Health Trainer Champions in a Health Trainer Champions in a Category A Prison in England:Category A Prison in England:

Lessons Learned for Health Improvement of OffendersDi Bailey

Nottingham Trent University

Health Trainer Champion Project Health Trainer Champion Project

6 HTCs recruited in first cohortRole is to offer basic healthy lifestyle

advice on a range of health issuesWork with other men in the jail on a 1:1

basisCompleted a 12 week training course

accredited by the Royal Society of Public Health

NTU Evaluation NTU Evaluation

Evaluation strategy tried and testedDraws from two modelsIncludes an evaluation of:

◦Context ◦Inputs◦HTCs’ reactions to the training they received◦Modification of attitudes and perceptions◦Outcomes

Outcome Evaluation Outcome Evaluation

Knowledge and skills

Change in behaviour and the organisation

Benefits for prisoners

1. What is the context in which the Health Trainer Champions (HTCs) initiative is being implemented?

2. How have the HTCs experienced the training?

3. What have the HTCs learned from the training?

4. Have the HTCs changed their views about their own lifestyles?

5. What knowledge and skills have the HTCs gained as a result of the training?

6. What do the men in Frankland think about the HTC role? Have they benefitted and if so how?

7. Has there been any change in in the behaviour of the HTCs and men in Frankland?

Data Collection Data Collection

Documentary analysisParticipant observation

of training sessionsInterviews

Focus groupsSatisfaction

questionnairesSTAR tool attitude

measure

Themes from the Documentary Analysis of Steering Group Minutes

HTCProject

Networks and Communication (22)

Recruitment (18)

Training Needs/Support (15)

External Networking (14)Communication within

the Prison (7)

Security (8) Retention (5) Recruitment and Selection (5)

Tapping into Existing Resources (10)

Ongoing Training Needs Analysis (TNA) (5)

Figure 2: Before and After Training Scores on the STAR Tool

Attitudes to Healthy Lifestyle

0

2

4

6

8

10

12

Alcohol Use ofTime

PhysicalHealth

Emotionaland Mental

Health

DrugMisuse

Offending Money Family

Sco

re o

n S

tar

To

ol

Before

After

Frequency of the Top 10 Issue Categories Being Presented to HTCs

The top 10 issues categories arising with Health Trainer Champions in HMP Frankland

0

2040

6080

100

HTC Role Fitness andExercise

HealthyEating

Form help GeneralHealth Chat

Accessinghealthcareservices

Prison life Smoking Target/goalsetting

MentalHealthIssues

Issue category

Freque

ncy of

issue arisin

g Frequency (no. of visits)

The type of help required from the Health Trainer Champion

0123456

Immediatehealth

problem

Long termgoal to behealthier

Didn't reallyknow

Wanted tofind out

more

Type of help

No. of

clients

Type of Help Wanted from HTCs

Prisoners’ Reactions to HTCs Interventions Prisoners’ Reactions to HTCs Interventions

Clients thoughts of the information given from HTC's

Definitely happy

Mostly happy

Not sure

Poor

Prisoners’ Ratings of Helpfulness of HTCsPrisoners’ Ratings of Helpfulness of HTCs

How helpful the clients found the Health Trainer Champions

Very helpful

Mostly helpful

Not sure

Not helpful

Figure 7: Return Visits Figure 7: Return Visits

Would the client return to the Health Trainer Champion in the future

Definitely yes

Probably yes

I doubt it

Definitely not

Did Prisoners Act on the Advice Given by HTCs?Did Prisoners Act on the Advice Given by HTCs?

Number of clients acting on advice given by Health Trainer

Champion

02468

101214

Yes No

Acting on advice

Num

ber

of

clients

SummarySummary

Extensive planning, strong leadership, good networking and communication

Continued involvement from stakeholders

HTCs needed to be trusted prisoners and security cleared

Role clarity for HTCs and information about their role within the jail

HTCs changed their attitudes to a healthy lifestyle

Prisoners found HTCs accessible and helpful

Good links with healthcare