Research Statement

Statement of Interest: Correctional health programs in the US are faced with two convergent problems of epic proportions: 1) The US correctional system (state prisons, community jails and federal institutions) has become our nation’s largest mental health “system”, housing and providing services to more persons with mental illness than any other sector, at any level, in the country; 2) Elderly prisoners are now the fastest growing segment of the US prison population, and a growing number of prisoners have chronic comorbidities and life limiting illness.  More prisoners will die while incarcerated, affected by the sequelae of  structural violence including chronic illness, poverty, addiction, disparate access to health care and illness prevention, racist sentencing policies and an historical lack of political and economic will to provide adequate health care for those we incarcerate.  Corrections administrators and staff see the influx of persons with SMI and the needs of aging prisoners both as significant challenges to their mission correctional institutions are largely ill-suited and ill-equipped to adequately  provide care for seriously mentally ill or debilitated prisoners.

Completed Research: My doctoral research (F31 NR07826-01A1) examined how prisoners, staff and administrators in a supermaximum security prison understand mental illness and negotiate interactions and resource use based on this context.  My early research as an assistant professor at Utah focused on recidivism rates and risk for persons with SMI. Through a series of studies based on prison and community mental health data spanning 1995-2010, we found the following: 1) A sizable contingent (23%) of the Utah State prison population met criteria for SMI; 2) Recidivism rates (calculated via survival analysis) for this group were significantly higher than all other persons in the same time period-- controlling for demographic, crime-related and condition of release data, this difference is attributable to factors directly related to SMI; 3) An index of severity of illness, constructed from historical and clinical data for the SMI sample, showed variability in illness severity, and higher severity was associated with increased survival risk and shorter community tenure post-release; 4) Latent class analysis confirmed the association of illness severity and survival, and indicates significant and clinically relevant heterogeneity in this sample; 5) Gender-based comparisons within our sample showed that, while women tended to have lower recidivism rates in general and were also more likely to remain connected to children and community, having an SMI had a greater negative effect of the trajectory on women than men; 6) Only 7% of persons with SMI in our sample who were released from prison received mental health services post-release; 7) Logistic regression of factors that predicted service receipt vs. non-receipt showed that women and those with substance abuse histories were less likely to receive services post-release while men with psychotic illness of high severity were most likely to receive services.

Current Research: Through engaging in research with prisons and criminal justice involved groups over the past decade, like a growing number of providers and researchers I have become acutely aware of issues related to the exponential increase in numbers of aging prisoners. Older prisoners are now the fastest growing segment of the US prison population, with higher prevalence of chronic and comorbid illnesses, age-related dysfunction, depression and anxiety than their free-world counterparts. They also face risks amplified by the prison environment such as fear of victimization, loss of social status, and diminished physical and social autonomy. Moreover, more prison inmates than ever before will face life-limiting illness and death while incarcerated. My current program of research focuses on identifying clinical, social and organizational characteristics of sustainable and effective models of prison-based geriatric, EOL, palliative and hospice care. I am particularly interested in prison hospice and EOL programs that use inmate volunteer models to provide 1:1 peer care, including how such approaches affect patient outcomes, the wellbeing of participating volunteers, and institutional culture. Since August 2010 I have led a team of researchers engaged in mixed methods field research, in partnership with the Louisiana State Penitentiary at Angola, to study their long running volunteer-centric prison hospice program.  Our goal is to extend research on prison aging, EOL, palliative and hospice care models into multi-state and multi-model comparison studies, to increase our shared knowledge of effective and sustainable EOL care in corrections.

 

 

 

 

Research Keywords

  • Serious mental illness and incarceration
  • Mixed Methodology (qualitative and quantitative)
  • Institutional and critical ethnography
  • End of life care in prisons
  • Critical discourse analysis
  • Correctional health

Presentations

  • Cloyes, K.G., Yang, R., Jones, A.K. & White, S. “Tattoos or tutus, treat everyone well”: LGBT older adults’ experiences of provider bias and support. Gerontological Society of America Annual Scientific Meeting. New Oreleans, LA. Presentation, Presented, 11/19/2016.
  • Cloyes, K.G., Yang, R. & Latimer, S. Pain-related disability in lesbian, gay, bisexual and transgender older adults with chronic illness. Gerontological Society of America Annual Scientific Meeting. New Orleans, LA. Poster, Presented, 11/18/2016.
  • Cloyes, K.G., Yang, R. & Latimer, S. Refusal to respond to BRFSS sexual orientation and transgender survey items among adults aged 60 +. Gerontological Society of America Annual Scientific Meeting. New Orleans, LA. Presentation, Presented, 11/18/2016.
  • Eaton, J. & Cloyes, K.G. Knowledgeable Nursing Assistants as Creative Caregivers (the KNACC.) National Center on Creative Aging Leadership Exchange and Conference. Washington, D.C. Presentation, Presented, 09/21/2016.
  • Warner E.L, Cloyes K. “Unbelievable Humans”: Social media posts about young adult cancer. Podium presentation at the Council for Advancement of Nursing Science State of the Science Congress on Nursing Research. Washington, D.C. Presentation, Presented, 09/16/2016.
  • Lai, D., Doyon, K., Cloyes, K.G., Ellington, L., Reblin, M. & Clayton, M.F. W e’re the eyes and ears but don’t have a voice: Perspectives of hospice aides. Annual Meeting of the American Association of Hospice and Palliative Medicine/Hospice and Palliative Nurses Association. Chicago, IL. Poster, Presented, 03/17/2016.
  • Cloyes, K.G., Yang, R., Latimer, S., & Rivera, A. Knowing better, doing better: Effects of minority stress on mental health and pain for underserved older adults. National Hartford Center of Gerontological Nursing Excellence Annual Leadership Conference. Orlando, FL. Poster, Presented, 11/2015.
  • Blaz, J., Doig, A. K., Cloyes, K. G., & Staggers, N., (2015, November). The Hidden Life of Nurses' Cognitive Artifacts, AMIA Annual Symposium, American Medical Informatics Association. San Francisco, CA. Presentation, Presented, 11/2015.
  • Cloyes, K.G., Yang, R., Latimer, S. & Rivera, A. (2015). Measuring LGBT older adults’ perceptions of discrimination in medical settings. 2015 Annual Scientific Meeting of the Gerontological Society of America. Orlando, FL. Presentation, Presented, 11/2015.
  • Lai, D., Doyon, K., CLoyes, K.G., Ellington, L. & Clayton, M. (Accepted). We're the eyes and ears but have no voice: Perspectives of hospice aides. 2016 Annual Assembly of the American Association of Hospice and Palliative Medicine/Hospice and Palliative Nurses Association. Chicago, IL. Poster, Accepted, 06/2015.
  • Spoken metaphors for hope in oncology research patients’ discourse (K. Shannon-Dorcy, PI). Western Institute of Nursing’s 47th Annual Communicating Nursing Research Conference. Poster, Presented, 11/2014.
  • End of life symptom prevalence in prison hospice patients. Podium presentation, Western Institute of Nursing’s 47th Annual Communicating Nursing Research Conference. Presentation, Presented, 11/2014.
  • Supporting home hospice family caregivers: Insight across perspectives. Podium presentation, Western Institute of Nursing’s 47th Annual Communicating Nursing Research Conference. Presentation, Presented, 11/2014.
  • Cloyes, KG. A critical analysis of 'social justice' in nursing discourse. Western Institute of Nursing’s 47th Annual Communicating Nursing Research Conference. Poster, Accepted, 12/2013.
  • Cloyes, KG, Bellury, L, Berry, PH, Clayton, M, Reblin, M, Ellington, L. Supporting home hospice family caregivers: Insight across perspectives. Podium presentation, Western Institute of Nursing’s 47th Annual Communicating Nursing Research Conference. Presentation, Accepted, 12/2013.
  • Shannon-Dorcy, K. & Cloyes, KG. Spoken metaphors for hope in oncology research patients’ discourse (K. Shannon-Dorcy, PI). Western Institute of Nursing’s 47th Annual Communicating Nursing Research Conference. Presentation, Presented, 12/2013.
  • Cloyes, KG, Martz, K, Berry, PH, Suipano, KP. End of life symptom prevalence in prison hospice patients. Podium presentation, Western Institute of Nursing’s 47th Annual Communicating Nursing Research Conference. Presentation, Accepted, 12/2013.
  • Cloyes, KG, Rosencranz, S & Berry, PH. It Takes a Real Man: Masculinity and hospice care in a maximum security prison. Podium presentation, International Critical Perspectives in Nursing and Health Care Conference. Conference Paper, Refereed, Presented, 06/2013.
  • Cloyes, KG, Rosencranz, S & Berry, PH. Creating community through care of the vulnerable: Grief, bereavement and bearing witness as acts of resistance in prison hospice care. Podium presentation, International Critical Perspectives in Nursing and Health Care Conference. Conference Paper, Refereed, Presented, 06/2013.
  • Reblin, M., Cloyes, K.G., Carpenter, J., Berry, P.H., Clayton, M., & Ellington, L. Social support needs: Discordance between home hospice nurses and former family caregivers. Annual Meeting of the Society for Behavioral Medicine. Poster, Presented, 03/2013.
  • Cloyes, KG, Berry, PH, Supiano, KP, Faust, T, Bourdreaux, J. Building effective and sustainable prison hospice programs: Best practices and processes for developing, managing, evaluating and sustaining end of life care in prisons. Concurrent education session with J. Boudreaux, T. Faust, C. Washington, P. Berry, K. Supiano, American Academy of Hospice and Palliative Medicine/Hospice and Palliative Nurses Association Annual Assembly. Presentation, Presented, 03/2013.
  • Cloyes, KG. Building an effective and sustainable peer-care model for prison hospice: Evidence and experience. Ethics and Aging in Prison Conference. Warren, Maine. Invited Talk/Keynote, Presented, 09/19/2012.
  • Cloyes, KG, Berry. PH. The prison hospice patient and the role of the volunteer: Evidence and best practices from a long-running program.” Louisiana Prison Hospice Conference. Louisiana State Prison at Angola, LA. Invited Talk/Keynote, Presented, 03/2012.
  • Baraki, K. & Cloyes, KG. Developing cognitive flexibility using a "smart game" approach. Western Institute of Nursing 44th Annual Communicating Research Conferece. Las Vegas, NV. Poster, Presented, 04/2011.
  • Cloyes, KG, Wong, B & Latimer, S. Out of Service: Community Treatment Post Prison for People with SMI. Western Institute of Nursing 44th Annual Communicating Research Conferece. Las Vegas, NV. Conference Paper, Refereed, Accepted, 12/2010.
  • Cloyes, K.G., Reblin, M., Berry, P. Clayton, M. & Ellington, L. (2010). Facilitative and directive communication patterns in home hospice care interactions: Content analysis of RN and caregiver/patient speech. Late-breaking poster presentation at the annual meeting of the Gerontological Society of America, New Orleans, LA. Poster, Presented, 11/2010.
  • Invited plenary speaker, "Patterns of recidivism and mental health treatment for people with serious mental illness: Looking for longer time out". International Custody and Caring Conference, International Association of Forensic Nurses. Saskatoon, Saskatchewan, Canada. Invited Talk/Keynote, Presented, 10/01/2009.
  • Prison recidivism for women with serious mental illness: Gender matters. Podium presentation, Western Institute of Nursing 39th Annual Communicating Nursing Research Conference, 22nd Annual WIN Assembly. Conference Paper, Refereed, Presented, 2009.
  • Patterns of psychotropic medication youth in a youth prison: CHAID analysis. Podium presentation, Western Institute of Nursing 39th Annual Communicating Nursing Research Conference, 22nd Annual WIN Assembly. Conference Paper, Refereed, Presented, 2009.
  • Cloyes, K.G. Patterns of psychotropic medication youth in a youth prison: Thematic analysis. Western Institute of Nursing 39th Annual Communicating Nursing Research Conference, 22nd Annual WIN Assembly. Poster, Presented, 2009.
  • Cloyes, KG. (Spring 2008). Prison research and the politically defended subject: The possibility for more truth [Abstract]. 4th International Congress of Qualitative Inquiry Conference Proceedings. Conference Paper, Refereed, Presented, 05/2008.
  • "Criminalization, salvation, consternation: Medication, drugs and the offender with serious mental illness”. Drugs: Addiction, Therapy and Crime: 1st Annual Conference of the University of Utah Center on Criminal and Juvenile Justice. Invited Talk/Keynote, Presented, 03/2008.
  • Law and the Constitution of Mental Illness. 14th International Critical and Feminist Perspectives in Nursing Conference. Victoria, Britich Columbia. Invited Talk/Keynote, Presented, 09/2007.
  • Zombies, Dings and Criminal Thought: Mental Illness in Prison Talk and Text. Podium Presentation, Western Institute of Nursing 39th Annual Communicating Nursing Research Conference, 20th Annual WIN Assembly. Conference Paper, Refereed, Presented, 04/2007.
  • Mine the gap: A strong theory of biopower as a conceptual bridge between structure and agency, political theory and poststructural methodology. 13th International Critical and Feminist Theory in Nursing Conference. Milwaukee, WI. Conference Paper, Refereed, Presented, 04/2006.

Grants, Contracts & Research Gifts

  • Interactions with the hospice team implications for end of life and bereavement outcomes . PI: Lee Ellington. NIH/NINR, 06/2016 - 05/2020. Total project budget to date: $2,745,095.00
  • Knowledgeable Nursing Assistance as Creative Caregivers (the KNACC). PI: Jacqueline Eaton. Co-PI(s): Kristin CLoyes, Lee Ellington, Connie Madden. Vice President's Pilot Grant, 01/01/2016 - 12/2016. Total project budget to date: $19,966.00
  • Developing a high-fidelity web-based learning environment to promote cognitive flexibility for advanced practice clinicians. PI: Kristin G. Cloyes Phd MN RN. Co-PI(s): Katie Baraki MN RN. University of Utah Teaching Grant, 11/15/2010 - 11/15/2011. Total project budget to date: $1,000.00

Languages

  • English, fluent.

Publications

  • *#Ellington, L., Cloyes, K.G., Xu, J., Bellury, L., Berry, P.H., Reblin, M., & Clayton, M.F. (Accepted November 2016). Supporting home hospice family caregivers: Insights across perspectives. Palliative and Supportive Care.. Accepted, 01/09/2017.
  • Cloyes, K.G., Rosenkranz, S., Supiano K.P., Berry, P.H., Routt, M., Llanque, S.M. & Shannon-Dorcy-K. (2017). Caring to learn and learning to care: Inmate hospice volunteers and the delivery of prison end-of-life care. Journal of Correctional Health Care, 23(1), 43-55.. Published, 01/02/2017.
  • Blaz, J.W., Doig, A.K., Cloyes, K.G. & Staggers, N. (2016). The hidden lives of nurses’ cognitive artifacts. Applied Clinical Informatics, 7, 832-49. Published, 09/05/2016.
  • Blaz, J.W., Doig, A.K., Cloyes, K.G. & Staggers, N. (2016). Information content across types of nurse cognitive artifacts. Studies in Health Technology and Informatics, 225, 641-2. Published, 08/22/2016.
  • Ellington, L, Clayton, MF, Reblin, M, Cloyes, K, Beck, A, Harrold, J, Harris, P, and Casarett, D (2016). Interdisciplinary team care and hospice visit patterns during the last week of life. Journal of Palliative Medicine. 19(5), 482-487. Published, 05/02/2016.
  • Cloyes, K.G. (2016). The silence of our science: Nursing research on LGBT older adult health. Research in Gerontological Nursing. Advance online publication. doi:10.3928/19404921-20151218-02. Published, 03/01/2016.
  • Cloyes, K.G., Berry, P.H., Supiano, K., & Martz, K. (2015). Characteristics of prison hospice patients and symptom prevalence on admission and 72 hours before death. Journal of Correctional Health Care, 21(3), 298-308. Published, 07/2015.
  • Cloyes, K.G. & Burns. K. (2015). Considerations in the care of geriatric patients in prisons and jails. In K.L. Appelbaum, J.L. Metzner & R.L. Trestman (Eds.) The Oxford textbook of correctional psychiatry (pp. 326-330). New York: Oxford University Press. Published, 05/2015.
  • Somayaji, D. & Cloyes, K.G. (2015). Cancer fear and fatalism: How African American participants construct the role of research subject in relation to clinical cancer research. Cancer Nursing: An International Journal for Cancer Care, 38(2), 133-44. Published, 03/2015.
  • Cloyes, K.G., Rosenkranz, S., Supiano, K.P., Berry, P.H., Routt, M., Shannon-Dorcy, K.S. & Llanque, S.M. (2015). Essential elements of a sustainable prison hospice. American Journal of Hospice and Palliative Medicine. Advance online publication. doi: 10.1177/1049909115574491. Published, 03/2015.
  • Goshen, L., Colbert, A. & Cloyes, K.G. (2015). Nursing in the era of mass incarceration. American Journal of Nursing, 115(2), 11.. Published, 03/2015.
  • Reblin, M, Cloyes, K.G., Carpenter, J., Berry, P.H., Clayton, M.F., & Ellington, L. (2015). Social support needs: Discordance between home hospice nurses and former family caregivers. Palliative and Supportive Care, 13(3), 465-72. Published, 02/2015.
  • Cloyes, K.G., Rosenkranz, S., Wold, D, Berry, P. & Supiano, K. (2014). To be truly alive: Motivation for providing end of life peer-care and service among prison inmate hospice volunteers. American Journal of Hospice and Palliative Medicine, 31(7), 735-748. Published, 11/04/2014.
  • Cloyes, K.G., Carpenter, J., Berry, P.H., Reblin, M., Clayton, M., Ellington, L. (2014). “A true human interaction”: Comparison of family caregiver and hospice nurse perspectives on needs of family caregivers in hospice. Journal of Hospice and Palliative Care Nursing, 16(5), 282-290. Published, 07/01/2014.
  • Supiano, K.P, Cloyes, K.G. & Berry, P.H. (2014). The grief experience of prison hospice inmate caregivers. Journal of Social Work in End of Life & Palliative Care, 10(1), 80-94. Published, 05/06/2014.
  • Saiki, L. S., & Cloyes, K. G. (2014). Blog text about female incontinence: Presentation of self, disclosure, and social risk assessment, Nursing Research, 63(2), 137-42. Published, 03/15/2014.
  • Somayaji, D. & Cloyes, K.G. (2014). Uniting postcolonial, discourse and linguistic theory to explore participation of African Americans in cancer research as an effect of social and historical race relationships. Advances in Nursing Science, 37(1), 32-47. Published, 01/01/2014.
  • Madden, C. & Cloyes, K.G. (2012). The discourse of aging. Advances in Nursing Science, 35(3), 264-272. Published, 12/2012.
  • Cloyes, K.G. (2011). The ethics of empirics and evidence in isolation: Sustaining critical investigations and promoting best practices. Corrections and Mental Health. Published, 03/2011.
    http://community.nicic.gov/blogs/mentalhealth/arch...
  • Matney, S., Brewtser, P., Sward, K., Cloyes, K.G. & Staggers, N. (2011).Philosophical underpinnings of DIKW model in informatics. Advances in Nursing Science, 34(1), 6-18. Published, 01/2011.
  • Cloyes, K.G. (2010). Rethinking biopower: Posthumanism and bare life in nursing research. Advances in Nursing Science, 33(3), 234-243. Published, 12/2010.
  • Cloyes, K.G., Wong, B., Latimer, S. & Abarca, J. (2010). Women, serious mental illness and recidivism: A gender based analysis of recidivism risk for women with SMI. Journal of Forensic Nursing, 6(1), 3-14. Published, 10/2010.
  • Roberts, L., Gulliver, B., Fisher, J. & Cloyes, K.G. (2010). The Coping with Labor © algorithm: An alternative pain assessment tool for the laboring women. Journal of Midwifery and Womens’ Health, 55(2), 107-116. Published, 06/2010.
  • Cloyes, K.G. (April 2009). Patterns of psychotropic medication youth in a youth prison: CHAID analysis [Abstract]. Communicating Nursing Research Conference Proceedings, 42. Published, 04/2009.
  • Cloyes, K.G. (April 2009). Patterns of psychotropic medication youth in a youth prison: Thematic analysis [Abstract]. Communicating Nursing Research Conference Proceedings, 42. Published, 04/2009.
  • Cloyes, KG, Groot, J., Basset, J., Beck, C., Iribarren, S. (May 2008). Prescription and use of psychotropic medication in Utah Division of Juvenile Justice Secure Care facilities. Salt Lake City, UT: Utah State Commission on Criminal and Juvenile Justice. Available:. Published, 2008.
    http://www.law.utah.edu/_studyfiles/95/95.pdf
  • Cloyes, K.G. (2008). Disclosure of past mental health care and the health professional: An untenable double standard. Archives of Psychiatric Nursing, 22(6), 394. Published, 2008.
  • Cloyes, K.G., Abarca, J., Hennick, E., & Bassett, J. (June 2007). Women, Incarceration and Serious Mental Illness in Utah State Prison System. In Utah’s Health: An Annual Review Volume 12: Special Supplement on Women’s Health in Utah. Salt Lake City: University of Utah National Center for Excellence in Women's Health. Published, 06/2007.
  • Cloyes, K.G. (2007). Challenges in residential treatment for prisoners with mental illness: A follow-up report. Archives of Psychiatric Nursing, 21(4), 192-200. Published, 03/2007.
  • Cloyes, K.G. (2007). Prisoners signify: A political discourse analysis of mental illness in a prison control unit. Nursing Inquiry. 14(3), 202-211. Published, 02/2007.
  • Cloyes, K.G. (2006). An ethic of analysis. Advances in Nursing Science, 29(2), 84-97. Published, 09/2006.
  • Cloyes, K.G., Lovell, D., Allen, D.G. & Rhodes, L.R. (2006). Assessment of psychosocial impairment in a supermaximum security unit sample. Criminal Justice and Behavior, 33(4), 1-22. Published, 08/2006.
  • Allen, D.G. & Cloyes, K.G. (2005). The language of “experience” in nursing research. Nursing Inquiry, 12(2), 98-105. Published, 08/2005.
  • Cloyes, K.G. (2002). Agonizing care: Care ethics, agonistic feminism and a political theory of care. Nursing Inquiry, 9(3), 203-214. Published, 11/2002.
  • Lovell, D., Cloyes, K., Allen, D.G. & Rhodes, L. (2000). Who lives in Supermaximum custody? A Washington Case Study Federal Probation, 64(2), 33-38. Published, 03/2000.