correctional health conference boston 212 march 2015

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow.

The acceptability of a football-based healthy lifestyle programme delivered to inmates in two Scottish prisons Matt Maycock, Cindy Gray*, Alice MacLean & Kate HuntMRC|CSO Social and Public Health Sciences Unit,University of Glasgow*Institute for Health and Wellbeing, University of Glasgow

8th Academic and Health Policy Conference20th March 2015, Boston


IntroductionWhen delivered in a community setting (Scotland’s top professional football clubs), the Football Fans in Training (FFIT) programme attracted overweight and obese men and helped them:

• Lose weight

• Improve their diet

• Become more active (Hunt et al 2014)

This presentation outlines our experience of testing the feasibility of delivering an adapted version of FFIT to men in two secure institutional settings in Scotland.


Health in UK/Scottish prisons• Men living within prisons experience many context-specific

challenges to their mental and physical well-being, often compounded by lifetime disadvantage.

• The prevalence of overweight/obesity among male prisoners in the UK is ‘unacceptably high’ (Herbert K et al (2012).

• Despite being given opportunities to eat healthily and take part in PA, many prisoners choose not to do so (ibid).

• Prisoners in the UK are less likely to achieve recommended minimum PA guidelines than non-incarcerated men (ibid).

• National recommendations suggest using prison settings to promote PA, healthy eating and wellbeing (Scottish Prison Service (2002))


The p-FFIT Programme - AimsAim 1: To adapt FFIT for delivery to prisoners in a secure institutions.

Aim 2: To assess the feasibility of collecting baseline, post-programme, 6-month, 9-month and 12-month health-related outcome data and process evaluation data from thetarget population.

Aim 3: To assess the likelihood of a range of health benefits and hence the outcomes and sample size for a future randomised controlled trial.

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you need aslid on what FFIT is before this - see BASES talk


Prison AState run, high

security, all male

Adult short & long term prisoners

Three deliveries completed, led by prison gym staff (PEIs) with local

football club coaches at 2

sessions

Prison BPrivately run, high security, all male

Adult short & long term prisoners

Two deliveries completed, led by local football club

club coaches supported by PEIs &

other prison staff

Prison A

Phase 1Phase 2Phase 3

Prison B

Phase 1Phase 3


MethodsPrison A (Phase two) Prison B (Phase one)

Delivered to 17 prisoners in total by prison Physical Education Instructors (PEIs) Data collection • Observations of 9 sessions• Interviews with participants

who completed programme (n=7)

• Interviews with participants who did not complete (n=5)

• Informal conversations with PEIs

Delivered to 17 prisoners by community coaches from a professional football club and Physical Education Instructors (PEIs)

Data collection • Observations of 6 sessions• Interviews with participants

who completed programme (n=9)

• Interviews with PEIs and staff (n=1)


p-FFIT Results - Observations • Generally speaking the fidelity [what was outlined in the delivery notes

being comprehensively delivered] of the sessions was high

• Towards the end of the programme fidelity declined noticeably

• There was a sense of the group supporting and encouraging one another as the programme progressed

• PEIs and football club coaches were committed, enthusiastic and well prepared

• Prison management seem engaged with and supportive of, the p-FFIT programme

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this finding is not all from the observations

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FC coaches were not well-prepared in my view)

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THIS DEFINITELY DID NOT COME FROM THE OBSERVATIONS, DUD IT?I AM CONCERNED THAT THERE IS SOMETIMES A TENDENCY TO PRESENT 'RESULTS' WITHOUT DATA TO SUPPORT THEM - DO WE HAVE ANY DATA ON THIS?


Well I got a lot o’ knowledge and understand aboot the portion sizes an’ healthy eating an’ healthy living… an’ good knowledge aboot daein’ the steps an’ the cell workoots an’ that. Gottae meet new people (P2)

I benefited from losing weight, getting fit, achieving something I probably would never ever do outside. It’s all helpful information. When I first started, I couldn't get up those stairs without having breathing problems. So my level of fitness has increased quite (P1)

Well I got a lot of knowledge and understanding about the portion sizes and healthy eating and healthy living… and good knowledge about doing the steps and the cell workouts and that. I got to meet new people (P2)

p-FFIT Results Participant Perspectives – Positive

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WHICH PRISON DO THESE COME FROM?


There is barriers in prison. The food obviously number one, eh? But you could ask the prison all day long tae change it – they won’t change it. Yeah, but very expensive. (P5)

You’ve got somebody else in the cell with you. Mind you, the co-pilot I’m in with now he does cell workouts, know what I mean? Well, as I say, if you've got money you can buy things off the sundries like fruit and things, so that's probably the biggest barrier for people would be… Aye. That's probably the biggest barrier for most people would be motivation.It was for me anyway. (P7)

There are barriers in prison. The food is obviously number one. But you could ask the prison all day long to change it – they won’t change it. Yeah, but very expensive. (P5)

p-FFIT Results Participant Perspectives - barriers


p-FFIT ConclusionsThis presentation has illustrated that:

• FFIT has the potential to be successfully adapted for secure settings

• The p-FFIT programme was successful in HELPING SOME men MAKE positive lifestyle change with a secure setting, but there are important barriers to making and sustaining change in this context.

• Delivering a gender and context sensitised health promotion intervention in a secure setting has the potential to facilitate engagement with a cohort of hard to reach and disadvantaged men

• There were issues of participant retention with p-FFIT that were more significant within the prison context than in the community deliveries of FFIT

• Further development work needs to be done on adapting FFIT for secure settings

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yOU NEED TO PRESENT DATA TO SUPPORT THESE CONCLUSIONS


AcknowledgmentsThanks to Participants, SPFL coaches, MRC/CSO SPHSU Survey Office, Sally Wyke, Nanette Mutrie, Bill Mullen

Collaborators Alice MacLean, Cindy Gray, Kate Hunt

Programme Delivery Scottish Prison Service Physical Education Instructors, Coaches from SPFL clubs

Programme Funding Scottish Prison Service, NHS Ayrshire and Arran

Research Funding This research was funded by CSO grant - CZH-4-886 and Gender and Health Programme core funding


[email protected] www.matthewmaycock.com

Thanks

mailto:[email protected]

http://www.matthewmaycock.com/

correctional health conference boston 212 march 2015

Health & Medicine