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Am J Public Health. 2014 Dec;104(12):2385-91. doi: 10.2105/AJPH.2014.302035. Epub 2014 Oct 16.

Efficacy of a process improvement intervention on delivery of HIV services to offenders: a multisite trial.

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Frank S. Pearson is with the Center for the Integration of Research and Practice, National Development and Research Institutes Inc, New York, NY. Michael S. Shafer is with the Center for Applied Behavioral Health Policy, School of Social Work, Arizona State University, Phoenix. Richard Dembo is with the Department of Criminology, College of Behavioral and Community Sciences, University of South Florida, Tampa. Graciela del Mar Vega-Debién is with the Graduate School of Public Health, University of Puerto Rico, San Juan. Jennifer Pankow is with the Institute of Behavioral Research, Texas Christian University, Fort Worth. Jamieson L. Duvall is with the Department of Behavioral Science, University of Kentucky, Lexington. Steven Belenko and Michele Pich are with the Department of Criminal Justice, Temple University, Philadelphia, PA. Linda K. Frisman and Yvonne Patterson are with the School of Social Work, University of Connecticut, West Hartford. Christy A. Visher is with the Center for Drug and Health Studies, University of Delaware, Newark.



We tested a modified Network for the Improvement of Addiction Treatment (NIATx) process improvement model to implement improved HIV services (prevention, testing, and linkage to treatment) for offenders under correctional supervision.


As part of the Criminal Justice Drug Abuse Treatment Studies, Phase 2, the HIV Services and Treatment Implementation in Corrections study conducted 14 cluster-randomized trials in 2011 to 2013 at 9 US sites, where one correctional facility received training in HIV services and coaching in a modified NIATx model and the other received only HIV training. The outcome measure was the odds of successful delivery of an HIV service.


The results were significant at the .05 level, and the point estimate for the odds ratio was 2.14. Although overall the results were heterogeneous, the experiments that focused on implementing HIV prevention interventions had a 95% confidence interval that exceeded the no-difference point.


Our results demonstrate that a modified NIATx process improvement model can effectively implement improved rates of delivery of some types of HIV services in correctional environments.

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