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Prisoners’ self-reported health and attitudes to health promotion initiatives in a Scottish Prison

Objective: To explore prisoners’ views on their own health, health promotion and harm reduction measures, prior to a period of significant change in the way these services are delivered in the prison setting. Design: Structured interviews with prisoners as part of a wider Health Needs Assessment of a local prison. Setting: A high security prison in the West of Scotland with capacity for 700 male prisoners. Methods: A structured questionnaire with prisoners recruited from education, regular wings, and protection wings. Responses were analysed using thematic analysis and statistical techniques. Results: Seventy-nine prisoners were interviewed. Most prisoners reported their health as good or excellent, despite reporting high levels of risk-taking behaviour. Nearly half thought their health had improved since incarceration, citing reduced drug and alcohol use and healthier lifestyles. Prisoners expressed mixed views on harm reduction initiatives, with concerns around confidentiality, bullying, and being exposed to drug use or sexual activity in their ‘home’ environment. Conclusion: This study indicates the importance of listening to prisoners’ views about health promotion and harm reduction initiatives, and also of challenging their perceptions of what constitutes ‘good health’ and risk-taking behaviour. It also highlights the importance of environmental factors on prisoners’ health both within the prison and upon release.