A Captive Audience: Bringing the WISEWOMAN Program to South Dakota Prisoners

Khavjou, Olga A.; Clarke, Jacy; Hofeldt, Roberta M.; Lihs, Patty; Loo, Ryan K.; Prabhu, Malavika; Schmidt, Norma; Stockmyer, Chrisandra K.; Will, Julie C.

doi:10.1016/j.whi.2007.02.008

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Volume 17, Issue 4 , Pages 193-201, July 2007

A Captive Audience:

Bringing the WISEWOMAN Program to South Dakota Prisoners

Olga A. Khavjou, MA
- RTI International, Research Triangle, North Carolina
- Correspondence to: Olga A. Khavjou, MA, Public Health Economics, RTI International, 701 13th Street, NW, Suite 750, Washington, DC 20005-3962.
Jacy Clarke, MPH
- South Dakota Department of Health, Pierre, South Dakota
Roberta M. Hofeldt, RN
- South Dakota Department of Health, Pierre, South Dakota
Patty Lihs, BS
- South Dakota Department of Health, Pierre, South Dakota
Ryan K. Loo, PhD
- Centers for Disease Control and Prevention, Division for Heart Disease and Stroke Prevention, Atlanta, Georgia
Malavika Prabhu, BS
- RTI International, Research Triangle, North Carolina
Norma Schmidt, MA
- South Dakota Department of Health, Pierre, South Dakota
Chrisandra K. Stockmyer, MPH, RD
- Centers for Disease Control and Prevention, Division for Heart Disease and Stroke Prevention, Atlanta, Georgia
Julie C. Will, PhD, MPH
- Centers for Disease Control and Prevention, Division for Heart Disease and Stroke Prevention, Atlanta, Georgia

Received 17 May 2006; received in revised form 5 February 2007; accepted 5 February 2007. published online 16 June 2007.

Purpose

This analysis compares the baseline heart disease risk profile of WISEWOMAN participants screened in the South Dakota Women’s Prison with the general WISEWOMAN population in South Dakota and explores the potential benefits of lifestyle intervention programs to reduce heart disease risk factors among women during incarceration.

Methods

Using baseline data for WISEWOMAN participants in South Dakota, we compared participants who were enrolled in prison (n = 261) with nonincarcerated participants enrolled throughout the state (n = 1,427). Using regression analysis and adjusting for demographics, we assessed differences in baseline prevalence of risk factors (hypertension, high cholesterol, smoking, and obesity), awareness and treatment of hypertension and high cholesterol, and attendance at lifestyle intervention sessions.

Results

Incarcerated participants had significantly lower (p < .01) total cholesterol (183 mg/dL) than nonincarcerated participants (199 mg/dL). However, a significantly higher (p < .03) percentage of incarcerated women (85%) than nonincarcerated women (54%) with high cholesterol were unaware of their condition. Despite the smoke-free status of the prison, 24% of incarcerated participants reported smoking. Attendance at lifestyle intervention sessions was significantly higher among incarcerated participants than among nonincarcerated participants with intervention take-up rates of 53% among incarcerated versus 23% among nonincarcerated women (p < .01) and intervention completion rates of 43% and 4% (p < .01).

Conclusions

The results illustrate the need for screening and education programs in prisons. WISEWOMAN screenings helped identify undiagnosed cases of abnormal blood pressure and cholesterol, and educational interventions provided women with opportunities to improve their health. Such programs may also improve discharge planning and linkages between released women and community health providers.