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Abstract
Objective To develop an international consensus statement to advise on designing, delivering and evaluating sport-based interventions (SBIs) aimed at promoting social, psychological and physical well-being in prison.
Design Modified Delphi using two rounds of survey questionnaires and two consensus workshops.
Participants A multidisciplinary panel of more than 40 experts from 15 international jurisdictions was formed, including representation from the following groups and stakeholders: professionals working in the justice system; officials from sport federations and organisations; academics with research experience of prisons, secure forensic mental health settings and SBIs; and policy-makers in criminal justice and sport.
Results A core research team and advisory board developed the initial rationale, statement and survey. This survey produced qualitative data which was analysed thematically. The findings were presented at an in-person workshop. Panellists discussed the findings, and, using a modified nominal group technique, reached a consensus on objectives to be included in a revised statement. The core research team and advisory board revised the statement and recirculated it with a second survey. Findings from the second survey were discussed at a second, virtual, workshop. The core research team and advisory board further revised the consensus statement and recirculated it asking panellists for further comments. This iterative process resulted in seven final statement items; all participants have confirmed that they agreed with the content, objectives and recommendations of the final statement.
Conclusions The statement can be used to assist those that design, deliver and evaluate SBIs by providing guidance on: (1) minimum levels of competence for those designing and delivering SBIs; (2) the design and delivery of inclusive programmes prioritising disadvantaged groups; and (3) evaluation measures which are carefully calibrated both to capture proposed programme outcomes and to advance an understanding of the systems, processes and experiences of sport engagement in prison.
- PUBLIC HEALTH
- SPORTS MEDICINE
- Social Interaction
- PSYCHIATRY
- Protocols & guidelines
- FORENSIC MEDICINE
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STRENGTHS AND LIMITATIONS OF THIS STUDY
More than 40 experts from 15 countries came together to construct this statement.
There was overwhelming support that a consensus statement was required for sport-based interventions (SBIs) in prisons and that consultation events were required to achieve this.
Two rounds of surveys and two consultation events were completed by a multidisciplinary expert panel to develop and gather feedback from a broad range of stakeholders with expertise in designing, delivering and evaluating SBIs in prison.
While the study has incorporated some input from experts in the Global South (including those from Chile, Nigeria and Thailand), the statement has largely been constructed by experts from the Global North.
Despite engagement of many stakeholders, a limitation was the absence of views and input of people in prison.
Introduction
A growing number of sport-based interventions (SBIs) are delivered in prison settings. This creates a need to maximise the quality of intervention design and delivery, the clarity of theoretical underpinning, consistency in the training of facilitators and organisers, and the robustness of approaches to monitoring and evaluation.1–4 This growth in SBIs coincides with increased public and political interest in the use of sport to promote social, psychological and physical well-being,5 6 and in the impact of sport and physical activity-based programmes on mental health following the COVID-19 pandemic.7 Research has consistently demonstrated the capacity of sport and physical activity to promote social cohesion, psychological well-being and improved cognitive skills.8–11 However, existing studies have focused predominately on community-based sports programmes7 12–17 and relatively few prison-based programmes have been adopted, conducted and evaluated.1 18–20 The research which has taken place indicates that prison SBIs have been conceived, designed, measured, delivered, theorised and evaluated in very different ways.1 2 21–23 Although there are methodological advantages to evaluative diversity, a lack of consensus makes comparison between studies difficult and presents challenges for policy-makers.
Consensus and position statements have been published on psychosocial and policy-related approaches to mental health awareness programmes in sport,24 on applied and research aspects of sport and mental health,25 on elite athlete service provision26–28 and health-related issues in prison.29 A consensus statement on implementing and evaluating SBIs in prisons is notably absent, but necessary given the unique circumstances and vulnerabilities of those involved in such programmes.30 This is perhaps unsurprising, given that incarcerated populations are often regarded as a ‘forgotten’ group in society, this despite the fact that their well-being is an ‘important public health concern’, (Gatherer A,31:p.1) and the high prevalence of physical and mental ill-health in prison populations, including histories of victimisation and exposure to trauma.32–34 Reflecting wider patterns of structural inequality, socioeconomically disadvantaged and ethnic minority groups are significantly over-represented in many prison systems worldwide. People with poor physical and mental health are similarly over-represented. 35–38 This has led to ubiquitous calls to address the physical and mental health and well-being needs of those in prisons, and to safeguard their health entitlement in national and international prison health policies.39–42 However, research has consistently identified limitations in the availability and delivery of healthcare in prison settings.34 43 44 Indeed, some have suggested that the nature of imprisonment renders systems and settings incapable of adequately meeting the needs of people in prison.45 46
Due to heterogenous prison demographics, and the multiplicity of geographic, social and cultural contexts in which prison-based SBIs are designed, delivered and evaluated, it is our collective view that practitioners, policy-makers and sporting professionals would benefit from a sense of consensus on how they: (1) define ‘SBIs in prison’; (2) implement key elements of their design, including the choice of behaviour change theory that underpins intervention content; (3) set proposed goals, processes and outcomes for measuring programme impact and effectiveness; (4) operationalise methods for conducting and reporting interventions; and (5) make programmes inclusive. This statement aims to facilitate consistency, clarity and precision in these aspects of SBIs in prison and proposes a series of quality standards for future programme development, intervention, research and reporting.
Methods
The consensus statement was developed according to published guidance by the Enhancing the Quality and Transparency of Health Research Network for the development of reporting guidelines.47 We used the AGREE Reporting Checklist48 as a template, which is increasingly being used as a means of providing systematic processes for the transparent and complete reporting of essential information.24
Research design, advisory board and expert panel
The methodology for the research was developed by the core research team (CM, BC, GBre and FG), none of whom participated in the surveys. The research team was supported by a three-member advisory board (HM, IM and RM) who had extensive experience of designing, delivering and evaluating SBIs in prison. A panel of more than 40 experts from 15 international jurisdictions was formed, including representation from the following groups and stakeholders: professionals working in the criminal justice system (including representatives from prison, police and probation services); officials from sport federations and sports organisations; academics with research experience of prisons, secure forensic mental health settings and SBIs; members of the editorial committees of academic journals; and policy-makers in criminal justice and sport.
Round 1 of Delphi: initial survey development, analysis and results
The Delphi method is an approach to gaining consensus from a panel of anonymous experts using a phased process of surveys and feedback.49 The initial step using the Delphi method involved developing a rationale and summary statement for the international consensus statement, which were made available to panel members for them to read, discuss and importantly, adjust and build on. An online survey was also circulated to capture the expert panel’s perspectives on the rationale and summary statement. Sixteen respondents completed the first survey. Contributors to the survey and discussions represented 11 countries: Albania, England, Italy, Israel, the Netherlands, Northern Ireland, Palestine, Republic of Ireland, Scotland, Thailand and the USA. The survey consisted primarily of open-ended questions, producing qualitative data which was then analysed thematically using Braun and Clarke’s Six Step Data Analysis Process50 51 to search inductively for concepts, categories and themes emerging from the data collected. The reliability and validity of the analysis and final theme construction were established through cyclical checks conducted throughout the data analysis process to ensure the accuracy and rigour of the findings.52 The main themes emerging from the responses included the accessibility and attainability of the statement for practitioners, a need for more guidance on methodological design in research on SBIs and the need to differentiate between programme design and programme implementation and delivery.
Round 2 of Delphi: 2-day in-person group consultation
A total of 38-panel members attended the 2-day in-person group consultation at Ulster University’s Belfast campus on 29 and 30 June 2022, predominantly from across the UK and Ireland, with some from the Netherlands and Italy. On the first day, participants discussed the rationale and summary statement. They also engaged with five presentations by international researchers, policy-makers and practitioners with expertise in the implementation of SBIs in prisons. The presentations highlighted the need for: (1) consensus across a range of pertinent issues; (2) robust evidence and research into the effectiveness and outcomes of SBIs; and (3) coherent national and international policy development. The five presentations were titled: Developing a sport and physical activity strategy for youth and adult prisons in England and Wales (RM); The power of football in prisoner rehabilitation: understanding ‘The Twinning Project’ (CK); Key mechanisms for SBIs in criminal justice (HM); ‘Football works’: showcasing the ‘inside projects’ in Dutch prisons (GBri and HR); and Stay onside: a psychosocial evaluation of accredited SBIs with people in prison in Northern Ireland (CM and Mark Dennison, a member of Irish Football Association). Each presentation concluded with a key question for the panel of experts on good practice or minimum standards for delivering SBIs in prison.
Following this, GBre led a discussion exploring an array of emergent themes from the presentations and posing four key questions to participants: (1) Is there a need for a consensus statement on psychosocial and policy-related approaches to SBIs in prison? (2) Did they want to help shape the statement? (3) What information or objectives would they add to the summary statement (eg, on aims of the statement)? and (4) Did they have other comments or suggestions? The participants agreed that an international consensus statement was required, with seven reasons cited why there was an urgency for its development (see box 1 below).
Reasons to develop an international consensus statement on the design, delivery and evaluation of sport-based interventions (SBIs) aimed at promoting social, psychological and physical well-being in prison
The role of sport in improving health and well-being in prisons is being increasingly recognised.
The growing number of, and resources dedicated to, SBIs being delivered in prisons.
Programme content, design, theorisation and evaluation are not consistent.
The impact of programmes on people in prison and prison staff is not clear.
Various tools are used to measure impact; their validation and reliability are mixed.
Minimum training standards for people who deliver and evaluate SBIs in prisons have not been agreed.
Policy-makers are seeking consistent recommendations and guidance from evidence that is currently available.
On the second day of the consultation event, GBre reflected on the seven reasons identified above and summarised the survey findings from Round 1 of Delphi. Additionally, he presented a draft of preliminary objectives for the consensus statement, which had been constructed by the core research team based on survey responses and discussions from day 1.
GBre then facilitated a further discussion using a modified nominal group technique53 to reach a consensus on objectives for the consensus statement. Several additional questions and discussion points emerged: should the statement recommend a standardised validated instrument to evaluate SBIs in prison? Should it be expanded to include SBIs in the community with people who were ‘at-risk’ of becoming involved in the criminal justice system? Should SBIs in prison provide ‘through-the-gate’ (post custody) support to participants? If so, what kind of support would be appropriate and who should be responsible for this? Participants also decided that academics, policy-makers and practitioners should find agreed-on language to describe SBIs and that the statement should render domain-specific technical terms (‘coproduction’, ‘through-the-gate’, ‘desistance’, etc) accessible.
Attendees also discussed the benefits of a single, standardised instrument to assess SBIs, but concluded that it would be too restrictive for both researchers and practitioners and that outcomes for programmes often vary: some are team based or more oriented towards the individual, some have more of an emphasis on physicality,54 while others are less physical and have a greater emphasis on psychoeducation.55 It was agreed that the prison environment and the needs of individual people in prison posed a unique set of challenges and that interventions therefore require individual, bespoke assessment. However, several noted that many of the issues facing people in prison (such as physical and mental health, trauma and problematic substance use) could be traced to the community, therefore prisons should not be regarded as isolated penal institutions but part of a larger system of support. Reflecting this, the participants agreed that SBIs should provide some form of postcustody support, but recognised that this may be constrained by resourcing issues.
The survey responses further confirmed that an international consensus statement would be useful in helping to guide approaches to developing, delivering and evaluating SBIs in prisons. All those who completed the survey and attended the in-person consultation expressed an interest in helping to develop a statement and agreed to provide feedback on a draft statement. Despite there being agreement on the seven key objectives drafted and presented over the course of the initial, in-person consultation, there was a need to reconvene after the consensus statement was redrafted to consider the wording of the document, any required further revisions and to provide time for those involved to review the information presented.
Round 3 of Delphi: second survey and one-day virtual group consultation
The 24-panel members who attended the 1-day virtual group consultation hosted online by the Ulster University on 14 December 2022 were a more internationally diverse cohort than those who participated in the in-person consultation, with attendees emanating from the UK, Ireland, Sweden, the Netherlands, Italy, the USA and Canada. Members representing interdisciplinary groups were invited as experts to discuss the seven agreed objectives. Additional invitations were sent to experts who had not attended the first consultation event to increase the breadth of the expert panel.
Before the second consultation, participants were sent a draft consensus statement with the agreed revisions made to the objectives after the initial consultation event. A second survey was then distributed, which requested proposed amendments to the statement. A total of 16 respondents completed the second survey online, and a further 14 responded to the survey by email. This latter group addressed the questions in the survey, and also provided tracked changes on a Microsoft Word document. As in the first survey, across both sets of responses several common issues were raised, for example, that the consensus statement needed to be accessible and attainable for practitioners and that it needed to be theoretically and conceptually sound.
The virtual group consultation was chaired by GBre who introduced the session and presented the rationale for the event. BC and CM collected response data. The introductory presentation began with a progress report on what had been achieved since the first consultation. This included a summary of responses to the second survey, which captured participants’ perspectives on the draft consensus statement and the revisions that had been made to the statement as a result. The participants and panel then responded to two questions: (1) Did the seven objectives capture all that was needed for the consensus statement?; and (2) Should any other factors be considered?
Those who participated were actively involved in editing the draft objectives and agreed to review a new version of the consensus statement. The panel considered all suggested revisions and integrated those it accepted in the draft. Finally, all participants were asked to confirm that they agreed with the content, objectives and recommendations of the final consensus statement. Figure 1 outlines the different steps of the research process.
Methods flow chart: the methods flowchart is a visual representation of the sequence of stages involved in developing the consensus statement.
Agreed objectives of the consensus statement
Box 2 outlines the seven objectives that were agreed during the second consultation process (Round 3 of Delphi). The seven objectives are intended to: (1) inform those developing SBIs in prisons; and (2) provide direction for practitioners, policy-makers and researchers working in the area.
Agreed objectives of the consensus statement
Definition. The statement will describe ‘sport-based interventions (SBIs) delivered in prisons’ and key-related concepts.
Research design. The statement will identify standards for suitable and ethical data collection, analysis and reporting procedures, as well as appropriate and valid tools for studying the impact, experience and development of SBIs in prisons. The statement will also identify the roles of people in prison, prison officers and prison institutions, programme facilitators and organisers, and other stakeholders, in coproducing SBIs in prisons.
Programme design. The statement will provide guidance on the selection of appropriate theories, models and constructs to inform the content, implementation, practices and evaluation of SBIs in prisons.
Human capital. The statement will offer guidance on the knowledge, skills and competencies required for those who design and deliver SBIs in prisons.
Participant inclusion. The statement will provide guidance on how programmes are designed mindful of equity and inclusion to maximise opportunities for people in prison to engage and benefit from participating in SBIs.
Programme oversight. The statement will provide guidance on achieving multiagency buy-in, support from gatekeepers and good practices for stakeholder engagement.
Sustainability and impact. The statement will provide guidance on how to maximise the likelihood that SBIs in prisons have long-term sustainability and impact, through stakeholder reflection and evaluation.
Consensus statement objectives: explanation, elaboration and examples
This section elaborates on the seven consensus statement objectives and gives examples of practice from existing SBIs and research. It is worth noting that across the three rounds of Delphi, panellists repeatedly emphasised that there should not be one single, standardised instrument to design, deliver and evaluate SBIs in prison as programmes and outcomes are varied, and it would be too restrictive for both researchers and practitioners. The examples included below have been identified as instances of good practice and are not intended to be prescriptive or exhaustive.
Objective 1: definition
The statement describes ‘SBIs delivered in prisons’ and key-related concepts.
Definition explanation and elaboration
To begin, there are a range of descriptions and definitions of ‘sport’ as an activity, set of activities or broader concept. In this instance, due to its broad applicability in a range of geographic, economic, political, social and cultural contexts, we adopted the definition used by the United Nations Inter-Agency Task Force on Sport for Development and Peace (United Nations Inter-Agency Task Force on Sport for Development and Peace,56: p.2), which describes sport as: ‘all forms of physical activity that contribute to physical fitness, mental well-being and social interaction, such as play, recreation, organised or competitive sport, and indigenous sports and games’. Based on this definition, we suggest that academics, practitioners and policy-makers should consider SBIs as intentional interventions that have the potential to take steps towards addressing the structural position, social relationships and mental health needs of groups of multiple disadvantage in society.55 SBIs can be augmented by other components (‘sport-plus’) that may lead to positive outcomes for those people in prison, such as educational accreditation, employment and volunteering opportunities, community placements, and guest speakers.57 The aims of sport and recreation activities in prisons have been predominately framed in three ways1: (1) to improve the health and well-being of people in prison; (2) to support processes of desistance, rehabilitation and recovery; and (3) as an offender management tool. Attempting to understand the impact of sport only activities, versus the ‘sport-plus’ approaches, can make cause and effect conclusions difficult to make during evaluation. Indeed, striving for a contextual and nuanced understanding of the configuration of processes and mechanisms through which interventions seek to affect proposed outcomes is at least as important as seeking to evaluate causality.
Definition example
SBIs in prisons are intentional interventions that use sport to take steps towards addressing the structural position, social relationships and physical and mental health needs of groups experiencing multiple disadvantages in prison settings.55
Objective 2: research design
The statement identifies standards for suitable and ethical data collection, analysis and reporting procedures, as well as appropriate and valid tools for studying the impact, experience and development of SBIs in prisons. The statement also identifies the roles of people in prison, prison officers and prison institutions, programme facilitators and organisers, and other stakeholders, in coproducing SBIs in prisons.
Research design explanation and elaboration
With respect to research design, many individuals in prisons have experienced abuse, violence, substance misuse, various forms of trauma and psychological challenges including poor mental health.58 59 When evaluating, and reporting on SBIs in prisons, researchers must comply with appropriate ethical guidelines. These may include (but are not necessarily limited to), those set out by World Medical Association in the Declaration of Helsinki,60 the Economic and Social Research Council (Framework for Research Ethics),61 the British Psychological Society (Code of Human Research Ethics),62 the British Society of Criminology (Statement of Ethics)63 and the Social and Legal Studies Association (Statement of Ethical Practice).64 When collecting, analysing and reporting empirical data, programmes should adopt validated, theoretically informed and contextually appropriate tools to measure the mechanisms, processes and intended outcomes of any interventions and should not exacerbate harms experienced by people who are incarcerated. Measures should be aligned with the intended outcomes of programmes.24 65 66 Where appropriate, research should seek to measure not only reductions in recidivism but important experiences and effects that contribute to improved well-being, meet needs, and encourage, support, and maintain processes of desistance.67–70 Those involved in quantitative or qualitative programme evaluation should favour research designs that are carefully calibrated to both capture proposed programme outcomes and advance understandings of the systems, processes and experiences of sporting engagement in prison.
Those involved in developing SBIs for prison delivery should recognise that all stakeholders, including those in prison, prison officers and prison institutions, programme facilitators and organisers, and other workers and volunteers, can play a significant role in coproducing programmes.7 24 71 Coproduction can be facilitated by introducing a Steering Group for programmes and inviting relevant stakeholders to participate. Considering The National Institute for Health Research’s72 five minimal principles of coproduction in programme and research development will help underpin the success of the coproduction process. These include: sharing of power (ie, the research is jointly owned and people work together to achieve a joint understanding of project aims); including all perspectives and skills (ie, make sure the research team includes all those who can make a contribution); respecting and valuing the knowledge of all those working on the research and that everyone is of equal importance; reciprocity (ie, all contributors benefit from working together) and building and maintaining relationships—where an emphasis is on relationships to sharing power and a joint understanding and consensus and clarity over roles and responsibilities. In the absence of a coproduction approach, those developing SBIs must understand the organisational structure of the prison (departments and services), operations of the various departments and units (levels of security) and forensic competency (violence/sexual risk assessment, competency, etc).
Research design example
Developed in line with the British Society of Criminology’s Statement of Ethics and the British Psychological Society’s Code of Human Research Ethics, Murray et al’s23 research received ethical approval from Ulster University’s School of Applied Social and Policy Sciences Ethics Committee (20.0014) and the Office for Research Ethics Committees Northern Ireland (20/NI/0099). This research comprised a psychosocial evaluation of the Stay Onside: Applied Football Studies intervention delivered to people imprisoned on the separated regime in HMP Maghaberry, Northern Ireland. The research was set against five research objectives: (1) to understand participants’ experiences and attitudes towards the programme; (2) to explore the benefits and identify areas that could be improved; (3) to conduct primary research with programme participants and facilitators/organisers; (4) to assess the psychosocial impact of the intervention on well-being and opportunities for engaging in volunteering, education or employment; and (5) to provide material that could potentially contribute to the development of more appropriate policies and practice for SBIs in the prison system.
The research incorporated qualitative and quantitative elements. The qualitative element took the form of semistructured interviews with participants and facilitators/organisers. These were conducted on a one-to-one basis and in a separate room, out of earshot of other participants and module facilitators/organisers. The quantitative element included three validated psychological instruments to assess resilience (Brief Resiliency Scale), well-being (Warwick-Edinburgh Mental Well-being Scale-7) and general health (General Health Questionaire-28). Participants completed these measures at baseline (on the day module delivery commenced) and then again at endpoint (on the day that module delivery concluded).
Objective 3: programme design
The statement provides guidance on the selection of appropriate theories, models and constructs to inform the content, implementation and evaluation of SBIs in prisons.73
Programme design explanation and elaboration
Programme designers should underpin intervention components with appropriate theoretical and conceptual models, such that the design, delivery, evaluation and proposed outcomes of programmes are guided by robust, theoretically derived models of change that are likely to make interventions more effective.73–75 Programmes should identify clear learning outcomes for participants (what they can expect to experience and gain, in terms of accredited certification, enjoyment, health, well-being, etc). In turn, they should list and describe the sport content, practical sessions, theory classes and the duration and frequency of programmes, etc. Theoretical models of programme design and behaviour change that have previously shown promise include: Self-Determination Theory76 and the Theory of Planned Behaviour.77 However, given that prison environments may not always be conducive to research approaches that work in community settings, it may be more feasible to combine a focus on outcomes with a concern to undertake process evaluations of programmes within the framework of realist evaluation, which is a form of theory-driven evaluation.7 73 78–80 Realist approaches acknowledge and seek to explain the complexities of real-world factors, in this case prison environments. They ask questions about ‘how’ and ‘for whom’ interventions are effective, ‘why’ and ‘what outcomes’ result from those interventions. Realist evaluation may therefore be suitable when other approaches are beyond practical and logistical implementation within prisons. However, as Haudenhuyse and Debognies81 have argued, realist evaluative approaches might endanger space for democratic contestation by downgrading the expertise and agency of practitioners (and participants). Practitioners still need to be able to decide not to act according to academic evidence about ‘what works’, if they judge that such a line of action would be undesirable or even unethical for the incarcerated people they work with.
Programme design example
Morgan et al73 presented an academic evaluation of a theory of change model, developed in the UK by the Alliance of Sport in Criminal Justice, which highlights three interlinked phases that are critical to informing SBIs in criminal justice settings. In phase 1, the focus is on generating initial engagement from potential participants with the sports-based intervention offered. Engagement can be optimised by ensuring that the activity or sport(s) that is offered is: (1) popular or appealing to the targeted participants; (2) accessible for a broad range of participants which encompass diversity in terms of need, ability, gender and demographic background; (3) able to provide participants with a clear sense of ownership and control over the activities that are offered; (4) able to provide a release or a distraction from the routine of participants’ lives or acts as an antidote to boredom; and (5) delivered in a ‘safe’ and ‘neutral’ space where participants can express themselves with confidence, and develop and mature at their own pace. In phase 2, Morgan et al73 highlight the critical importance of relationships between sport delivery staff and participants as a platform for additional support and personal development. Constructing relationships that are trust based and enable participants to feel valued, or that recognise the challenges that programme participants encounter in their everyday lives, are vital to in this regard. Finally, in phase 3, interventions must ensure that they offer activities that run in parallel to the sport provision which also promote individual development opportunities for participants. Morgan et al73 propose that activities which enable the acquisition of human capital (ie, activities that involve opportunities for education and training, certification and qualifications82) or positive psychological capital (ie, activities that enhance prosocial qualities such as self-efficacy, self-esteem, personal resilience and emotional control83) are particularly beneficial.
Objective 4: human capital
The statement offers guidance on the knowledge, skills and competencies required for those who design and deliver SBIs in prisons.
Human capital explanation and elaboration
Those who design and deliver SBIs in prisons should possess a minimum level of prison awareness, safeguarding and workplace and personal safety training. When developing and delivering SBIs in prisons, stakeholders should adhere to relevant standards of professional practice and safeguarding, including, but not limited to, the United Nations Standard Minimum Rules for the Treatment of Prisoners,41 United Nations Sustainable Development Goals,84 the United Nations General Assembly Universal Declaration on Human Rights85 and CIMPSA Professional Standards.86 Moreover, they should understand the many forms of vulnerability that those in prison face and be capable of observing and acting on changes in moods or behaviours in others. They should know how and when to refer individuals for professional or other support if they require help. In so doing, they may learn from the experience and materials developed for existing global initiatives, such as Sport for Development and Peace (United Nations Department of Economic and Social Affairs87) and Youth Crime Prevention Through Sport88—the latter being underpinned by an Economic and Social Council89 Resolution. We suggest that practitioners should also be sensitive to prison cultures and environments and engage with awareness programmes which highlight relevant sensitivities.90
Human capital example
The United Nations Office on Drugs and Crime91 has developed a globally accessible eLearning platform which offers several self-paced online courses that are open to the public and free of charge. Anyone can access these courses after self-registering on the eLearning platform. One of these courses focuses on ‘The Nelson Mandela Rules’—the universally recognised minimum standard for the management of prisons and the treatment of imprisoned people. The course contains seven modules that are designed to assist the user in understanding and applying the Nelson Mandela Rules and users are provided with a certificate on completion. Each substantive module is comprised of both a theoretical and a practical element. Resource sections throughout the course provide references and access to more in-depth technical guidance materials. The course is primarily designed as a practical training tool for prison officers and other officials working in prisons. However, the course’s focus on security, safety, respect and the well-being of people in prison is equally relevant for anyone involved in the design, delivery or evaluation of SBIs in prison settings, in line with international standards.
Objective 5: participant inclusion
The statement provides guidance on how programmes are designed in relation to equity, diversity and inclusion in order to maximise opportunities for people in prisons to engage and benefit from participating in SBIs.
Participant inclusion explanation and elaboration
As a matter of both principle and good practice, SBIs in prisons should be inclusive and ‘designed to suit the requirements and personal characteristics of those practising them, as well as the institutional, cultural, socioeconomic and climate conditions of each country’ (United Nations Educational, Scientific and Cultural Organization,92: p.3). In turn, they should give priority to the requirements of disadvantaged groups.92 These may include people in prisons who are struggling to cope with the transition to a carceral environment, those who lack strong social connections in prison, and those who do little (if any) health-related physical activity, or have traditionally not readily engaged with public health services, or efforts to maintain or improve well-being (or desistance-oriented services). Particular attention should be given to the inclusion of imprisoned women, a traditionally forgotten population amid the historically androcentric structures of prison systems,93–96 along with gender and sexual minority populations.
Participant inclusion example
In their analysis of the relationship between well-being, desistance and physical activity, Meek and Lewis96 draw from qualitative data in the form of focus groups and semistructured interviews with imprisoned women (n=45) whose participation in SBIs in prison varied. The authors highlight that, compared with their male counterparts, there are low levels of participation in prison-based sport and physical activity by women in prison. This despite clear physical and psychological benefits, correlations in promoting desistance from crime and imprisoned women being aware of these advantages. Meek and Lewis outline a number of institutional barriers to participation, such as the poor promotion of sporting activities to women, a lack of choice of activity, conflicts with other aspects of prison regimes (such as work responsibilities) and the dearth of female physical education staff. These issues were exacerbated by wider gender issues, such as self-presentational and motivational concerns. Although respondents articulated these barriers, findings also suggested that many of the above obstacles could potentially be overcome if sporting activities or SBIs were designed with heightened sense of equity and inclusion in mind. Innovative practices and supportive staff who promote women’s strengths could actively contribute to this process. The authors outline principles of ‘best practice’ in terms of how sporting activities or SBIs might be offered to women in prisons, including providing a diverse programme of activities; promoting physical and mental health in conjunction with healthcare and gym departments; embedding literacy and numeracy into programmes; offering sports-based qualifications and/or community-based work experience; and/or providing ‘through-the-gate’ support via establish links with potential employers and community groups. Where such practices were evident, sport contributed more readily to meeting the complex well-being and resettlement needs of women, playing a potentially significant role in the promotion of desistance.
Objective 6: programme oversight
The statement provides guidance on achieving multiagency buy-in, support from gatekeepers and good practices for stakeholder engagement.
Programme oversight explanation and elaboration
Designers and organisers of SBIs in prisons should seek to obtain multiagency buy-in from key stakeholders, including the prison service, prison officers, wider support organisations, funders and relevant sports teams and federations prior to the programme design phase. To this end, they should maintain open lines of communication and be transparent with key stakeholders to develop genuinely collaborative and communicative partnerships and relationships.97 It may help to invite such stakeholders to join programme steering groups, thereby fostering a sense of stakeholder ownership via, for example, the oversight of programme delivery. In addition, steering group membership has the potential to further promote self-reflection, transparency, accountability and external, objective evaluation. These groups may also contribute to programme coproduction, as described above, and where possible, the use of high-profile sports personnel as role models/champions and ‘influencers’ in encouraging initial and sustained engagement.
Programme oversight example
In August 2021, Ulster University academics (CM, GBre, BC) set up a Research and Impact Advisory Panel for the ‘Stay Onside: Applied Football Studies’ interventions consisting of representatives from the Northern Ireland’s Department for Communities, Department of Justice, Prison Service and other external stakeholders that are involved in writing policy and shaping practice in prisons. The panel meets biannually to: share expertise and information about prison settings; discuss strategies to engage and accommodate the complex needs of imprisoned people; steer and inform research questions, interpret data from the evaluations, discuss findings, agree various types of dissemination for best potential impact; discuss the implications of the research; and discuss how it can shape future policy and practice.
Objective 7: sustainability and impact
The statement provides guidance on how to maximise the likelihood of SBIs having long-term sustainability and impact, through stakeholder reflection and evaluation.4 13
Sustainability and impact explanation and elaboration
All of those involved in the design and delivery of SBIs in prisons should endeavour to ensure that programmes are sustainable and have the potential for long-term impact, both on the lives and circumstances of participants, and also on the carceral systems and structures within which programmes operate. Defining, conceptualising and measuring sustainability is a complex task, with relatively little agreement regarding its definition across the wider literature on public health interventions.98 99 We rely here on100 distillation of sustainability as three core constructs: (1) the continuation of health benefits for individuals after initial funding ends; (2) the continuation of programme activities within one or more organisations; and (3) the building of a community’s capacity to develop and deliver programmes.
To achieve these goals, it is important to link what happens during the programme with what happens when it ends. Challenges in measuring and demonstrating the impact of SBIs remain.101 It is notoriously difficult to maintain contact with individuals after their release from prison, but it is possible to observe official reconviction data through initiatives such as the Justice Data Lab102 and it may be possible to identify community connection and employment patterns, especially if programme steering groups seek to include health, probation and reintegration services. Programmes should aspire to provide and consistently signpost support for people in prison post release.68 103 Programmes should also seek to build links with further and higher education institutions that deliver sport and exercise science and sports management courses at different levels, given that SBIs have been shown to offer legitimate educational pathways2 104 and to engage previously reluctant and/or disengaged prison learners.105
It is equally important to manage participants’ expectations at the point of programme completion and release from prison and to avoid creating unrealistic expectations in relation to the availability and suitability of employment pathways, for example, sports coaching opportunities with children or ‘at-risk’ vulnerable populations. Likewise, it is important to manage the expectations of stakeholders and policy-makers in terms of proposed programme outcomes, given that the processes in the programme’s delivery may have intrinsic value beyond intended outcomes. It is possible that some participants in SBIs will not seek or achieve developmental outcomes. Any form of activity that eases the ‘pains of imprisonment’106—whether through providing a source of pleasure, an opportunity to develop and master athletic skills, the ability to express agency and creativity, or a site for socialising with other imprisoned people, staff or volunteers—should still be recognised as valuable and meaningful in the lives of incarcerated individuals.
Sustainability and impact example
In the Netherlands, FC Emmen and Naoberschap United have joined forces to deliver the ‘Naoberschap Inside’ project which focuses on supporting the reintegration of people in prison by securing employment on release. Naoberschap Inside is an SBI that works with people during their imprisonment. FC Emmen aim to deliver club trainers for the prison in Veenhuizen so that people in prison can play football at least twice a week. As participants enter the latter stages of their imprisonment, those that pass specific security checks can engage in community-based volunteer work in local football stadiums. In cooperation with ‘MatchBoyz Recruiting and Career’, and in preparation for paid work on release, the SBI works with participants to complete a curriculum vitae outlining their employability skills. Once participants are released from prison, the networks of FC Emmen and Naoberschap United seek to find employment or further education/training opportunities for each individual. The SBI collaborates with more than 50 sports clubs, and since inception has worked with more than 400 people in prison, securing remunerated positions for 150 on release.107 108
Discussion
As a collective, and from our cumulative experience across the sport and criminal justice sector, we believe that implementing these consensus statement recommendations will enhance SBI programme design and delivery leading to a strengthening of the psychosocial approaches to SBIs in prison, and their development, delivery, impact and evaluation. In addition, we believe that a robust, evidence-based implementation of SBIs in prisons is required internationally to ensure that people in carceral settings have the opportunity to engage with theoretically informed, well-resourced, objective-led and sustainable sport and physical activity programmes. Equally, a robust evidence-base should ensure that ethically and methodologically sound data collection mechanisms are used in the monitoring and evaluation of such programmes. This consensus statement is designed to provide guidance for the development, delivery and evaluation (process and outcome) of SBIs in prisons. It is evident from previous studies of SBIs that examples of good/best practice are already in place.1 In turn, the continual undertaking of rigorous research is imperative to the promotion of critical reflection on the processes and practices of programme design, the facilitation of cross-jurisdictional policy dialogue and knowledge transfer, and the careful crafting of SBIs to help improve the lives and circumstances of people in prison. Moreover, the dissemination of empirical findings is crucial to the continued evolution of these programmes both inside and outside prisons. Going forward, there will be a need to translate these recommendations into prison service and national association policies on SBIs in prisons and to continually review their relevance and applicability in line with participants, practitioners and policy-makers. There is evidence of this already taking place and the impact of the statement being realised. Our hope is that this statement serves simply as a baseline and starting point to support professionals within the sector in optimising future work for the benefit of people in prison and their wider family networks.
Ethics approval
This study involves human participants and was approved by Ulster University’s School of Applied Social and Policy Sciences Ethics Committee (FCASPS-22-009). Participants gave informed consent to participate in the study before taking part.
Acknowledgments
We would like to thank all of those who took part in the surveys and events that contributed to shaping this consensus statement. Since the commencement of the process of writing this consensus statement, two authors have changed institutions. MM moved from University of Dundee, Scotland, to Monash University, Australia. GBre moved from Ulster University, Belfast, to Queen’s University, Belfast.
References
Footnotes
Twitter @cmurrayuuj, @BrendanCrim, @HaydnMorgan2, @iancriminology, @davegwoods, @tandy_tj, @FGenovesi1, @DrRosieMeek, @chriskay1, @hrovers, @Nagore_MM, @markdavidnorman, @emmaesherry, @breslin_g
Contributors CM, BC, GBre and FG, the core research team, designed and carried out this study. They were supported in doing so by HM, IM and RM, the three-member advisory board. CM, BC, GBre and FG convened both the consensus development conferences, which were attended by members of the expert panel, including DW, TH, MM, AP, AS, CK, GBri, HR, RH, DR, FC-O, BD, GBo, NM, DM-G, MW, MN, RD, ES, NC and KAA. The paper was initially drafted by CM, with feedback from BC, GBre and FG. It was then circulated two times to all authors who critically reviewed the drafts and provided written and verbal feedback. The final version was then circulated and approved by all authors before submission.
Funding This research was made possible by two support grants from Ulster University: the University’s Early Career Researcher Impact Fund, and the School of Applied Social and Policy Sciences’ Impact Fund. Funders had no role in study design, data collection, data analysis, decision to publish or preparation of the manuscript for publication.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.