The role of sport in promoting prisoner health

Sport, Physical Activity, and Young People Who Are Incarcerated: A Scoping Review

We present a scoping review of qualitative scholarly publications on sport and physical activity in secure custody facilities for young people published over a 22-year period, finding the literature remains geographically, substantively, and theoretically scant. We identify and assess predominant themes in the following four areas: (1) sport's potential contribution to young persons' rehabilitation and desistance; (2) the structure and organization of sport programs; (3) sport and coping with the experience of incarceration; and (4) other themes, including health outcomes and gender and race. Our scoping review provides a foundation for researchers and policymakers to advance knowledge about sport-based interventions in the lives of young people who are incarcerated.

Evaluating the Efficacy of Behavior Modification Strategies on Physical Activity Levels Among Incarcerated Youth

This study examined the impact of prompting only and prompting combined with independent group-oriented contingency on incarcerated adolescent males' physical activity level during a sport-leadership program. An alternating treatment design was employed to allow for the evaluation among multiple treatment conditions. The study occurred during 35 consecutive sport programming lessons at a juvenile correctional facility. Participants were 16 adolescent males (Mage = 18.79). Two behavior modification strategies, prompting only and prompting combined with independent group-oriented contingency, were employed. Data were plotted graphically so visual analysis could be determined in order to explore any functional associations between the treatment conditions (e.g., interventions) and target behavior (e.g., step count). Prompting only slightly increased physical activity, whereas prompting in conjunction with independent group-oriented contingency elevated activity levels by 36%, with a smaller standard deviation indicating that all participants were equivalently physically active. The results of this study underpin the expansive benefits of sport-leadership programming, not just in similar programs' ability to develop life skill integration, positively impact life during incarceration, improve attitudes, and promote physical activity, but also to provide elevated opportunities for youth to be physically active.

Sport in prison: social and subjective health outcomes of different sport programs

PURPOSE

The purpose of this study is to examine the effects of four different sport programs on various social and subjective health outcomes among prisoners.

DESIGN/METHODOLOGY/APPROACH

Four different sport programs (endurance, strength, dance-like martial arts, soccer) were provided in 2020 and 2021 in a German prison. Participants completed paper-pencil surveys before and after the sport programs (n = 134 observations), including questions about potential social health (enjoyment of physical activity, interpersonal exchange, interpersonal trust, self-efficacy) and subjective health outcomes (health status, health satisfaction, well-being). Further information such as prisoner characteristics were added to the data.

FINDINGS

Results of regression analyses show that the endurance program had a significant positive effect on interpersonal trust, while the soccer program had a negative effect. Subjective well-being increased significantly after the strength and the soccer program. The weekly sport hours before imprisonment had a positive association with enjoyment of physical activity and interpersonal exchange while being negatively related to health status and health satisfaction. Furthermore, the number of months of imprisonment before the survey, being a young offender, the prisoners' body mass index, educational level and migration background were significantly associated with several social and subjective health outcomes.

ORIGINALITY/VALUE

This study analyzed the effects of different sport programs for prisoners on various social and subjective health outcomes, revealing differences across programs and outcomes. The findings suggest that sport can be a way to enhance prisoners' social and subjective health, ultimately facilitating their rehabilitation process.

Exploring physical activity trends and lesson context of incarcerated youth in a sport-leadership program

Incarcerated youth are one subset of the population in dire need of physical activity interventions. As inactivity within incarcerated populations has become a mounting public health concern, several sport-based physical activity and fitness programs within prisons have emerged. The purpose of this study is to explore physical activity levels and lesson context of a sport-leadership program in one juvenile detention center. Participants in this study were 27 incarcerated males (Mage = 19.3), imprisoned in one juvenile detention center. Participants participated in 20, 40-min sport-leadership lessons over the course of 3 months. Each lesson was live coded using the System for Observing Instructional Time (SOFIT) to examine physical activity levels and lesson context. Over the course of 20 lessons, participants engaged in moderate to vigorous physical activity (MVPA) for 61% of lesson time (24.5 min). Further, over 23% of lesson time was spent vigorously (9.5 min). Specific to lesson context, 18% of total lesson time (7.5 min) was spent in management whereas 7.96% (3.1 min) was consumed by knowledge acquisition. Furthermore, a vast majority of each session (70%) was spent in gameplay (28.04 min). This study is the first to adopt the SOFIT systematic observation instrument to evaluate and quantify MVPA and lesson context during a sport-leadership program within a juvenile detention center. Results from this study indicate incarcerated youth who participated in this program engaged in MVPA for more than 60% of lesson time. It was reported that overall MVPA of participants within programming slightly decreased across the 20 total lessons.

Research Brief: Physical Activity Trends Among Incarcerated Youth During a Sport Leadership Program

Research indicates that engagement in physical activity is advantageous to adolescents' overall health. One subset of the population that is not provided with ample opportunities to be physically active includes incarcerated youth. To date, sport leadership programs have been designed to target this population; yet, little is known about physical activity opportunities for participants. The purpose of this study was to explore physical activity during a sport leadership program within a juvenile detention center. The participants were 27 incarcerated male youth (Mage = 18.7 years), all of whom participated in a sport leadership program. Physical activity was assessed during 32 sessions using Yamax DigiWalker SW 701 pedometers. Youth who participated in the sport leadership program accumulated an average of 3232 steps per session, with average standard deviation of 1245.5. As youth attended more sessions, overall physical activity levels during programming increased with a drastic reduction in variance among participants. This study is the first to closely examine and provide insights into youths' physical activity trends across programming and demonstrates a noticeable uptrend in activity and deceleration of variability among participants. Findings suggest that participation in a structured sport leadership program within juvenile detention centers can provide participants a critical opportunity to engage in physical activity.

Physical health programs and interventions with women during incarceration: a scoping review

PURPOSE

The USA outpaces most other countries in the world in the rates at which it incarcerates its citizens. The one million women held in US jails and prisons on any day in the USA face many physical health challenges, yet interventional work to address physical health in carceral settings is rare. This study's purpose was to summarize the literature on programs and interventions implemented with women in US carceral settings (jail or prison) that primarily addressed a physical health issue or need.

DESIGN/METHODOLOGY/APPROACH

A scoping review was conducted. The authors searched databases, reference lists, individual journals and websites for physical health program descriptions/evaluations and research studies, 2000-2020, that included women and were set in the USA.

FINDINGS

The authors identified 19 articles and a range of problem areas, designs, settings and samples, interventions/programs, outcomes and uses of theory. The authors identified two cross-cutting themes: the carceral setting as opportunity and challenges of ethics and logistics.

RESEARCH LIMITATIONS/IMPLICATIONS

Much potential remains for researchers to have an impact on health disparities by addressing physical health needs of women during incarceration.

ORIGINALITY/VALUE

Interventional and programmatic work to address physical health needs of women during incarceration is sparse and diversely focused. This review uniquely summarizes the existing work in a small and overlooked but important area of research and usefully highlights gaps in that literature.

COVID-19 Pandemic and Physical Exercise: Lessons Learnt for Confined Communities

The novel pandemic called "Coronavirus Disease 2019" (COVID-19), as a global public health emergency and global threat, has affected many countries in unpredictable ways and impacted on physical activity (PA) behaviors to various extents. Specific populations including refugees, asylum seekers, and prisoners, are vulnerable groups with multiple complex health needs and worse health outcomes with respect to the general population worldwide and at high risk of death from the "Severe Acute Respiratory Syndrome-related Coronavirus type 2" (SARS-CoV-2). Governments around the world have been implementing preventive healthcare policies, including physical and social distancing, isolation, and confinement, to mitigate against the burden imposed by the COVID-19 outbreak. This pandemic period is characterized by reduced or lack of movement. During this period of lockdown, PA can represent an immunotherapy and a preventative approach to avoid the harmful effects of inactivity due to the pandemic. Moreover, PA could be prescribed to improve the immune system of specific populations (refugees, asylum seekers, and prisoners), which particularly experience the condition of being confined. The present narrative review discusses the potential impacts of COVID-19 pandemic on these specific populations' health status and the importance of performing PA/exercise to reduce the deleterious effects of COVID-19 pandemic. In addition, we aim to provide useful recommendations on PA/exercise for these specific populations to maintain their level of independence, physical, and mental health as well as their wellbeing.

The Level of Aggressiveness During Karate Practice of Inmates in Correctional Settings

Karate is known to enhance cognitive functioning, emotional well-being, and self-regulation and to contribute to an overall behavior rehabilitation process. However, few data are available on the impact of practicing karate in adult prison inmates. The main objective of this research was to evaluate aggressive behavior, comparing prison inmates and club practitioners during karate practice. The level of aggressiveness was rated by observers during defined elements and training situations in karate classes held in France. Data were collected during 77 observations of 75 prison inmates (55 male and 20 female) in a prison setting, and 188 observations of 117 club practitioners (80 male and 37 female) in a club setting over a period of 26 months. Licit aggressiveness was graded by observers during launched actions, kiais, and bows, and the practice level (belts) was also considered. Interrater reliability of the observational measure was highly acceptable (Cohen κ = 1). Comparisons between female and male prison inmates and club practitioners were made using the non-parametric Mann–Whitney U-test for independent samples. The results revealed that a higher level of aggressiveness was observed in both male and female club practitioners during launched actions and kiais than in prison inmate practitioners (p < 0.001, small effect size). However, prison inmates (of both genders) showed a higher level of aggressiveness during bows (p < 0.001, medium effect size). While the analyses showed no significant differences between genders, the level of karate practice was associated with distinct changes. Significant differences in observed aggressiveness were present only in beginners and in those with a low level of karate practice, whereas no differences in aggressiveness between prison or club practitioners were observed during karate practice in those with a high level of karate practice (black belt). However, these results must be interpreted with caution as there was no way to control the multiple factors that might also affect inmate behaviors in a correctional setting. We suggest that karate practice in prison may positively contribute to interactional behaviors.

PRuNUS: design and validation of a questionnaire among prisoners - data of pilot study in the Penitentiary Institute of Perugia, Italy

PURPOSE

The PRison NUtrition Surveillance (PRuNUS) questionnaire aimed to assess the eating behaviour, diet knowledge and lifestyle of Italian prisoners. The purpose of this paper is to present both data from the validation process and from the cross-sectional study.

DESIGN/METHODOLOGY/APPROACH

In order to perform the validation process, the authors evaluated the reproducibility and the consistency of the questionnaire, using Cohen's k and Cronbach's α, the agreement between the two administrations was evaluated by the Landis and Koch score. The authors performed the study in the "Capanne" Prison, Perugia. A multivariable logistic regression model adjusted for age and gender was used.

FINDINGS

Out of 300 men, 11 participated in the validation process and 68 in the survey. Among 47 women, 11 participated in the validation and 17 in the survey, with a 26.2 per cent (85/325) cumulative response rate. The questionnaire obtained a good concordance with a k-value=0.61 and 74.48 per cent of agreement and a high level of inter-correlations among items with α=0.8452. Half of the prisoners were overweight/obese and 68.6 per cent were smokers. Moreover, smoking habits were statistically associated with a low educational level, duration of conviction, body mass index and coffee consumption.

ORIGINALITY/VALUE

The results highlighted the need for an educational programme in prison. Detention period could be a good opportunity to promote healthy habits.

Developing mental health awareness and help seeking in prison: a feasibility study of the State of Mind Sport programme

Purpose

The high prevalence of mental illness within the prison population necessitates innovative mental health awareness provision. This purpose of this feasibility study with 75 males (47 intervention; 28 control) was to evaluate State of Mind Sport (SOMS), originally developed as a community based mental health and well-being initiative, in a notoriously challenging prison setting.

Design/methodology/approach

A mixed 2 (group) × 2 (time) factorial design was adopted. Questionnaires tested for effects on knowledge of mental health, intentions to seek help, well-being and resilience. For each outcome measure, main and interaction effects (F) were determined by separate mixed factors analysis of variance. Two focus groups (N = 15) further explored feasibility and were subjected to general inductive analysis.

Findings

A significant group and time interaction effect were shown for mental health knowledge, F(1, 72) = 4.92, p = 0.03, ηp2 = 0.06, showing a greater post-programme improvement in mental health knowledge score for the intervention group. Focus group analysis revealed an increase in hope, coping efficacy and intentions to engage more openly with other prisoners regarding personal well-being as a result of the SOMS programme. However, fear of stigmatisation by other inmates and a general lack of trust in others remained as barriers to help-seeking.

Originality/value

The implications of this study, the first to evaluate a sport-based mental health intervention in prison, are that a short intervention with low costs can increase prisoner knowledge of mental health, intentions to engage in available well-being opportunities and increase a sense of hope, at least in the short term.

Analysis of a Sports-Educational Program in Prisons

The aim of this study was to analyze the implementation of a sports-educational program in prisons where the Real Madrid Foundation’s Social-Sports Program is carried out. For that purpose, a survey of 468 inmates was conducted at 21 prisons in Spain where the Real Madrid Foundation implements its program (441 men (94.23%) and 27 women (5.77%)). Inmates stated that the program had had a favorable influence on their life in prison and considered that their participation in the program might have a significant influence on the likelihood of them continuing to play sports when they are released. In addition, inmates felt that they had learned a great deal about the contents relating to football and the values they had worked on, and that the program had had a very positive effect on their overall development as a person.

Rugby as a rehabilitation program in a United Kingdom Male Young Offenders' Institution: key findings and implications from mixed methods research

There is a growing body of research on the effectiveness of rehabilitation programs in a Young Offenders' Institution (YOI). The aim of the present study is to investigate the effectiveness of rugby training as a rehabilitation intervention in a YOI in the United Kingdom. Young adult males (n=46) currently serving sentences at the YOI were split into two groups, intervention (n=25; mean age, 19.64±0.81 years) and no intervention (n=21; mean age, 19.76±0.89). Participants completed the Criminal Attitudes and Associates (MCAA) instrument at three different time cycles and then pre/post for intervention group. Additionally, qualitative interviews (one to one and focus groups) were carried out with the intervention and no intervention groups during the same cycles of the study. The results of questionnaire analysis showed no significant difference in MCAA measures taken before and after rugby intervention. Interestingly, the intervention group showed more procriminal attitudes on their responses compared to the no intervention group. Finally, analysis of the 3 cycles of data collected showed that the time of the year the questionnaire was completed has a significant impact on the responses given. In contrast, the qualitative interviews showed a very positive change of attitude towards rehabilitation from the intervention group after rugby training. The implications of the results in relation to studies aimed at evaluation of the intervention programs in YOI are discussed.

The efficacy of exercise referral as an intervention for Irish male prisoners presenting with mental health symptoms

Purpose The use of exercise as an intervention to improve health in the general population is well documented. The purpose of this paper is to explore whether an exercise referral scheme can be an effective health promotion tool for male prisoners in Ireland, presenting with mental health symptoms. Design/methodology/approach This mixed methods study with a pre- and post-intervention design was conducted in Mountjoy Prison, Dublin, which has a capacity for approximately 790 prisoners. Reliable and validated symptom assessment scales were used to assess levels of depression, anxiety, stress, self-esteem and anger amongst a sample of 40 prisoners pre- and post-intervention. The scales used were the Depression, Anxiety and Stress scale or DASS-42 (Lovibond and Lovibond, 1995), the Novaco Anger Scale (Novaco, 1994), the Rosenberg Self-Esteem Scale ( Rosenberg, 1965 ) and the Zung Self-Rated Anxiety Scale (Zung, 1971). Semi-structured interviews were also conducted with a subset of the participants post-intervention to further test and contextualise the symptom ratings. The data gathered from the self-rating scales were imported into SPSS 22 for statistical testing for significance. Wilcoxon's signed-rank test was then used to measure significance of changes. Thematic analysis was performed on the qualitative data. Findings In the post-intervention, significant levels of improvement were achieved in the levels of depression, anxiety (DASS), anxiety (Zung), stress, anger, and self-esteem for 29 of the 30 prisoners who completed the study. The incidence of normal mood scores rose from 33 to 90 per cent after the intervention; the incidence of extremely severe scores for anxiety changed from 40 to 7 per cent, severe stress scores changed from 27 to 3 per cent, normal stress levels rose from 17 to 73 per cent, marked anger ratings reduced from 40 to 3 per cent and low self-esteem levels reduced from 20 per cent of participants pre-intervention to 7 per cent post-intervention. In the main, participants perceived the experiences and outcomes of the intervention positively. Research limitations/implications There are some limitations to the design of this study. Operational circumstances within the prison at the start of this study prevented the authors from accessing a larger sample. A control group would add greatly to the study but this was not possible within a single prison setting. The possible influence of extraneous variables such as increased attention and social contact, and more time out of one's cell may have contributed to improved symptom scores as much as the exercise intervention in this study. This possibility was recognised from the outset but the authors proceeded because the aim was to test if an exercise referral package (and all that inevitably goes with that) would make a difference for symptomatic prisoners. Practical implications The organisation and smooth running of the intervention and the positive results therein underpinned the practicality of this project. The significantly positive results contribute new knowledge to the profile of Irish male prisoners' mental health. Social implications This study could be the foundation for a larger study or set of studies which should include a control group and one or more female prisoner cohorts. The impact of positive changes in prisoners' mental health on the prison staff and environment could also be researched. This type of study could lead to important social implications in relation to its impact on prisoner rehabilitation. Originality/value This study was the first of its kind to explore the effectiveness of exercise referral as a health promotion intervention for Irish male prisoners presenting with mental health symptoms.

Inmates with Harmful Substance Use Increase Both Exercise and Nicotine Use Under Incarceration

Exercise is increasingly understood as an important resource for people who engage in harmful substance use, including those in prison. Little is known about how inmates adopt various health behaviors during incarceration, without interventions. This cross-sectional study analyzed self-reports from 1464 inmates in Norwegian prisons in 2013–2014, compared them according to harmful substance use pre-incarceration, and explored changes in exercise and nicotine use during incarceration. Results were presented in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Inmates with harmful substance use reported higher rates of smoking, smokeless tobacco, and physical inactivity pre-incarceration than inmates without harmful use. However, inmates with harmful use also exhibited more behavioral changes: they adopted exercise, ceased smoking, and adopted smokeless tobacco at higher rates during incarceration than the non-harmful group, to the extent that inmates with harmful use exercised during incarceration more. Exercise is being taken up by a significant proportion of inmates, and may in particular be a replacement behavior for substance use. However, unhealthy behaviors also begin or are maintained. If prisons were used as an arena to facilitate healthy behaviors, the public health benefits to a marginalized group such as substance-using inmates could be substantial.

Health related quality of life and physical activity in prison: a multicenter observational study in Italy

Background

Inmates have a poorer health status than the general population. The physical activity is well know that improve the wellness of the people. This multicentric cross-sectional study aimed to assess the relationship between Quality of Life (QoL) and physical activity levels among Italian prisoners.

Methods

Inmates from eight prisons compiled a questionnaire. The Metabolic Equivalent of Task (MET) was used to measure inmates' weekly physical activity levels (MATwk). Their QoL was measured using two components of Short Form with 12 items (SF12): MCS (mental score) and PCS (physical score).

Results

A total of 636 questionnaires were compiled. High level of MET was significantly (P <0.05) associated with both PCS (OR = 1.02) and MCS (OR = 1.03). The correlations between PCS, MCS vs. METwk scores were respectively significant: r = 0.17 and r = 0.10, P < 0.05. The number of years of detention was associated to higher MET (OR = 1.04 P < 0.05). The presence of Physical Exercise Areas (PEAs) within Jails did not improve the QoL level.

Conclusions

Jails may not seem like the ideal place to fight sedentary behavior, but, in any case, health promotion can occur within its walls. The heterogeneity of Italian jails, and particularly relative PEAs therein (areas had different characteristics between jails), suggests that such spaces should be regulated or well defined. Furthermore, the implement of training schedules could be done in a standardized way. Despite this heterogeneity both the physical and mental components of inmates' quality of life were associated to a high level of physical activity.

Benefits of selected physical exercise programs in detention: a randomized controlled study

The aim of the study was to determine which kind of physical activity could be useful to inmate populations to improve their health status and fitness levels. A repeated measure design was used to evaluate the effects of two different training protocols on subjects in a state of detention, tested pre- and post-experimental protocol.Seventy-five male subjects were enrolled in the studyand randomly allocated to three groups: the cardiovascular plus resistance training protocol group (CRT) (n = 25; mean age 30.9 ± 8.9 years),the high-intensity strength training protocol group (HIST) (n = 25; mean age 33.9 ± 6.8 years), and a control group (C) (n = 25; mean age 32.9 ± 8.9 years) receiving no treatment. All subjects underwent a clinical assessmentandfitness tests. MANOVA revealed significant multivariate effects on group (p < 0.01) and group-training interaction (p < 0.05). CRT protocol resulted the most effective protocol to reach the best outcome in fitness tests. Both CRT and HIST protocols produced significant gains in the functional capacity (cardio-respiratory capacity and cardiovascular disease risk decrease) of incarcerated males. The significant gains obtained in functional capacity reflect the great potential of supervised exercise interventions for improving the health status of incarcerated people.