Using qualitative data to produce an animated clinical engagement tool: secondary health-care experiences of people in prison

Abstract

BackgroundHealth care service access and health outcomes are poorer in prisoners than the wider population. The closed prison environment restricts access to community (ie, external to prison) secondary care. Prisoners can feel discriminated against when attending hospital appointments, leading to self-exclusion from health services while imprisoned. Hospitals that are informed about these issues can make simple changes to address inequalities. We aimed to influence community health professionals to design improved services through the use of an animation based on prisoner experiences of secondary care. MethodsWe developed the key ideas for this arts-based approach to clinical engagement through collaboration with people with lived experience, a prison charity, prison clinicians, and an animation company. We collected focus group and interview data about hospital health-care experiences with people in prison and analysed these data with input from the collaborative group. A rapid two-stage thematic analysis identified key themes and phrases to support the animation narrative. We interviewed prisoners to collect audio. We developed the 5-min animation through our collaborative key ideas, qualitative themes, and audio collected. We will evaluate our methods and the animation's impact through post-screening activities with clinicians to determine how effectively knowledge is transferred to target groups. If proven effective, opportunities for using the method to increase knowledge about other excluded groups (eg, homeless people) will be explored. FindingsWe have produced an animation that will be evaluated for its ability to engage hospital clinicians in service change. The animation provokes engagement by explaining the effects of the prison regime and security measures on prisoners admitted to hospital. Such effects include humiliation and fear, the unwanted presence of prison officers in medical consultations, and individuals’ inability to manage their own health care. InterpretationIncarcerated patients have shared their experiences to show the need for service change, not to simply invoke empathy. We hope to produce a tool to engage secondary care staff and not simply tell prisoners’ stories. These will act as the vehicle for change. FundingWellcome Trust Public Engagement grant scheme and Surrey Heartlands Health and Care Partnership Citizen Engagement work stream.