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11 Health & Just. 1 (2023)

handle is hein.journals/hlthjs11 and id is 1 raw text is: 

Blackaby etal. Health &Justice  (2023) 11:1
https://doi.org/1 0.1186/s40352-022-00200-x

Health and Justice

Interventions to improve

the implementation of evidence-based

healthcare in prisons: a scoping review

Jenna  Blackaby

,Jordan   Byrne,  Sue Bellass2, Krysia Canvin' and  Robbie  Foyl

Background:   There  are challenges to delivering high quality primary care within prison settings and well-recognised
gaps between   evidence and practice.There is a growing body of literature evaluating interventions to implement
evidence-based  practice in the general population, yet the extent and rigour of such evaluations in incarcerated
populations are unknown.  We  therefore conducted  a scoping literature review to identify and describe evaluations of
implementation   interventions in the prison setting.
Methods:   We  searched EMBASE,  MEDLINE,  CINAHL  Plus, Scopus, and grey literature up to August 2021, supple-
mented  by hand  searching. Search terms included prisons, evidence-based practice, and implementation science
with relevant synonyms. Two  reviewers independently  selected studies for inclusion. Data extraction included study
populations, study design, outcomes, and author conclusions. We took a narrative approach to data synthesis. We fol-
lowed  Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance  for scoping reviews.
Results:  Fifteen studies reported in 17 papers comprised one randomised controlled trial, one controlled interrupted
time series analysis and 13 uncontrolled before and after studies. Eight studies took place in the US and four in the
UK.Ten  studies evaluated combined  (multifaceted) interventions, typically including education for staff or patients.
Interventions most commonly   targeted communicable diseases,   mental health and screening uptake. Thirteen stud-
ies reported adherence to processes of care, mainly testing, prescribing and referrals. Fourteen studies concluded that
interventions had positive impacts.
Conclusions:  There  is a paucity of high-quality evidence to inform strategies to implement evidence-based health
care in prisons, and an over-reliance on weak evaluation designs which may over-estimate effectiveness. Whilst most
evaluations have focused on recognised  priorities for the incarcerated population, relatively little attention has been
paid to long-term conditions core to primary care delivery. Initiatives to close the gaps between evidence and prac-
tice in prison primary care need a stronger evidence base.
Keywords:   Prison healthcare, Incarceration healthcare, Quality improvement, Intervention, Evidence-based

'enna Blackaby and Jordan Byrne are jointfirst authors.
*Correspondence: jenna.blackaby@nhs.net
' Leeds Institute of Health Science, University of Leeds, Leeds, UK
Full list of author information is available at the end of the article


The global incarcerated population  has grown  by a quar-
ter over in the past two  decades, to 11  million in 2021
(Fair & Walmsley,   2021). Multiple social and  economic
disadvantages  contribute to a high burden  of long-term
conditions, communicable diseases, mental illness, and
drug misuse  in this population (Condon  et al., 2007; Fazel
&  Baillargeon, 2011; Kinner &  Young, 2018;  Stiirup-Toft

O The Author(s) 2022. Open Access This artide is licensed under a Creative Commons Attribution 4.0 International License, which
permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the
original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.The images or
other third party material in this article are incuded in the article's Creative Commons licence, unless indicated otherwise in a credit line
to the material. If material is not incuded in the article's Creative Commons licence and your intended use is not permitted by statutory
regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.To view a copy of this
licence, visit http://creativecommons.org/licenses/by/4.0/.The Creative Commons Public Domain Dedication waiver (http://creativeco
mmnsorg/publicdomain/zero/10/ applies to the data made available in this artide, unless otherwise stated in a credit line to the data.


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