Search results

The number of prisoners over 55 years is increasing and many are at risk of developing dementia. This has generated new responsibilities for prisons to provide health and social care for older persons. The purpose of this paper is to synthesize the existing research literature regarding the phenomenon of the health and social care needs of older persons living with dementia in correctional settings.

Using an integrative review method based on Whittemore and Knafl, the inclusion criteria for the review are: articles written in English; a focus on some form of dementia and/or older persons with discussion of dementia; to be set in a correctional context (correctional facility, prison and jail); be derived from a published peer-reviewed journal or unpublished dissertation/thesis; and be a qualitative, quantitative or mixed methods study. Based on those criteria, a search strategy was developed and executed by a health sciences librarian in the following databases: Medline, CINAHL, Embase, PsychINFO, Proquest Nursing and Allied Health and Web of Science; searches were completed up to April 2019. After data were extracted from included studies, synthesis of findings involved an iterative process where thematic analysis was facilitated by Braun and Clarke’s approach.

Eight studies met the inclusion criteria. Key findings of the eight studies include recognition of dementia as a concern for correctional populations, dementia-related screening and programming for older persons and recommendations for improved screening and care practices. Most significant is the paucity of research available on this topic. Implications for research are discussed.

This paper identified and synthesizes the limited existing international research on the health and social care needs of older persons with dementia living in correctional settings. Although existing research is scant, this review highlights the need for increased awareness of dementia as a concern among older persons living in correctional settings. As well, the review findings emphasize that enhanced screening and interventions, particularly tailored approaches, are imperative to support those living with dementia in correctional settings.

Community health workers (CHWs) are vital to addressing public health system limitations in developing countries. However, effective identification and support of underperforming CHWs remains a challenge. This study develops a predictive model to proactively identify underperforming CHWs, facilitating targeted interventions for improved CHW programmes.

We developed a predictive model to identify underperforming CHWs in Uttar Pradesh, India. Data from 140,101 CHWs over a 12-month period was used to build, test and validate the model. Classification techniques, ensemble modeling and a model tuning algorithm were employed for accuracy optimization and early identification.

Logistic regression, decision trees and random forests yielded the best performance. While ensemble models offered no significant performance improvements over the base models, the model tuning algorithm effectively increased prediction accuracy by 19 percentage points. This enabled early identification of poor-performing CHWs and high-risk CHW clusters early in the year.

The developed model has significant potential to improve CHW programmes. It enables targeted support, feedback and resource allocation, leading to enhanced CHW performance, motivation and healthcare outcomes in the communities they serve. The model can provide personalised feedback to help CHWs overcome challenges and dynamic clustering facilitates proactive identification and tailored support for those at risk of underperformance.

This study is the first attempt to use predictive modelling to identify underperforming CHWs, advancing the nascent field of CHW performance analytics. It underscores the effectiveness of digital technologies and data in improving CHW programmes.