Computer-based Training Archives

Just Care for Dementia in Prison

April 9, 2024 Klein Buendel

A research team from The Penn State University Ross and Carol Nese College of Nursing and Klein Buendel made two presentations related to formative research on the development of Just Care for Dementia at the 36th Annual Scientific Sessions of the Eastern Nursing Research Society April 4-5, 2024 in Boston, MA.

Presentation 1

Title: Dementia Care Training Needs for Corrections Staff and Peer Caregivers

Presenter: Dr. Susan Loeb

The number of people living in prison with Alzheimer’s Disease and Related Dementias (ADRD) is growing. Care inequities for ADRD between prisons and community settings exist and warrant addressing. A standardized, evidence-based, feasible, and acceptable ADRD e-training program is needed to prepare corrections staff and peer caregivers for better managing and caring for people with ADRD in prisons.

The purposes of this study were to (1) identify three priority learning needs of corrections staff and peer caregivers who manage and/or care for people living with ADRD in prisons; (2) identify a logo for the Just Care for Dementia training that was desirable to end-users; and (3) translate best practices from community-based ADRD care into evidence-based, accessible, and relevant ADRD content for prison settings. The end goal was to program prototypes for three highly interactive e-learning modules that fit within the restrictive context of corrections.

Focus group methodology guided potential future users in providing insights to ensure the content, design, and technology plans match the needs and constraints of prisons. Human subjects approvals were secured and participants’ signed informed consent was obtained. Settings were one men’s and one women’s state prison in the northeastern United States. Twelve corrections staff and 11 peer caregivers participated. Focus groups were audio recorded, transcribed, and deidentified.

Thematic analysis was completed independently by two researchers. The three priority content areas identified were fostering a safe and calm environment, addressing behavioral and psychological symptoms of dementia, and enhancing awareness of need. Participants identified two logo preferences. Advisory board consultation informed logo selection. Module content was developed via an iterative process to ensure contextual relevance of training, accessibility within the constraints of prisons, and the e-training matched identified training needs.

In summary, participants confirmed the need for ADRD training and indicated e-learning is a viable approach for addressing a pressing care need in prisons.

This research was funded by an STTR grant to Klein Buendel from the National Institute on Aging (AG057239; Dr. Susan Loeb from Penn State and Dr. Barbara Walkosz from Klein Buendel, Multiple Principal Investigators). Collaborators included Dr. Erin Kitt-Lewis and Sherif Olanrewaju from Penn State University; and Amanda Brice and Steve Fullmer from Klein Buendel.

Presentation 2

Title: Small-Scale Usability Testing: E-learning modules for Peer Caregivers

Presenter: Dr. Susan Loeb

Growing numbers of people will grow old and die while incarcerated. Research evidence supports using peer caregivers to assist staff with geriatric and end-of-life care. Peer caregivers training varies widely in content and duration. Evidenced-based, accessible, and contextually relevant materials are needed to effectively prepare peer caregivers. 

The purpose of this study was to conduct research and development for Just Care, a six-module e-learning program for peer caregivers and a single module to guide corrections staff in launching the program. Deputy Wardens identified people meeting our inclusion criteria. Nineteen people living in prison and 11 staff participated. Throughout usability testing, participants shared their thoughts aloud, while field notes were taken. Participants completed six open-ended questions, a demographic survey, and the System Usability Scale (SUS).

All users easily navigated through the program with minimal guidance. Many noted Just Care’s utility for future peer caregivers. Some users who were incarcerated had difficulty navigating the post-test assessments. A few staff users noted liking the additional resources available via links to PDFs. One staff user voiced concern about the safety of having incarcerated people help with care. Just Care received Round 1 SUS scores of 87.5 by users living in prison and 74.5 by staff. Following rapid refinement, Just Care received Round 2 mean SUS scores of 85.28 by users living in prison and 83.75 by staff. A SUS score of 68 is an above average score.

Overall, participants found Just Care innovative, useful, engaging, interactive, and relevant to providing geriatric and end-of-life care in prisons. Staff noted that Just Care raised awareness about the growing need for programming on geriatric care in prisons and that a peer caregiver program is a viable solution that is implementable by prison staff.  

Just Care for Dementia in Prisons

May 18, 2022 Klein Buendel

Prison systems in the United States face sharply increased demands in caring for older people living in prisons. Alzheimer’s Disease and related dementias (ADRD) are age-related diseases. Prison health, social, and security staff perceive they lack the skills and knowledge essential for identifying dementia and supporting people who are incarcerated and living with ADRDs.

A research team from Klein Buendel and The Pennsylvania State University (Penn State) are launching a new research project to address ADRD care in prisons. The project is entitled “Computer-based Learning to Enhance ADRD Care in Prison: Just Care for Dementia.” The effort is being led by Dr. Susan Loeb from the Penn State College of Nursing and is being funded by a Phase I STTR grant to Klein Buendel from the National Institute on Aging (AG078103; Dr. Susan Loeb, Principal Investigator).

The mission of Corrections is to provide care, custody, and control for incarcerated individuals. Prisons are required by law to provide adequate care for growing numbers of older people who are incarcerated—a group who are disproportionately at risk for ADRD. This Phase I feasibility project focuses on research and development of highly interactive computer-based learning modules, for prison staff and people who are incarcerated and serving as peer caregivers to promote an integrated systems approach for enhancing the care of people with ADRD in prison.

The project will transform best practices in ADRD care into media-rich, highly interactive, computer-based educational module prototypes and conduct in-person usability testing of the learning module prototypes with corrections staff and peer caregivers to evaluate the user interface, ease of use, and perceived barriers in order to refine the product and optimize implementation in prison settings.

Dr. Loeb is a Professor in the College of Nursing and the Department of Medicine at Penn State University. Her research collaborators include: Dr. Donna Fick, a Professor in the College of Nursing and the Director of the Center for Geriatric Nursing at Penn State University; and Dr. Barbara Walkosz, a Senior Scientist at Klein Buendel. The ADRD modules will be programmed by Klein Buendel’s Creative Team.

Evaluation of the ECAD-P Program for Prison Staff

April 27, 2022 Klein Buendel

There are nearly 2.3 million people incarcerated in U.S. prisons. Many grow old there and need end-of-life care. Geriatric and end-of-life care in Corrections is not as equitable as care in the free world. The results of a study led by researchers from Penn State University and Klein Buendel were published recently in the International Journal of Prisoner Health. The research team developed and evaluated the technological delivery of geriatric training for prison staff as a novel approach to improve care and reduce disparities among those who are most vulnerable during confinement.

Evaluation of the ECAD-P computer-based learning program occurred at seven sites, including six state prisons and one prison healthcare vendor. A total of 241 staff were recruited and 173 completed posttesting. The outcomes were (a) knowledge acquisition regarding care for aging and dying incarcerated persons, and (b) attitudes, motivations and values for providing geriatric and end-of-life care. Staff improved their knowledge and affective indicators after receiving the training. ECAD-P was determined to be acceptable, feasible, and usable in Corrections.

Correctional settings face increasing pressures to better address the healthcare and management needs of aged, chronically ill, and dying incarcerated persons. ECAD-P may contribute to better preparation of Corrections staff to effectively care for these populations.

This research was funded by a Small Business Technology Transfer grant to Klein Buendel from the National Institute on Aging at the National Institutes of Health (AG049570; Dr. Susan Loeb and Dr. Valerie Myers, Multiple Principal Investigators). The authors of this publication are Dr. Valerie Myers, formerly of Klein Buendel; Dr. Susan Loeb and Dr. Erin Kitt-Lewis from the Ross and Carol Nese College of Nursing at The Pennsylvania State University; and Tiffany Jerrod, formerly of Klein Buendel.

Computer-Based Training for Geriatric and End-of-Life Care in Prisons

July 22, 2021 Klein Buendel

In a recent publication in the Journal of Correctional Health Care, authors from Penn State University, Indiana University, King’s College, and Klein Buendel share insights into the testing of a computer-based training for peer caregivers (PCs) in prisons to care for aged and dying prisoners.

As the aged and dying incarcerated population increases, so does the demand on corrections health care. In the publication, the research team describes their process of conducting focus groups and performing usability testing with PCs and corrections staff members who ultimately helped identify the priority training topics.

The focus groups, in consultation with an Expert Advisory Board, led to the creation of three prototype modules: Standard Precautions; Loss and Grief; and Role of the Inmate Caregiver in the Final Hours. Following the focus groups, face-to-face usability testing was conducted with PCs and staff who confirmed the contextual training relevance and feasibility of the computer-based training program.

The team concluded that the computer-based training, Inmates Care, provides evidence to complement nurse-led training within the corrections setting with a standardized e-training package. A full description of the methods, results, discussion, strength and limitations, and conclusions can be found in the publication.

This research was funded by a Phase I grant from the National Institute on Aging (AG057239). The project was led by Principal Investigator Dr. Susan Loeb from Penn State University and Co-Investigator Dr. Valerie Myers from Klein Buendel. Additional authors include Dr. Erin Kitt-Lewis from Penn State University, Tiffany Jerrod from Klein Buendel, Dr. Rachel Wion from Indiana University, and Dr. Julie Murphy from King’s College.

Computer-based Learning for End-of-Life Care in Prisons

July 24, 2019 Klein Buendel

In a recent publication in the Journal of Forensic Nursing, authors from The Pennsylvania State University and Klein Buendel describe, in detail, the design and development of a computer-based learning program for geriatric and end-of-life (EOL) care for incarcerated people. The program, called Enhancing Care for the Aged and Dying in Prison (ECAD-P), was funded by a Small Business Technology Transfer (STTR) grant to Klein Buendel from the National Institute on Aging.

Content creation was based on the Phase I Principal Investigators’ paper-based EOL Toolkit. The systematic design and development of the training program was guided by the Institute for Healthcare Improvement’s Framework for Going to Full Scale. The Journal of Forensic Nursing paper describes the painstaking processes of designing a program logo, recording video testimonials, creating graphic novels, incorporating visually-stimulating images, confirming reading level, and programming the functionality of the media-rich, interactive computer-based training program. The final ECAD-P program has six modules which take approximately 2.5 hours to complete in one or more sessions.

The STTR Phase I and Phase II projects were funded by a grant from the National Institute on Aging (AG049570). The Phase I Multiple Principal Investigators, Dr. Janice Penrod and Dr. Susan Loeb, are from The Pennsylvania State University. The Phase II Multiple Principal Investigators, Dr. Susan Loeb and Dr. Valerie Myers, are from The Pennsylvania State University and Klein Buendel, respectively. Other paper coauthors include Rachel Wion from The Pennsylvania State University, Tiffany Jerrod from Klein Buendel, and Sophia Strickfaden from Johnson & Wales University. ECAD-P was programmed by the Creative Team at Klein Buendel.

Inmate Caregiver Training in Geriatrics and End-Of-Life

April 10, 2019 Klein Buendel

Dr. Susan Loeb from Penn State University presented on the development of computer-based learning modules for caregivers of the aged and dying in prisons at the 31st Annual Scientific Sessions of the Eastern Nursing Research Society (ENRS) held in Providence, RI on April 3-5, 2019. This research is being conducted with Klein Buendel Senior Scientist, Dr. Valerie Myers, a co-author on the presentation.

More men and women are aging and facing end-of-life (EOL) while incarcerated. Early research by this research team found that computer-based training for inmates assisting staff in geriatric and EOL care was feasible. This collaborative team of nurse scientists, small business partners, and the correctional community are working to advance the quality of care provided for those aging and dying in our nations’ correctional institutions. Specifically, the purpose of the research presented at ENRS was to identify inmate peer caregiver training needs, and discover priority content areas and core values for inmate computer-based modules with the help of stakeholders and experts.

Six focus groups were conducted with stakeholders at one men’s and one women’s state correctional institution in a Mid-Atlantic state. Stakeholders included information technology and human resources staff, interdisciplinary front line staff who oversee inmate peer caregivers, and inmate peer caregivers. A content analysis identified content areas and core values. An Advisory Board of experts in EOL and geriatric care, corrections health, and corrections training, suggested combining some of the priority content areas. The resulting priority content areas for the initial Inmates Care modules were Universal Precautions, Role of the Inmate Caregiver in the Final Hours, and Loss and Grief. The core values identified for the inmates training were respect, dignity, and compassion. The next steps of the research project include completing three prototype modules, testing them for usability, and developing a specifications document for technology programming and production congruent with correctional facility security precautions.

This research was funded by a Small Business Technology Transfer (STTR) grant to Klein Buendel from the National Institute on Aging at the National Institutes of Health (AG057239; Dr. Susan Loeb, Principal Investigator) and Dr. Valerie Myers, Co-Investigator. Additional collaborators on the work presented at the conference include Dr. Erin Kitt-Lewis, Dr. Rachel Wion, and Julie Murphy from the Penn State University College of Nursing, and Tiffany Jerrod and Morgan Carter from Klein Buendel. The technology-based modules are being developed by the Creative Team at Klein Buendel.

Using E-Training to Enhance Geriatric and End-of-Life Care in Prisons

March 14, 2019 Klein Buendel

Klein Buendel Senior Scientist, Dr. Valerie Myers, presented preliminary findings from a project that provides e-training of inmate peer caregivers to enhance geriatric and end-of-life (EOL) care in prisons at the 40th Annual Meeting and Scientific Sessions of the Society of Behavioral Medicine (SBM), March 6-9, 2019 in Washington, DC.

The United States has an incarceration rate of 655 people per 100,000, making it the highest globally. The older adult segment of the prison population has more than tripled since 1990 and their health issues are comparable to those of free people who are 10-15 years their senior. Inmates over the age of 55 have a death rate that is 10 times that of prisoners aged 25-34. United States prison systems are facing increased demands in caring for aged and dying inmates. A systematic review revealed that inmate peer caregivers can figure prominently in delivery of EOL care in prison. However, the degree of training received by inmate peer caregivers varies widely.

The lack of consistent training points to a need for evidence-based, current, and readily accessible training for this population to mitigate the growing need for EOL care in United States prisons. In response to this need, the E-training of Inmate Peer Caregivers for Enhancing Geriatric and End-of-Life Care in Prisons project, will demonstrate the scientific merit and feasibility of developing cutting edge, media-rich learning modules to train inmate peer caregivers in geriatric and EOL care. The aims of the project are to: (1) transform best practices in inmate peer caregiving into a comprehensive training program that consists of media-rich and highly interactive computer-based learning modules for providing geriatric and EOL care to their peers; and (2) conduct in-person usability testing of the media-rich and highly interactive web-based prototypes with inmates who are currently Mental Health Peer Support Specialists (that is, prisoners who are experienced caregivers, but naïve to geriatric and EOL care) and prison staff to evaluate the user interface, ease of use, and perceived barriers in order to refine and optimize the product.

Focus groups were conducted with three different groups, inmates, IT staff, and interdisciplinary staff, at a men’s and a women’s state correctional institution to inform content and program development of the training modules. Focus group participants prioritized the Universal Precautions, Loss/Grief, and Role of Inmate Caregivers in the Final Hours modules. These modules will be programmed and tested in state prisons in a mid-Atlantic state. The System Usability Scale, a validated tool for assessing the usability and acceptability of technological products, will serve as the primary outcome.

Insights on Computer-Based End-of-Life Training in Prisons

April 19, 2018 Klein Buendel

Dr. Valerie Myers, KB Senior Scientist and SBM Fellow, presented a poster on the Enhancing Care of the Aged and Dying in Prison project at the 39^th Annual Meeting and Scientific Sessions of the Society of Behavioral Medicine (SBM), April 11-14, 2018 in New Orleans, Louisiana.

The prison population is aging at a rapid rate and is expected to continue to do so into the foreseeable future. As a result, prisons in the United States are facing increased demands in caring for aged, chronically ill, and dying inmates. Despite advances in the free world, best practices for managing geriatric issues and life-limiting or terminal illness have not been adapted for use in corrections settings. Implementing a training program addressing the health issues related to this population could mitigate legal risks and enhance care. However, the paramount focus on security makes technological advances available in the free word inaccessible inside prison walls.

Lessons learned from prior development, implementation, and evaluation research targeted at enhancing care for the aged and dying in prison led to the development of a media-rich interactive computer-based learning prototype, Enhancing Care of the Aged and Dying in Prison (ECAD-P). ECAD-P contains six modules that address end-of-life and geriatric care issues in prisons. The purpose of this aim of the project focused on a small-scale evaluation of ECAD-P. Specifically, in-person usability testing was conducted at one state department of corrections and one large city jail. Twelve participants evaluated the user interface, ease of use, and perceived barriers of the prototype, so that the research team may further understand user preferences, optimize the learning modules, and prepare for implementation.

A summary evaluation of the computer-based prototype training includes the participants’ impressions regarding the user interface of the computer-based training modules, beliefs about ease of use of the computer-based training modules, perceived barriers regarding the use of the computer-based training modules. Findings will be used to refine the computer-based training modules for large-scale usability testing targeting 12 prisons and jails across the United States. Lessons learned from this usability study and the larger scale usability study will inform future dissemination of the product. The intent of this educational product is to extend our reach to promote quality of health and health equity, as well as narrow the gap in health disparities experienced by a group that has often been described as “the least among us.”

This research project is funded by a grant from the National Institute on Aging (AG049570; Dr. Janice Penrod, Penn State University, Principal Investigator). Collaborators included Dr. Valerie Myers, Sophia Strickfaden, and Tiffany Jerrod from Klein Buendel, and Dr. Susan Loeb, Dr. Erin Kitt-Lewis, and Rachel Wion from the Penn State University College of Nursing.

KB Collaboratory

Research, Technology & Health Communication

Browsed by
Tag: Computer-based Training