Abstract

BackgroundUnder- and over nutrition as well as nutrition risk factors such as communicable and non-communicable diseases are a common and major cause of morbidity and mortality in correctional facilities. Consequently, medical nutrition therapy (MNT), a spectrum of nutrition services aimed at optimizing individual well-being, is being recognized as integral to the health of people who experience incarceration. However, there is a paucity of research that explores the delivery of MNT in correctional facilities.MethodsA scoping review combined with secondary analysis of qualitative data (field notes, in-depth stakeholder interviews) from a 2-year ethnographic study about food insecurity and incarceration was undertaken to gain insights about the delivery of corrections-based MNT in Canada. Thematic analysis of all documents was done using an interpretive framework.ResultsAn understanding about MNT was developed within three themes: 1) specialized service provision in a unique environment; 2) challenges with the provision of MNT; and 3) consideration of corrections-based MNT alternatives. An incarcerated individual’s nutritional health was conceptualized as culminating from various factors that included dietary intake and health status, enabling environments, access to quality health services, and clinical nutrition services. Nutrition care practices, which range from health promotion to rehabilitation, are challenged by issues of access, visibility, adequacy, and environmental barriers. Their success is dependent on demand (e.g., ability of recipient to act) and factors that enable quality health and food services. Advancing corrections-based MNT will require policies that provide supportive food and health environments and creating sustainable services by integrating alternatives such as peer approaches and telehealth.ConclusionsProfessional associations, government, researchers and other stakeholders can help to strengthen corrections-based MNT by fostering shifts in thinking about the role of health practitioners in these contexts, preparing future health professionals with the specialized skills needed to work in these environments, generating evidence that can best inform practice, and cultivating collaborations aimed at crime prevention, successful societal reintegration, and the reduction of recidivism.

Highlights

  • Under- and over nutrition as well as nutrition risk factors such as communicable and non-communicable diseases are a common and major cause of morbidity and mortality in correctional facilities

  • medical nutrition therapy (MNT) is often delivered by a registered dietitian or nutrition professional who works as part of an interdisciplinary health team

  • Scoping review Description of corrections-based health and nutrition Services in Canada The standards for health care in Canadian federal correctional facilities are outlined in the Corrections and Conditional Release Act [39]

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Summary

Introduction

Under- and over nutrition as well as nutrition risk factors such as communicable and non-communicable diseases are a common and major cause of morbidity and mortality in correctional facilities. Medical nutrition therapy (MNT), a spectrum of nutrition services aimed at optimizing individual well-being, is being recognized as integral to the health of people who experience incarceration. Providing appropriate nutrition and food services as a form of duty of care has the potential to generate critical benefits including the prevention of communicable diseases that poses threats to community health, reducing risk of developing non-communicable health conditions and associated cost burdens, improving chronic condition management, reducing problematic and self-harm behaviors, and preventing recidivism [3, 9, 11, 14,15,16]. A deepened understanding of the relationships and contextual factors that impact MNT in correctional systems could provide information to improve food and nutrition programs, practices, and policies which, in turn, could reduce health care and criminal justice system costs

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