Supporting the Achievement of Health Goals with Formerly Incarcerated Men
Project Funding: The Vancouver Foundation, the Peter Wall Institute for Advanced Studies, Michael Smith Foundation for Health Research, and Face the World Foundation
Project Period: 2014 – 2017
The CCPHE and the John Howard Society of Canada are partnering on this community-based participatory research project. The project seeks to answer the question: what are the facilitators and barriers to achieving health and successful reintegration for men leaving federal correctional facility in BC? Using participatory processes, this project aims to determine the immediate, short- and long-term health goals and priorities of formerly incarcerated men and to understand the factors acting as barriers and facilitators in achieving these health goals. The project will determine whether peer-mentorship is helpful for participants to achieve their health goals. Our goal is to identify how to best support men as they transition from a federal correctional facility back into the community.
Guidelines for the Implementation of Mother-Child Units in Canadian Correctional Facilities
Project Funding: First Nations Health Authority, Interior Health Authority, Native Youth Sexual Health Network, University of the Fraser Valley Centre for Safe Schools and Communities, Vancouver Island Health Authority, Women’s Health Research Institute, Provincial Health Services Authority.
Project Period: 2014-2015
The CCPHE developed the Guidelines following the Supreme Court of British Columbia ruling in the case of Inglis v. British Columbia (Ministry of Public Safety) 2013 BCSC 2309. The Guidelines describe the administrative principles, and includes internationally sourced best practices for Mother-Child Units (MCU’s), while also recommending that every effort should be made for women to receive care in the community and to find alternatives to incarceration. The Guidelines describe basic principles of care that are required for optimal child and maternal health for the correctional context, during pregnancy, birth, and the first two years of life. The Guidelines describe the collaborative interdisciplinary, inter-agency approach that is essential to promote stability and continuity for mother-child health and bonding to build strong parental relationships in and beyond the correctional facility. Delegates from 40 organizations collaborated in the development of these internationally unique Guidelines during two days’ of working meetings at the University of British Columbia, CCPHE, and was followed by multiple rounds for editing and input by all meeting delegates. Twenty-three international and national organizations have endorsed these Guidelines. The Guidelines have been mailed to every Canadian MP, every provincial/territorial Minister of Justice, Health and Child Protection, and to every Canadian women’s correctional facility.
Participatory Prison Community-based HIV Prevention Feasibility Research Project (P4HIV)
Project Funding: The Canadian Institutes of Health Research (Catalyst Grant)
Project Period: 2012 – 2014
Individuals with incarceration experience have a higher prevalence of HIV/AIDS than the general population. HIV prevention and treatment in prison faces many barriers. Our objective was to determine whether a HIV prevention program, developed in collaboration with currently incarcerated men and piloted outside prison, is effective in improving health knowledge and HIV prevention behaviours.
Twelve currently incarcerated men participated from the medium security Mission Institution in May 2014. Four major themes emerged, as voiced by the participants:
- Increased HIV education/information, which decreased their stigma and fear;
- Improved awareness about HIV-prevention and treatment;
- Increased social cohesion; and,
- Increased awareness about action with which they might engage.
Participants described their difficulty in trusting others because they fear letting people into their personal space. These men stated that it was not normal for them to talk to people that were not part of their own group of friends with whom they shared a level of trust. The participants began talking to other inmates in the institution who approached them with questions about the HIV-prevention workshops. Participants radiated knowledge to their incarcerated peers, families, and communities. This feasibility project paves the way for future community-based research HIV interventions that collaborate with correctional organizations and engage incarcerated men.
A Participatory Approach to Developing Preventative Health Tools for BC Individuals with Lived Incarceration Experience (P4H)
Project Funding: The Vancouver Foundation
Project Period: 2011 – 2014
The CCPHE recently completed a three-year project to promote holistic health and preventive practices for individuals with incarceration experience in the areas of mental health and addictions, cancer, and blood-borne infectious diseases. By sharing knowledge, supporting self-advocacy, and strengthening relationships, this project aimed to employ community-based participatory processes to develop, pilot and evaluate self-management, cancer screening, and peer coaching tools.
This project was developed in response to the findings of the CCPHE’s meetings in May and June 2011 with partners Long-term Inmates Now in the Community (L.I.N.C.) and Women in2 Healing (Wi2H). The groups met to determine areas of preventive health that the current project should explore. Formerly incarcerated men and women were invited to participate in focus group discussions where they identified the priority areas for this project: cancer, hepatitis C, HIV, mental health, and addiction. The findings indicated that many incarcerated persons developed feelings of alienation and ambivalence about the medical community. Barriers to care were reinforced by system complexities, mistrust, stigma and a feeling that “no one cared.” Additionally, personal impediments, including a lack of hope, low self-esteem, unhealthy relationships, isolation, and trauma, left men and women with a feeling that health was not a priority area for them. See below for the ‘iceberg image’ that resulted from these discussions.
Based on information gathered during the focus group discussions, the project team planned and implemented a series of interactive workshops for participants with incarceration experience. The workshop themes were as follows: Peer Support, Navigating the Healthcare System, hepatitis C prevention, transmission, and treatment, HIV prevention and care, mental health, addiction, cancer prevention, and cancer screening.
This project involved ongoing consultations with incarcerated and formerly incarcerated persons in BC, policy-makers, academic researchers, community organizations and stakeholders, and health care providers. During the final phase of the project, the project team evaluated and disseminated findings through traditional academic means, the CCPHE-hosted Health Beyond Bars: Towards Healthy Prisons in Canada conference, and media channels that advance a national dialogue. In addition, the project advisory committee members promoted knowledge transfer and uptake into their respective communities and organizations.
Project Publications and Resources:
- Findings from the Priority Setting Focus Groups: Iceberg Poster
- Publication: O’Gorman CM, Martin MS, Oliffe JL, Leggo C, Korchinski M, Martin RE. Community Voices in Program Development: The Wisdom of Individuals with Incarceration Experience. Can J Public Health. 2012: Sep/Oct: 379-383.CommunityVoices_O’Gorman.Claire_2012
- Project Brief 1: Health Priorities of Individuals with Incarceration Experience: What Lies Beneath Link: CCPHE_Brief_1_FINAL-MAIL
- Project Brief 2: Participatory Approach to Developing Preventive Health Tools for Individuals with Incarceration Experience Link:CCPHE_Brief_2_FINAL-mail
- Project Brief 3: Navigating the Health Care System Link: CCPHE_NHCS_FINAL
A Participatory Approach to Improving Cancer Screening and Early Detection among Individuals with Incarceration Experience (P4C)
Project Funding: The Public Health Agency of Canada
Project Period: 2012 – 2014
Men and women who have been in prison are an underserved group with higher rates of all types of cancer. In addition, they have higher rates of several cancer risk factors, such as infectious disease exposure (such as STD and HPV infection) and cigarette smoking, along with poor socio-economic health determinants including poverty, unstable housing, low literacy, and/or low education levels, and mental health and physical disability. Post-release, men and women are often overwhelmed by the complexities of seeking and receiving health care in the community. Receiving primary care, including cancer screening and early detection, can become a “back-burner” issue, coming well after housing, parole, financial, and family responsibilities. Another significant barrier to accessing care and early screening stems from the lack of trust between this population and service providers, including healthcare practitioners. Cancer screening services are effectively non-accessible to individuals with incarceration experience (IIE) due to perpetual stigmatization.
This two year project was designed to activate BC individuals with incarceration experience (IIE) to direct their own care in cancer screening and early detection, by removing barriers and raising awareness with and for them. Participatory processes were used to engage IIE to pinpoint gaps in existing cancer screening and awareness tools/programs and self-management tools. With the help of these men and women, this project modified existing tools/programs to make them more accessible and relevant to this population. We held a Cancer Prevention Tools Feedback Session in December 2012 and held a series of interactive workshops on Cancer Screening and Awareness for breast, cervical, and colon cancer in Metro Vancouver and Nanaimo in late 2013. Cancer Walks Free, a short documentary film, was produced based on interviews with individuals with incarceration experience and the healthcare practitioners who treat them (see link below). This project developed a model that has the potential to be replicated nationally and within correctional institutions.
The P4C had shared some joint goals and activities with the P4H project. The P4H project focused on general preventative health among men and women with incarceration experience (IIE). The P4C focused mainly on ONE aspect of preventative health, namely cancer prevention. Both the P4H and the P4C projects shared the same coordinators, co-investigators and principal investigator. The Project Advisory Committee (PAC) for this P4C project is made up from members of the P4H committee who have a specific interest in cancer screening.
- Arresting Cancer: Using Community-based Participatory Approaches to Improve Cancer Screening and Awareness with Formerly Incarcerated Men and Women
English version: CCPHE_Arresting Cancer_EN_FINAL
French version: CCPHE_Arreter Le Cancer-FR-FINAL
- Cancer Walks Free: Click hereto watch Cancer Walks Free, an educational documentary by Women in 2 Healing’s Mo Korchinski about the impact of cancer within incarcerated populations.