Measuring the quality of life of incarcerated individuals

Healthy prison cultures: factors influencing male prisoners' engagement in exercise and subsequent healthy behaviours

PURPOSE

The purpose of this paper is to identify the factors which influence male prisoners' motivation for, and engagement in, exercise and subsequent healthy behaviours.

DESIGN/METHODOLOGY/APPROACH

The first authors conducted 20 semi-structured interviews with male prisoners inside an English medium-security male prison. Interviews were recorded and transcribed, themes were identified using thematic analysis and a critical realist perspective applied to understand objective processes behind prisoners' experiences and shared meanings of exercise and engaging in healthy behaviours in prison.

FINDINGS

Emerging themes indicate that in the context of healthy behaviours male prisoners aspired to a masculine ideal that was characterised by a culture of either adaptive behaviours, or maladaptive behaviours. The former fostered an adaptive exercise culture which promoted psychological well-being through an autonomy-supportive environment, consequently internalising motivation and minimising perceived barriers to engaging in healthy behaviours. Conversely, a culture of maladaptive behaviours fostered a maladaptive exercise culture which led to negative psychological well-being, underpinned by external forms of motivation which emphasised barriers to engaging in healthy behaviours.

PRACTICAL IMPLICATIONS

Findings emphasise the need for prisons to promote an internal perceived locus of control for male prisoners when engaging in healthy behaviours.

ORIGINALITY/VALUE

The authors adopt a rare interdisciplinary approach combining a psychological theory of motivation and criminological perspectives of prison culture to understand how best to minimise the impact of prisons as an institution on the psychological well-being of male prisoners.

Psychometric properties of the WHOQOL-BREF in a population of older adults in prison: measuring quality of life in a carceral setting

PURPOSE

Valid and reliable measurement is critical to the assessment and evaluation of health interventions. However, few scholars have examined the psychometric properties of "gold standard" measures in carceral settings, and no research has explored the reliability, validity and factor structure of the 26-item World Health Organization Quality of Life (WHOQOL) BREF among older adults incarcerated in prison, a large and growing population marked by substantial chronic and life-limiting illness. This study aims to examine the reliability, validity and factor structure of the WHOQOL-BREF.

DESIGN/METHODOLOGY/APPROACH

Secondary data from a large-scale study with older adults (age 45+) incarcerated in a Midwestern state were used (N = 499). Floor and ceiling effects were examined, as was the reliability of the measure (Cronbach's alpha). The structural validity of a four-factor and second-order four-factor model of the WHOQOL-BREF was examined using confirmatory factor analysis. Model data fit was examined using chi-square, standardized root mean square residual, comparative fit indices, Akaike information criterion and the Bayesian Information Criterion. Pearson product-moment correlation coefficients were also used to assess validity.

FINDINGS

Results indicate adequate construct validity and reliability for the WHOQOL-BREF using the current sample. Model-data fit indexes also reveal adequate structure of the measure relative to other older adult samples. Non-random data and item exclusion are noteworthy limits, and future researchers are encouraged to co-conceptualize and operationalize life quality with older adults who are incarcerated.

ORIGINALITY/VALUE

To the best of the authors' knowledge, this is the first study to explore the psychometric properties of the WHOQOL-BREF among older adults incarcerated in prison.

Exploring Norwegian prison frontline workers' perceptions of inter professional collaboration - a pilot study

PURPOSE

Interprofessional collaboration is necessary for handling the complex psychosocial needs of prisoners. This collaboration must be addressed to avoid high recidivism rates and the human and societal costs linked to them. Challenges are exacerbated by a linear approach to handling prisoners' problems, silo working between welfare agencies and professional boundaries between frontline workers. There are few adequate theoretical frameworks and tools to address these challenges in the prison context. The purpose of this study is to explore the perceptions that frontline staff working in Norwegian prison facilities have regarding interprofessional collaboration in providing mental health services for prisoners.

DESIGN/METHODOLOGY/APPROACH

This study had a non-experimental, cross-sectional design to explore perceptions of interprofessional collaboration in a prison context. Descriptive and multifactorial analyses (exploratory factor analysis and confirmatory factor analysis) were used to explore the data.

FINDINGS

The analysis showed that three factors, communication, organizational culture and domain, explained 95% of the variance. Results are discussed using relational coordination, as well as the conceptual PINCOM model, as a theoretical framework.

ORIGINALITY/VALUE

Few studies explicitly explore collaboration between professionals in mental health and prison services despite its being a prerequisite to achieving sufficient services for prisoners. To our knowledge, this current study is one of the first in Norway to explore collaboration in a prison context by analysing quantitative data and focusing on frontline workers perception of the phenomenon.

Visitation and quality of life among older adults in jail

PURPOSE

The purpose of this paper aims to examine differences in measures of and relationships between visitation and quality of life (QOL) among older and younger jailed adults. The authors also explored the contribution of visitation to QOL among adults in this setting. The authors anticipated fewer visits and lower QOL among older adults. Framed by psychosocial developmental theory, the authors also anticipated a larger effect in the relationship between visitation and QOL among older rather than younger adults and that visitation would contribute most readily to psychological QOL.

DESIGN/METHODOLOGY/APPROACH

Cross-sectional data from a large US jail were used (n = 264). The authors described the sample regarding visitation and QOL measures among older (≥45) and younger adults (≤44) and examined differences in measures of and relationships between visitation and QOL using independent sample t-tests and bivariate analyses. The authors explored the contribution of visitation to psychological, social relationships, physical and environmental QOL among jailed adults using hierarchical multiple linear regression.

FINDINGS

Older adults had fewer family visits and lower physical QOL than younger adults, disparities were moderate in effect (d range = 0.33-0.35). A significant difference also emerged between groups regarding the visitation and environmental QOL relationship (z = 1.66, p <0.05). Visitation contributed to variation in physical and social relationships QOL among jailed adults (Beta range = 0.19-0.24).

ORIGINALITY/VALUE

Limited research exists among jailed older adults and scholars have yet to examine the relationship between visitation and QOL among persons in these settings.

Older adults incarcerated in state prison: health and quality of life disparities between age cohorts

OBJECTIVES

This research sought to describe the physical and psychological health and quality of life among older adult men incarcerated in a state prison and to examine the role of age and historical time between age cohorts.

METHODS

Survey responses from male respondents incarcerated in a medium-security prison (N = 186) were described using frequencies and descriptive statistics; chi-square and analysis of variance analyses were used to examine differences between age cohorts.

RESULTS

The average number of chronic health conditions for the sample was higher than those in similar samples; the proportion of older adults with four or more chronic conditions was 10% higher than the national average for adults age 65 or older. Depression and post-traumatic stress (PTS) symptom severity scores were higher than those found in community-based samples. Significant differences were identified between cohorts regarding physical (number of chronic conditions, F = 12.48, p < .01); functional impairment, F = 4.28, p < .05) and psychological health (PTS symptom severity, F = 3.16, p < .05).

CONCLUSION

Policy and practice implications are discussed including the expansion of on- and off-site services for older adults in prisons, enhanced accessibility, and the use of grief counseling and stress management strategies.

A Systematic Review of Quality of Life Assessments of Offenders

Strength-based theories of rehabilitation emphasize the importance of opportunities for offenders to achieve "good lives" to not re-offend. The extent to which these groups feel enabled to achieve a good life may be measured through subjective, overall quality of life (QoL). The aim is to systematically review the QoL instruments used among detained offenders and synthesize the factors related to their QoL. A systematic literature review was conducted to retrieve articles that assessed the overall QoL of a sample of detained offenders using a validated instrument. The instruments' specificity, dimensionality, and respondent and administrator burden were assessed, and factors reported as significantly related to QoL were summarized. In total, 41 articles were included in the review: 20 reported on forensic samples and 20 on prisoners, with one study randomly assigning offenders to either forensic treatment or prison. Among the included articles, 12 validated instruments were utilized. Only one instrument, the Forensic Inpatient Quality of Life Questionnaire, was specifically developed for and validated in forensic patients. Detained offending populations reported lower QoL than the general population, and those with untreated mental illness reported the lowest. The most consistent predictors of QoL longitudinally were social factors, while substance use and detention-specific variables were not consistently related. In general, the relationships between poor mental health, loneliness, and poor QoL seen in offenders are also seen among other marginalized populations. To improve the evidence base for QoL assessment in this vulnerable group, current gold standard QoL instruments should be validated in detained populations.

Quality of Life in Jail: Gender, Correlates, and Drivers in a Carceral Space

Quality of life (QOL) is an important area of exploration in U.S. corrections linked closely to well-being and an important indicator of intervention efficacy. Little is known of QOL in U.S. jails despite the admittance of over 10-million people to these settings every year. Research regarding the dimensions, correlates, and gender disparities in QOL in jails is important to shaping gender-responsive supports and reducing recidivism. Independent t tests and correlational and regression analyses were used to explore dimensions, correlates, and gender disparities in QOL among persons incarcerated in a large, southeastern jail (N = 299). All QOL domains were significantly related to overall QOL, and psychological QOL contributed most readily to respondent's overall QOL. Females, on average, reported lower QOL than males with significant differences between the groups in physical health and psychological domains. The importance of psychological QOL intervention and healthcare continuity are discussed.

Factors associated with drug use in prison - results from the Norwegian offender mental health and addiction (NorMA) study

BACKGROUND

Remarkably little is known about drug use during imprisonment, including whether it represents a continuation of pre-incarceration drug use, or whether prison is also a setting for drug use initiation. This paper aims to describe drug use among people in prison in Norway and investigate risk factors associated with in-prison drug use.

METHODS

We used data from the Norwegian Offender Mental Health and Addiction (NorMA) Study, a cross-sectional survey of 1499 individuals in Norwegian prisons. Respondents reported on drug use (narcotics and non-prescribed medications) both before and during imprisonment. We used multivariate logistic regression to investigate the associations between drug use in prison and demographics, previous drug use, mental health, and criminal activity.

RESULTS

Sixty-five percent of respondents reported lifetime drug use, and about 50% reported daily use of drugs during the 6 months before incarceration. Thirty-five percent reported ever using drugs in prison, but initiation of drug used during incarceration was uncommon. In a multivariate model, factors independently associated with drug use in prison included lifetime number of drugs used (adjusted odds ratio [aOR] = 1.17; 95% confidence interval [CI] 1.12-1.23; p <  0.001), daily drug use in the 6 months before imprisonment (aOR = 7.12; 95%CI 3.99-12.70; p <  0.001), and being intoxicated while committing the crime related to current imprisonment (aOR = 2.13; 95%CI 1.13-4.03; p = 0.020).

CONCLUSIONS

In-prison drug use is independently associated with high-risk drug use before imprisonment. To reduce drug use in prison, correctional services must systematically screen for pre-prison drug use and offer effective drug treatment for those in need.

Effectiveness of Prison-Based Exercise Training Programs: A Systematic Review

Background: The promotion of physical activity among imprisoned people is a public health strategy that could help to improve the health status of this collective. This systematic review is aimed at reviewing the scientific evidence regarding the effects of exercise training programs performed by inmates.Methods: A systematic search for randomized controlled trials aimed at identifying the characteristics and effects of prison-based exercise training programs on imprisoned people was carried through MEDLINE, SPORTDiscus, and Scopus.Results: A total of 11 randomized controlled studies were selected, and the methodological quality of these was acceptable according to the Downs and Black scale. The proposed interventions were mainly based on the performance of aerobic or combined exercise training programs. Generally, the participants were healthy men who were imprisoned for at least 2 months and up to 15 years. Ten out of the 11 studies reported significant changes on physical and mental health–related variables, after the intervention took place.Conclusion: These findings suggest that prison-based exercise programs constitute a feasible and useful strategy for improving the physical and mental health status of prisoners.