心，寻找同行评审的随机对照试验(RCT)。自2010年以来出版，其中包括成年人，并衡量了就业结果。我们使用随机效应模型和亚组和敏感性分析进行了荟萃分析。我们评估了每个结果的偏差风险，并将其纳入对每个结果的确定性估计的评估中。在整个项目中，一群有监禁经验的人与我们会面，以告知我们的搜索策略和结果解释。
结果：我们纳入了12项RCT（2,875名参与者），均在美国进行。很少有结果具有低偏倚风险。与对照组相比，干预参与者至少工作一天的可能性增加2.5倍（95％CI：1.82-3.43），并且在12个月内工作更多（MD=59.07，95％CI：15.83-102.32）。对研究结束时的平均就业状况或就业没有影响。这些估计有适度的确定性。
结论：干预措施可以改善出狱人员的一些就业结果。需要更多的证据来建立有效的干预措施，以维持高质量的就业，特别是在美国以外，考虑到不同人群的结果，例如妇女或有健康或物质使用需要的人。
