E-training of Inmate Peer Caregivers for Enhancing Geriatric and End-of-life Care in Prisons - Phase II

美国有超过1，719所州和联邦监狱，关押着230多万名囚犯。2017年，更多 超过20%的被判刑囚犯年龄在50岁或以上。老年囚犯的健康状况往往与 年龄大得多的自由生活的人（例如，10 - 15岁）。年龄较大的囚犯不成比例地助长了 惩教保健费用急剧上升，他们的死亡率是年轻囚犯的10倍。 惩教预算紧张，因为他们努力满足老年和垂死囚犯的护理需要。仔细 经过挑选和审查的囚犯提供了丰富的人力资源，准备在重要方面做出贡献 增加监狱工作人员，以满足老年和垂死囚犯日益增长的护理需求。但缺乏 目前，针对这一目标受众的标准化、循证培训是确保 高质量的囚犯生活为了满足这一需求，我们的第一阶段项目-囚犯同伴电子培训 加强监狱中老年人和临终关怀的护理人员表明，囚犯获得 技术正在发展，囚犯可以成为成功的电子学习者。具体来说，我们了解到：（1）有一个 需要和兴趣的产品，如我们的囚犯照顾计算机为基础的学习（CBL）;（2）培训应 对特定环境、目标用户和安全性具有吸引力、交互性和上下文敏感性 限制因素，同时注意到囚犯使用技术方面的新趋势 (e.g.,在许多州都有平板电脑可供购买和使用）;最后，（3）交互式、媒体丰富的 可以开发出具有高可接受性和可用性的原型模块。规格文件和 商业化计划表明，有可能在第二阶段开发一个全面的囚犯护理学习系统 技术利基分析显示市场潜力存在。第二阶段申请的目的是 继续研究和开发囚犯护理学习系统，重点是开发一个 在数量更多、种类更多样化的州立监狱中进行商业化和扩大试验的可扩展单位。更 具体地说，第二阶段研究的目标是：1）开发一个全尺寸的多媒体交互式计算机基础 学习系统囚犯护理，包括六个模块，旨在增强高度可变的面对面， 面对州立监狱的囚犯改造计划，进行标准化的循证培训， 协助临终关怀和老年护理的囚犯;以及一个培训概述和推出模块， 工作人员使用囚犯护理作为囚犯同伴护理者培训的工具; 2）进行 在州立监狱分两轮实施全面的囚犯关怀计划，以评估后勤、囚犯和工作人员 印象、用户界面、易用性和感知障碍，以优化可扩展单元， 更广泛的传播（n = 30）;和3）在州立监狱中测试扩大全面囚犯护理方案 在全国范围内评估知识获取成果，使用模式和商业化 机会（n = 288）。

There are over 1,719 United States (US) state and federal prisons with over 2.3 million prisoners. In 2017, more than 20% of sentenced prisoners were age 50 or older. The health status of older inmates is often parallel with free-living people who are far older (e.g., 10-15 years). Older prisoners disproportionately contribute to the steeply rising correctional healthcare costs and their death rate is 10 times that of younger prisoners. Corrections budgets are stretched as they strive to meet the care needs of aged and dying prisoners. Carefully selected and vetted inmates offer an abundant human resource that is poised to contribute in important ways to augment prison staff in meeting growing care needs of older and dying inmates. However, the lack of standardized, evidence-based, training that is geared toward this target audience is a current barrier to ensuring high quality inmate caregiving. In response to this need, our Phase I project E-training of Inmate Peer Caregivers for Enhancing Geriatric and End-of-Life Care in Prisons demonstrated that inmate access to technology is growing and inmates can be successful e-learners. Specifically, we learned: (1) there is a need and interest for products such as our Inmates Care computer-based learning (CBL); (2) trainings should be engaging, interactive, and contextually sensitive to the specific environment, target user, and security constraints, while at the same time being mindful of emerging trends in regard to technology use by inmates (e.g., availability of tablets for purchase and use in many states); and finally, (3) that interactive, media-rich prototype modules with high acceptability and usability could be developed. The specifications document and commercialization plan indicated it is possible to develop a full-scale Inmates Care learning system in Phase II and a Technology Niche Analyses® revealed market potential exists. The purpose of this Phase II application is to continue research and development of the Inmates Care learning system with an emphasis on developing a scalable unit for commercialization and testing scale-up in a larger number of more diverse state prisons. More specifically, the aims of this Phase II study are to: 1) Develop a full scale media-rich interactive computer-based learning system Inmates Care, that consists of six modules aimed at augmenting the highly variable face-to- face inmate caregiving programs in state prisons with standardized, evidence-based training to prepare inmates in assisting with EOL and geriatric care; and one Training Overview and Rollout module that prepares staff to use Inmates Care as a tool for inmate peer caregiver training; 2) Conduct in-person usability testing of the full-scale Inmates Care program in two rounds in state prisons to evaluate logistics, inmate and staff impressions, user interface, ease of use, and perceived barriers in order to optimize the scalable unit for broader dissemination (n=30); and 3) Test scale-up of the full-scale Inmates Care program in state prisons across the nation to evaluate knowledge acquisition outcomes, usage patterns, and commercialization opportunities (n=288).