Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Date of Graduation


Document Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing


Maria deValpine

Erica Lewis

Kristina Blyer


Problem: The COVID-19 case rate as of June 5, 2020, for prisoners was 5.5 times higher than the United States (US) population case rate (Saloner et al., 2020). A secure behavioral rehabilitation facility in the US was challenged to mitigate the spread of COVID-19 and made many changes to facility and program protocol in order to meet this challenge.

Methods: The purpose of this program evaluation was to examine the COVID-19 facility response, case rates, percent positivity and attack rates between units at a secure behavioral rehabilitation facility to inform further policy and procedure recommendations for the mitigation of COVID-19 transmission in congregate living facilities. Case rates and percent positivity were used as a surrogate measure to evaluate this facility's COVID-19 program. A logic model and PRECEDE/PROCEED model were used to guide this program evaluation.

Results: Attack rates varied significantly by unit, from 1 resident case (3.94%) to 31 cases (92.26%). The 7-day rolling average ranged from 0.0% to 4.34% positivity during the study period, and 205/355.6 residents (57.56%) were infected during the 3-month study period.

Summary: COVID-19 places significant logistical and human strain on residents, employers, and administrators of secured congregate settings. Despite a sustained and flexible effort at infection control measures, the study facility still experienced a significant number of cases, special hospitalizations, and deaths. Due to variation in attack rate between units, further research regarding uptake of infection control measures by residents in secured settings may be beneficial. In addition, this study reinforces the need for feasible and standardized data collection and reporting methods in secured environments. Finally, studies on maintaining core behavioral rehabilitation services in a secured setting during an infectious disease outbreak are recommended.

Keywords: COVID-19, postrelease programs, infection control, congregate setting, program evaluation



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.