Recruiting, Retaining and Engaging Men in Social Interventions: Lessons for Implementation Focusing on a Prison-based Parenting Intervention for Young Incarcerated Fathers

Reimbursing incarcerated individuals for participation in research: A scoping review

BACKGROUND

Little is known about global practices regarding the provision of reimbursement for the participation of people who are incarcerated in research. To determine current practices related to the reimbursement of incarcerated populations for research, we aimed to describe international variations in practice across countries and carceral environments to help inform the development of more consistent and equitable practices.

METHODS

We conducted a scoping review by searching PubMed, Cochrane library, Medline, and Embase, and conducted a grey literature search for English- and French-language articles published until September 30, 2022. All studies evaluating any carceral-based research were included if recruitment of incarcerated participants occurred inside any non-juvenile carceral setting; we excluded studies if recruitment occurred exclusively following release. Where studies failed to indicate the presence or absence of reimbursement, we assumed none was provided.

RESULTS

A total of 4,328 unique articles were identified, 2,765 were eligible for full text review, and 426 were included. Of these, 295 (69%) did not offer reimbursement to incarcerated individuals. A minority (n = 13; 4%) included reasons explaining the absence of reimbursement, primarily government-level policies (n = 7). Among the 131 (31%) studies that provided reimbursement, the most common form was monetary compensation (n = 122; 93%); five studies (4%) offered possible reduced sentencing. Reimbursement ranged between $3-610 USD in total and 14 studies (11%) explained the reason behind the reimbursements, primarily researchers' discretion (n = 9).

CONCLUSIONS

The majority of research conducted to date in carceral settings globally has not reimbursed incarcerated participants. Increased transparency regarding reimbursement (or lack thereof) is needed as part of all carceral research and advocacy efforts are required to change policies prohibiting reimbursement of incarcerated individuals. Future work is needed to co-create international standards for the equitable reimbursement of incarcerated populations in research, incorporating the voices of people with lived and living experience of incarceration.

The Case for Targeted Parenting Interventions with Reference to Intergenerational Transmission of Parenting: Qualitative Evidence from Three Studies of Marginalised Mothers’ and Fathers’ Participation in Parenting Programmes

The idea that how you were parented is key to how you parent your own children is widely recognisable. It is present in popular cultural references, underpins much policy on families and parenting in the UK, and is supported by a substantive body of academic literature. We explore this concept of intergenerational transmission of parenting, understanding it as the context in which parenting interventions have been implemented. We draw on interview data from three Scottish samples of marginalised parents (n = 54) to explore how participants think their own parenting behaviours have been shaped by their experience of being parented and how they talk about participation in a parenting intervention in relation to this. We find that how these parents have been parented is salient in considering their own parenting behaviour, and is a key context for their engagement with the intervention. We make the case for parenting interventions targeted at marginalised parents, arguing that they are acceptable to, and useful for, these parents and may, potentially, be effective in breaking cycles of negative parenting. Policy-makers should not shy away from implementing targeted parenting programmes as part of endeavours to address negative parenting.

Fit for LIFE: the development and optimization of an intervention delivered through prison gymnasia to support incarcerated men in making positive lifestyle changes

BACKGROUND

Despite prison settings presenting opportunities for healthy eating and regular exercise, many incarcerated men supplement prison food with unhealthy snacks and drinks, and are less likely to achieve recommended physical activity guidelines than non-incarcerated men. This paper describes the co-development with prison staff of a healthy lifestyle intervention for delivery to incarcerated men, and feasibility testing of its delivery through prison physical education departments.

METHODS

The starting point for intervention development was Football Fans in Training (FFIT), an evidence-based intervention successful in engaging men and supporting them to lose weight, make positive lifestyle changes and maintain these long term. We iteratively tested and adapted FFIT for delivery in prison gym facilities through a four Phase pilot and optimisation study. Methods used to evaluate each phase included: observations of session deliveries; semi-structured interviews with participants; and a focus group/semi-structured interviews with prison Physical Education Instructors (PEIs) who delivered the programme. Data were analysed thematically using the Framework approach. Findings from each phase informed development of the optimised programme.

RESULTS

We iteratively co-developed a healthy lifestyle intervention (known as Fit for LIFE) tailored to the needs of incarcerated men and prison operational constraints. Fit for LIFE comprises elements specifically designed to address common barriers to a healthy lifestyle within prison, including: discussion of healthiest available food choices; trying out different physical activity options in the prison gym; and strategies (such as in-cell workouts) for dealing with prolonged time in cells at evenings/weekends. Weight loss was not always the most valued outcome. Instead, participants cited a wide range of behavioural, physical and mental health improvements as important to them, and were more motivated if they could focus on identifying and achieving personally relevant objectives.

CONCLUSIONS

Fit for LIFE is a 10-week, group-based healthy lifestyle programme tailored for delivery to incarcerated men in prison gymnasia. Weekly 90-min sessions include informative and interactive 'classroom' activities followed by a practical physical activity training session, often with group activities. Fit for LIFE aims to help incarcerated men to: increase physical activity; reduce sedentary time; eat more healthily; and start and maintain using prison gym facilities with confidence.

Lessons Learned on Recruiting and Retaining Young Fathers in a Parenting and Repeat Pregnancy Prevention Program

Introduction

Research shows that mainstream parenting and repeat pregnancy prevention programs generally do not effectively engage with fathers and that young men’s levels of participation in such services are low. To support practitioners in overcoming the barriers to recruiting and retaining young fathers, the current study aimed to gather lessons learned from one program’s state administrators, case managers, and young fathers about the most effective strategies for engaging this population in intensive case management.

Methods

Three focus groups were conducted. One focus group was held with the creators and managers of the Michigan Adolescent Pregnancy and Parenting Program MI-APPP at the state Department of Health and Human Services (n = 3). The other two groups were designed to jointly engage young fathers currently involved in intensive case management (n = 11) and their case managers (n = 5). A qualitative analysis of the focus group transcripts was conducted using a coding scheme developed from emerging themes in the transcripts and related literature.

Results

The findings highlight a selection of those strategies that focus group participants perceived to be most successful in improving male recruitment and retention in intensive ongoing case management. Among these strategies were centralizing feedback from young fathers in program decision making, offering opportunities for young fathers to connect, and challenging staff’s negative stereotypes about young fathers.

Discussion

Despite the small sample size, the results of this study nevertheless contribute to debates in the field regarding appropriate strategies for engaging young fathers by informing professional practice.

Prevalence of Oral Human Papillomavirus Infection Among Australian Indigenous Adults

IMPORTANCE

Human papillomavirus (HPV) infection is associated with oropharyngeal squamous cell carcinoma. International estimates suggest overall oral HPV prevalence is 7.5%, with prevalence of oral HPV types 16 and 18 being 1.6%; prior Australian estimates suggest oral HPV prevalence is 2.3%, with HPV-16 and HPV-18 being 1.3%.

OBJECTIVES

To estimate the prevalence of oral HPV infection among Indigenous Australians and to report the prevalence of factors associated with high-risk HPV types (ie, HPV-16 and HPV-18) and HPV types linked with Heck disease (ie, HPV-13 and HPV-32).

DESIGN, SETTING, AND PARTICIPANTS

This cross-sectional study analyzed HPV screening results from saliva samples collected from 1011 Indigenous Australians between February 2018 and January 2019. Data were analyzed from May 2018 to May 2019. Recruitment occurred through Aboriginal Community Controlled Health Organisations in South Australia. Eligibility included identifying as Indigenous, residing in South Australia, and being aged 18 years or older.

MAIN OUTCOMES AND MEASURES

Saliva samples were collected, with microbial DNA for genotyping extracted. Sociodemographic parameters, health-related behaviors, and sexual history data were collected. Analyses were stratified by sex as well as by HPV types 13 and 32 (Heck disease) and 16 and 18 (high risk of oropharyngeal squamous cell carcinoma). Multivariable analyses were conducted to obtain adjusted odds ratios (ORs).

RESULTS

Data were obtained for 910 participants (median [interquartile range] age, 37 [27-51] years); 595 participants (65%) were female and 572 (63%) resided in nonmetropolitan locations. In all, 321 saliva samples (35.3%; 95% CI, 32.2%-38.4%) were positive for oral HPV (106 [33.7%] men; 215 [36.1%] women). The highest prevalence was found for HPV types 13 and 32 (207 [22.7%] total; 60 [19.0%] men; 147 [24.7%] women) followed by HPV types 16 and 18 (30 [3.3%] total; 9 [2.9%] men; 21 [3.5%] women). After multivariable analysis, risk factors associated with HPV types 13 and 32 included nonmetropolitan residential status (OR, 2.06; 95% CI, 1.10-3.88) and not having had a tonsillectomy (OR, 2.74; 95% CI, 1.05-7.16). Among women, having obtained a high school education or less was associated with lower odds of HPV-16 and HPV-18 infection (OR, 0.16; 95% CI, 0.03-0.97).

CONCLUSIONS AND RELEVANCE

Prevalence of oral HPV infection in a large sample of Indigenous Australians was high, with one-third testing positive. The most prevalent HPV types were those associated with Heck disease. The prevalence of HPV types associated with oropharyngeal squamous cell carcinoma exceeded both Australian and international population-level estimates.

Did We Forget Something? Fathering Supports and Programs in Prisons in Victoria, Australia

This article draws from data gathered for an Australian Research Council-funded study conducted in Victoria and New South Wales between 2011 and 2015, which examined how dependent children are responded to when their primary carer is imprisoned. In particular, this article specifically addresses a gap in knowledge by examining the current state of fathering programs in prison in Victoria. To do so, the views of 39 primary carer fathers incarcerated in Victoria are analysed. We argue that there is a distinct lack of support for fathers in prison, acting as a barrier towards maintaining father-child relationships. Findings indicate that 79% of the fathers in this study were never offered any parenting support services or programs. By clearly highlighting the state of fathering programs in prisons in Victoria, this article offers suggestions as to how best to facilitate the connection between incarcerated fathers and their children.

Developing a Sexual Health Promotion Intervention With Young Men in Prisons: A Rights-Based Participatory Approach

Background

The sexual health of young men in prisons is often among the poorest in any given country. They may have developed sexual behaviors that, from a public health perspective, are considered problematic and burdensome. These include poorer use of condoms and engaging in more frequent casual sex, resulting in higher rates of sexually transmitted infections, including HIV and viral hepatitis. Thus, young incarcerated men are a highly marginalized and socially excluded high-risk group, in greater need of sexual health education and services.

Objective

The aim of this study was to create an innovative sexual health promotion intervention, made for and with young men in prisons, to encourage them to avail of regular sexual health checkups. This included developing a Web-based animated-style sexual health promotion intervention (1.42 min) coupled with upskilling the prison nurses to offer a partnership approach to prison health care. This paper focuses on the development of the intervention and the importance of the underpinning rights-based (RB) participatory intervention design.

Methods

We employed an RB participatory approach and recruited 14 participants who attended 3 coproduction workshops held within a prison site in Northern Ireland, United Kingdom. A bespoke 3-day training for nurses beforehand, ensured they gained a deeper understanding of the determinants of poor sexual health. The coproduction team comprised young men, prison nurses, nurse sexual health consultant, media company representatives, and facilitator. Workshops focused on content, design, tone and medium of communication for a Web-based intervention that would be appealing and engaging for young incarcerated men.

Results

A 1.42-min animation Dick loves Doot was created to promote a positive attitude toward sexual health checkups. The RB approach enabled the young men to participate, have their voices heard and see their stories reflected through the animation. The nurses’ capacities to protect, fulfill, and respect the young men’s rights to appropriate sexual health services and education was also enhanced. Evaluations confirmed that we successfully provided accurate sexual health information in a way that was engaging and accessible and that encouraged the young men to avail of the new prison sexual health services that were set up in the prison and now provided by nurses.

Conclusions

The RB participatory approach to health advanced in this study provided a means to (1) gain invaluable insider knowledge to understand the impact of structural determinants on health and health inequalities and strategies by which to target young incarcerated men (2) create inclusive opportunities for developing bespoke targeted interventions, and (3) galvanize collaborative partnerships to disrupt the structures and processes that lead to and encourage health inequities. To reduce future risk, effective treatment, coupled with coproduced interventions that transmit relevant health messages in a relevant and meaningful way, is key to success.

The reflective component of the Mellow Bumps parenting intervention: Implementation, engagement and mechanisms of change

Understanding why parenting programmes work or do not work, and for whom, is crucial for development of more effective parenting interventions. In this paper we focus on a specific component of Mellow Bumps: reflection on one's own childhood/past/life. We explore how this component was implemented, how participants engaged with it, the facilitating and constraining factors shaping this, whether and how it appeared to work, or not, and for whom. The paper analyses data from the Process Evaluation of the Trial of Healthy Relationships Initiatives for the Very Early years, which is evaluating two antenatal interventions delivered to vulnerable women, one of which is Mellow Bumps. Data were collected from January 2014 to June 2018 for 28 groups, 108 participants and 24 facilitators in a comprehensive and rigorous Process Evaluation designed to complement the Outcome Evaluation. Data were gathered at various time points using multiple methods, and were synthesised to triangulate findings. The reflective component was implemented with fidelity and participants engaged with it to varying degrees, dependent largely on the coherence of the group. Patchy attendance compromised the coherence of some groups, with the development of rapport, which is key to delivering reflective exercises, more difficult when group composition varied from week to week. Where there was a coherent group, powerful mechanisms of change, leading to stress reduction, included: relief through unburdening, empowerment through support given and received, reduced isolation through sharing anxieties, and control through self-care advice. A minority of highly vulnerable mothers seemed not to benefit from the reflective exercises and were marginalised within their groups. In order to minimise potential harmful effects of such exercises, allocation of participants to groups should strive to maximise group homogeneity. More research is needed to explore how very vulnerable parents can be supported in attending parenting interventions from start to finish.