Description and evaluation of a health education program for women offenders.

Abstract: One percent of the population of the United States consists of women offenders, who are at-risk for numerous preventable diseases. Since health promotion is not a high priority when women are incarcerated, the author used group education as one way of increasing participants' knowledge and self-efficacy. Results indicated that a group health education program is an excellent way to change participants' knowledge and self-efficacy in a women's prison population. Key Words: Women Prisoners, Incarcerated Women, Women in Prison, Health Education Program, Outcome Evaluation, Advanced Nursing Practice Role. An important role component for advanced practice nurses is health educator. Advanced practice nurses often teach clients on a one-to-one basis. Group education is not a frequently implemented education strategy. More clients can be taught at one time by group education. This is a description of one advanced practice nurse's group education project in a women's state correctional facility and how outcomes from these education sessions were documented. COURSE EVOLUTION This health education course evolved from a student's need to develop a health education pamphlet to meet a course requirement in a family nurse practitioner clinical course. The student examined the types of client needs in her clinical practice to determine the first topic. A lesson plan for the first topic was developed to include objectives, pretest, client handout and post-test. This lesson plan along with a cover letter outlining the reason for the lesson, format of the lesson, and request to teach the topic was sent to the director of nursing at this facility. The manager of health services, the attending physician, and the student's preceptor all received a copy of the letter and the teaching plan. After the first lesson other topics were developed from participants requests. Each health lesson was sent to the director of nurses for approval prior to presentation. Topics for the health teaching sessions were hepatitis, the Food Guide Pyramid and sexually transmitted diseases. Women in Correctional Settings General Information. In 1998, one out of every 109 adult women in the United States had some type of correctional designation. Eighty-five percent of women offenders were supervised in the community and 15% confined to prisons on the local, state and deferral levels (Bureau of Justice Statistics, 2000). Eighty percent of women offenders in state prisons were either repeat offenders or had a current conviction for perpetrating violence (Bureau of Justice Statistics, 2000). In 1996, women accounted for about 16% of all felons convicted in state courts. The nature of their convictions was categorized as 8% convictions for violent crimes, 23% for property crimes, and 17% for drug convictions. Forty-one percent were convicted of forgery, fraud, and embezzlement (Bureau of Justice Statistics, 2000). Demographic Characteristics of Women offenders in State prisons. Women offenders in state and federal prisons are older than women in local jails. In state prisons, only one in eight were under 25. Nearly half of the women have never been married, 33% described themselves as white, 48% as black, 15% as Hispanic and 4% as other. Of the 75,200 in state prisons in 1998, 49,200 described themselves as having children under 18. Prior to their arrest, 4 in 10 women reported that they had full-time employment. Thirty percent at the time of their arrest reported receiving welfare assistance (Bureau of Justice Statistics, 2000). Challenges. Providing health care to women offenders offers some unique challenges. Security comes first (e.g., health care providers cannot be alone in an examining room with an offender). There is a lack of control over health care practices, certain measures cannot be suggested, and offenders can only keep certain medications on their person. Information gathered during history taking might not be truthful. …