Mitigating Infectious Disease within Prisons: Implementing Health Promotion Principles to Improve outcomes

Abstract

Purpose: To increase knowledge of infectious diseases prevalent in prisons and increase intent to modify behaviors to regularly include transmission prevention strategies among inmates of a unit in a prison system in the southwestern United States. Background: The United States incarceration system holds nearly 2.5 million inmates. Infectious disease (ID) disproportionately affects the incarcerated. Their limited health literacy and education, oversaturated environments, risky substance dependence and sexual practices, sentence lengths, and release and recidivism rates are social determinants exacerbating the risk of ID contraction and transmission within incarcerated and surrounding communities. Health care costs associated with poor health literacy reach over $240 billion a year and the efforts on health education and promotion within incarceration settings are inadequate. The gap in prisoner health education is an opportunity for APRNs to address population health goals and increase health equity through health promotion principles. Methods: This project was inspired by Young and Weinert’s Improving Literacy with Inmates program. PICOT inquiry and Squire 2.0 guidelines directed research. Search engines included CINAHL, Cochrane Library, EBSCO, Google Scholar, MEDLINE, and PubMed. Nola Pender’s Health Promotional Model and the Model for Improvement guided development and implementation. A health promotion series on ID was conducted for inmates of a unit in a prison system in the southwestern United States. Pre- and post-intervention surveys elicited information on knowledge of infection detection, prevention, and curative behaviors to gauge intent to modify behaviors to include ID prevention practices. 12 Results: Pre-intervention surveys suggested a greater proportion than predicted of participants who possessed knowledge and practiced ID preventative behaviors post-intervention surveys suggested an increase in baseline knowledge and intent to practice and champion ID prevention among peers. Conclusions: Sustained efforts directed to improving health literacy and behaviors among the incarcerated are limited and this project sought to address that gap. Implementation of the project revealed numerous barriers to inmate health promotion, yet results suggest health promotion and discussion can increase intent to modify behaviors and champion ID prevention strategies among inmates of a unit in a prison system in the southwestern United States.