Presentation (CTI)

OBJECTIVES: Incarcerated individuals face unique healthcare challenges, including isolation, chronic diseases, costly escorts, and social stigma. WMH, a public health system covering the rural western Queensland, also provides primary care and low-risk ambulatory care across eight correctional centers. Recently, WMH has introduced some virtual care initiatives to expand their prison COVID-19 Lite-Touch model, improve inmates' access to care while reducing hospital transfers. This study aims to quantify the preferences of prisoners for a person-centered virtual care model in correctional settings. It also seeks to explore preference variations among diverse groups of prisoners to guide tailored virtual care design.
METHODS: A discrete choice experiment (DCE) is being conducted face-to-face in three correctional centers: a low-risk female, a low-risk male, and a high-security prison. Relevant attributes were identified through a literature review, qualitative interviews with prisoners, nurses, and custodial officers, and expert panel discussions. The survey will then be pilot-tested before full administration. Data analysis employs a mixed multinomial logit model and latent class model in Nlogit and Stata to identify heterogeneity in preferences across prisoner subgroups.
RESULTS: (preliminary) Initial findings from qualitative interviews indicate that prisoners prefer virtual care to avoid the stigma associated with attending community-based care while restrained in handcuffs. Important attributes influencing their preferences include effective communication, short waiting time, and continuity of care. Challenges identified include prisoners’ low literacy, logistical constraints, and rigid scheduling, which require flexible approaches to appointment management. The final data collection for the DCE survey is scheduled for completion in early May this year.
CONCLUSIONS: This study represents one of the first DCEs conducted in correctional settings worldwide. The findings will guide strategic planning and the development of virtual care models within WMH, addressing health inequities and improving care delivery for incarcerated individuals.