Mission

This research aims to improve the use of Prison Needle Exchange Programs (PNEPs) in Canadian federal prisons, focusing on people who inject drugs while incarcerated. The study involves nine federal prisons, including five women's prisons where more individuals report injection drug use. The goal is to increase program adoption and sustainability by identifying what helps and hinders participation and implementing strategies based on evidence. The study uses a step-wedge design over 24 months, with nine prisons divided into three groups that receive the intervention at staggered intervals every six months. The intervention involves the Network for the Improvement of Addiction Treatment (NIATx) model, which uses expert coaching and quality improvement tools aimed specifically at behavioral healthcare settings to enhance access and retention. After the intervention period, there is an additional 12-month phase to assess how well the program is sustained. Participants include all people incarcerated at the study sites during the intervention period. Researchers will observe changes in PNEP uptake throughout the study and monitor the effectiveness of the NIATx strategy in improving program engagement. The study also assesses sustainability of the needle exchange programs after the intervention ends, with no exclusions at the participant level since the intervention is applied site-wide.