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

Gray, C. M. , MacLean, A., Maycock, M., Hunt, K. , Mailer, C. and Mason, K. (2022) Fit for LIFE: the development and optimization of an intervention delivered through prison gymnasia to support incarcerated men in making positive lifestyle changes. BMC Public Health, 22, 783. (doi: 10.1186/s12889-022-13004-3) (PMID:35436873) (PMCID:PMC9017016)

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Abstract

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.

Item Type:Articles
Additional Information:This study was funded by the Chief Scientist Office for Scotland (CSH-4-886). AMacL and KH received core funding from the MRC and Chief Scientist Office (MC_UU_12017/12; SPHSU12).
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Gray, Professor Cindy and Hunt, Professor Kathryn and Maycock, Dr Matthew and MacLean, Dr Alice
Authors: Gray, C. M., MacLean, A., Maycock, M., Hunt, K., Mailer, C., and Mason, K.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO SPHSU
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Social Scientists working in Health and Wellbeing
Journal Name:BMC Public Health
Publisher:BioMed Central
ISSN:1471-2458
ISSN (Online):1471-2458
Published Online:18 April 2022
Copyright Holders:Copyright © The Author(s) 2022
First Published:First published in BMC Public Health 22:783
Publisher Policy:Reproduced under a Creative Commons Licence

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
727641Understanding and Improving Health within Settings and OrganisationsKathryn HuntMedical Research Council (MRC)MC_UU_12017/12HW - MRC/CSO Social and Public Health Sciences Unit
727641Understanding and Improving Health within Settings and OrganisationsKathryn HuntChief Scientist Office (CSO)SPHSU12HW - MRC/CSO Social and Public Health Sciences Unit