An RCT Testing a Health Literacy Intervention to Reduce Disparities in Access to Care Among Justice Involved Adults (JIA)

Abstract The ability to find, understand, and use health-related information is essential for effectively managing one’s health. Difficulties in doing so have been linked to increased healthcare costs and are frequently observed among U.S. adults with prior justice involvement—an estimated population of 20 million. This group often reports low levels of engagement with healthcare services and irregular medical service use, contributing to untreated conditions over time. For this study, we define effective healthcare engagement as: 1) current health insurance coverage, 2) a consistent healthcare provider, and 3) use of services when needed. Few structured programs have been tested to help individuals in this group better connect with healthcare systems. We propose a longitudinal, randomized controlled trial (RCT) to assess the impact of the UCSD RELINK coach- guided health coaching program versus a self-directed learning approach. A total of 300 participants aged 18– 50 in San Diego, CA, will be enrolled and randomized equally into the two study arms. The primary outcome will measure self-reported use of healthcare services at the 6-month mark; secondary outcomes include follow- up at 12 months to assess consistency of service use. In addition, we will conduct follow-up interviews at 6 and 12 months to explore participants’ experiences with the program, how it influenced their healthcare decisions, and the degree to which they felt more prepared to engage with services. The study will provide operational insights into practical health education strategies and system navigation approaches for adults with prior justice involvement.