Incarceration and women's health: Including voice and choice in effective health education programming

Significance: Incarcerated women suffer from an epidemic of physical and/or sexual abuse as well as multiple health risks such as chronic and infectious diseases, substance abuse, risky sexual behaviors, and mental health problems. As the fastest growing segment of incarcerated people, these women need primary, secondary, and tertiary health promotion educational interventions that address their health. Prison represents a unique health promotion educational opportunity. Improved health knowledge and attitudes can lead to healthier lives for these women and their families, and can promote connection to health care upon release, which may in turn reduce recidivism.

Methods: We have developed a new framework for approaching health education for incarcerated women based on a learner-centered, culturally appropriate series of 6-7 one hour long interactive workshops tailored to the participants' needs and interests. To date, we have conducted the series twice on a unit housing 45-55 women.

Results: The introductory session set the tone by helping participants identify their health issues. By giving them a voice in tailoring topics in subsequent sessions, the women became invested in the programming. An effective exercise, The Family Health Tree, helped women comprehensively approach health and risks. Healthy relationships was identified as high priority topic in both series, and served as a powerful connector among the health issues discussed.

Conclusions: Interactive, learner-centered educational programs need to be widely implemented for incarcerated women to realize the potential of improving their own health, the health of their families, and reducing recidivism.