Correctional medical staff have been on the front lines of the current COVID-19 pandemic. Medical staff working in prisons and jails are responsible for providing healthcare in very challenging correctional environments. As county jails have been among the hotspots for COVID-19 related outbreaks, it is imperative to better understand perceptions of COVID-19 related risk, experiences with COVID-19 risk mitigation strategies, and willingness to participate in COVID-19 vaccination campaigns among correctional healthcare providers.

This study originated from a request from Turnkey Health Clinics, Inc. to better understand the willingness of their jail based healthcare staff to receiving COVID-19 vaccination when it becomes available to them. Turnkey provides healthcare services to 65 jail and detention facilities across eight states (OK, AR, TX, LA, KS, MO, NM, CO) and has nearly 600 employees.

This study aims to administer a brief (~15 minute) one-time survey to assess experiences around COVID-19 risk mitigation strategies and intention to be vaccinated among all jail and detention-based Turnkey healthcare providers (N=599). Surveys will be anonymous and no identifying information will be collected. Potential participants, all adults, will be emailed a link to the online survey by the medical director (or his administrator). Eligibility criteria includes being currently employed as a healthcare professional at one of the 65 Turnkey jail or detention facilities. Participation is strictly voluntary and informed consent will be required before a participant can work on a survey.

Survey items will cover the nature of the participants’ work, work environment, perceived risks for COVID-19, documented exposure to COVID-19, use of personal protective equipment (PPE) and adoption of prevention behavior in their work environment and personal PPE use and prevention behavior, use of COVID-19 testing, knowledge of COVID-19 and misconceptions, COVID-19/flu vaccination history and hesitancy, perceptions of personal physical and mental health (general anxiety, depressions and PTSD), COVID-19 anxiety, medical mistrust, experiences and endorsement of racial discrimination, and a series of demographic and background questions.

Descriptive analyses will be conducted based on participant responses and demographic characteristics. Additionally, the study team plans to conduct stratified analyses by specific demographic characteristics of interest (e.g. race, gender, etc.) to assess potentially important differences across these characteristics. For dichotomous variables, Chi2 tests will be performed, using Fisher’s Exact Test to correct for potential small cell sizes. For continuous variables, t-tests will be performed. Finally, this study will examine correlates associated with indicators of vaccine willingness and hesitancy (to be treated as separate dependent variables) among sample participants using logistic regression modeling. All analyses will use two-tailed tests of significance, with significance at alpha = 0.05 and analyses will be performed in STATA and/or SAS.

Study Settings: Jails/Prisons