Factors Influencing the Health-Promotion Behaviors of Older Male Inmates

1992年至2001年，美国监狱中50岁以上的囚犯人数增长了172%。越来越多的老年囚犯通常患有三种或三种以上的慢性疾病，估计纳税人的住房费用是年轻囚犯的三倍。此外，许多年龄较大的囚犯最终被释放回到社区，直接影响社区的健康。尽管认识到与老年囚犯相关的日益增加的财政、医疗、人道主义和社会挑战，但在加强他们的健康自我管理方面所做的工作相对较少;具体而言，健康促进和疾病预防是健康维护和成本控制的标志。本研究将采用问卷调查和焦点小组（FG）方法，探讨老年男性囚犯的健康管理和健康促进行为。在调查阶段，将对两所州立监狱中192名50岁及以上的男性囚犯进行简单的随机抽样，并将其作为FG阶段的抽样框架，其中将进行4-6个FG，每个FG有5-7名参与者，以确定一些囚犯在监狱中如何能够改善他们的健康状况，而另一些则不能。研究目的是：1）确定老年男性囚犯的健康管理自我效能与健康促进行为、健康监测行为和自测健康状况之间的关系; 2）研究监狱中老年男性囚犯的自测健康状况和健康管理自我效能的差异; 3）确定老年男性囚犯用于管理健康的自我护理策略。将使用慢性病自我效能量表测量健康管理的自我效能。健康促进行为将通过老年人健康促进活动测量进行评估。自我评定的健康状况是老年男性健康计划和筛查清单的一个组成部分，该计划将被管理，以及一组针对健康监测行为，人口统计学和特定于被监禁者的项目的问题。目标一将使用相关性进行分析，以评估关系的强度和方向，目标二将使用一般线性模型进行分析。焦点小组数据将使用内容和主题分析进行分析。研究结果将提供规划干预方案所需的关键知识，可以为这一独特人群开发和测试新的或改进的自我效能增强策略。拟议的研究有希望：有助于建立一个更有效的囚犯保健系统;减少公共财政的财政压力;为我们社区的长期健康支付红利;提高护士对老年囚犯健康需求的认识;将越来越多的关于一般人口健康的研究文献的分析范围扩大到研究不足的囚犯人口;提高国家实现2010年健康人口目标的能力。

DESCRIPTION (provided by applicant): 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.