The health-promoting prison: can it improve oral health? An evaluation of an Oral Health Improvement Project for high-security prisoners

Abstract

The aim of the evaluation was to examine the impact of an Oral Health Improvement Project on the oral health-related knowledge, attitudes and behaviours of prisoners in this high-security gaol. Prisoners in a high-security prison that had adopted a health-promoting prison agenda were invited to take part. Prisoners in locations where the Project had been active acted as the intervention group and those in other settings where there was no formal involvement with the Project acted as controls. All consenting prisoners were asked to complete questionnaires to assess their Project awareness, oral health-related knowledge, attitudes and behaviours. The data were subjected to Chi-squared tests, t-tests, correlation analysis and ANCOVA. Fifty-nine intervention and 48 control group prisoners completed questionnaires. Intervention group prisoners were more Project-aware (F[1,97] = 6.98, p = 0.01) and more knowledgeable about oral health (F[1,97] = 12.02, p = 0.001) when controlling for duration of current imprisonment. No significant associations between intervention group status and oral health-related attitudes or behaviours were found. Increased reported smoking and poorer dietary habits were significantly explained by duration of current imprisonment. This evaluation highlights the difficulties in changing health-related attitudes and behaviours in the prison setting. It also demonstrates the need for effective deployment of the health-promoting prison approach to improve the oral health of prisoners.