Thomson P, Mohan AA, Haw S, Leslie S & MacKay J (2017) Exploration of the factors that promote positive health behaviours related to cardiovascular health in prisoners [Cardiovascular health and prisoners]. In: TBC. Published abstract, 16 (S1) EuroHeartCare 2017, Jonkoping, Sweden, 18.05.2017-20.05.2017. Academia Press, p. 1.
Abstract Background: Prisoners are disproportionately affected by cardiovascular disease and there is a higher prevalence of risk factors such as smoking, physical inactivity and unhealthy diet in prisoners. Despite the increased availability of healthcare services and health promotion interventions in prisons, the health of many prisoners declines whilst in prison. Few studies have explored the factors that promote positive health behaviours in prison. Understanding these factors can help healthcare professionals improve services or interventions to improve the cardiovascular health of prisoners.
Purpose: To explore the factors that promote the adoption and maintenance of positive health behaviours related to cardiovascular health while in prison.
Methods: A qualitative study involving 16 semi-structured interviews with male prisoners was conducted in a Scottish prison between 2015 and 2016. The interviews were audio-recorded and transcribed. The data was analysed using the framework approach.
Results: Six main themes emerged from the data and were classified into two main categories: environmental factors and personal factors. Environmental factors were: the fixed prison regime, self-direction opportunities in prison and rewards or incentives. The fixed prison regime enabled some prisoners to form a routine in which time was made for regular exercise in the gym. However some prisoners who were serving long sentences reported becoming bored with the fixed regime and experienced moments of amotivation throughout their sentences. Prisoners who were given self-direction opportunities found it easier to adopt positive behaviours. For example, prisoners who worked in the kitchen had more choice over preparing their own meals and were able to eat healthily while in prison. Rewards or incentives such as certificates for participating in health interventions encouraged prisoners to be more physically active although this was often a temporary effect. Personal factors were: peer motivation, intrinsic motivation and personal relationships. Prisoners who worked out with peers felt motivated and encouraged to exercise more regularly and felt more able to avoid junk food. Prisoners who saw a positive physical change in their own appearance felt an increased sense of well-being and exercised because it made them happy. Prisoners who were able to share their successes with family or friends felt an increased sense of personal responsibility and felt competent in maintaining control over their own health.
Conclusion: Environmental and personal factors influenced positive health behaviours linked to cardiovascular health in prisoners. Further opportunities exist to promote more person-centred self care activities that promote cardiovascular health in prisoners’ work and leisure time.