Smiths Crossing

This research aims to improve the use of Prison Needle Exchange Programs PNEPs in Canadian federal prisons to help people who inject drugs while incarcerated. The study is conducted in nine federal prisons, including five womens prisons where more individuals report injection drug use. The goal is to identify obstacles and supports to increase PNEP adoption and make these programs more sustainable over time. The study uses a step-wedge design with a Type 2 hybrid implementation trial to evaluate how the Network for the Improvement of Addiction Treatment NIATx strategy bundle affects PNEP uptake over 24 months. Nine prisons are divided into three groups that receive the NIATx intervention in staggered intervals every six months. Each group undergoes a control period, a NIATx intervention period, and then a 12-month maintenance phase to assess how well improvements last. Participants include all people incarcerated at the study sites during the intervention period. Researchers will monitor measures such as the effectiveness of program uptake, bloodborne virus care, and enrollment in opioid agonist therapy throughout the intervention. The study includes ongoing observation during and after the intervention to assess program sustainability, with a total study period extending up to 54 months for some groups.