By  Catriona Connell , Mary Birken, Hannah Carver, Tamara Brown, and Jessica Greenhalgh

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 reofending. Multiple interventions are provided to support people into employment on release. The efectiveness of interventions for improving employment outcomes has not previously been evaluated in a meta-analysis. Aim Our objective was to examine the efectiveness of interventions to improve employment following release from prison. Method 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 efects 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 efect on average employment status or employment at study end. There is moderate certainty in these estimates. Conclusion Interventions can improve some employment outcomes for people released from prison. More evidence is required to establish efective interventions for sustaining quality employment, particularly outside the USA, and which consider outcomes for diferent groups of people released, such as women or those with health or substance use needs

  Health & Justice (2023) 11:17