Between 1992 and 2001, the inmate population over 50 years of age in US prisons grew by 172%. This growing cohort of older prisoners commonly surfers from three or more chronic conditions and is estimated to cost taxpayers three times as much to house as do younger inmates. Additionally, many older inmates are eventually released back into the community, directly impacting that community's health. Despite recognition of the mounting financial, medical, humanitarian, and social challenges associated with aging inmates, relatively little has been done to enhance their health self-management; specifically, health promotion and disease prevention, hallmarks of health maintenance and cost containment. The proposed 2-phase prospective study will use survey and focus group (FG) methodologies to explore health management and health-promotion behaviors in older male inmates. A simple random sample of 192 male inmates age 50 and older incarcerated at two state prisons will be obtained for the survey phase and serve as the sampling frame for the FG phase, whereby 4-6 FGs of 5-7 participants each will be conducted to determine how some inmates are able to improve their health while in prison, yet others are not.
Study aims are: 1) To confirm relationships between self-efficacy for health management and: health-promotion behaviors; health- monitoring behaviors; and self-rated health status in older male prisoners; 2) To examine variations in self- rated health status and self-efficacy for health management by inmate characteristics of older men in prison; and 3) To identify self-care strategies used by older male inmates to manage their health. Self-efficacy for health management will be measured using the Chronic Disease Self-Efficacy Scale. Health promotion behaviors will be assessed by the Health Promotion Activities of Older Adults Measure. Self-rated health status is a component of the Older Men's Health Program and Screening Inventory, which will be administered, as will a set of questions addressing health-monitoring behaviors, demographics, and items specific to incarcerated people.
Aim one will be analyzed using correlations to evaluate the strength and direction of the relationships and aim two will be analyzed using general linear models. Focus group data will be analyzed using content and thematic analyses. Study findings will provide key knowledge needed to plan intervention protocols, where new or improved strategies for self-efficacy enhancement for this unique population can be developed and tested. The proposed research holds promise for: contributing to a more efficient inmate health system; decreasing the financial strain on the public treasury; paying dividends in the long-term health of our communities; improving nurses' knowledge of older inmates' health needs; expanding the analytic scope of the growing research literature on health in the general population to an understudied inmate population; and enhancing the nation's ability to meet the Healthy People 2010 goals. ? ? ?
| Loeb, Susan J; Steffensmeier, Darrell (2011) Older inmates' pursuit of good health: a focus group study. Res Gerontol Nurs 4:185-94 |
| Loeb, Susan J; Steffensmeier, Darrell; Kassab, Cathy (2011) Predictors of self-efficacy and self-rated health for older male inmates. J Adv Nurs 67:811-20 |
