A novel application of process mapping in a criminal justice setting to examine implementation of peer support for veterans leaving ... View Full Text


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Article Info

DATE

2019-12

AUTHORS

Bo Kim, Megan B. McCullough, Molly M. Simmons, Rendelle E. Bolton, Justeen Hyde, Mari-Lynn Drainoni, B. Graeme Fincke, D. Keith McInnes

ABSTRACT

BACKGROUND: Between 12,000 and 16,000 veterans leave incarceration every year, yet resources are limited for reentry support that helps veterans remain connected to VA and community health care and services after leaving incarceration. Homelessness and criminal justice recidivism may result when such follow-up and support are lacking. In order to determine where gaps exist in current reentry support efforts, we developed a novel methodological adaptation of process mapping (a visualization technique being increasingly used in health care to identify gaps in services and linkages) in the context of a larger implementation study of a peer-support intervention to link veterans to health-related services after incarceration ( https://clinicaltrials.gov/ , NCT02964897, registered November 4, 2016) to support their reentry into the community. METHODS: We employed process mapping to analyze qualitative interviews with staff from organizations providing reentry support. Interview data were used to generate process maps specifying the sequence of events and the multiple parties that connect veterans to post-incarceration services. Process maps were then analyzed for uncertainties, gaps, and bottlenecks. RESULTS: We found that reentry programs lack systematic means of identifying soon-to-be released veterans who may become their clients; veterans in prisons/jails, and recently released, lack information about reentry supports and how to access them; and veterans' whereabouts between their release and their health care appointments are often unknown to reentry and health care teams. These system-level shortcomings informed our intervention development and implementation planning of peer-support services for veterans' reentry. CONCLUSIONS: Systematic information sharing that is inherent to process mapping makes more transparent the research needed, helping to engage participants and operational partners who are critical for successful implementation of interventions to improve reentry support for veterans leaving incarceration. Even beyond our immediate study, process mapping based on qualitative interview data enables visualization of data that is useful for 1) verifying the research team's interpretation of interviewee's accounts, 2) specifying the events that occur within processes that the implementation is targeting (identifying knowledge gaps and inefficiencies), and 3) articulating and tracking the pre- to post-implementation changes clearly to support dissemination of evidence-based health care practices for justice-involved populations. More... »

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References to SciGraph publications

  • 2013-12. A cluster randomized trial of utilizing a local change team approach to improve the delivery of HIV services in correctional settings: study protocol in HEALTH & JUSTICE
  • 2018-12. Using Goal Achievement Training in juvenile justice settings to improve substance use services for youth on community supervision in HEALTH & JUSTICE
  • 2017-12. A two-state comparative implementation of peer-support intervention to link veterans to health-related services after incarceration: a study protocol in BMC HEALTH SERVICES RESEARCH
  • 2013-12. Implementing drug abuse treatment services in criminal justice settings: introduction to the CJ-DATS study protocol series in HEALTH & JUSTICE
  • 2013-12. A cluster randomized trial of an organizational linkage intervention for offenders with substance use disorders: study protocol in HEALTH & JUSTICE
  • 2013-12. Implementation of contingency management in probation agencies using a case controlled longitudinal design: a PDSA study protocol in HEALTH & JUSTICE
  • 2014-12. The prevention of mother-to-child transmission of HIV cascade analysis tool: supporting health managers to improve facility-level service delivery in BMC RESEARCH NOTES
  • 2014-12. A cluster randomized trial of an organizational process improvement intervention for improving the assessment and case planning of offenders: a Study Protocol in HEALTH & JUSTICE
  • 2015-12. A systematic review of the effectiveness and cost-effectiveness of peer education and peer support in prisons in BMC PUBLIC HEALTH
  • 2006-02. The role of formative evaluation in implementation research and the QUERI experience in JOURNAL OF GENERAL INTERNAL MEDICINE
  • 2018-12. A model for rigorously applying the Exploration, Preparation, Implementation, Sustainment (EPIS) framework in the design and measurement of a large scale collaborative multi-site study in HEALTH & JUSTICE
  • 2015-12. Primary healthcare needs and barriers to care among Calgary’s homeless populations in BMC FAMILY PRACTICE
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    DIMENSIONS

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/30915620


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    37 schema:description BACKGROUND: Between 12,000 and 16,000 veterans leave incarceration every year, yet resources are limited for reentry support that helps veterans remain connected to VA and community health care and services after leaving incarceration. Homelessness and criminal justice recidivism may result when such follow-up and support are lacking. In order to determine where gaps exist in current reentry support efforts, we developed a novel methodological adaptation of process mapping (a visualization technique being increasingly used in health care to identify gaps in services and linkages) in the context of a larger implementation study of a peer-support intervention to link veterans to health-related services after incarceration ( https://clinicaltrials.gov/ , NCT02964897, registered November 4, 2016) to support their reentry into the community. METHODS: We employed process mapping to analyze qualitative interviews with staff from organizations providing reentry support. Interview data were used to generate process maps specifying the sequence of events and the multiple parties that connect veterans to post-incarceration services. Process maps were then analyzed for uncertainties, gaps, and bottlenecks. RESULTS: We found that reentry programs lack systematic means of identifying soon-to-be released veterans who may become their clients; veterans in prisons/jails, and recently released, lack information about reentry supports and how to access them; and veterans' whereabouts between their release and their health care appointments are often unknown to reentry and health care teams. These system-level shortcomings informed our intervention development and implementation planning of peer-support services for veterans' reentry. CONCLUSIONS: Systematic information sharing that is inherent to process mapping makes more transparent the research needed, helping to engage participants and operational partners who are critical for successful implementation of interventions to improve reentry support for veterans leaving incarceration. Even beyond our immediate study, process mapping based on qualitative interview data enables visualization of data that is useful for 1) verifying the research team's interpretation of interviewee's accounts, 2) specifying the events that occur within processes that the implementation is targeting (identifying knowledge gaps and inefficiencies), and 3) articulating and tracking the pre- to post-implementation changes clearly to support dissemination of evidence-based health care practices for justice-involved populations.
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