Health promoting prisons: an overview and critique of the concept

The notion that prisons should become more ‘health promoting’ is a policy agenda that is gaining increasing momentum, particularly in England and Wales1 , Scotland2 and across other European nations. The political strides made in this regard have been recognised globally, especially in the United States, where penal health reformers are attempting to replicate successful policy initiatives in Europe3 . Despite the favourable rhetoric, the extent to which the concept of a ‘health promoting prison’ is fully understood and implemented ‘on the ground’ by prison staff and managers in England varies4 . The primary aim of this article, therefore, is to open up and stimulate discussion on the World Health Organisation’s (WHO) concept of a health promoting prison, as the extent to which this idea has been critically considered and debated is minimal. To encourage this wider discussion, the paper has three primary aims. It will first seek to introduce the origins and principles underpinning the health promoting prison; it will then set the health promoting prison within a political context. The paper will go on to explore some drawbacks to the approach, including the underlying conceptual and practical challenges

Social and environmental factors influencing in-prison drug use

Purpose – There is a strong political imperative to regard the prison as a key social setting for health promotion, but evidence indicates that drug misuse continues to be a significant issue for many prisoners. This paper aims to examine the social and environmental factors within the setting that influence individuals' drug taking. Design/methodology/approach – Focus groups and interviews were conducted with prisoners and staff in three male training prisons in England. The sampling approach endeavoured to gain “maximum variation” so that a broad based understanding of the prison setting could be gathered. The data were analysed in accordance with Attride-Stirling's thematic network approach. Findings – The findings suggest a myriad of social and environmental factors influencing drug use. While staff recognised the scale of the drugs problem, they struggled to cope with creative inmates who were not perturbed by taking risks to gain their supplies. Fellow prisoners played a major role in individuals' decision making, as did the boredom of institutional life and Mandatory Drug Testing (MDT) policies within the institutions. Practical implications – Drug treatment is an essential component of prison healthcare, but it only forms a small part of creating a health-promoting setting. If the health-promoting prison is to be fully realised, a more radical, upstream and holistic outlook is required. Originality/value – The settings approach is an important theoretical and practical approach in health promotion. In comparison to other settings (such as schools), however, there has been limited research on the prison as a health-promoting environment

Identifying health promotion needs among prison staff in three English prisons: results from a qualitative study.

Prisons are seen as a (temporary) home and community for offenders, yet they also have a dual role as a workplace for prison staff. This article explores how the "healthy settings" philosophy, commonly used in schools, applies in the prison environment. The article explores the concept of the health-promoting prison from the perspective of prison staff using semistructured interviews in three English prisons. Data were analyzed using Attride-Stirling's thematic network approach. The findings indicate that working in a prison can be highly stressful and can have a negative impact on physical and mental health. Staff perceived that the focus of health promotion efforts was in many cases exclusively focused on prisoners, and many suggested that prison staff needs were being overlooked. The article argues that the theory and practice of a health-promoting prison have developed rapidly in recent years but still lag behind developments in other organizations. The article suggests that health promotion policy and practice in prison settings may need to be reconfigured to ensure that the needs of all those who live and work there are recognized

Prison staff and the health promoting prison.

Purpose – This paper aims to discuss some of the obstacles to implementing policy and strategy related to health promoting prisons. It focuses on the role of prison officers and raises issues concerning their conditions of service, training and organisational culture in a situation where the prison system faces security issues, overcrowding and high levels of ill health among prisoners. Design/methodology/approach – This paper emerged as a result of significant overlapping themes between two separate studies conducted by the authors. The paper draws on the authors' qualitative data from these studies. Findings – The findings demonstrate the ambiguities and tensions in changing organisational cultures and among prison staff. Alongside the qualitative data, the paper draws on theory regarding policy implementation at the micro-level to show how staff can block or speed up that implementation. Practical implications – Prison officers are an essential part of health promoting prisons, but have been relatively ignored in the discussion of how to create healthier prisons. Originality/value – The contribution that prison staff make to creating health promoting prisons has been under-explored, yet pertinent theory can show how they can be more effectively involved in making changes in organisational culture

Control and choice in English prisons: developing health-promoting prisons.

The 'health-promoting prison' has been informed by a broader settings-based philosophy to health promotion which conceptualizes health as the responsibility for all social settings. Though in its relative infancy, the notion of a health-promoting prison has gained political backing from international organizations like the World Health Organization, but the implementation of the policy rhetoric has not translated across all prison environments. The aim of this paper is to consider how key elements of health promotion discourse-choice, control and implicitly, empowerment-can apply in the context of imprisonment. These concepts were examined in three category-C (secure) prisons in England, through interviews with 36 male prisoners and 19 prison staff conducted by the first author. Analysis showed that prisoners negotiated the norms, structures and strictures of prison life by both relinquishing control and also by taking control, showing resistance and exercising some element of choice. The paradox is that, as most prisoners are expected to be released at some point they need to exercise some agency, control and choice, but these learning experiences may be constrained whilst 'inside'. The paper argues that if a settings approach in prison is truly to move forward, both conceptually and practically, then health promoters should seek to embed the key values of health promotion within the prison setting

Improved photovoltaic devices, using transparent contacts

Transparent conducting coating is applied to narrow pn junction surface to provide ohmic contact for majority carrier flow. Coating can be made thick to prevent series resistance problem

The optimization of Ga (1-x)Al (x)As-GaAs solar cells for air mass zero operation and a study of Ga (1-x)Al (x)As-GaAs solar cells at high temperatures, phase 1

The three types of solar cells investigated were: (1) one consisting of a nGaAs substrate, a Zn doped pGaAs region, and a Zn doped Ga(1-x)Al(x)As layer, (2) one consisting of an nGaAs substrate, a Ge doped pGaAs region, and a pGa(1-x)Al(x)As upper layer, and (3) one consisting of an n+GaAs substrate, an nGa(1-x)Al(X)As region, a pGa(1-x)Bl(X) As region, and a pGa(1-y)Al(y)As upper layer. In all three cases, the upper alloy layer is thin and of high Al composition in order to obtain high spectral response over the widest possible range of photon energies. Spectral response, capacitance-voltage, current-voltage, diffusion length, sunlight (or the equivalent)-efficiency, and efficiency-temperature measurements were made as a function of device parameters in order to analyze and optimize the solar cell behavior

Optimization of solar cells for air mass zero operation and study of solar cells at high temperatures, phase 4

The Pd contact to GaAs was studied using backscattering, Auger analysis, and sheet resistance measurements. Several metallurgical phases were present at low temperatures, but PdGa was the dominant phase in samples annealed at 500 C. Ti/Pd/Ag contacts appeared to have the lowest contact resistance. Etchback epitaxy (EBE) was compared to saturated melt epitaxy (SME) method of growing liquid phase epitaxial layers. The SME method resulted in a lower density of Ga microdroplets in the grown layer, although the best solar cells were made by the EBE method. Photoluminescence was developed as a tool for contactless analysis of GaAs cells. Efficiencies of over 8 percent were measured at 250 C

Optimization of solar cells for air mass zero operation and a study of solar cells at high temperatures, phase 2

Crystal growth procedures, fabrication techniques, and theoretical analysis were developed in order to make GaAlAs-GaAs solar cell structures which exhibit high performance at air mass 0 illumination and high temperature conditions

An evaluation of a toothbrushing programme in schools

Purpose: This paper assesses the effectiveness of a toothbrushing intervention delivered in primary schools in Yorkshire and the Humber, a Northern district of England. The toothbrushing intervention was designed with the intention of improving the oral health of young children. The paper reports the effectiveness of the intervention and explores process issues related to its co-ordination and delivery. Design/methodology/approach: The evaluation had three data gathering approaches. These were: in-depth case studies of three selected schools participating in the toothbrushing programme; interviews with oral health programme leads; and a small scale questionnaire based survey which was sent to the 18 schools participating in the intervention. Findings: The intervention was accepted by children and they enjoyed participating in the toothbrushing scheme. Moreover, children had often become more knowledgeable about toothbrusing and the consequences of not regularly cleaning their teeth. The scheme was contingent on key staff in the school and the programme was more successful where school’s embraced, rather than rejected the notion of improving children’s health alongside educational attainment. Whether the intervention made differences to brushing in the home requires further investigation, but there is a possibility that children can act as positive ‘change agents’ with siblings and other family members. Practical implications: This paper suggests that schools can be an effective setting for implementing toothbrushing interventions. Originality/value: Toothbrushing in schools programmes are a relatively new initiative that have not been fully explored, especially using qualitative approaches or focussing on the views of children. This paper makes a particular contribution to understanding the process and delivery of toothbrushing interventions delivered in primary schools. The implications for programmes outside of the UK context are discussed