Long after a drug-fueled HIV outbreak in Scott County, Ind., left the national spotlight, initiatives at the state and local level in Indiana were implemented in an attempt to avert future public health crises. One such effort continues to train Indiana prison inmates to become peer health educators for their fellow prisoners.
Following the Project ECHO (Extension for Community Healthcare Outcomes) model for prison peer education that was launched in New Mexico in 2009, the Indiana Peer Education Program ECHO team has now conducted two 40-hour trainings of inmates. All of the participants have successfully graduated from the training, qualifying them to teach workshops for their fellow prisoners on health topics ranging from infectious disease prevention to substance use to diabetes education to basic hygiene.
“The training helps teach participants how to work in a team, teaches them public speaking skills, and teaches them how to engage people, not lecture,” Andrea Janota, program coordinator at the ECHO Center based at Indiana University-Purdue University Indianapolis (IUPUI), tells Addiction Professional.
Such initiatives have demonstrated that peers can successfully deliver messages about health risk behaviors in ways that individuals without an incarceration history cannot. “They know what it's like to live in a facility,” Janota says.
Buy-in from authorities
Joan Duwve, associate dean of public health practice at IUPUI's Richard M. Fairbanks School of Public Health, tells Addiction Professional that the idea for the inmate training was conceived after another ECHO initiative in the state was funded for training primary care professionals in delivering medication-assisted treatment for opioid addiction. The Scott County HIV outbreak had highlighted the numerous public health risks from drug use, and leaders wanted to come up with a way to assist an at-risk population, Duwve says.
Once leaders at IUPUI became familiar with how New Mexico's prison peer education program had developed, they needed to gain buy-in from state corrections officials to launch a similar effort. “They were excited around the issue of hepatitis C prevention and treatment,” Janota says of corrections leaders. “They have been very supportive.”
The training effort was launched at two correctional facilities where wardens had demonstrated progressive attitudes in this area: the Correctional Industrial Facility in Pendleton and the Plainfield Correctional Facility.
The training of the peer educators takes place over what essentially resembles a workweek for the inmates. They are then able to conduct 10-hour workshops for their fellow inmates, in sessions that usually extend over several days. The peer educators' work is treated as paid employment within the prison system.
The IUPUI trainers remain available to consult with the peer educators on an ongoing basis. “The peers can join in a videoconferencing format from their location, and talk with us and each other,” Janota says.
Experience in the ECHO model has demonstrated benefits for both peers and the other inmates. Participation in the workshops leads to more confidence among inmates in their ability to avoid health risks, Janota says. In New Mexico, she adds, three former inmates who had become peer educators while incarcerated now work full-time in the community for the University of New Mexico and Project ECHO. “They are true role models for the program,” Janota says.