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.
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
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
548
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.
Edmonton Institution for Women
Edmonton, Alberta, Canada
NOT_YET_RECRUITINGFraser Valley Institution for Women
Abbotsford, British Columbia, Canada
NOT_YET_RECRUITINGMission Institution
Mission, British Columbia, Canada
NOT_YET_RECRUITINGDorchester Medium
Dorchester, New Brunswick, Canada
RECRUITINGAtlantic Institution
Smiths Crossing, New Brunswick, Canada
RECRUITINGNova Institution for Women
Truro, Nova Scotia, Canada
RECRUITINGJoyceville Institution
Kingston, Ontario, Canada
NOT_YET_RECRUITINGGrand Valley Institution for Women
Kitchener, Ontario, Canada
NOT_YET_RECRUITINGJoliette Institution for Women
Joliette, Quebec, Canada
NOT_YET_RECRUITINGEffectiveness
Number of participants on the PNEP
Time frame: From start to end of intervention period (24 months)
Bloodborne virus cascade of care
Number of HIV and hepatitis C virus screenings/tests, diagnoses, and treatment initiations, among the total prison population
Time frame: From start to end of intervention period (24 months)
Enrollment in opioid agonist therapy
The number of people who inject drugs who access opioid agonist therapy among the total prison population
Time frame: From start to end of intervention period (24 months)
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