Barriers and enablers to health and social services for older prisoners transitioning to community

Purpose When properly designed and implemented, prison-to-community transition programs targeting older prisoners could potentially save resources, reduce reoffending rates and contribute to improved public protection and safety. However, older prisoners transitioning to community are often neglected and overlooked, and thus, interventions targeted to address their needs are limited. The purpose of this study was to identify barriers and enablers to health and social services for older prisoners transitioning to community. Design/methodology/approach A qualitative study was conducted using focus group discussions with corrections officers, community corrections officers and parole officers (n = 32) in four correctional centres, two community corrections offices (CCOs) and one parole unit in New South Wales (NSW) in 2019. The authors used thematic analysis to analyse the findings. Findings The study identified three main themes relating to barriers and enablers: organisational, social and economic and individual and family and seven sub-themes: planning the transition, communication, assisting prisoners, transition programs, officers’ knowledge and scope of work, social and economic issues and offenders’ conditions Research limitations/implications The processes required to ensure effective prison-to-community transition of older prisoners are not well-developed suggesting the need for more systemic and organised mechanisms. Implications of the barriers and enablers for policy, research and practice are discussed. Originality/value This study identified a composite of barriers and enablers to health and social services for older prisoners in NSW prisons and CCOs.

Implementation fidelity of a transition program for adolescents with congenital heart disease: the STEPSTONES project

Background Although transition programs have been evaluated for adolescents with chronic conditions, these have rarely involved process evaluations investigating the implementation process. The aim of this study was to evaluate the extent to which a transition program for adolescents with congenital heart disease was delivered as intended. Research questions were 1) to what level of fidelity was the program delivered? and 2) what potential moderating factors affected the delivery of the program and overall fidelity? Methods A mixed methods design was used, where a process evaluation was embedded in the STEPSTONES randomized controlled trial in Sweden. The implementation fidelity framework by Carrol (2007) and Hasson (2010) was used to design, collect and analyze data. Quantitative data consisted of intervention records on adherence and were analyzed with descriptive statistics. Qualitative data on moderators affecting fidelity were collected through interviews, log-books and focus group interviews with healthcare professionals implementing the intervention and participatory observations of the implementation process. Data were analyzed with deductive content analysis. Triangulation was used to integrate quantitative and qualitative data within the fidelity framework. Results Six out of eight components of the transition program were delivered to an extent that adhered to the program theory or achieved a high level of fidelity. However, components involving peer support had a low attendance by the participating sample (32.2%), and the joint transfer meeting was challenging to implement, despite achieving high adherence. Moderators affecting the implementation process were the adolescent’s and healthcare professional’s engagement in the intervention, contextual factors and a lack of standard operating procedures for all components in the program. Conclusion Barriers and facilitators for a future implementation of transition programs have been illuminated in this study. The use of an implementation fidelity framework in the process evaluation proved successful in providing a comprehensive evaluation of factors affecting the implementation process. However, implementation fidelity must be considered in relation to adaptations to the local and personal prerequisites in order to create interventions that can achieve fit.

Short, multi-modal, pre-commencement transition programs for a diverse STEM cohort

A ‘quantum leap’ (Kift, 2015) in our understanding of the transition to university studies has brought about a reimagining of the role of transition programs from attempting to remediate deficiencies in ‘underprepared’ students, to instead using engagement with the curriculum to instil success-oriented behaviours and attitudes in them. In particular commencers from non-traditional backgrounds are confronted by greater sociocultural incongruities when starting higher education (Devlin, 2013), and face greater challenges in developing their new student identity. While affective change of this kind may necessarily be long-term in nature, semester or year-long ‘foundation’ or ‘bridging’ programs create barriers themselves in terms of time, cost, and stigma. This study provides evidence that significant results can be achieved with short, accessible, manageable, pre-commencement transition programs, that are situated in the curriculum, but also focussed on nurturing those behaviours and attitudes in at-risk students that are associated with greater likelihood of success and retention.