Barriers to Needle Exchange Success in Canadian Prisons
Notice bibliographique
Résumé
In 2018, Correctional Service Canada rolled out the Prison Needle Exchange Program (PNEP) in response to growing human rights and public health concerns surrounding the spread of HIV and HCV in Canadian prisons. Despite having goals to save lives and reduce harm, an independent program evaluation in 2020 revealed that numerous prisons had zero program participants and, as of 2022, fewer than fifty individuals were participating in the program. In 2019, members of the University of Alberta Prison Project (UAPP: PI Drs. Bucerius and Haggerty) interviewed 15 prison staff and 63 incarcerated women and surveyed 74 prison staff at one of Canada’s federal women’s prisons regarding their views of substance use and harm reduction strategies. Using a mixed-methods research approach, I conduct a thematic analysis of these qualitative interviews to identify perceptions toward the prison needle exchange program. Further, I augment qualitative insights with findings from the institution-wide survey of 74 prison staff, including 38 correctional officers and 36 other staff. In Paper 1, I use an implementation science research perspective, which aims to translate research findings into practice, identifying numerous barriers to the PNEPs’ successful implementation. My findings reveal an overwhelming lack of support toward the PNEP for both prison staff and incarcerated women. Interviews reveal three main themes for such disapproval: organizational barriers to program uptake, subcultural barriers to program uptake, and health and safety concerns. In Paper 2, I run a stepwise linear regression analysis of 74 prison staff to understand what factors influence staff approval toward the PNEP, with several notable results. My findings show significant differences between correctional officers and other staff, with correctional officers being more disapproving toward the PNEP. Interestingly, prison staff’s familiarity with harm reduction programs has a negative relationship with PNEP approval, with further analysis revealing this relationship is only significant for correctional officers. This finding suggests a different understanding of “familiarity” between correctional officers and other staff, which may be informed by their unique lived experiences and work responsibilities. Perceptions of harm reduction program effectiveness has a significant positive relationship with PNEP approval, which suggests the more effective staff perceive programs, the higher approval they will have toward such programs. Overall, my research reveals significant barriers to the PNEPs’ success, identifying a lack of support from both incarcerated women and correctional staff. These findings are consistent with previous literature, which highlight numerous problems with PNEP design and implementation. I conclude with recommendations for future research and possible reforms to improve implementation fidelity moving forward.
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Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,006 | 0,023 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,003 |
| Études des sciences et des technologies | 0,025 | 0,005 |
| Communication savante | 0,005 | 0,001 |
| Science ouverte | 0,003 | 0,005 |
| Intégrité de la recherche | 0,001 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
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Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».