ABSTRACT
This article describes how community-based participatory research (CBPR) led to the discovery of the unintended consequences of jail and prison copayment policy on women prisoners' health. The article addresses (a) a working definition of participatory research; (b) the importance of research with women prisoners; (c) the origins and development of our work and its grounding in CBPR; (d) issues related to research with prisoners; and (e) recommendations for using participatory methods to bring women prisoners into the discourse about the practices and policies that impact their lives. These methods have the potential to minimize the invisibility of prisoners and their health disparities.
Subject(s)
Community-Based Participatory Research , Prisoners , Quality of Health Care , Women's Health , Adult , California , Female , Health Services Accessibility , Humans , Middle Aged , Young AdultABSTRACT
OBJECTIVES: We sought to analyze women prisoners' use of co-payments for health care; how co-payments affect their access to health care; and how they view the impact of co-payments on their health. METHODS: Using a community-based participatory research approach, we conducted six focus groups with 31 previously incarcerated women. Data were analyzed using qualitative field research methods, grounded theory, and consensual qualitative research strategies to construct a shared understanding of the data. RESULTS: Co-payments hindered women prisoners' access to health care. Women reported inequitable implementation of the policy and foregoing care because of the financial burden of the co-payment. Co-payments contributed to delays in treatment, avoidance of health care professionals, unnecessary suffering, and poor health outcomes. In response, women used self-advocacy skills to manage their health care needs and deal with the prison health care system. CONCLUSION: Co-payments place an unfair burden on prisoners who are poor, limit access to health care, and contribute to needless suffering and potentially to preventable deaths.
Subject(s)
Cost of Illness , Deductibles and Coinsurance , Health Expenditures , Health Services Accessibility/economics , Patient Satisfaction/economics , Prisoners , Adult , Female , Focus Groups , Health Policy/economics , Health Services/economics , Health Services/standards , Humans , Middle Aged , Prisons/economics , Qualitative Research , Quality of Health Care , United States , Young AdultABSTRACT
The purpose of this article is to describe health issues of women prisoners, analyze the implications of these issues for nursing practice, and consider strategies to improve the health of this vulnerable population. The article focuses primarily on women prisoners in the United States and includes a brief contextual background to explain the rapid increase in their numbers. Although the incarceration of women is increasingly a global problem, the authors focus primarily on the situation in the United States.
Subject(s)
Health Promotion/methods , Nurse's Role , Prisoners , Women's Health , Adult , Child , Child Care , Criminal Law , Female , Health Policy , Health Services Needs and Demand , Health Status Disparities , Humans , Mental Health , Prisoners/education , Prisoners/psychology , Prisoners/statistics & numerical data , Social Isolation , Socioeconomic Factors , United StatesSubject(s)
Health Services Needs and Demand/organization & administration , Mental Disorders/prevention & control , Mental Health Services/organization & administration , Prisons/organization & administration , Women's Health Services/organization & administration , Female , Health Status Disparities , Humans , Mental Disorders/epidemiology , Psychiatric Nursing , United States/epidemiologyABSTRACT
In the last decade, the number of women in US jails has increased at an annual average of 7.0%. These women typically suffer from untreated, serious health problems. This participatory research project explored health problems and healthcare from the perspective of women incarcerated in a county detention facility located in the western US. A convenience sample of 78 inmates and former inmates participated in 10 focus groups. Using the constant comparative method, the data analysis revealed that they suffered from physical, mental, and iatrogenic health problems. Barriers to care included concerns about privacy and dignity as well as waiting time for treatment, co-payments, and concealing problems in order to obtain work opportunities. Women in the project identified solutions for these problems and analyzed why incarceration made them aware of previously ignored health concerns. The findings suggest the importance of further research with this vulnerable, hidden population.
