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.

Details

Title
A novel application of process mapping in a criminal justice setting to examine implementation of peer support for veterans leaving incarceration
Author
Kim, Bo 1 ; McCullough, Megan B 2 ; Simmons, Molly M 3 ; Bolton, Rendelle E 4 ; Hyde, Justeen 5 ; Mari-Lynn Drainoni 6 ; Fincke, B Graeme 2 ; McInnes, D Keith 2 

 VA Center for Healthcare Organization and Implementation Research, Bedford/Boston, MA, USA; Harvard Medical School, Boston, MA, USA 
 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 
 VA Center for Healthcare Organization and Implementation Research, Bedford/Boston, MA, USA; Brandeis University Heller School for Social Policy and Management, Waltham, MA, USA 
 VA Center for Healthcare Organization and Implementation Research, Bedford/Boston, MA, USA; Boston University School of Medicine, Boston, MA, USA 
 VA Center for Healthcare Organization and Implementation Research, Bedford/Boston, MA, USA; Boston University School of Public Health, Boston, MA, USA; Boston University School of Medicine, Boston, MA, USA 
Pages
1-11
Publication year
2019
Publication date
Mar 2019
Publisher
Springer Nature B.V.
e-ISSN
21947899
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2197846788
Copyright
Health & Justice is a copyright of Springer, (2019). All Rights Reserved., © 2019. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.