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E-learning modules for peer end-of-life caregivers living in prison

E-learning modules for peer end-of-life caregivers living in prison

A research team led by Dr. Susan Loeb from Penn State University and Dr. Barbara Walkosz from Klein Buendel, has published results from a recent study in the Journal of Offender Rehabilitation. The paper reports findings from the usability testing of the Just Care electronic learning program for training carefully vetted people living in prison to assist staff with geriatric and end-of-life care. 

Aging is accompanied by an increased probability of health problems and subsequent need for health care. According to the authors, “The growing number of older adults living in prison, who will likely age and die in prison, calls attention to the challenge of how correctional facilities will care for this population’s health needs, which includes the increasing demand for geriatric and end-of-life care.” Training men and women who live in prison to assist corrections staff with the care of growing numbers of older, sicker, cognitively impaired, and dying people in prison is an innovative and viable option to help meet pressing care demands. 

Two rounds of usability testing were conducted via videoconference. Prison personnel (such as corrections specialists, supervisors, nurses, and chaplains) and people living in prison were recruited from one men’s prison and one women’s prison. Fifteen participants completed the testing in each of two rounds. Methods and analyses are described in the paper.

Results include participant demographics, concerns and areas for improvement by severity level of programming, and mean scores for both participant groups on the System Usability Scale.  Overall, both the incarcerated and staff participants found the program easy to navigate and the interactive content was useful, engaging, and relevant to caring for incarcerated aging and dying people. The findings helped refine Just Care before additional evaluation was conducted with a larger sample.

This research was funded by an STTR grant to Klein Buendel from the National Institute on Aging (AG057239; Dr. Susan Loeb and Dr. Barbara Walkosz, Multiple Principal Investigators). The lead author on this Journal of Offender Rehabilitation paper is Dr. Erin Kitt-Lewis from Penn State University. Additional authors are Dr. Susan Loeb and Mr. Sherif Olanrewaju from Penn State University; and Dr. Barbara Walkosz, Mr. Brandon Herbeck, and Mr. Steve Fullmer from Klein Buendel. 

Advisory Boards and Usability Testing of an E-Training Program for End-of-Life Care in Prisons

Advisory Boards and Usability Testing of an E-Training Program for End-of-Life Care in Prisons

The 14th Annual Academic and Health Policy Conference on Criminal Justice Health, hosted by the Academic Consortium on Criminal Justice Health, was held virtually on April 8-10, 2021. Susan J. Loeb, PhD, RN, FGSA, FAAN, from the Penn State College of Nursing gave two presentations on research conducted in collaboration with Klein Buendel Senior Scientist, Valerie Myers, PhD. The presentations were titled, “Planning, Maximizing, and Sustaining Advisory Boards to Inform and Facilitate Research in Prisons” and “Usability Testing of an E-Training Package to Enhance Geriatric and End-of-Life Care in Prisons.” 

Planning, Maximizing, and Sustaining Advisory Boards to Inform and Facilitate Research in Prisons 

Dr. Susan J. Loeb discussed working with Advisory Boards for research in prisons. Advisory Boards are comprised of targeted stakeholders who collaborate with researchers to promote cultural awareness, consideration of environmental facilitators and constraints, and the upholding of ethical responsibilities to keep the best interests of research participants at the forefront. 

Effective partnering with Advisory Boards can promote entrée and execution of corrections research and enhance the credibility, relevance, and translation of study findings. The team systematically considered stakeholders who were engaged on Advisory Boards across four previous NIH-funded studies to assess how to promote stability, infuse fresh perspectives, refine the focus of consultation, and extend the array of research settings during an era when in-person meetings were not feasible due to a pandemic. 

Adopting multiple advisory boards with unique foci and constituted by people possessing expertise in a focused area, allows for laser-focused videoconference meetings. While virtual meetings may not afford the same intensive opportunities for relationship building that on-site meetings do, the former does lessen travel-related budgetary, logistical, and time burdens. 

The research team concluded that teaming with and sustaining a diverse array of community stakeholders is a key strategy for generating science that is tailored to address the health needs and promote health equity for people living in prisons. 

Usability Testing of an E-Training Package to Enhance Geriatric and End-of-Life Care in Prisons 

Dr. Susan J. Loeb presented on usability testing and best practices of a full-scale media-rich interactive computer-based learning system for corrections staff in response to the growing population needing geriatric and end-of-life (EOL) care in prisons, which are not consistently adopted. The training is called, Enhancing Care of the Aged and Dying in Prisons (ECAD-P). 
 
The research team conducted face- to- face usability testing of the 6-module ECAD-P training with corrections staff in two rounds at two correctional facilities in different states. The System Usability Scale (SUS) was administered to assess usability and acceptability of ECAD-P. Full scale testing included 173 participants at seven state prisons who completed cognitive and posttest measures and the SUS. 
 
The mean SUS score was 75.10 in the face-to-face usability testing, which indicated a high level of acceptability and usability since a score of 68 is above average. For the large-scale testing, cognitive posttest scores were significantly higher than cognitive pretest scores. At posttest, affective measures were significantly higher than at pretest. The mean SUS score for the full-scale testing was 69.34. 

The corrections environment is not technology-rich; however, prison administration and staff are accustomed to and receptive of computer-based learning (a frequently used delivery platform for mandatory training sessions). Therefore, the research team concluded the ECAD-P product is acceptable, feasible, and usable in corrections.  

The research presented at ACCJH was funded by multiple SBIR/STTR grants to Klein Buendel from the National Institute on Aging (AG049570; AG057239; Dr. Susan J. Loeb and Dr. Valerie Myers, Multiple Principal Investigators). Collaborators on the two presentations also included Dr. Erin Kitt-Lewis, Sherif Olanrewaju, and Katherine Fiochetta from Penn State University; and Jeannyfer Reither and Savanna Olivas from Klein Buendel. 

Working with Advisory Boards for Research in Prisons

Working with Advisory Boards for Research in Prisons

Susan Loeb, PhD, RN, FGSA, FAAN, from the Penn State College of Nursing presented research conducted in collaboration with Klein Buendel Senior Scientist, Valerie Myers, PhD, at the 33rd Annual (Virtual) Scientific Sessions of the Eastern Nursing Research Society on March 25 and 26, 2021. This year’s conference theme was Generating Nursing Science to Meet the Needs of a Diverse Society. Dr. Loeb’s poster was entitled, “Planning, Maximizing, and Sustaining Advisory Boards to Promote Equitable Care for Diverse Populations.”  

The poster reported the exploration of effective ways to partner with Advisory Boards to promote successful entrée into prisons to (1) conduct and execute study aims; (2) enhance credibility, relevance, and translation of research; and (3) promote equitable health and health care for diverse populations. The specific study utilizing Advisory Boards was designed to engage carefully vetted men and women who are incarcerated to assist in caring for their older or sicker peers, and provide them with consistent high quality peer caregiving training. Trained peers contribute to a pressing health care need in our nation’s prisons.

In order to maximize Advisory Board effectiveness, the research team:

  • Reflected on past experiences and considered key stakeholders engaged on Advisory Boards across four previous NIH-funded studies in this area of research;
  • Deliberated on what worked well and challenges encountered;
  • Identified enthusiastic leaders and staff at prior research location with a focus on broadening the array of disciplines represented;
  • Bolstered representation of people who were previously incarcerated; and
  • Appraised budgetary capacity.

As a result, Advisory Board meetings were shortened and focused, representation by Departments of Corrections was expanded, relationship building and networking opportunities were achieved, virtual events reduced budgetary and logistical burdens associated, and cost savings allowed for more frequent Advisory Board engagement.

Building commitment of representative Advisory Boards facilitates access to hard-to-reach and often overlooked research populations. Advisory boards of invested and representative stakeholders are key to generating nursing science that addresses health needs and promotes health equity for people living in prison.

The research presented was funded by the following SBIR/STTR grants to Klein Buendel from the National Institute on Aging at the National Institutes of Health (AG049570; AG049570; AG057239; AG057239; Dr. Susan Loeb and Dr. Valerie Myers, Multiple Principal Investigators). Collaborators on this poster also included Dr. Erin Kitt-Lewis, Sherif Olanrewaju, and Katherine Fiochetta from Penn State University; and Jeannyfer Reither and Savanna Olivas from Klein Buendel.