Knowledge and cardiovascular disease risk perception from the perspectives of prisoners and staff in a Scottish prison: a qualitative study

• DOI: https://doi.org/10.1108/IJPH-05-2021-0037
• Published date: 21 October 2021
• Date: 21 October 2021
• Pages: 335-349
• Subject Matter: Health & social care,Criminology & forensic psychology,Prisoner health,Sociology,Sociology of crime & law,Public policy & environmental management,Policing,Criminal justice
• Author: Andrea R.M. Mohan,Patricia Thomson,Sally Haw,Stephen J. Leslie,Janet McKay

Knowledge and cardiovascular disease

risk perception from the perspectives of

prisoners and staff in a Scottish prison:

a qualitative study

Andrea R.M. Mohan, Patricia Thomson, Sally Haw, Stephen J. Leslie and Janet McKay

Abstract

Purpose –Prisoners have an increasedrisk of cardiovascular disease (CVD) compared to the general

population. Knowledge and risk perception of CVD can influence engagement in preventative

behaviours that loweran individual’s CVD risk. This paper aims to explore prisoners’knowledge of CVD,

and prisonersand staff’s perceptions of prisoners’ CVD risk.

Design/methodology/approach –This was a qualitativestudy in which semi-structuredinterviews were

conducted with 16 prisonersand 11 prison and National Health Services staff in a Scottish prison.Data

were analysedthematically using the framework method.

Findings –Most prisoners had limited knowledge of CVD as they could not describe it or could only

identify one or two riskfactors or cardiovascular events. Both prisonersand staff viewed prisoners’ CVD

risk as either pertaining to one individual, or pertaining to the general prisoner population. Unhealthy

behaviours that were believed to increase CVD risk were linked to three perceived consequences of

imprisonment:mental health problems, boredomand powerlessness.

Originality/value –To the best of the authors’ knowledge, this is the first study to explore the CVD

knowledge of prisoners,and perceptions of CVD risk from the perspectivesof prisoners and prison staff.

Findings from this study indicate that CVD education needs to be a priority for prisoners, addressing

knowledge of CVD, its risk and risk perceptions. Additionally, the findings indicate that individual and

socio-environmentalfactors linked to prisoners’ CVD risk need to be targeted to reduce thisrisk. Future

research should focus on socio-environmental interventions that can lead to reducing the CVD risk of

prisoners.

Keywords Education, Health promotion, Knowledge, Cardiovascular disease, Risk perception,

Health behaviours

Paper type Research paper

Introduction

Cardiovascular disease (CVD) is a major public health problem, accounting for nearly 17.9

million deaths worldwide everyyear; 85% of these are due to heart attack and stroke (World

Health Organization, 2017). In high-income countries, there is an inverse relationship

between four markers of socioeconomic status (SES), i.e. income level, educational

attainment, employment status, neighbourhood socioeconomic factors and CVD risk

(Schultz et al., 2018). Prisoners mostly come from areas of low SES (WHO Regional Office

for Europe, 2014) and have low educational attainment (Natale, 2010;Prisoners’ Education

Trust, 2015); therefore, in many countries, they have an increased risk of CVD compared to

the general population. CVD is a major cause of death in prisons in the USA (Noonan and

Ginder, 2013), Russia (Bobrik et al., 2005) and England and Wales (Fazel and Benning,

Andrea R.M. Mohan is

based at the School of

Health Sciences, University

of Dundee, Dundee, UK.

Patricia Thomson and

Sally Haw are both based

at the Faculty of Health

Sciences and Sport,

University of Stirling,

Stirling, UK.

Stephen J. Leslie is based at

Cardiac Unit, Raigmore

Hospital, NHS Highland,

Inverness, UK.Janet McKay

is based at Cardiac

Rehabilitation, Lister

Centre, University Hospital

Crosshouse, NHS Ayrshire

and Arran, Ayr, UK.

Received 4 May 2021

Revised 2 September 2021

8 September 2021

Accepted 8 September 2021

Funding: This study was

undertaken as part of a

Doctoral studentship, which

was partly funded by NHS

Ayrshire & Arran.

Conflicts of interest: None to

declare.

DOI 10.1108/IJPH-05-2021-0037 VOL. 18 NO. 4 2022, pp. 335-349, ©Emerald Publishing Limited, ISSN 1744-9200 jINTERNATIONAL JOURNAL OF PRISONER HEALTH jPAGE 335