Offender health concerns health and social care for adults and children in contact with the criminal justice system. This population experiences significant health inequalities associated with multifaceted social problems. Research shows that ill health is more prevalent in the prison population than in the general population. Prison itself can produce adverse health impacts, particularly with regard to mental health.
Prisoners are more likely to engage in risky health behaviours, such as drug and alcohol misuse, and there are inequalities in long-term conditions. The prison setting offers opportunities for improving the physical and mental health of this socially excluded population. Peer-based interventions, in which prisoners provide education, support or advice to other prisoners, are an established feature of prison life in England and Wales.
More recently, health trainers have emerged as a feature of prison health services. Given the place of peer schemes in current practice, it is important to develop a robust evidence base to inform service commissioning and delivery options. The study aimed to synthesise the evidence on peer-based interventions in prison settings by carrying out a systematic review and holding an expert symposium.
Review questions were: 1 What are the effects of peer-based interventions on prisoner health and the determinants of prisoner health? A full study protocol was developed and peer reviewed by the study steering and advisory groups prior to publication in the PROSPERO database reference no. Unpublished grey literature was identified from contacts with experts, conference and dissertation abstracts, reference lists of key papers, hand searches of relevant book chapters and searches of relevant websites.
Population : Prisoners resident in prisons and YOIs in any country, all ages, male and female. Intervention : Any peer-based intervention operating within prisons and YOIs in any country. Comparators : For review question 3, studies comparing peer-led and professionally led approaches to the same health or social problem. For all other questions, studies with any or no comparator or usual care.
