Ministry of Community Safety and Correctional Services

Background Nurses are the primary healthcare providers in correctional facilities. A solid knowledge and expertise that includes the use of research evidence in clinical decision making is needed to optimize nursing practice and promote positive health outcomes within these settings. The institutional emphasis on custodial care within a heavily secured, regulated, and punitive environment presents unique contextual challenges for nursing practice. Subsequently, correctional nurses are not always able to obtain training or ongoing education that is required for broad scopes of practice. The purpose of the proposed study is to develop an educational intervention for correctional nurses to support the provision of evidence-informed care. Methods A two-phase mixed methods research design will be used. The setting will be three provincial correctional facilities. Phase one will focus on identifying nurses’ scope of practice and practice needs, describing work environment characteristics that support evidence-informed practice and developing the intervention. Semi-structured interviews will be completed with nurses and nurse managers. To facilitate priorities for the intervention, a Delphi process will be used to rank the learning needs identified by participants. Based on findings, an online intervention will be developed. Phase two will involve evaluating the acceptability and feasibility of the intervention to inform a future experimental design. Discussion The context of provincial correctional facilities presents unique challenges for nurses’ provision of care. This study will generate information to address practice and learning needs specific to correctional nurses. Interventions tailored to barriers and supports within specific contexts are important to enable nurses to provide evidence-informed care.

Background Nurses are the primary healthcare providers in correctional facilities. A solid knowledge and expertise that includes the use of research evidence in clinical decision making is needed to optimize nursing practice and promote positive health outcomes within these settings. The institutional emphasis on custodial care within a heavily secured, regulated, and punitive environment presents unique contextual challenges for nursing practice. Subsequently, correctional nurses are not always able to obtain training or ongoing education that is required for broad scopes of practice. The purpose of the proposed study is to develop an educational intervention for correctional nurses to support the provision of evidence-informed care. Methods A two-phase mixed methods research design will be used. The setting will be three provincial correctional facilities. Phase one will focus on identifying nurses’ scope of practice and practice needs, describing work environment characteristics that support evidence-informed practice and developing the intervention. Semi-structured interviews will be completed with nurses and nurse managers. To facilitate priorities for the intervention, a Delphi process will be used to rank the learning needs identified by participants. Based on findings, an online intervention will be developed. Phase two will involve evaluating the acceptability and feasibility of the intervention to inform a future experimental design. Discussion The context of provincial correctional facilities presents unique challenges for nurses’ provision of care. This study will generate information to address practice and learning needs specific to correctional nurses. Interventions tailored to barriers and supports within specific contexts are important to enable nurses to provide evidence-informed care.

There is little research with people who experience intellectual/developmental disabilities and imprisonment. The study linked health and correctional data to examine prevalence of intellectual/developmental disabilities and health and correctional characteristics among adults experiencing their first federal incarceration between 1 January 2002 and 31 December 2011 (n= 9278) and two non-incarcerated groups (n= 10,086,802). The prevalence of intellectual/developmental disabilities was 2.1% in the incarcerated group and 0.9% in the non-incarcerated group. Before incarceration, those with, versus without, intellectual/developmental disabilities were at greater risk of traumatic brain injury, mental illness, and substance use disorders. While incarcerated, those with intellectual/developmental disabilities were more likely to incur serious institutional disciplinary charges. Post-incarceration, persons with intellectual/developmental disabilities were at greater risk of emergency department visits, and psychiatric and acute hospitalizations, than the non-incarcerated groups. People with intellectual/developmental disabilities are overrepresented in Canadian federal correctional institutions. The authors offer strategies to support people prior to, during, and post-incarceration.

The present study examined latent constructs of dynamic sexual violence risk and need, as measured by the Violence Risk Scale-Sexual Offense version (VRS-SO), as a function of Indigenous ancestry among a Canadian federal sample of 1,063 treated men convicted for a sexual offense. Multigroup confirmatory factor analysis of VRS-SO dynamic items ratings supported a correlated 3-factor oblique solution across Indigenous (n = 393) and nonindigenous (n = 670) groups, corresponding broadly to the domains of sexual deviance, criminality, and treatment responsivity. Associations examined between pre- and posttreatment rated factor scores and sexual and violent recidivism were moderated less by Indigenous ancestry and more by victim profile. Specifically, sexual deviance scores were significantly associated with 5- and 10-year sexual recidivism outcomes among both ancestral groups, but only among men with exclusively child victims. Further, criminality was predictive of all outcomes, particularly violent recidivism, irrespective of ancestry or victim type. Treatment responsivity was significantly predictive of sexual and violent recidivism, but only among men who had an adult victim. Change scores on all 3 factors, while controlling for pretreatment score, were significantly associated with decreased sexual and violent recidivism across ancestry and victim groups. Results underscore a common structure to sexual violence risk that emerges from the VRS-SO for Indigenous and non-Indigenous men and that risk and change scores from the three factor domains have comparable predictive properties across these broad ancestral groups. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Over twenty years passed since American and Canadian forces arrived in Afghanistan to start the War on Terrorism as a response to 9/11, and during this period, there has been an enormous controversy about the nature and the scope of the Afghanistan intervention. Amidst this controversy, this dissertation aims to unravel a strategic puzzle: why and how the United States and Canada adopted similar engagement levels, especially similar counterinsurgency (COIN) strategies between 2005/2006 and 2011. During this time, the United States and Canada fought against insurgent groups, sought to maintain stabilized areas by mentoring Afghan forces, and invested in infrastructure and governance. These goals, which corresponded to the 'clear,' 'hold,' and 'build' COIN components, entailed sending troops and civilian officials to a war zone and committing financial resources. According to structural realism as a dominant IR theory, the similarity of American and Canadian engagements constitutes a puzzle because this theory would expect that countries with different relative standings in the international system are meant to adopt different foreign and security policies.

ABSTRACT Background Traumatic Brain Injury (TBI) is a serious hidden health issue disproportionately affecting people who experience incarceration. Objective We examined the association between TBI and serious disciplinary charges among men and women sentenced by the courts to terms of two or more years. Methods The study originated in Ontario, Canada and used linked administrative health and correctional data. The cohort included adults experiencing their first federal sentence between 1998 and 2011 (N = 12,038). We examined disciplinary charges incurred 2 years post-sentence commencement. TBI was defined using the International Classification of Diseases (ICD-9 and ICD-10) diagnostic codes. Robust Poisson regression was conducted to assess the association between TBI and disciplinary charges. Findings The prevalence of TBI for the full sample was 13.2%. One-third of adults with a recent TBI had a serious disciplinary charge. The unadjusted risk of incurring a serious charge for those with a history of TBI was 39% higher than those with no history of TBI (CI: 1.29–1.49). The adjusted risk was 1.14 (CI: 1.06–1.22). Conclusions TBI is a serious health concern that makes it difficult for incarcerants to adjust to prison. Additional support/resources are needed to support those with histories of TBI.

Correctional nursing requires a strong knowledge base with access to continuing education (CE) to maintain and enhance competencies. Nurses working in provincial prisons have reported many challenges in accessing CE, with online learning being identified as a potential solution. Limited research was found, however, which examined the correctional context in the development and delivery of online learning for nurses. The purpose of this study was to develop an online educational intervention tailored to correctional nurses and determine the feasibility and acceptability of implementing the intervention in a provincial prison context. A sequential mixed methods study was conducted. Participants included nurses from three correctional settings in the province of Ontario, Canada. Semistructured interviews examined contextual factors and educational needs. Delphi surveys determined the educational topic. Preintervention and postintervention questionnaires examined the context, educational content, and intervention's acceptability and feasibility. The online intervention focused on mental health and addictions with two 30-minute webinars delivered back-to-back over 15 weeks. Respondents expressed satisfaction with the convenience of online learning at work using short webinars, as well as the topics, relevance of information, and teaching materials, but dissatisfaction with presentation style. The feasibility of the intervention was limited by access to technology, time to attend, education space, and comfort with technology. The findings from this study provide insight to guide the future development of online CE for correctional nurses. If changes are made within correctional facilities in collaboration with nurses and managers, online learning holds the potential to facilitate access to ongoing professional development.

Police officers are often exposed to violence and potentially traumatic encounters, but they have not been a focus of research on compassion fatigue or compassion satisfaction. The current study examines compassion fatigue and satisfaction among police officers and how these variables are influenced by negative personality traits. This study’s participants were police officers ( n = 1,173) from the National Police of Finland, and its aims were twofold: (a) to explore the prevalence rates and relationships between compassion fatigue, compassion satisfaction, burnout, and personality traits (Machiavellianism, `narcissism, psychopathy) among study participants; and (b) to explore whether compassion satisfaction, burnout, years of police experience, and negative personality traits are predictors of compassion fatigue. The results of the current study indicated that 10% of police officers indicated high levels of compassion fatigue and 40% revealed low levels of compassion satisfaction. In addition, compassion fatigue was found to be negatively correlated with compassion satisfaction ( r = −.33, p < .01), whereas negative personality traits were positively correlated with compassion fatigue (Machiavellianism: r = .20; narcissism: r = .19; psychopathy: r = .23; p < .01). Furthermore, negative personality traits (except narcissism) were negatively correlated with compassion satisfaction (Machiavellianism: r = −.22; psychopathy: r = −.32). Structural equation modeling (SEM) was performed to assess predictors of compassion fatigue and it indicated good model fit to the data (goodness of fit index, GFI = .976; comparative fit index, CFI = .934; root mean square error of approximation, RMSEA = .092; standardized root mean square residual, SRMR = .421). In addition, SEM revealed that compassion satisfaction, burnout, and personality traits (Machiavellianism, narcissism, and psychopathy) were significant predictors of compassion fatigue. Clinical and training implications as well as future research recommendations are also discussed.

Disparities in mental health care exist between regional and demographic groups. While screening is recommended as part of a correctional mental health strategy, little work has been done to explore whether it can narrow regional and demographic disparities in access to care. We compared treatment access rates by sex, race, age, and region in relation to screening results. We conducted a retrospective cohort study using administrative data. All 7965 admissions to the prison system were followed for a median of 14 months. Males and non-Indigenous minority racial groups had lower rates of treatment regardless of screening results; they were less likely both to self-report needs and to receive treatment if these needs were reported. Regional differences revealed higher treatment rates in Atlantic Canada and Ontario, as well as higher rates of inmates self-reporting needs on screening who did not receive treatment in the Atlantic, Québec, and Pacific regions. There were minimal differences between inmates of different age groups. Findings suggest potential resource gaps and/or differences in the performance of screening to detect mental health needs across demographic and regional groups. Screening did not narrow, and may have widened, differences between groups.