Table 3 Facilitators and barriers table
Focus | Facilitators | Source |
Interdisciplinary collaboration & partnerships | Cross-disciplinary partnerships and collaboration | [29] |
Collaboration between people in prison and the prison workforce to develop resources | [29] | |
Multidisciplinary cooperation involving professionals from diverse fields | [33] | |
Long-term commitment from leadership figures to champion and guide | [34] | |
Critical insights from the expert advisory and community advisory boards to tailor strategies | [36] | |
Leveraging peer educators to mitigate trust issues and facilitate engagement | [38] | |
Integration of policies that promote the consistent application of learned skills | [39] | |
Program flexibility and adaptability | Flexibility in scheduling, allowing participants to attend sessions as able | [33] |
Curricula adaptable to different settings and participant needs | [42] | |
Flexibility in scheduling to accommodate participants across various shifts | [31] | |
Co-design of training materials with input from relevant stakeholders | [44] | |
Customizable training formats (e.g., full-day, half-day, mini-training modules) | [42] | |
Practical and experiential training methods | Application of case-based learning using real-world scenarios | [33] |
Practical role-playing to enhance the acquisition and retention of skills | [40] | |
Hands-on, group-based training sessions to facilitate learning | [43] | |
Interactive, in-person training with opportunities for real-time engagement | [31] | |
Supportive organizational structures | Engaging trainees in the establishment and ongoing sustainability of capacity-building through hands-on experience | [29] |
Organizational support from supervisors and management, increasing participant confidence | [39] | |
Institutional backing is critical for reaching a broad audience across multiple sites | [44] | |
Tailored and contextually relevant content | Familiarity with sociopolitical factors relevant to the intervention's context | [29] |
Perceived relevance and practical applicability of the training content | [30] | |
Tailoring training resources to the unique needs of correctional settings | [43] | |
Adapting materials to the prison environment, enhancing usability and relevance | [37] | |
Sustainability and communication | Ongoing consultation, biannual refreshers, and continuous assessment | [34] |
Maintaining communication with staff at correctional facilities | [29] | |
Continuous learning through sustained trainee involvement | [29] | |
Incorporating outcome measures to evaluate the impact of the strategy | [29] | |
Use of technology & digital media | Incorporation of digital media into content creation, increasing engagement and accessibility | [42] |
Recorded training sessions (e.g., via DVD) for broader and future use | [22] | |
Exploration of telehealth and remote work options to extend access | [29] | |
Focus | Barriers | Source |
Stigma & resistance to change | Stigmatization relative to substance use disorder and corrections, hindering engagement | [29] |
Stigma surrounding mental health in the workplace, discouraging participation | [30] | |
Resistance to adopting new treatment modalities for opioid use disorder (OUD) | [33] | |
Staff resistance to implementing trauma-informed practices | [34] | |
Reluctance and mistrust from people in prison towards the prison healthcare system | [38] | |
Institutional resistance to change due to high levels of stress and pre-existing demands on staff | [44] | |
Correctional culture of negative attitudes toward mental health and rehabilitation | [39] | |
Pre-existing negative attitudes toward certain training topics, particularly mental health | [47] | |
Resource constraints | Insufficient funding to support programs and strategies | [29] |
Resource constraints, including limited staffing, funding, and medical supplies | [38] | |
Lack of resources for therapeutic support, such as counselling and other outlets | [34] | |
Limited access to online tools and software to facilitate training | [41] | |
High workload and competing priorities within healthcare services | [43] | |
Limited access to digital technology and other supporting infrastructure | [41] | |
Logistical and scheduling challenges | Conflicting schedules that hinder participation in training programs | [29] |
Inadequate transportation options to facilitate access to training or treatment | [29] | |
Frequent facility lockdowns disrupt program continuity | [29] | |
Limited availability of usable spaces for training or strategies | [29] | |
Lack of dedicated time for correctional officers to implement learned practices | [37] | |
High turnover of staff impeding the sustainability and continuity of training programs | [44] | |
Time constraints due to heavy workload | [31] | |
Limited organizational support and engagement | Difficulty identifying supportive staff to champion program development and implementation | [29] |
Challenges in maintaining engagement from trainees, community, and facility staff | [29] | |
Lack of broader organizational support to ensure consistency in applying learned strategies | [40] | |
Trainers lacking firsthand experience in correctional settings, affecting their credibility and impact | [42] | |
Training decay & continuity | Desensitization to issues over time, reducing the vigilance required to identify and intervene effectively | [32] |
Skill decay when training is not followed by ongoing reinforcement or support | [48] | |
Cognitive & educational limitations | Training resources overly complex for participants with cognitive deficits or varied levels of education | [43] |
Complex patient needs, presenting significant challenges in managing the balance between care provision and resource availability | [45] |