{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T20:40:04Z","timestamp":1756672804767,"version":"3.44.0"},"reference-count":18,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Qual"],"accepted":{"date-parts":[[2017,12,8]]},"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:p>Many people enter prison with poor health from a background of deprivation and with unhealthy lifestyle habits, yet spending time in prisons is often actively detrimental to health. There is therefore a clear value in providing high-quality health promotion services in prisons that are effective at reaching those who need support to improve their lifestyle. The health promotion service at HMP Brixton provides a health trainers clinic to address lifestyle issues but found that it was sometimes challenging to identify appropriate patients and that the service was inefficient as a result. Analysis of our referral sources suggested that taking steps to increase the proportion of referrals made during screening and other clinics might lead to more appropriate and engaged patients. In this study, we set out to use quality improvement methods to increase referral from these sources. This involved improvements to the processes involved in delivering National Health Service Health Checks that were the primary source of referrals for health trainers and by improving links between the health trainer team and other clinicians. The changes were successful in increasing referrals from these sources. This work was completed during a period of exceptional disruption in the prison service and is relevant to secure healthcare sites that aim to ensure prevention activities are efficient and targeted.<\/jats:p>","DOI":"10.1136\/bmjoq-2017-000097","type":"journal-article","created":{"date-parts":[[2018,1,4]],"date-time":"2018-01-04T20:11:29Z","timestamp":1515096689000},"page":"e000097","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Integrating prevention and health promotion in a London prison"],"prefix":"10.1136","volume":"7","author":[{"given":"Adam John","family":"Finnie","sequence":"first","affiliation":[{"name":"Health Promoting Trust Office, Education Centre, Eastbourne District General Hospital, Eastbourne, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,1,3]]},"reference":[{"key":"2025083113095407000_7.1.e000097.1","unstructured":"M\u00f8ller L , St\u00f6ver H , J\u00fcrgens R , et al . 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The benefit of sport and physical education for young men in prison: An exploration of policy and practice in England and Wales. Prison Service Journal 2013:3\u201311."},{"key":"2025083113095407000_7.1.e000097.7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/hsdr02350","article-title":"A systematic review of the effectiveness and cost-effectiveness of peer-based interventions to maintain and improve offender health in prison settings","volume":"2","author":"South","year":"2014","journal-title":"Health Services and Delivery Research"},{"key":"2025083113095407000_7.1.e000097.8","unstructured":"Lyttle G . Sheppey cluster RSPH Newsletter report, 2010."},{"key":"2025083113095407000_7.1.e000097.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2013.02.014"},{"key":"2025083113095407000_7.1.e000097.10","unstructured":"Centre for Clinical and academic workforce innovation. A guide to implementing the new futures health trainer role across the criminal justice system. University of Lincoln: Lincoln, 2007."},{"key":"2025083113095407000_7.1.e000097.11","unstructured":"Mathers J , Taylor R , Parry J . Formulation and implementation of evidence-based public health policy in political environments: the health trainer service initiative in England. The Lancet 2017 http:\/\/www.thelancet.com\/ abstracts\/public-health-scienceinthe- uk (accessed 10 Mar 2016)."},{"key":"2025083113095407000_7.1.e000097.12","unstructured":"HM Inspectorate of Prisons. HM chief inspector of prisons for England and Wales annual report. London: HM Inspectorate of Prisons, 2017."},{"key":"2025083113095407000_7.1.e000097.13","doi-asserted-by":"publisher","DOI":"10.3310\/hta18520"},{"key":"2025083113095407000_7.1.e000097.14","unstructured":"Public Health England. NHS health check: best practice guidance. London: Public Health England, 2016."},{"key":"2025083113095407000_7.1.e000097.15","unstructured":"Public Health England. Physical health checks in prison webinar: Public Health England, 2016."},{"key":"2025083113095407000_7.1.e000097.16","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1186\/1748-5908-7-97","article-title":"Managing boundaries in primary care service improvement: a developmental approach to communities of practice","volume":"7","author":"Kislov","year":"2012","journal-title":"Implement Sci"},{"key":"2025083113095407000_7.1.e000097.17","unstructured":"Institute for Innovation and Improvement. The Handbook of quality and service improvement tools: NHS England."},{"key":"2025083113095407000_7.1.e000097.18","unstructured":"Royal Society for Public Health. Minded to change: The link between mental wellbeing and healthier lifestyles. 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