Date of Award
Open Access Thesis
Medical Doctor (MD)
Emily A. Wang
Medicine, Public health, Social research
Despite greater risk of cardiovascular disease (CVD) mortality in patients with a history of incarceration, little is known about how prisons manage CVD risk factors (CVR-RF) to mitigate this risk.
We conducted in-depth interviews with men and women with CVD-RF and who had been recently released from prison (n=26). Using a grounded theory approach and applying the constant comparative method, we inductively generated themes about CVD- RF care in prison. Data collection and analysis occurred iteratively to refine and unify emerging themes.
Four themes emerged from patient perspectives: (1) Access to care for chronic conditions is present, yet complicated in prisons. (2) Patient-provider partnerships can be undermined by providers' competing correctional and medical roles. (3) Informal support systems can improve self-management education and skills development. (4) The trade- off between prisoner security and patient autonomy influences opportunities for self- management.
Correctional policies pervaded patients' CVD-RF management, which undermined care delivered by providers and the development of critical self-management skills. Our findings support interventions to engage peers, providers, and care delivery systems in routine care to cultivate effective self-management strategies unique to prison.
Thomas, Emily Herron, "Patients' Experiences Managing Cardiovascular Disease Risk Factors In Prison" (2015). Yale Medicine Thesis Digital Library. 2017.