Health Promotion Grant Application And Assumptions

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Health Promotion Grant Application And Assumptions

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Discuss about the Health Promotion Grant Application and Assumptions.

Answer:
Introduction:

Users of illicit drugs represent a vast number of prisoner populations. Internationally, about 10-48 % of male and 30-65% of the female prisoners have been using illicit drugs in the month before entering the prison. In an Australian study, PWID has reported an average of 8 imprisonments (Dolan et al., 2015). The repetitive and the rampant use of the drug users have been found to be the key reason for the continuous growth of the prison population. As per the NSW Inmate health survey in the year 2001, about 74 percent of the female and 67 % of the male inmates were found to be using illicit drugs (Dolan & Rodas, 2014). In spite of all the restrictions and security drugs are being smuggled inside the Australian prison.
As per the reports the prison population in Australia with substance abuse problems has risen from 33% to 43 % within the year 2010- 2016 and the offenders who are drug dependant are likely to return to the prison than the other prisoners (Dolan et al., 2015). In Australia about 85% of the inmates who are heroin dependants have been incarcerated within two years of release compared to the other prisoners (Dolan & Rodas, 2014).
The most alarming thing is that the issue of sharing the same needle for the uptake of the illicit drugs is real. One of the dangerous effect of the use of drugs inside the prison is needle sharing (Dolan & Rodas, 2014). Sharing of needles while taking illicit drugs is increasing the chance of diseases like HIV and hepatitis. In Western Australia the HIV prevalence among the drug addicted inmates in prison accounts for 25 % of the prison population (Jürgens & Verster, 2009). The prison is perceived as a bridge in the HIV and HCV transmission from the high risk groups to the community at a large. Furthermore, the majority of the drug injectors are hetero sexual males who resume their sexual relationship among release, which may transmit HIV, HCV or hepatitis to the normal population (Ramaswamy & Freudenberg, 2008).
The Australian medical council has called for a needle and syringe program to be introduced in custodial settings and prisons in order to mitigate the spreading of the blood borne infectious diseases, including HIV, HCV and hepatitis B and C (Jürgens & Verster, 2009). The president of AMA has also admitted that the rates of drug injectors who are HIV positive are high in Australian prison. The AMA has conferred that infection control measures will not only protect those who are in the custody, but will also protect the prison staffs too (Dolan et al., 2015).
Hence the main aim of this project is to introduce a needle and syringe program that would mainly focus on providing health literacy to the prisoners regarding the ill effects of sharing same needle during taking drugs. This project will also aim to reduce the overall drug intake inside a prison to promote wellbeing.

Project description
According to the World Health Organization, the health promotion can be described as the process of enabling the people to establish control over their health and wellbeing. According to the Ottawa Charter for health promotion, there are five critical activities for the health promotion: The development of the personal skills for health, creation of a supportive environment, firming the action of the community, reorientation of the health services and developing suitable public health policy (Kwon et al., 2009). These theories can be complied with correctional health care from the medical care at the time of imprisonment to the preparation of a healthy living after the release.
The goal of this project is to conduct health promotion activities for providing education to the Western Australian prisoners about the ill effects of using drugs and how sharing needles while taking the drugs can make them vulnerable to diseases like HIV, HCV and hepatitis A,B and C (Moazen et al., 2015). In Australia, the needle and the syringe program have been the cornerstone strategies for reducing the sharing of the needles. The first Australian needle and the syringe program began in Darlinghurst, Sydney, which led to the spread of this program in New South Wales and other provinces.
One of the noteworthy steps that have been taken so far in the needle and the syringe program is the distribution of the sterile syringes and that will affect the incidence of the HIV and the HCV transmission among the injecting drug users (Kwon et al., 2009). The Australian government had set up several NSP outlets that had been providing mobile and outreach services, sterile injecting equipments and syringe vending machines. One of the criticism of the strategies taken; like provision of syringe vending machines and distribution of sterile syringes is that, these interventions only focused on the prevalence of the blood borne infections and not on the overall influence of the drugs on the health and the wellbeing of the prisoners (Iversen et al., 2014). Furthermore the prisoners often do not get access to fresh syringes or there were no such facilities of syringe vending machines on jail. This program might have been beneficial for the injecting drug users outside the jail, but certainly not the prisoners (Treloar, Treloar, Fraser, Treloar & Fraser, 2008).
The primary aim of this project is to educate the prisoners about how sharing needles can spread diseases like AIDS, HCV and hepatitis and how they can affect their personal life once they are out of the prison. It is necessary to educate them about the symptoms of these diseases so that screening of these diseases becomes easier for these prisoners. As needle and syringe programs do not affect the motivation of the drug users to reduced the drug use, hence the prisoners can be counseled to help them out in the rehabilitation process.
Secondly, the aim of this project is to reduce the transmission of the infections from the injector inmates to the healthy inmates. This can be facilitated by providing condoms and safe sex education. Such programs can also be an important point of contact for the different referral services.
One of the aims of this health promotion project is to provide a substitution therapy for the prisoners taking drug injections. This would presumably reduce the use of drugs and would drive to a path of rehabilitation. These alternative therapies would comparatively reduce the pain of the withdrawal symptoms.

SMART Objectives
Objective 1: Decreasing the access of the syringe in the prisons

S (Specific)

Increasing the security in order to cut-short the access of the either open or re-used syringe in the prison

Measurable (M)

The outcome of the goal will be measured on the basis of the CCV-Tv footage and rate of incidence rate of HIV among the prisoners

Achievable (A)

The goals will be achieved via increasing in the security checks of the entry of the syringe in the hospital via installation of the CCV-TV camera and proper disposal of the single used syringe or proper decomposition of the used syringe

Reliable (R)

The goal is reliable because syringe disposal machine is available at an cost-effective price and be easily handled without any special training

Time (T)

1 month

Objective 2: Decreasing the access of the opioid drugs and other in-toxication drugs inside the prison

S (Specific)

The goal is specific because decrease in the access of the intravenous drugs will reduce the chances of intravenous administration of drugs via the use of old-syringe

Measurable (M)

The goal is measurable via taking into consideration of the out-break of HIV among the prisoners of Western Australia

Achievable (A)

The goal is achievable via increasing the security checks of the drug delivery among the prisoners and reducing the access and the use of intravenous opioid among the prisoners

Reliable (R)

The goal is reliable as opioid is mainly used for the pain management among the prisoners. So substitute of opioid must be used for pain management via using non-pharmacological interventions. Like physical exercises or physiotherapy. Even if the opioid is used it must be used under the surveillance of the doctors so that the syringe is used and then damaged immediately

Time (T)

2 months to make all the necessary arrangement of increasing security checks and application of the non-pharmacological interventions for pain management

Objective 3: Increasing HIV awareness among the prisoners of Western Australia and the detrimental effects of used-syringe based drug administration

S (Specific)

The goal is specific because increasing the HIV awareness helps in the reduction drug injection via used-syringe among the prisoners

Measurable (M)

The goal is measurable via doing a survey among the prisoners both HIV prisoners and non-HIV prisoners about their understanding about syringe used and exchange of syringe among the prisoners

Achievable (A)

The goal is achievable via hold a community based interactive awareness approach procured by the community health nurse in the prison settings

Reliable (R)

The goal is reliable because setting up power-point audio-visual presentation by the community healthcare nurse is cost-effective and permission can be granted easily from the administrative authority of the prison

Time (T)

The time limit of the goal is one month of awareness or educational approach and next one month for conducting the survey in order to evaluate the outcome

Strategies
Increase in the installation of the CCTV camera and syringe disposal machines in order to regulate the use of the previously used syringes for the intravenous intake of the drug(Sawangjit, Khan & Chaiyakunapruk, 2017)
Proper installation of the CCTV camera will help to keep an eye on the unwanted use of the drugs via the prisoners. Use of non-pharmacological medication for pain management will help to reduce unwanted circulation of the opioid medication. N0on pharmacological interventions will mostly include physical exercise (Ambrose & Golightly, 2015)
Proper educational campaign via audio-visual interactive approach (power-point presentation)will be given by the community health nurse in the prison settings. This will help to increase the awareness about HIV among the prisoners(Bagnall et al., 2015)

Budget estimation
The expected budget for the overall plan will be ascertained and then simultaneously designed before the initiation of the health promotion plan of the prisoners of the Western Australia. The below mentioned Table provides the budget estimation details of this program. All the healthcare professionals who will be associated with this program will be given an average salary in accordance to the scale of the Health Care policy of Australia (Health Care Australia [HCA]).

Services

Cost ($)

Numbers

Total ($)

CCTV Camera

200

15

3000

Installation of CCTV Camera software system

1500

Installation of the syringe disposal units in the prison

100

3

300

Appointment of physiotherapists for the non-pharmacological pain management

25 (per hour)

2

50 x 8 hours = $ 400

Community health nurse for awareness program

35.49 (per hour)

2

574.4

Health counsellor

48. 95 (per hour)

2

783.2

Total Cost

$6557. 6

Time estimation (Grant Chart)

Tasks to be done

Week 1

Week 2

Week 3

Week 4

Week 5

Week 6

Week 7

Week 8

Week 9

Week 10

Preparation of the proposal

Approval of the proposal by the Jail committee

Sanction of the grant for financial assistance in accordance to the budget plan

Buying and installation of CCTV camera

Buying and installation of syringe disposal machine

Appointment of community health nurse, physiotherapists and healthcare counsellor

Awareness program

Physical exercise for pain management and reduction in opioid use

HIV survey among the prisoners

Survey to analyse the success of educational program

Evaluation
The evaluation will be done via conducting the blood test among all the inmates in order to elucidate the rate of prevalence of HIV. Decrease in the HIV in the blood of the inmate will indicate that there is decrease in the spread of HIV. Moreover, the blood of the inmates will also be scanned in order to find the trace of harmful intravenous drug which are not permissible inside the hospital. This blood test will help to ascertain that prisoners are actually getting affected by the awareness program (Mimiaga et al., 2018).

Working in partnership with others
In order to facilitate the project different organisations might be involved as partners. The main organisations include Australian Federation of AIDS organisations and AIDS trusts for Australia. The AIDs trust of Australia (https://www.aidstrust.com.au/) would help to generate more funds for the active management of HIV-AIDS among the inmates of the Western Australia prison. This AIDS trust might help to raise fund in order to conduct the overall evaluation process after the implementation of the program. The Australian Federation of AIDS Organisations (2018) (ttps://www.afao.org.au/australia/) will help to supply community health nurse who will help to increase the HIV-AIDS awareness. Another organisation which will also be invited to collaborate in this health promotion program will be the National Association of People with HIV Australia (https://napwha.org.au/). This member of this organisation will be asked to share thoughts and experience behind use of old syringes in HIV-AIDS transmission. The target population that is the prisoners will also be involved in the health awareness program in order to frame person-centred care approach. The overall outcome of the project will be disseminated in the quarterly souvenir of the jail and also in the jail’s notice board.
Sustainability
The exhaustion of the sanctioned budget will not cease the overall functioning of the project like the CCTV camera and the syringe disposal machines are long-term investments. These two equipments can be effectively used for controlling the spread of HIV through the use of old syringes. Moreover, the power-point or posters which will be used by the community health nurses for conducting the awareness program will be stored. The same resources will be used in future in order to educate the jail in-mates. The long term benefit of the project is reduction in the spread of HIV, HCV and hepatitis among the jail in-mates and thereby helping to reduce the number of the unwanted casualties in jail. This in turn will help to reduce the overall cost of care of the prisoners (McKinney & Marconi, 2016). This project is specifically directed towards the prisoners keeping in mind their daily living and lifestyles and hence cannot be implemented to wider population. However, proper awareness program is always an option for the wider audience in order to reduce the prevalence of HIV, HCV and hepatitis.

References
AIDs trust of Australia. (2018). About Us. Access date: 22nd August 2018. Retrieved from: https://www.aidstrust.com.au/
Ambrose, K. R., & Golightly, Y. M. (2015). Physical exercise as non-pharmacological treatment of chronic pain: why and when. Best Practice & Research Clinical Rheumatology, 29(1), 120-130.
Australian Federation of AIDS Organisations. (2018). About Us. Access date: 22nd August 2018. Retrieved from: https://www.afao.org.au/australia/
Bagnall, A. M., South, J., Hulme, C., Woodall, J., Vinall-Collier, K., Raine, G., … & Wright, N. M. (2015). A systematic review of the effectiveness and cost-effectiveness of peer education and peer support in prisons. BMC Public Health, 15(1), 290.
Dolan, K., & Rodas, A. (2014). Detection of drugs in Australian prisons: supply reduction strategies. International journal of prisoner health, 10(2), 111-117. https://doi.org/10.1108/IJPH-06-2013-0025
Dolan, K., Moazen, B., Noori, A., Rahimzadeh, S., Farzadfar, F., & Hariga, F. (2015). People who inject drugs in prison: HIV prevalence, transmission and prevention. International Journal of Drug Policy, 26, S12-S15. https://doi.org/10.1016/j.drugpo.2014.10.012
Iversen, J., Wand, H., Topp, L., Kaldor, J., & Maher, L. (2013). Reduction in HCV incidence among injection drug users attending needle and syringe programs in Australia: a linkage study. American journal of public health, 103(8), 1436-1444. doi: 10.1097/QAI.0b013e3181a2539a
Jürgens, R., Ball, A., & Verster, A. (2009). Interventions to reduce HIV transmission related to injecting drug use in prison. The Lancet infectious diseases, 9(1), 57-66. https://doi.org/10.1016/S1473-3099(08)70305-0
Kwon, J. A., Iversen, J., Maher, L., Law, M. G., & Wilson, D. P. (2009). The impact of needle and syringe programs on HIV and HCV transmissions in injecting drug users in Australia: a model-based analysis. JAIDS Journal of Acquired Immune Deficiency Syndromes, 51(4), 462-469. doi: 10.1097/QAI.0b013e3181a2539a
McKinney, M. M., & Marconi, K. M. (2016). Delivering HIV Services to Vulnerable Populations: A Review of CARE Act—Funded Research. Public Health Reports.
Mimiaga, M. J., Pantalone, D. W., Biello, K. B., Glynn, T. R., Santostefano, C. M., Olson, J., … & Mayer, K. H. (2018). A randomized controlled efficacy trial of behavioral activation for concurrent stimulant use and sexual risk for HIV acquisition among MSM: project IMPACT study protocol. BMC public health, 18(1), 914.
Moazen, B., Noori, A., Rahimzadeh, S., Farzadfar, F., & Hariga, F. (2014). HIV in prison: a global systematic review of prevalence, incidence, AIDS related mortality and HIV programs. Presented at 20th International Conference on AIDS, Melbourne, July.
National Association of People with HIV Australia. (2018). About Us. Access date: 22nd August 2018. Retrieved from: https://napwha.org.au/
Ramaswamy, M., & Freudenberg, N. (2008). Health promotion in jails and prisons: An alternative paradigm for correctional health services. In Public health behind bars (pp. 229-248). Springer, New York, NY. DOIhttps://doi.org/10.1007/978-0-387-71695-4_13
Sawangjit, R., Khan, T. M., & Chaiyakunapruk, N. (2017). Effectiveness of pharmacy?based needle/syringe exchange programme for people who inject drugs: a systematic review and meta?analysis. Addiction, 112(2), 236-247.
Treloar, C., Treloar, C., Fraser, S., Treloar, C., & Fraser, S. (2008). Public opinion on needle and syringe programmes: Avoiding assumptions for policy and practice. Drug and Alcohol Review, 26(4), 355-361. https://doi.org/10.1016/S1473-3099(08)70305-0

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