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Lafferty L, Altice FL, Leone F, Stoové M, Lloyd AR, Hajarizadeh B, Kronfli N. Using nominal group technique with people who are incarcerated in Canadian federal prisons to identify barriers and solutions to improving Prison Needle Exchange Program uptake. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 131:104549. [PMID: 39141957 DOI: 10.1016/j.drugpo.2024.104549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 07/30/2024] [Accepted: 07/30/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND Prison needle exchange programs (PNEPs) are a critical component for harm reduction in prisons. Little is known about the PNEP access barriers for people who are incarcerated, but the low uptake in the Canadian program highlights these constraints. We aimed to identify the barriers and potential solutions for increasing PNEP coverage in the nine Canadian federal prisons where they operate. METHODS Eighteen focus groups were conducted in nine prisons using nominal group technique (NGT) with two stakeholders: peer advocates and people who use or identified as potential users of the PNEP. NGT uses a round-robin technique followed by generating a list of barriers to PNEP enrolment within their prison. Participants then allocated votes to rank the highest priority barriers, followed by an identical process to generate solutions to address the top three barriers. Interview transcripts describing participant narratives during this process were de-identified and coded to generated themes. Barriers and solutions receiving >10 % of votes within respective participant groups, alongside associated narratives, are discussed more fully. RESULTS Fear of repercussions due to drug use, lack of confidentiality, and fear of being targeted and sanctioned by correctional authorities were perceived by both stakeholder groups as the top barriers inhibiting PNEP enrolment. Stigma (peer advocates) and the application process for the program (PNEP users) were also ranked as a priority. Proposed solutions included education and external oversight of PNEP (i.e., not via correctional officers) by both groups. Peer advocates regarded improving participant confidentiality and a supervised/safe injection site as potential enablers for program participation, while PNEP users identified wrap-around services as likely to improve access. CONCLUSION Barriers to increasing PNEP coverage in Canadian federal prisons proposed by participants highlight the importance of trust and perceived repercussions surrounding program participation. These barriers and proposed solutions highlight a need for changes in implementation to PNEP delivery if the potential health benefits of PNEPs are to be realised.
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Affiliation(s)
- Lise Lafferty
- Centre for Social Research in Health, UNSW Sydney, Level 1, Goodsell Building, Sydney NSW 2052, Australia; The Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth, Sydney NSW 2052, Australia
| | - Frederick L Altice
- Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, Yale School of Medicine, 135 College St., Suite 323, New Haven, CT 06510, USA; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA; Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Frederic Leone
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Mark Stoové
- Behaviours and Health Risks, Burnet Institute, 85 Commercial Road, Melbourne VIC 3004, Australia; Department of Epidemiology and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne VIC 3004, Australia; Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia
| | - Andrew R Lloyd
- The Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth, Sydney NSW 2052, Australia
| | - Behzad Hajarizadeh
- The Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth, Sydney NSW 2052, Australia
| | - Nadine Kronfli
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; Department of Medicine, Division of Infectious Disease and Chronic Viral Illness Service, McGill University, Montreal, Quebec, Canada.
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Ricciardelli R, Johnston MS, Maier K, Ferguson L. "Jail isn't the answer for these inmates": how to respond to methamphetamine use in prisons. INTERNATIONAL JOURNAL OF PRISON HEALTH 2024; 20:327-343. [PMID: 39183592 DOI: 10.1108/ijoph-12-2023-0084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Abstract
PURPOSE The correctional system continues to face challenges with responding to and managing methamphetamine use among incarcerated individuals. This study aims to uncover what resources and policies could better help correctional workers deal with these challenges. The authors also examined methamphetamine's impact on correctional work and staff well-being. DESIGN/METHODOLOGY/APPROACH An online survey was distributed to correctional workers (n = 269) in Manitoba, Canada, featuring questions about their experiences related to methamphetamine use in populations under their care, what supports are needed to adequately address the concern, and the potential effects on self and their occupational responsibilities. Using NVivo software, survey responses were analysed using an emergent theme approach. FINDINGS Correctional workers believed policies and protocols for managing methamphetamine use and withdrawal are currently inadequate. Correctional workers reported having monthly contact with incarcerated individuals experiencing methamphetamine withdrawal, posing safety concerns to them and other incarcerated individuals. Respondents proposed more education and training on managing incarcerated people withdrawing from methamphetamines, related to the symptoms of use and withdrawal and how to support persons detoxing. Increased human and material resources were reported as being needed (e.g. more nurses onsite and better screening devices). Respondents also desired more medical intervention, safe living spaces for methamphetamine users and programming to support addiction. ORIGINALITY/VALUE The current study unpacks correctional workers' perspectives, support desires and their experiences managing methamphetamine use amongst incarcerated people. The authors discuss the required knowledge to respond to gaps in prison living, re-entry and related policy needs.
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Affiliation(s)
- Rosemary Ricciardelli
- Fisheries and Marine Institute, School of Maritime Studies, Memorial University of Newfoundland, St. John's, Canada
| | - Matthew S Johnston
- Fisheries and Marine Institute, School of Maritime Studies, Memorial University of Newfoundland, St. John's, Canada
| | - Katharina Maier
- Department of Criminal Justice, The University of Winnipeg, Winnipeg, Canada
| | - Lorna Ferguson
- Department of Sociology, University of Western Ontario, London, Canada
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3
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Kronfli N, Lafferty L, Leone F, Stoové M, Hajarizadeh B, Lloyd AR, Altice FL. Using nominal group technique to identify perceived barriers and facilitators to improving uptake of the Prison Needle Exchange Program in Canadian federal prisons by correctional officers and healthcare workers. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 130:104540. [PMID: 39079352 DOI: 10.1016/j.drugpo.2024.104540] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 07/14/2024] [Accepted: 07/14/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND Elimination of bloodborne viruses including HIV and hepatitis C virus from prisons requires high coverage of evidence-based interventions that prevent bloodborne virus transmission, including needle and syringe programs. Canada launched a Prison Needle Exchange Program (PNEP) in nine federal prisons in 2018; however, uptake among people who inject drugs in prison remains low. We aimed to explore barriers and facilitators to improving PNEP uptake identified by correctional officers and healthcare workers. METHODS Participants from nine federal prisons with PNEP completed focus groups using nominal group technique, a rapid mixed-method consensus strategy. Responses were generated, rank-ordered, and prioritized by each stakeholder group. We identified the highest-ranking responses (≥10 % of the overall votes) to questions about barriers and facilitators to PNEP uptake. RESULTS Between September 2023 and February 2024, 16 focus groups were conducted with 118 participants (n = 51 correctional officers; n = 67 healthcare workers). Among correctional officers, the top perceived barriers were bullying from peers (22 %), fear of being targeted by correctional officers (14 %), and fear of repercussions due to drug use (13 %). The top facilitators were safe injection sites (30 %), provision of wrap-around services (16 %), and education of correctional officers (10 %). Among healthcare workers, the top perceived barriers were lack of confidentiality (16 %), fear of being targeted by correctional officers (12 %), and a long and complex application process (11 %). The top facilitators were education of correctional officers (29 %), delivery of PNEP by an external provider (15 %), automatic approval for participation in the PNEP (13 %), and safe injection sites (12 %). CONCLUSION Multiple modifiable barriers and solutions to improving PNEP uptake in Canadian federal prisons were identified by correctional employees. Both participant groups identified the potential for safe injection sites and education to correctional officers as enabling PNEP uptake. These data will inform Canadian efforts to improve engagement and to expand PNEP coverage.
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Affiliation(s)
- Nadine Kronfli
- Department of Medicine, Division of Infectious Disease and Chronic Viral Illness Service, McGill University, Montreal, Quebec, Canada; Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.
| | - Lise Lafferty
- Centre for Social Research in Health, UNSW Sydney, Level 1, Goodsell Building, Sydney, NSW 2052, Australia; The Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth, Sydney, NSW 2052, Australia
| | - Frederic Leone
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Mark Stoové
- Behaviours and Health Risks, Burnet Institute, 85 Commercial Road, Melbourne, VIC 3004, Australia; Department of Epidemiology and Preventive Medicine, Monash University, 553St Kilda Road, Melbourne, VIC 3004, Australia; Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia
| | - Behzad Hajarizadeh
- The Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth, Sydney, NSW 2052, Australia
| | - Andrew R Lloyd
- The Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth, Sydney, NSW 2052, Australia
| | - Frederick L Altice
- Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, Yale School of Medicine. 135 College St., Suite 323, New Haven, CT 06510, USA; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT 06510, USA; Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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4
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Moazen B, Stöver H. Needle and syringe programs in prisons: Does it really matter? JOURNAL OF COMMUNITY PSYCHOLOGY 2024; 52:611-612. [PMID: 38348871 DOI: 10.1002/jcop.23108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 01/22/2024] [Indexed: 04/19/2024]
Affiliation(s)
- Babak Moazen
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
- Department of Health and Social Work, Frankfurt University of Applied Sciences, Frankfurt/Main, Germany
| | - Heino Stöver
- Department of Health and Social Work, Frankfurt University of Applied Sciences, Frankfurt/Main, Germany
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5
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Dichtl A, Jamin D, Stöver H, Grabski M, Knorr B. [Hepatitis C in prisons : Treatment and barriers to the elimination goals of the United Nations]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:36-44. [PMID: 38155308 PMCID: PMC10776704 DOI: 10.1007/s00103-023-03808-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 11/15/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND Despite general advances in the treatment of people with hepatitis C in Germany, it is unclear to what extent this also applies to specific key populations, such as prisoners. METHODS In a short survey conducted in June 2021, the ministries of justice in the federal states were asked about data collection and diagnostic methods as well as the prevalence of infections caused by the hepatitis C virus (HCV) and HCV treatment among prisoners in Germany. In addition, expert interviews were conducted regarding HCV treatment barriers and missed opportunities in prisons. RESULTS It is evident that there is no complete and comprehensive data collection within the ministries of justice. Prevention measures, such as opiate substitution therapy in prison, are available in all participating federal states. More specific offers and measures (e.g., razor and syringe exchange) are only found in a few cases and are sometimes subject to a charge. Experts point out that although treatment in prison generally complies with the equivalence principle: it is more difficult to reach the target group. CONCLUSIONS Comprehensive education and counselling on HCV treatment, consistent HCV testing and treatment, and preventive measures to avoid (re-)infection are important for successful HCV elimination in prisons.
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Affiliation(s)
- Anna Dichtl
- Institut für Suchtforschung, Frankfurt University of Applied Sciences, Nibelungenplatz 1, 60318, Frankfurt am Main, Deutschland
| | - Daniela Jamin
- Institut für Suchtforschung, Frankfurt University of Applied Sciences, Nibelungenplatz 1, 60318, Frankfurt am Main, Deutschland
| | - Heino Stöver
- Institut für Suchtforschung, Frankfurt University of Applied Sciences, Nibelungenplatz 1, 60318, Frankfurt am Main, Deutschland
| | - Meryem Grabski
- Institut für Suchtforschung, Frankfurt University of Applied Sciences, Nibelungenplatz 1, 60318, Frankfurt am Main, Deutschland.
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Amaya A, Medina I, Mazzilli S, D'Arcy J, Cocco N, Van Hout MC, Stöver H, Moazen B. Oral health services in prison settings: A global scoping review of availability, accessibility, and model of delivery. JOURNAL OF COMMUNITY PSYCHOLOGY 2023. [PMID: 37566403 DOI: 10.1002/jcop.23081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 07/28/2023] [Indexed: 08/12/2023]
Abstract
This review aimed at evaluating the state of availability, accessibility and model of delivery of oral health services in prisons, globally. Five databases of peer-reviewed literature and potential sources of grey literature were systematically searched. Inclusion criteria encompassed oral health papers related to prisons globally, with exclusion of certain article types. Selection involved independent evaluations by two researchers, followed by quality assessment. Data on the availability of oral health interventions in prisons came from 18 countries, while information on the model of delivery of the services is scarce. In addition, two sets of individual and organizational barriers toward oral health service uptake in prisons were revealed and discussed in the text. Lack of oral health services in prisons affects people living in prisons and jeopardizes their reintegration. Urgent and concrete international actions are required to ensure the availability, accessibility, and quality of oral health services among people living in prisons.
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Affiliation(s)
- Arianna Amaya
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
| | - Ivan Medina
- School of Economic and Administrative Sciences, Corporación Universitaria de Asturias, Bogotá, Colombia
| | - Sara Mazzilli
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | | | - Nicola Cocco
- Infectious Diseases Service, Penitentiary Health System, ASST-Santi Paolo e Carlo, Milan, Italy
| | | | - Heino Stöver
- Department of Health and Social Work, Frankfurt University of Applied Sciences, Frankfurt/Main, Germany
| | - Babak Moazen
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
- Department of Health and Social Work, Frankfurt University of Applied Sciences, Frankfurt/Main, Germany
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7
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Dichtl A, Stöver H, Schäffer D. [HIV/HCV Among Drug Users in Germany: Elimination Targets in the Mirror of Practice]. DAS GESUNDHEITSWESEN 2023; 85:712-717. [PMID: 35738305 PMCID: PMC11248736 DOI: 10.1055/a-1819-6116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND In 2016, the World Health Organization presented the first strategy for the elimination of viral hepatitis by 2030, following the goals of the Agenda 2030. Ending Acquired Immune Deficiency Syndrome (AIDS) by 2030 was also formulated as one of the Sustainable Development Goals and subsequently included and elaborated in the Joint United Nations Programme on HIV/AIDS (UNAIDS) strategy. People who inject drugs (PWID) are among the most vulnerable groups in terms of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infection. Following the objectives of the WHO and the UN, the German Federal Ministry of Health (BMG) has presented the first integrated overall strategy for HIV and Hepatitis C (as well as Hepatitis B and other sexually transmitted infections). OBJECTIVES AND METHODS Six years after the adoption of the German government's BIS 2030 strategy this article discusses the role of PWID in Germany in relation to the elimination targets on HIV and HCV based on currently available data and in light of recent responses and efforts from the field. RESULTS Although there are multiple positive practice approaches, the WHO elimination targets have not yet been achieved with regard to HCV and HIV in PWID. CONCLUSION In order not to fail the elimination targets 2030, Germany will have to substantially improve the situation of PWID as a key group and in particular advance the implementation of diagnostics and treatment as well as evidence-based harm reduction measures.
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Affiliation(s)
- Anna Dichtl
- Institut für Suchtforschung Frankfurt am Main (ISFF), Frankfurt University of Applied Sciences, Frankfurt am Main, Germany
| | - Heino Stöver
- Institut für Suchtforschung Frankfurt am Main (ISFF), Frankfurt University of Applied Sciences, Frankfurt am Main, Germany
| | - Dirk Schäffer
- Drogen, Haft, Frauen und Migration, Deutsche Aidshilfe e.V., Berlin, Germany
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Stöver H, Dichtl A, Schäffer D, Grabski M. HIV and HCV among drug users and people living in prisons in Germany 2022: WHO elimination targets as reflected in practice. Harm Reduct J 2023; 20:50. [PMID: 37055763 PMCID: PMC10100628 DOI: 10.1186/s12954-023-00774-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 03/20/2023] [Indexed: 04/15/2023] Open
Abstract
People who inject drugs (PWID) and prisoners are considered key populations at risk for human immunodeficiency virus (HIV) and/or Hepatitis C Virus (HCV). In 2016, the Joint United Nations Program on HIV/AIDS (UNAIDS) was implemented to eliminate HIV and AIDS by 2030 and the World Health Organization (WHO) presented the first strategy to eliminate viral hepatitis by 2030 as well. Following the objectives of the WHO and the United Nations, the German Federal Ministry of Health (BMG) presented the first integrated overall strategy for HIV and HCV in 2017. This article discusses the situation of PWID and prisoners in Germany with regard to HIV and HCV five years after the adoption of this strategy, on the basis of available data and against the background of the most recent practice in the field. In order to meet the elimination goals by 2030, Germany will have to improve the situation of PWID and prisoners substantially, mainly through the implementation of evidence-based harm reduction measures as well as the promotion of diagnosis and treatment in prisons and in freedom.
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Affiliation(s)
- H Stöver
- Institute of Addiction Research, Health and Social Work, Frankfurt University of Applied Sciences, Nibelungenplatz 1, 60318, Frankfurt am Main, Germany.
| | - A Dichtl
- Institute of Addiction Research, Health and Social Work, Frankfurt University of Applied Sciences, Nibelungenplatz 1, 60318, Frankfurt am Main, Germany
| | | | - M Grabski
- Institute of Addiction Research, Health and Social Work, Frankfurt University of Applied Sciences, Nibelungenplatz 1, 60318, Frankfurt am Main, Germany
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Reid L. The Language of Incarceration and of Persons Subject to Incarceration. Public Health Ethics 2022. [DOI: 10.1093/phe/phac024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Reflecting on Smith (2021) in this issue, this commentary extends our consideration of issues in carceral health and questions the dehumanizing language we sometimes use—including in public health and public health ethics—to talk about persons held in incarceration. Even the language we use for the carceral system itself (such as ‘criminal justice system’) is fraught: it casts a laudatory light on the system and papers over its role in compounding racial health inequities and in sustaining colonialism. A host of issues call out for ethical analysis, using lenses that can encompass the tensions and contradictions experienced by people within the system who deliver healthcare and those within the system trying to access that care. Beyond access to health care (promotion, prevention, treatment and palliation), the societal commitment to dealing with social issues by depriving people of many key social determinants of health is at the heart of many of these tensions and contradictions.
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Affiliation(s)
- Lynette Reid
- Department of Bioethics, Faculty of Medicine, Dalhousie University
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HCV Elimination in Central Europe with Particular Emphasis on Microelimination in Prisons. Viruses 2022; 14:v14030482. [PMID: 35336889 PMCID: PMC8952509 DOI: 10.3390/v14030482] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/13/2022] [Accepted: 02/25/2022] [Indexed: 11/16/2022] Open
Abstract
In 2016, the WHO announced a plan to eliminate viral hepatitis as a public health threat by 2030. In this narrative review, experts from Bulgaria, Croatia, the Czech Republic, Hungary, Latvia, Lithuania, Poland and Slovakia assessed the feasibility of achieving the WHO 2030 target for HCV infections in Central Europe. They focused mainly on HCV micro-elimination in prisons, where the highest incidence of HCV infections is usually observed, and the impact of the COVID-19 pandemic on the detection and treatment of HCV infections. According to the presented estimates, almost 400,000 people remain infected with HCV in the analyzed countries. Interferon-free therapies are available ad libitum, but the number of patients treated annually in the last two years has halved compared to 2017–2019, mainly due to the COVID-19 pandemic. None of the countries analyzed had implemented a national HCV screening program or a prison screening program. The main reason is a lack of will at governmental and prison levels. None of the countries analyzed see any chance of meeting the WHO targets for removing viral hepatitis from the public threat list by 2030, unless barriers such as a lack of political will and a lack of screening programs are removed quickly.
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Showalter D, Wenger LD, Lambdin BH, Wheeler E, Binswanger I, Kral AH. Bridging institutional logics: Implementing naloxone distribution for people exiting jail in three California counties. Soc Sci Med 2021; 285:114293. [PMID: 34388622 DOI: 10.1016/j.socscimed.2021.114293] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 07/27/2021] [Accepted: 08/02/2021] [Indexed: 11/25/2022]
Abstract
Drug overdose is the leading cause of death among formerly incarcerated people. Distribution of the opioid overdose medication naloxone to people who use drugs reduces overdose mortality, and officials in many jurisdictions are now considering or implementing programs to offer naloxone to people exiting jails and prisons. The principles and practices of harm reduction programs such as naloxone distribution conflict with those of penal institutions, raising the question of how organizations based on opposing institutional logics can collaborate on lifesaving programs. Using in-depth interviews and observations conducted over four years with 34 penal, medical, public health, and harm reduction practitioners, we introduce and conceptualize two organizational features to explain why this therapeutic intervention was implemented in local jails in two of three California counties. First, interorganizational bridges between harm reduction, medical, and penal organizations facilitated mutual understanding and ongoing collaboration among administrators and frontline workers in different agencies. Second, respected and influential champions within public health and penal organizations put jail-based naloxone distribution on the local agenda and cultivated support among key officials. Our findings offer guidance for future studies of institutional logics and policy responses to the overdose crisis.
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Affiliation(s)
- David Showalter
- Sociology Department, University of California-Berkeley, 410 Social Sciences Building, Berkeley, CA, 94720-1980, USA.
| | - Lynn D Wenger
- RTI International, 2150 Shattuck Avenue Suite 800, Berkeley, CA, 94704, USA
| | - Barrot H Lambdin
- RTI International, 2150 Shattuck Avenue Suite 800, Berkeley, CA, 94704, USA
| | - Eliza Wheeler
- Homeless Youth Alliance, PO Box 170427, San Francisco, CA, 94117, USA
| | - Ingrid Binswanger
- Kaiser Permanente Colorado, Institute for Health Research, 2550 S. Parker Rd Suite 200, Aurora, CO, 80014, USA
| | - Alex H Kral
- RTI International, 2150 Shattuck Avenue Suite 800, Berkeley, CA, 94704, USA
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12
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Tavoschi L. Treatment-as-prevention in prison settings: a growing evidence base for HCV elimination efforts. Lancet Gastroenterol Hepatol 2021; 6:512-513. [PMID: 33965005 DOI: 10.1016/s2468-1253(21)00133-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 03/26/2021] [Accepted: 03/26/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Lara Tavoschi
- Department of Translational Research and new Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
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