Health Promotion Grant Application for Prisoners in Western Australia

This grant application aims to provide better life to prisoners in Western Australia by adding reforms to the current needle and syringe programs, providing health literacy regarding drug use and preventive measures against infections. The project also aims to reduce the overall drug intake inside a prison to promote wellbeing.

Running head: HEALTH PROMOTION GRANT APPLICATION
HEALTH PROMOTION GRANT APPLICATION
Name of the Student
Name of the university
Author’s note

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HEALTH PROMOTION GRANT APPLICATION
Executive Summary
The wide spread use of illicit injectable drugs have been found to increasing upon the prisoners
of Western Australia. The use of drugs not only delays their rehabilitation period, but also
deteriorates the quality of life after the commencement of the period of imprisonment. One of the
potential risk of using injectable drugs are the transmission of the blood borne infections like
HIV, HCV and hepatitis A,B and C. This grant application is to provide a better life to the
prisoners, to add on some reforms to the current needle and syringe programs, to provide them
with health literacy regarding the use of the drugs and the preventive measures against the
infections. This grant application has put down a set of smart goals with the probable time frame
and the budgeting. Furthermore information about the stakeholders involved and the evaluation
technique has also been provided.

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HEALTH PROMOTION GRANT APPLICATION
Table of Contents
Assignment 2– Health Promotion Grant application.......................................................................3
Project title:......................................................................................................................................3
Population and Health Issue............................................................................................................3
Project description...........................................................................................................................4
SMART Objectives.........................................................................................................................6
Strategies..........................................................................................................................................8
Budget estimation............................................................................................................................9
Time estimation (Grant Chart).......................................................................................................10
Evaluation......................................................................................................................................12
Working in partnership with others...............................................................................................12
Sustainability.................................................................................................................................13
References......................................................................................................................................14

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HEALTH PROMOTION GRANT APPLICATION
Assignment 2– Health Promotion Grant application
Project title: Health promotion grant application -prisoners in Western Australia
Population and Health Issue
Users of illicit drugs represent a vast number of prisoner populations. Internationally,
about 10-48 % of male and 30-65% of the female prisoners have been using illicit drugs in the
month before entering the prison. In an Australian study, PWID has reported an average of 8
imprisonments (Dolan et al., 2015). The repetitive and the rampant use of the drug users have
been found to be the key reason for the continuous growth of the prison population. As per the
NSW Inmate health survey in the year 2001, about 74 percent of the female and 67 % of the
male inmates were found to be using illicit drugs (Dolan & Rodas, 2014). In spite of all the
restrictions and security drugs are being smuggled inside the Australian prison.
As per the reports the prison population in Australia with substance abuse problems has
risen from 33% to 43 % within the year 2010- 2016 and the offenders who are drug dependant
are likely to return to the prison than the other prisoners (Dolan et al., 2015). In Australia about
85% of the inmates who are heroin dependants have been incarcerated within two years of
release compared to the other prisoners (Dolan & Rodas, 2014).
The most alarming thing is that the issue of sharing the same needle for the uptake of the
illicit drugs is real. One of the dangerous effect of the use of drugs inside the prison is needle
sharing (Dolan & Rodas, 2014). Sharing of needles while taking illicit drugs is increasing the
chance of diseases like HIV and hepatitis. In Western Australia the HIV prevalence among the

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HEALTH PROMOTION GRANT APPLICATION
drug addicted inmates in prison accounts for 25 % of the prison population (Jürgens & Verster,
2009). The prison is perceived as a bridge in the HIV and HCV transmission from the high risk
groups to the community at a large. Furthermore, the majority of the drug injectors are hetero
sexual males who resume their sexual relationship among release, which may transmit HIV,
HCV or hepatitis to the normal population (Ramaswamy & Freudenberg, 2008).
The Australian medical council has called for a needle and syringe program to be
introduced in custodial settings and prisons in order to mitigate the spreading of the blood borne
infectious diseases, including HIV, HCV and hepatitis B and C (Jürgens & Verster, 2009). The
president of AMA has also admitted that the rates of drug injectors who are HIV positive are
high in Australian prison. The AMA has conferred that infection control measures will not only
protect those who are in the custody, but will also protect the prison staffs too (Dolan et al.,
2015).
Hence the main aim of this project is to introduce a needle and syringe program that
would mainly focus on providing health literacy to the prisoners regarding the ill effects of
sharing same needle during taking drugs. This project will also aim to reduce the overall drug
intake inside a prison to promote wellbeing.
Project description
According to the World Health Organization, the health promotion can be described as
the process of enabling the people to establish control over their health and wellbeing. According
to the Ottawa Charter for health promotion, there are five critical activities for the health
promotion: The development of the personal skills for health, creation of a supportive
environment, firming the action of the community, reorientation of the health services and

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HEALTH PROMOTION GRANT APPLICATION
developing suitable public health policy (Kwon et al., 2009). These theories can be complied
with correctional health care from the medical care at the time of imprisonment to the
preparation of a healthy living after the release.
The goal of this project is to conduct health promotion activities for providing education
to the Western Australian prisoners about the ill effects of using drugs and how sharing needles
while taking the drugs can make them vulnerable to diseases like HIV, HCV and hepatitis A,B
and C (Moazen et al., 2015). In Australia, the needle and the syringe program have been the
cornerstone strategies for reducing the sharing of the needles. The first Australian needle and the
syringe program began in Darlinghurst, Sydney, which led to the spread of this program in New
South Wales and other provinces.
One of the noteworthy steps that have been taken so far in the needle and the syringe
program is the distribution of the sterile syringes and that will affect the incidence of the HIV
and the HCV transmission among the injecting drug users (Kwon et al., 2009). The Australian
government had set up several NSP outlets that had been providing mobile and outreach
services, sterile injecting equipments and syringe vending machines. One of the criticism of the
strategies taken; like provision of syringe vending machines and distribution of sterile syringes is
that, these interventions only focused on the prevalence of the blood borne infections and not on
the overall influence of the drugs on the health and the wellbeing of the prisoners (Iversen et al.,
2014). Furthermore the prisoners often do not get access to fresh syringes or there were no such
facilities of syringe vending machines on jail. This program might have been beneficial for the
injecting drug users outside the jail, but certainly not the prisoners (Treloar, Treloar, Fraser,
Treloar & Fraser, 2008).

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HEALTH PROMOTION GRANT APPLICATION
The primary aim of this project is to educate the prisoners about how sharing needles can
spread diseases like AIDS, HCV and hepatitis and how they can affect their personal life once
they are out of the prison. It is necessary to educate them about the symptoms of these diseases
so that screening of these diseases becomes easier for these prisoners. As needle and syringe
programs do not affect the motivation of the drug users to reduced the drug use, hence the
prisoners can be counseled to help them out in the rehabilitation process.
Secondly, the aim of this project is to reduce the transmission of the infections from the
injector inmates to the healthy inmates. This can be facilitated by providing condoms and safe
sex education. Such programs can also be an important point of contact for the different referral
services.
One of the aims of this health promotion project is to provide a substitution therapy for
the prisoners taking drug injections. This would presumably reduce the use of drugs and would
drive to a path of rehabilitation. These alternative therapies would comparatively reduce the pain
of the withdrawal symptoms.
SMART Objectives
Objective 1: Decreasing the access of the syringe in the prisons
S (Specific) Increasing the security in order to cut-short the access of the either open or
re-used syringe in the prison
Measurable (M) The outcome of the goal will be measured on the basis of the CCV-Tv
footage and rate of incidence rate of HIV among the prisoners
Achievable (A) The goals will be achieved via increasing in the security checks of the

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HEALTH PROMOTION GRANT APPLICATION
entry of the syringe in the hospital via installation of the CCV-TV camera
and proper disposal of the single used syringe or proper decomposition of
the used syringe
Reliable (R) The goal is reliable because syringe disposal machine is available at an
cost-effective price and be easily handled without any special training
Time (T) 1 month
Objective 2: Decreasing the access of the opioid drugs and other in-toxication drugs inside the
prison
S (Specific) The goal is specific because decrease in the access of the intravenous
drugs will reduce the chances of intravenous administration of drugs via
the use of old-syringe
Measurable (M) The goal is measurable via taking into consideration of the out-break of
HIV among the prisoners of Western Australia
Achievable (A) The goal is achievable via increasing the security checks of the drug
delivery among the prisoners and reducing the access and the use of
intravenous opioid among the prisoners
Reliable (R) The goal is reliable as opioid is mainly used for the pain management
among the prisoners. So substitute of opioid must be used for pain
management via using non-pharmacological interventions. Like physical
exercises or physiotherapy. Even if the opioid is used it must be used
under the surveillance of the doctors so that the syringe is used and then

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damaged immediately
Time (T) 2 months to make all the necessary arrangement of increasing security
checks and application of the non-pharmacological interventions for pain
management
Objective 3: Increasing HIV awareness among the prisoners of Western Australia and the
detrimental effects of used-syringe based drug administration
S (Specific) The goal is specific because increasing the HIV awareness helps in the
reduction drug injection via used-syringe among the prisoners
Measurable (M) The goal is measurable via doing a survey among the prisoners both HIV
prisoners and non-HIV prisoners about their understanding about syringe
used and exchange of syringe among the prisoners
Achievable (A) The goal is achievable via hold a community based interactive awareness
approach procured by the community health nurse in the prison settings
Reliable (R) The goal is reliable because setting up power-point audio-visual
presentation by the community healthcare nurse is cost-effective and
permission can be granted easily from the administrative authority of the
prison
Time (T) The time limit of the goal is one month of awareness or educational
approach and next one month for conducting the survey in order to
evaluate the outcome

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HEALTH PROMOTION GRANT APPLICATION
Strategies
Strategies for objective 1
Increase in the installation of the CCTV camera and syringe disposal machines in order to
regulate the use of the previously used syringes for the intravenous intake of the drug(Sawangjit,
Khan & Chaiyakunapruk, 2017)
Strategies for objective 2
Proper installation of the CCTV camera will help to keep an eye on the unwanted use of
the drugs via the prisoners. Use of non-pharmacological medication for pain management will
help to reduce unwanted circulation of the opioid medication. N0on pharmacological
interventions will mostly include physical exercise (Ambrose & Golightly, 2015)
Strategies for objective 3
Proper educational campaign via audio-visual interactive approach (power-point
presentation)will be given by the community health nurse in the prison settings. This will help to
increase the awareness about HIV among the prisoners(Bagnall et al., 2015)
Budget estimation
The expected budget for the overall plan will be ascertained and then simultaneously
designed before the initiation of the health promotion plan of the prisoners of the Western
Australia. The below mentioned Table provides the budget estimation details of this program.
All the healthcare professionals who will be associated with this program will be given an
average salary in accordance to the scale of the Health Care policy of Australia (Health Care
Australia [HCA]).

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HEALTH PROMOTION GRANT APPLICATION
Services Cost ($) Numbers Total ($)
CCTV Camera 200 15 3000
Installation of CCTV
Camera software system
1500 1500
Installation of the syringe
disposal units in the
prison
100 3 300
Appointment of
physiotherapists for the
non-pharmacological
pain management
25 (per hour) 2 50 x 8 hours = $
400
Community health nurse
for awareness program
35.49 (per hour) 2 574.4
Health counsellor 48. 95 (per hour) 2 783.2
Total Cost $6557. 6
Time estimation (Grant Chart)
Tasks to be
done
Week
1
Week
2
Week
3
Wee
k 4
Week
5
Week
6
Week
7
Week
8
Week
9
Week
10
Preparation of
the proposal
Approval of the

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HEALTH PROMOTION GRANT APPLICATION
proposal by the
Jail committee
Sanction of the
grant for
financial
assistance in
accordance to
the budget plan
Buying and
installation of
CCTV camera
Buying and
installation of
syringe disposal
machine
Appointment of
community
health nurse,
physiotherapists
and healthcare
counsellor
Awareness
program

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HEALTH PROMOTION GRANT APPLICATION
Physical
exercise for pain
management
and reduction in
opioid use
HIV survey
among the
prisoners
Survey to
analyse the
success of
educational
program
Evaluation
The evaluation will be done via conducting the blood test among all the inmates in order
to elucidate the rate of prevalence of HIV. Decrease in the HIV in the blood of the inmate will
indicate that there is decrease in the spread of HIV. Moreover, the blood of the inmates will also
be scanned in order to find the trace of harmful intravenous drug which are not permissible
inside the hospital. This blood test will help to ascertain that prisoners are actually getting
affected by the awareness program (Mimiaga et al., 2018).

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HEALTH PROMOTION GRANT APPLICATION
Working in partnership with others
In order to facilitate the project different organisations might be involved as partners. The
main organisations include Australian Federation of AIDS organisations and AIDS trusts for
Australia. The AIDs trust of Australia (http://www.aidstrust.com.au/) would help to generate
more funds for the active management of HIV-AIDS among the inmates of the Western
Australia prison. This AIDS trust might help to raise fund in order to conduct the overall
evaluation process after the implementation of the program. The Australian Federation of AIDS
Organisations (2018) (ttps://www.afao.org.au/australia/) will help to supply community health
nurse who will help to increase the HIV-AIDS awareness. Another organisation which will also
be invited to collaborate in this health promotion program will be the National Association of
People with HIV Australia (http://napwha.org.au/). This member of this organisation will be
asked to share thoughts and experience behind use of old syringes in HIV-AIDS transmission.
The target population that is the prisoners will also be involved in the health awareness program
in order to frame person-centred care approach. The overall outcome of the project will be
disseminated in the quarterly souvenir of the jail and also in the jail’s notice board.
Sustainability
The exhaustion of the sanctioned budget will not cease the overall functioning of the
project like the CCTV camera and the syringe disposal machines are long-term investments.
These two equipments can be effectively used for controlling the spread of HIV through the use
of old syringes. Moreover, the power-point or posters which will be used by the community
health nurses for conducting the awareness program will be stored. The same resources will be
used in future in order to educate the jail in-mates. The long term benefit of the project is
reduction in the spread of HIV, HCV and hepatitis among the jail in-mates and thereby helping

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HEALTH PROMOTION GRANT APPLICATION
to reduce the number of the unwanted casualties in jail. This in turn will help to reduce the
overall cost of care of the prisoners (McKinney & Marconi, 2016). This project is specifically
directed towards the prisoners keeping in mind their daily living and lifestyles and hence cannot
be implemented to wider population. However, proper awareness program is always an option
for the wider audience in order to reduce the prevalence of HIV, HCV and hepatitis.

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HEALTH PROMOTION GRANT APPLICATION
References
AIDs trust of Australia. (2018). About Us. Access date: 22nd August 2018. Retrieved from:
http://www.aidstrust.com.au/
Ambrose, K. R., & Golightly, Y. M. (2015). Physical exercise as non-pharmacological treatment
of chronic pain: why and when. Best Practice & Research Clinical Rheumatology, 29(1),
120-130.
Australian Federation of AIDS Organisations. (2018). About Us. Access date: 22nd August 2018.
Retrieved from: https://www.afao.org.au/australia/
Bagnall, A. M., South, J., Hulme, C., Woodall, J., Vinall-Collier, K., Raine, G., ... & Wright, N.
M. (2015). A systematic review of the effectiveness and cost-effectiveness of peer
education and peer support in prisons. BMC Public Health, 15(1), 290.
Dolan, K., & Rodas, A. (2014). Detection of drugs in Australian prisons: supply reduction
strategies. International journal of prisoner health, 10(2), 111-117.
https://doi.org/10.1108/IJPH-06-2013-0025
Dolan, K., Moazen, B., Noori, A., Rahimzadeh, S., Farzadfar, F., & Hariga, F. (2015). People
who inject drugs in prison: HIV prevalence, transmission and prevention. International
Journal of Drug Policy, 26, S12-S15. https://doi.org/10.1016/j.drugpo.2014.10.012
Iversen, J., Wand, H., Topp, L., Kaldor, J., & Maher, L. (2013). Reduction in HCV incidence
among injection drug users attending needle and syringe programs in Australia: a linkage

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study. American journal of public health, 103(8), 1436-1444. doi:
10.1097/QAI.0b013e3181a2539a
Jürgens, R., Ball, A., & Verster, A. (2009). Interventions to reduce HIV transmission related to
injecting drug use in prison. The Lancet infectious diseases, 9(1), 57-66.
https://doi.org/10.1016/S1473-3099(08)70305-0
Kwon, J. A., Iversen, J., Maher, L., Law, M. G., & Wilson, D. P. (2009). The impact of needle
and syringe programs on HIV and HCV transmissions in injecting drug users in
Australia: a model-based analysis. JAIDS Journal of Acquired Immune Deficiency
Syndromes, 51(4), 462-469. doi: 10.1097/QAI.0b013e3181a2539a
McKinney, M. M., & Marconi, K. M. (2016). Delivering HIV Services to Vulnerable
Populations: A Review of CARE Act—Funded Research. Public Health Reports.
Mimiaga, M. J., Pantalone, D. W., Biello, K. B., Glynn, T. R., Santostefano, C. M., Olson, J., ...
& Mayer, K. H. (2018). A randomized controlled efficacy trial of behavioral activation
for concurrent stimulant use and sexual risk for HIV acquisition among MSM: project
IMPACT study protocol. BMC public health, 18(1), 914.
Moazen, B., Noori, A., Rahimzadeh, S., Farzadfar, F., & Hariga, F. (2014). HIV in prison: a
global systematic review of prevalence, incidence, AIDS related mortality and HIV
programs. Presented at 20th International Conference on AIDS, Melbourne, July.
National Association of People with HIV Australia. (2018). About Us. Access date: 22nd August
2018. Retrieved from: http://napwha.org.au/

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Ramaswamy, M., & Freudenberg, N. (2008). Health promotion in jails and prisons: An
alternative paradigm for correctional health services. In Public health behind bars (pp.
229-248). Springer, New York, NY. DOIhttps://doi.org/10.1007/978-0-387-71695-4_13
Sawangjit, R., Khan, T. M., & Chaiyakunapruk, N. (2017). Effectiveness of pharmacy‐based
needle/syringe exchange programme for people who inject drugs: a systematic review
and meta‐analysis. Addiction, 112(2), 236-247.
Treloar, C., Treloar, C., Fraser, S., Treloar, C., & Fraser, S. (2008). Public opinion on needle and
syringe programmes: Avoiding assumptions for policy and practice. Drug and Alcohol
Review, 26(4), 355-361. https://doi.org/10.1016/S1473-3099(08)70305-0