Health Justice. 2019 Mar 26;7(1):3. doi: 10.1186/s40352-019-0085-x.
A novel application of process mapping in a criminal justice setting to examine implementation of peer support for veterans leaving incarceration.
Health & justice
Bo Kim, Megan B McCullough, Molly M Simmons, Rendelle E Bolton, Justeen Hyde, Mari-Lynn Drainoni, B Graeme Fincke, D Keith McInnes
Affiliations
Affiliations
- VA Center for Healthcare Organization and Implementation Research, Bedford/Boston, MA, USA. [email protected].
- Harvard Medical School, Boston, MA, USA. [email protected].
- VA Center for Healthcare Organization and Implementation Research, Bedford/Boston, MA, USA.
- Boston University School of Public Health, Boston, MA, USA.
- RAND Corporation, Boston, MA, USA.
- Brandeis University Heller School for Social Policy and Management, Waltham, MA, USA.
- Boston University School of Medicine, Boston, MA, USA.
PMID: 30915620
PMCID: PMC6718000 DOI: 10.1186/s40352-019-0085-x
Abstract
BACKGROUND: Between 12,000 and 16,000 veterans leave incarceration every year, yet resources are limited for reentry support that helps veterans remain connected to VA and community health care and services after leaving incarceration. Homelessness and criminal justice recidivism may result when such follow-up and support are lacking. In order to determine where gaps exist in current reentry support efforts, we developed a novel methodological adaptation of process mapping (a visualization technique being increasingly used in health care to identify gaps in services and linkages) in the context of a larger implementation study of a peer-support intervention to link veterans to health-related services after incarceration ( https://clinicaltrials.gov/ , NCT02964897, registered November 4, 2016) to support their reentry into the community.
METHODS: We employed process mapping to analyze qualitative interviews with staff from organizations providing reentry support. Interview data were used to generate process maps specifying the sequence of events and the multiple parties that connect veterans to post-incarceration services. Process maps were then analyzed for uncertainties, gaps, and bottlenecks.
RESULTS: We found that reentry programs lack systematic means of identifying soon-to-be released veterans who may become their clients; veterans in prisons/jails, and recently released, lack information about reentry supports and how to access them; and veterans' whereabouts between their release and their health care appointments are often unknown to reentry and health care teams. These system-level shortcomings informed our intervention development and implementation planning of peer-support services for veterans' reentry.
CONCLUSIONS: Systematic information sharing that is inherent to process mapping makes more transparent the research needed, helping to engage participants and operational partners who are critical for successful implementation of interventions to improve reentry support for veterans leaving incarceration. Even beyond our immediate study, process mapping based on qualitative interview data enables visualization of data that is useful for 1) verifying the research team's interpretation of interviewee's accounts, 2) specifying the events that occur within processes that the implementation is targeting (identifying knowledge gaps and inefficiencies), and 3) articulating and tracking the pre- to post-implementation changes clearly to support dissemination of evidence-based health care practices for justice-involved populations.
Keywords: Care coordination; Community providers; Implementation methods; Incarceration; Intervention design; Peer support; Process mapping; Qualitative analysis
References
- Psychiatr Serv. 2006 Apr;57(4):544-9 - PubMed
- J Gen Intern Med. 2006 Feb;21 Suppl 2:S1-8 - PubMed
- Psychiatr Serv. 2007 Jul;58(7):955-61 - PubMed
- JAMA. 2009 Feb 25;301(8):848-57 - PubMed
- Fam Community Health. 2009 Oct-Dec;32(4):309-13 - PubMed
- J Am Coll Surg. 2011 Jul;213(1):83-92; discussion 93-4 - PubMed
- AIDS Res Treat. 2011;2011:680617 - PubMed
- Psychol Serv. 2013 Feb;10(1):48-53 - PubMed
- J Am Acad Psychiatry Law. 2012;40(3):348-54 - PubMed
- J Dual Diagn. 2013 Jan 1;9(1):11-22 - PubMed
- Health Justice. 2013 Dec 1;1(1):5 - PubMed
- Am J Pharm Educ. 2014 Sep 15;78(7):139 - PubMed
- Health Justice. 2013 Dec 19;1(6): - PubMed
- BMC Res Notes. 2014 Oct 21;7:743 - PubMed
- Health Justice. 2013 Dec;1(1):8 - PubMed
- Health Justice. 2014;2(1): - PubMed
- BMC Public Health. 2015 Mar 25;15:290 - PubMed
- Nurs Res. 2015 May-Jun;64(3):177-89 - PubMed
- Prog Community Health Partnersh. 2015 Spring;9(1):91-100 - PubMed
- J Drug Issues. 2015 Jan 1;45(1):38-52 - PubMed
- J Assoc Nurses AIDS Care. 2015 Sep-Oct;26(5):542-55 - PubMed
- BMC Fam Pract. 2015 Oct 13;16:139 - PubMed
- Med Care. 2017 Feb;55(2):173-181 - PubMed
- BMC Health Serv Res. 2017 Sep 12;17(1):647 - PubMed
- Cancer Cytopathol. 2017 Dec;125(12):887-890 - PubMed
- Health Justice. 2018 Apr 13;6(1):9 - PubMed
- Health Justice. 2018 Apr 30;6(1):10 - PubMed
Publication Types
Grant support