目标:计划和实施基于监狱的物质使用障碍(SUD)干预措施具有挑战性。我们想了解惩教机构(CS)中的人们为什么以及如何使用药物,并探索哪些政策,环境,人际关系因素影响被监禁者的物质使用。使用行为改变轮(BCW)框架,我们提出了具有干预功能的主题图,以减少CS中的物质使用。
方法:我们使用定性分析的框架方法。我们为被监禁的吸毒人员(PWD)进行了滚雪球采样,并为工作人员进行了便利采样。深度访谈样本包括17名成人PWD,三监狱行政、和两名医护人员。我们通过主题数据饱和度确定样本量。我们采用了混合编码方法来生成类别,即,演绎(基于BCW框架)和归纳法。该研究通过确定类别的属性和类别之间的关系来构建最终的理论框架。
结果:我们确定了与BCW框架一致的11个类别。主题是监狱常规,被监禁人口的人际动态,接触物质使用,员工对PWD的态度,监狱医疗保健的经验,意愿(减少吸毒)和应对,同情,吸毒危害,员工和居民之间的冲突,污名,和家庭/同伴支持。BCW框架有助于识别潜在的干预功能及其与可能影响PWD的能力-机会-动机(COM)和药物使用行为(B)的组织政策的相互作用。
结论:有必要提高决策者对SUD预防和干预的认识,并重新审视监狱政策。
Planning and implementing prison-based substance use disorder (SUD) interventions are challenging. We wanted to understand why and how people in correctional settings (CS) use drugs and to explore what policies, environmental, and interpersonal factors influence substance use among incarcerated people. Using the Behavior Change Wheel (BCW) framework, we proposed a thematic map with intervention functions to reduce substance use in CS.
We used the Framework Method of qualitative analysis. We did snowball sampling for the incarcerated people with drug use (PWD) and convenience sampling for the staff. The in-depth interview sample comprised 17 adult PWD, three prison administrative, and two healthcare staff. We determined the sample size by thematic data saturation. We followed a mixed coding approach for generating categories, i.e., deductive (based on the BCW framework) and inductive. The study constructed the final theoretical framework by determining the properties of the categories and relationships among the categories.
We identified eleven categories aligned with the BCW framework. The themes were prison routine, interpersonal dynamics of the incarcerated population, exposure to substance use, attitude of staff towards PWD, experience with prison healthcare, willingness (to reduce drug use) and coping, compassion, drug use harms, conflict between staff and residents, stigma, and family/peer support. The BCW framework aided the identification of potential intervention functions and their interactions with the organizational policies that could influence PWD\'s capability-opportunity-motivation (COM) and drug use behavior (B).
There is a need to raise awareness of SUD prevention and intervention among decision-makers and revisit the prison policies.