title: Efficacy of a Process Improvement Intervention on Inmate Awareness of HIV Services: A Multi-Site Trial.
abstract: The prevalence of HIV among U.S. inmates is much greater than in the general population, creating public health concerns and cost issues for the criminal justice system. The HIV Services and Treatment Implementation in Corrections protocol of the NIDA funded Criminal Justice Drug Abuse Treatment Studies cooperative tested the efficacy of an organizational process improvement strategy on improving HIV services in correctional facilities. For this paper, we analyzed efficacy of this strategy on improving inmate awareness and perceptions of HIV services. The study used a multi-site (n=28) clustered randomized trial approach. Facilities randomized to the experimental condition used a coach-driven local change team approach to improve HIV services at their facility. Facilities in the control condition were given a directive to improve HIV services on their own. Surveys about awareness and perceptions of HIV services were administered anonymously to inmates who were incarcerated in study facilities at baseline (n=1253) and follow-up (n=1048). A series of one-way ANOVAs were run to test whether there were differences between inmates in the experimental and control facilities at baseline and follow-up. Differences were observed at baseline, with the experimental group having significantly lower scores than the control group on key variables. But, at post-test, following the intervention, these differences were no longer significant. Taken in context of the findings from the main study, these results suggest that the change team approach to improving HIV services in correctional facilities is efficacious for improving inmates' awareness and perceptions of HIV services.
authors.affiliation: Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial VA Hospital, 200 Springs Road (152), Bedford, MA, 01730, USA.
authors.forename: Holly
authors.initials: H
authors.lastname: Swan
authors.affiliation: Associate Professor, Temple University; Department of Criminal Justice, 1115 W. Polett Walk, Philadelphia, PA, 19122, USA, P - 215-204-9030. F - 215-204-3872.
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Hiller
authors.affiliation: Center for Evaluation and Sociomedical Research (CIES), Graduate School of Public Health, Medical Sciences Campus University of Puerto Rico, San Juan, Puerto Rico, 787-522-9036.
authors.forename: Carmen E
authors.initials: CE
authors.lastname: Albizu-García
authors.affiliation: Faculty Center for Excellence in Teaching and Learning, Law and Justice Studies; Rowan University, Glassboro, NJ, 08028, USA, 856-256-4669.
authors.forename: Michele
authors.initials: M
authors.lastname: Pich
authors.affiliation: Elms College, Chicopee, MA, 01013, USA.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Patterson
authors.affiliation: Center for Drug and Health Studies; University of Delaware, 257 East Main Street, Newark, DE, 19716, 302-831-4649; Fax 302-831-3307.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: O'Connell
keywords: HIV; criminal justice settings; implementation; inmates; process improvement