If the scale-up plan encompasses multiple individual prisons which form an organisational entity, a pilot should be considered in one or a small number of centres before jurisdiction-wide roll-out is considered. A short term pilot over 6-12 months should be undertaken in a centre(s) with characteristics suggesting good feasibility, as described below.
Choice of prison
Suitable health clinic, existing hepatitis service, and good prisoner access windows.
Engagement of staff
Correctional and health staff well-resourced and supportive.
Feasibility of evaluation
Good correctional and health care data systems.
Suitable characteristics including a high hepatitis C prevalence and a sufficient incarceration period for testing and treatment.
The SToP-C program was successfully implemented sequentially in four correctional centres in New South Wales, Australia. A continuing improvement approach was adopted with successful initiatives from one centre then commenced in other centres (e.g. employment of a dedicated correctional officer to support testing and treatment scale-up).