Factors Influencing the Health-Promotion Behaviors of Older Male Inmates

描述(由申请人提供)：1992至2001年间，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来自三种或三种以上的慢性疾病，据估计，纳税人支付的住宿费用是年轻囚犯的三倍。此外，许多年长的囚犯最终被释放回社区，直接影响社区的健康。尽管认识到与老龄囚犯相关的财政、医疗、人道主义和社会挑战日益增加，但在加强他们的健康自我管理方面所做的工作相对较少；具体地说，就是促进健康和预防疾病，这是维持健康和控制成本的标志。拟议的两阶段前瞻性研究将使用调查和焦点小组(FG)方法来探索老年男性囚犯的健康管理和健康促进行为。将在调查阶段对两所州立监狱关押的192名50岁及以上男性囚犯进行简单随机抽样，作为FG阶段的抽样框架，将对5-7名参与者进行4-6个FG，以确定一些囚犯如何能够在狱中改善他们的健康，而另一些人则不能。研究的目的是：1)确定健康管理自我效能感与老年男性囚犯的健康促进行为、健康监测行为和自我健康状况之间的关系；2)根据监狱中老年男性囚犯的特点，考察他们自我评估的健康状况和健康管理自我效能的变化；3)确定老年男性囚犯在管理自己的健康时所使用的自我护理策略。健康管理的自我效能将使用慢性病自我效能量表进行测量。健康促进行为将通过《老年人健康促进活动测量》进行评估。自我评估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，将进行管理，以及一系列涉及健康监测行为、人口统计数据和特定于被监禁人员的项目的问题。目标一将使用相关性来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。重点小组数据将使用内容分析和专题分析进行分析。研究结果将提供计划干预方案所需的关键知识，在这些方案中，可以为这一独特的人群开发和测试增强自我效能的新策略或改进策略。拟议的研究有望：促进更有效的囚犯健康系统；减轻公共财政的财政压力；为我们社区的长期健康带来红利；提高护士对老年囚犯健康需求的了解；将日益增长的关于普通人群健康的研究文献的分析范围扩大到未得到充分研究的囚犯群体；以及增强国家实现2010年健康人目标的能力。

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.