The goal of this study is to reduce morbidity and mortality from COVID-19 amongst people who are detained in and work in correctional facilities. The overall objective is to identify feasible and effective interventions to improve vaccine uptake in correctional facilities and study the effectiveness of these interventions through rapid cycle, cluster randomized trials in the Pennsylvania prison system.
Aim 1: To identify correctional system strategies to address COVID-19 and influenza vaccine acceptance amongst incarcerated people and correctional staff. Aim 2: To select feasible strategies for a statewide correctional system at the patient-, provider-, practice- and prison-level to address COVID-19 and influenza vaccine uptake through a community engaged research approach. Aim 3: To compare the effectiveness of interventions to address COVID-19 and influenza vaccine acceptance using a rapid cycle cluster randomized trial design in prison. This study is highly innovative in its application of rapid cycle, cluster randomized trials in correctional systems to test the effectiveness of strategies identified using a community based participatory research approach. The results will serve as an evidence base for improving vaccine uptake that can be scaled nationally and adapted for other populations affected by the criminal legal system.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
37,122
Interventions will be selected by the ADVANCE Steering Committee and will be rapidly deployed without additional effort on the part of front-line staff at four distinct levels: patient, provider, practice and prison level. Interventions will be tested one at a time in an iterative process. A participatory, assets-based framework will be used to identify acceptable and feasible strategies to improve vaccine acceptance. Each round of testing will include 1 month of preparation by the steering committee,12-week intervention period, and 2 months for analysis and rapid dissemination.
Pennsylvannia Department of Corrections
Schwenksville, Pennsylvania, United States
RECRUITINGCOVID-19 vaccine acceptance rate
COVID-19 vaccine acceptance rate amongst incarcerated people and correctional staff assessed as the number of participants that receive a COVID-19 vaccine dose or complete the COVID-19 vaccine series by electronic health record (EHR) or self report. This will apply to anyone not fully up-to-date with the full immunization series, which is defined as inclusive of boosters.
Time frame: up to 12 weeks post intervention
COVID-19 infections
Number of participants with COVID-19 infections by EHR or self report.
Time frame: up to 12 weeks post intervention
Hospitalization Rate
Total number of new admissions for COVID-19 infections by EHR or self report.
Time frame: up to 12 weeks post intervention
Deaths
Number of deaths from COVID-19 infections by EHR
Time frame: up to 12 weeks
Change in vaccination for other respiratory outbreaks
Change in vaccination rates for other respiratory outbreaks during winter season including influenza vaccine
Time frame: up to 12 weeks
Vaccine refusal rate
Vaccine refusal rate assessed by number of vaccines refused/total number fully vaccinated at start of the intervention
Time frame: up to 12 weeks post intervention
Vaccine acceptance rate
Vaccine acceptance rate assessed by number of vaccines administered/total number fully vaccinated at start of the intervention
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Time frame: up to 12 weeks post intervention