Large-scale evaluation of a computer-based learning program to increase prison staff knowledge on geriatric and end-of-life care

• DOI: https://doi.org/10.1108/IJPH-08-2021-0078
• Published date: 29 March 2022
• Date: 29 March 2022
• Pages: 185-199
• Subject Matter: Health & social care,Criminology & forensic psychology,Prisoner health,Sociology,Sociology of crime & law,Public policy & environmental management,Policing,Criminal justice
• Author: Valerie Harwell Myers,Susan Loeb,Erin Kitt-Lewis,Tiffany Jerrod

Large-scale evaluation of a

computer-based learning program to

increase prison staff knowledge on

geriatric and end-of-life care

Valerie Harwell Myers, Susan Loeb, Erin Kitt-Lewis and Tiffany Jerrod

Abstract

Purpose –The purpose of this study is to continueresearch and development of the ECAD-P learning

system with an emphasis on developing a scalable unit for testing in a larger number of more diverse

correctional settings. There are almost 2.3 million US persons incarcerated. Geriatric and end-of-life

(EOL) care in correctionsis not as equitable as care in the free world. Technologicaldelivery of geriatric

training to staff through computer-based learning (CBL) offers a novel approach to improve care and

reducedisparities among those who are most vulnerableduring confinement.

Design/methodology/approach –This mixed methods study built an interactive CBL for

multidisciplinary staff to address EOL and geriatric issues in prisons. The CBL was iteratively built and

testedprior to launching a full-scale evaluationusing a pre/post-interventiondesign.

Findings –Evaluation of the CBL occurred at 7 sites (i.e. 6 state prisons and 1 prison health-care

vendor). A total of 241 staff were recruited with 173 completing post-tests. Outcomes were knowledge

acquisition regarding care for aging and dying incarcerated persons (i.e. cognitive measure) and

attitudes,motivations and values for providing care (i.e. affective measure).Cognitive and affective post-

tests were significantly better than at pre-test (all ps <0.01). ANCOVAs revealed no significant

differencesfor sex or ethnicity.

Originality/value –Outcomesreveal that the CBL is acceptable, feasibleand usable in corrections. Staff

improved their knowledgeafter receiving the training. Correctional settingsface increasing pressures to

better address the health care and management needs of aged, chronically ill and dying incarcerated

persons. This e-learning holds promise to contribute to better preparation of corrections staff to

effectivelycare for these populations.

Keywords Prison health care, Computer-based training, Corrections staff, End-of-life care,

Geriatric care, Health in prison

Paper type Research paper

Introduction

The USA has the highest incarceration rate with nearly a quarter of the global prison

population (World Population Review, 2021). Although the rate of incarceration has

decreased in the past decade (Kang-Brown et al., 2021), nearly 2.2 million persons are

currently confined within 3,134 local jails and 1,933 state and federal prisons (Sawyer and

Wagner, 2020).

An aging prison population has become an increasing concern. Outside of corrections,

persons aged 65years and older are referred to as older adults. While there is no definitive

lower age criterion for older adults in prison, data nearly always include people either 50 or

Valerie Harwell Myers is

based at Klein Buendel

Inc., Golden, Colorado,

USA.

Susan Loeb and

Erin Kitt-Lewis are both

based at the Ross and

Carol Nese College of

Nursing, The Pennsylvania

State University, University

Park, Pennsylvania, USA.

Tiffany Jerrod is based at,

Klein Buendel Inc., Golden,

Colorado, USA.

Received 10 August 2021

Revised 25 November 2021

4 February 2022

Accepted 23 February 2022

The authors acknowledge

Rachel K. Wion, PhD, RN, Julie

Murphy, PhD, RN and Kale

´iH.

Kolawchik, BSN, RN for their

contributions as research

assistants earlier in this

research.

Researchreported in this

publication/pressrelease was

supportedby the National

Instituteon Aging of the

NationalInstitutes of Health

underaward number

R42AG049570.The content

is solelythe responsibility of

the authorsand does not

necessarilyrepresent the

officialviews of the National

Institutesof Health.

DOI 10.1108/IJPH-08-2021-0078 VOL. 18 NO. 2 2022, pp. 185-199, ©Emerald Publishing Limited, ISSN 1744-9200 jINTERNATIONAL JOURNAL OF PRISONER HEALTH jPAGE 185