Alcohol Brief Interventions (ABIs) for male remand prisoners: protocol for development of a complex intervention and feasibility study (PRISM-A)

Abstract

IntroductionIn the UK, a significant proportion of male remand prisoners have alcohol problems. Alcohol Brief Interventions (ABIs) are an effective component of a population-level approach to harmful and hazardous drinking. ABIs have been shown to reduce the aggregate level of alcohol consumed and therefore reduce harm to the individual and to others. However, in relation to remand prisoners, there is no evidence as to how effective ABIs could be. The aims of this study are therefore to explore the feasibility and acceptability of an ABI for adult male remand prisoners and to develop an ABI for this group to be piloted in a future trial.Methods and analysisThe study will comprise three stages. Stage 1: a cross-sectional survey of adult male remand and convicted prisoners (n=500) at one Scottish prison and one English prison will be undertaken to assess acceptability and feasibility of delivering an ABI, as well as prevalence rates of harmful, hazardous and dependent drinking. Stage 2: in-depth interviews will be conducted with a sample of remand prisoners (n=24) who undertook the survey (n=12 in Scotland; n=12 in England). Two focus groups (one in Scotland and one in England) with six to eight key stakeholders associated with alcohol-related healthcare provision in prisons will be conducted to explore views on barriers, facilitators and levers to ABI delivery. Stage 3: through formal intervention mapping, the analysed data will inform the refinement of an acceptable ABI that is feasible to deliver to male remand prisoners.Ethics and disseminationThe project has been approved by the National Research Ethics Committee (NRES), National Offender Management System, Health Board Research and Development, Scottish Prison Service and ethics committee at The University of Edinburgh. Results will be published in peer-reviewed journals and presented at local, national and international conferences.

Suicide by Medication Overdose in Prison: A Study of Three Cases

“…Preventive actions and health promotion and education can also be carried out on a collective level. This approach is beginning to develop in prisons in various countries, with in particular actions related to alcohol, tobacco, and substances of abuse . Furthermore, peer‐based health interventions on various themes including mental health have begun to appear , but their efficacy has not yet been formally demonstrated.…”

A two-arm parallel-group individually randomised prison pilot study of a male remand alcohol intervention for self-efficacy enhancement: the APPRAISE study protocol

“…In the recently completed Alcohol Brief Interventions (ABIs) for male remand prisoners: an Medical Research Council (MRC) complex intervention framework development and feasibility study (PRISM-A), an ABI was developed and refined within the prison setting, working with men on remand to include a synthesis of their views, with reviews of the evidence base and theoretical underpinnings. 16 17 The findings also showed a high prevalence of at-risk drinking, with 82% of participants scoring ≥8 on the Alcohol Use Disorders Test (AUDIT). 17 This is comparable with other findings in the prison system in the UK 1–5 but is more than three times higher than primary care settings.…”

“…A suitable process of participant identification was established and found to be successful in the PRISM-A study. 16 17 The prison induction team (consisting of prison officers and peer prisoners) will provide potential participants with a verbal account of the study and a Participant Information Sheet (PIS) during their prison induction. Researchers will liaise with relevant prison officers each week to identify potential participants.…”

“…These sites were purposively selected following PRISM-A, as they offer geographical, socioeconomic and ethnic diversity, along with differing procedures and structures. 16 Both prisons provide alcohol services via external agencies who engage with people in custody and following release. Prisons have varying induction procedures, communication mechanisms and processes, and available, secure space to engage participants.…”

“…The proposed primary outcome measure is alcohol consumed, in units where one unit equals 8 g or 10 mL of ethanol, per week will be derived from the frequency and quantity of alcohol consumption questions in the extended version of AUDIT using a formula developed and employed in a number of RCTs of interventions for alcohol consumption. 36 37 A score of 8+ is referred to as a 'positive screen' and indicates drinking at hazardous (score of 8-15), harmful (score of [16][17][18][19] or probable dependent level (score of 20+). A score of 8 or more out of a possible 40 on the AUDIT has an established sensitivity of 92% and specificity of 94% 28 to detect those at risk of harm from alcohol use.…”