Plain English Summary
From punishment, deterrence or incapacitation, the aim of detention has switched over the past decades toward the reintegration of offenders. However, the evidence regarding the success of rehabilitation to transform people living in detention settings (PLD) into empowered, productive and active citizens who abide by rules and regulations remain conflicting.
Could active participation of PLD in the design, implementation, and evaluation of health interventions to improve the quality of care (QOC) play a role in ensuring that health solutions are respectful of PLD empowerment, rights and needs? International experience is promising but there are limited experience and no published research on the subject in Switzerland, including in the Geneva detention system.
Participatory action research (PAR) is a dynamic and non-traditional research methodology, whereby research priorities, research instruments, and indicators and outcomes to be evaluated emerge through the research process. This said, clues regarding the general research direction are provided by published literature combined with our long-standing experience delivering health services and doing research in detention settings.
Background and study aims
The aim of detention has switched over recent years from punishment and prevention of crime to rehabilitation so that people can reintegrate into law-abiding society. However, there is little research on how successful prisons are in developing prisoners into citizens who are empowered, productive, active and respectful. This research will investigate whether people in detention can benefit from participating in improving healthcare in their prison.
Who can participate?
People in detention in Geneva, Switzerland, regardless of age or gender.
What does the study involve?
This is an umbrella project with different small studies and themes. The themes will be identified in collaboration with people in detention and would concern the following categories:
- evaluation of existing processes (such as the way medicines are distributed)
- design and implementation of new projects (such as a quit-smoking program)
What are the possible benefits and risks of participating?
The inclusion of people in detention might lead to feelings of empowerment and satisfaction for the participants and might benefit future people in detention when they come into contact with healthcare services in prison. There will be minimum risk involved in this research, since there is no testing of treatments. Results may indicate that meaningfully engaging people living in detention helps to give them more tools to reintegrate into life after detention.
Where is the study run from?
The study is run by the Division of Health in Prison of the University Hospitals of Geneva, Switzerland. The Division of Health collaborates with the Department of Justice to offer health care for and conduct research with people detained in the Geneva detention system.
When is the study starting and how long is it expected to run for?
June 2017 to December 2022
Who is funding the study?
Geneva University Hospitals (Switzerland)
Who is the main contact?
Dr. Nguyen-Toan Tran, nguyen-toan.tran@unige.ch
Trial website
Contact information
Type
Scientific
Primary contact
Dr Nguyen Toan Tran
ORCID ID
http://orcid.org/0000-0001-7134-7878
Contact details
Division of Prison Health
Geneva University Hospitals and University of Geneva
Ch. du Petit-Bel-Air 2
Chêne-Bourg
Geneva
1225
Switzerland
+41223055218
nguyen-toan.tran@unige.ch
Additional identifiers
EudraCT number
Nil known
ClinicalTrials.gov number
Nil known
Protocol/serial number
2017-01379
Study information
Scientific title
Participatory action research to improve the quality of health care in detention settings: a multi-center pilot project in Geneva, Switzerland
Acronym
PARity
Study hypothesis
From punishment, deterrence or incapacitation, the aim of detention has switched over the past decades toward the reintegration of offenders. However, the evidence regarding the success of rehabilitation to transform people living in detention settings (PLD) into empowered, productive and active citizens who abide by rules and regulations remain conflicting.
Could active participation of PLD in the design, implementation, and evaluation of health interventions to improve the quality of care (QOC) play a role in ensuring that health solutions are respectful of PLD empowerment, rights and needs? International experience is promising but there are limited experience and no published research on the subject in Switzerland, including in the Geneva detention system.
Ethics approval
Approved 04/12/2017, Cantonal Research Ethics Commission, Health General Directorate, Geneva Republic and Canton (Rue Adrien-Lachenal 8, 1207 Geneva, Switzerland; +41 (22) 54 65 101; cer@etat.ge.ch), ref: 2017-01379
Study design
Mixed method:
1. Exploratory qualitative research
2. Cross-sectional observational study
Primary study design
Observational
Secondary study design
Cross sectional study
Trial setting
Other
Trial type
Other
Patient information sheet
Not available in web format, please use contact details to request a participant information sheet
Condition
Healthcare services in detention
Intervention
With regard to interventions, our study does not aim to test new pharmacological treatment, medical procedures or devices. but rather to improve health service management through mixed-method approaches and in particular participatory action research.
Mixed method:
1. Exploratory qualitative research using participatory action research (PAR) design in which data is collected at the individual and group levels (health-related personal data, opinions and views of participants). No biological material will be collected.
2. Cross-sectional observational study to co-evaluate services/interventions being offered.
For cross-sectional KAP surveys, all incarcerated individuals will be invited to participate. The required sample size will be calculated according to the expected prevalence rate of the condition under study (using published literature), using a +/-5% margin error and a 95% confidential interval for a closed population, which is for instance of 168 at la Brenaz. For the assessment of particular interventions, we will invite only voluntary participants (eg, smokers who wish to enter the stop-smoking project) or those concerned by the interventions (eg, only patients with a prescribed treatment in their individual medication storage boxes in the assessment of the feasibility and acceptability of medication storage boxes). Follow-up period from enrollment will vary according to the condition/intervention under study but will range from 3 months to 1 year.
Intervention type
Other
Phase
Drug names
Primary outcome measure
1. Feasibility of participatory action research to improve the quality of care in detention settings
2. Acceptability of participatory action research to improve the quality of care in detention settings
Secondary outcome measures
Secondary outcomes will emerge from the participatory action research prioritization exercise. Each sub-study, in addition to contributing to understanding whether participatory action research is feasible and acceptable in improving quality of care in detention settings, will have their own secondary outcomes. These outcomes will be co-defined and the assessment tools co-designed in the PAR process of each sub-study.
Overall trial start date
01/06/2017
Overall trial end date
31/12/2022
Reason abandoned (if study stopped)
Eligibility
Participant inclusion criteria
People living in detention (PLD):
1. Adult (male, female, gender-fluid) without age restriction
2. Have demonstrated the ability to interact with one another in a respectful manner
3. Able to converse in French for the focus group discussion
4. Interested in the study and have given informed consent
5. Sufficient length of detention to match the sub-study period
6. For specific sub-studies: PLD with specific health conditions that are relevant to the topic of the sub-study
Key informants:
1. People who can provide specific insights into the health topic being researched (e.g. members of the detention authorities, social workers working in detention facilities, health professionals, among others)
2. Have given informed consent
Participant type
Mixed
Age group
Mixed
Gender
Both
Target number of participants
Mixed method: qualitative (15-30); quantitative (40-70)
Participant exclusion criteria
1. Consent not given
2. In disciplinary confinement
3. Physical or mental conditions preventing taking part in participatory action research groups
Recruitment start date
01/07/2017
Recruitment end date
31/12/2021
Locations
Countries of recruitment
Switzerland
Trial participating centre
Etablissements pénitentiaires de l'office cantonal de la détention de Genève (Brenaz, Villars, Favra, Champ-Dollon, Clairière, Unité cellulaire hospitalière)
Chemin de Favra 10
Puplinge
1241
Switzerland
Sponsor information
Organisation
Division of Prison Health, Geneva University Hospitals and University of Geneva
Sponsor details
Ch. du Petit-Bel-Air 2
Chêne-Bourg
Geneva
1225
Switzerland
+41223055218
hans.wolff@hcuge.ch
Sponsor type
Hospital/treatment centre
Website
Funders
Funder type
Hospital/treatment centre
Funder name
Hôpitaux Universitaires de Genève
Alternative name(s)
Geneva University Hospitals, HUG
Funding Body Type
government organisation
Funding Body Subtype
Local government
Location
Switzerland
Results and Publications
Publication and dissemination plan
The essence of PAR is the meaningful engagement of participants. Several internal validation loops are embedded in the research process, including the sharing and discussion of the final study results.
For external validation of the study results, we intend to disseminate them to:
- the other key informants
- the health (Geneva University Hospitals) and non-health (education, social work sectors) professionals / technical advisers
We aim to publish the results of PARity in relevant peer-reviewed journals.
IPD sharing statement:
The data sharing plans for the current study are unknown and will be made available at a later date.
Intention to publish date
31/12/2022
Participant level data
To be made available at a later date
Basic results (scientific)
Publication list