Condition category
Not Applicable
Date applied
28/07/2019
Date assigned
01/08/2019
Last edited
01/08/2019
Prospective/Retrospective
Retrospectively registered
Overall trial status
Ongoing
Recruitment status
Recruiting

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

https://www.hug-ge.ch/en/penal-medicine

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

government non-federal

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

Publication citations

Additional files

Editorial Notes

30/07/2019: Trial's existence confirmed by the Cantonal Research Ethics Commission of Geneva.