Jane South|Anne?Marie Bagnall|Claire Hulme|James Woodall|Roberta Longo|Rachael Dixey|Karina Kinsella|Gary Raine|Karen Vinall?Collier|Judy Wright
A systematic review of the effectiveness and cost-effectiveness of peer-based interventions to maintain and improve offender health in prison settings
Leeds Beckett University|Leeds Beckett University|University of Leeds|Leeds Beckett University|University of Leeds|Leeds Beckett University|Leeds Beckett University|Leeds Beckett University|University of Leeds|University of Leeds
background offender health deemed priority issue department health peer support established feature prison life england wales however needs known effectiveness peerbased interventions maintain improve health prison settings objectives study aimed synthesise evidence peerbased interventions prison settings carrying systematic review holding expert symposium review questions 1 effects peerbased interventions prisoner health determinants prisoner health 2 positive negative impacts health services within prison settings delivering peerbased interventions 3 effects peerbased approaches compare professionally led approaches 4 costs costeffectiveness peerbased interventions prison settings data sources systematic review 20 electronic databases including medline psycinfo cumulative index nursing allied health literature embase searched 1985 grey literature relevant websites also searched supplement review findings 58 delegates representing variety organisations attended expert symposium provided contextual information review methods two reviewers independently selected studies using following inclusion criteria population prisoners resident prisons young offender institutions intervention peerbased interventions comparators review questions 3 4 compared peerled professionally led approaches outcomes prisoner health determinants health organisationalprocess outcomes views prison populations study design quantitative qualitative mixedmethods evaluations two reviewers extracted data assessed validity using piloted electronic forms validity assessment criteria based published checklists results quantitative studies combined using narrative summary metaanalysis appropriate results qualitative studies combined using thematic synthesis results total 15320 potentially relevant papers identified 57 studies included effectiveness review one study included costeffectiveness review poor methodological quality typology peerbased interventions developed evidence suggested peer education interventions effective reducing risky behaviours peer support services provide acceptable source help within prison environment positive effect recipients strongest evidence came listener scheme consistent evidence many predominantly qualitative studies suggested peer deliverer associated positive effects across intervention types limited evidence recruitment peer deliverers recurring themes importance prison managerial staff support schemes operate successfully risk management little evidence costeffectiveness peerbased interventions economic model developed results effectiveness review although based data variable quality number assumptions showed costeffectiveness peerled professionally led education prison prevention human immunodeficiency virus hiv infection limitations 58 included studies whole poor methodological quality conclusions consistent evidence large number studies peer worker associated positive health peer support services also provide acceptable source help within prison environment positive effect recipients confirmed expert evidence research costeffectiveness sparse limited hivspecific economic model although based number assumptions evidence variable quality showed peer interventions costeffective compared professionally led interventions welldesigned intervention studies needed provide robust evidence including assessing outcomes target population economic analysis costeffectiveness impacts prison health services research needed examine issues reach utilisation acceptability perspective recipients choose receive peer support study registration study registered prospero crd42012002349 funding national institute health research health services delivery research programme