Maximizing the scalability of the chronic disease self-management program among older adults in state correctional...

Incarcerated individuals have high rates of chronic disease, which will likely increase as the prison population ages. Despite this, prison healthcare services primarily focus on infectious diseases, mental illness, and substance abuse, largely neglecting chronic physical health conditions. The Chronic Disease Self-Management Program (CDSMP) is an evidence-based program that supports self-management for people with chronic illnesses. Although numerous pilot studies of CDSMP have been conducted in correctional settings, there has been little research into efficient and effective strategies for scaling up the intervention within state corrections systems. The purpose of this project is to evaluate and develop an implementation approach to maximize the scalability of CDSMP among older adults in state correctional systems.

Guided by the Scaling up Management Framework, we will use a mixed-methods approach to assess scalability, utilizing both quantitative survey data and qualitative interviews. Study participants will include external agency leaders (n = 20), prison staff (n = 20), and incarcerated individuals (n = 20) who have been involved in CDSMP implementation within a U.S. state prison system. Data from this study will be used to develop a scale-up manual to be tested in a subsequent randomized trial. This study does not meet the World Health Organization (WHO) definition of a clinical trial.

As the prison population continues to age, the burden of chronic disease within correctional systems will continue to increase, which contributes to skyrocketing correctional costs. Understanding how to expand evidence-based chronic disease programs within correctional systems is crucial for reducing disease-related morbidity and mortality among incarcerated individuals and for reducing costs. This line of research will identify and test scale-up strategies for chronic disease management in prisons.