Hepatitis C Virus (HCV), HIV
Conditions
Keywords
Needle-Exchange Programs, Prisons, Health Services for Prisoners, Blood-Borne Pathogens, HIV, Hepatitis C
Brief summary
This study is focused on improving the implementation of Prison Needle Exchange Programs (PNEPs) in Canadian federal prisons, with the goal of increasing the uptake of these programs among people who inject drugs in prison. The study is being conducted in nine federal prisons, including five women's prisons, where a higher proportion of incarcerated individuals report a history of injection drug use. This study aims to improve PNEP adoption and sustainability by identifying barriers and facilitators and implementing evidence-based strategies to enhance program engagement.
Detailed description
Using a step-wedge design, we will conduct a Type 2 hybrid implementation trial to assess the extent to which PNEP uptake is improved over 24 months of observation using the Network for the Improvement of Addiction Treatment (NIATx) implementation strategy bundle. Nine prisons were non-randomly\* allocated to one of three groups, with the groups receiving the intervention (i.e., NIATx) over 24 months at staggered time intervals (every 6 months). This will be followed by an additional 12 month post-intervention period, when sustainability will be assessed. \*Originally randomized; allocation was modified due to logistical constraints
Interventions
BEHAVIORALNIATx
The Network for the Improvement of Addiction Treatment (NIATx) model uses a bundle of implementation tools that include expert facilitation (coaching) and quality process improvement specifically for behavioural healthcare settings to improve access and retention in treatment.
Sponsors
Yale University
Burnet Institute
Kirby Institute
McGill University Health Centre/Research Institute of the McGill University Health Centre
Study design
Allocation
NON_RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Intervention model description
Hybrid type 2 stepped-wedge implementation trial. All sites will receive the intervention (NIATx); the order in which they receive the intervention was non-randomized\*. \*Originally randomized; allocation was modified due to logistical constraints
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* All people incarcerated at a study site during the intervention period
Exclusion criteria
\- None (site level intervention)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Effectiveness | From start to end of intervention period (24 months) | Number of participants on the PNEP |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Bloodborne virus cascade of care | From start to end of intervention period (24 months) | Number of HIV and hepatitis C virus screenings/tests, diagnoses, and treatment initiations, among the total prison population |
| Enrollment in opioid agonist therapy | From start to end of intervention period (24 months) | The number of people who inject drugs who access opioid agonist therapy among the total prison population |
Countries
Canada
Contacts
Primary ContactNadine Kronfli
Outcome results
None listed