Table 1 Included Studies

Ashton 2010 [75]

Canada

Qualitative

HIV/AIDS and HCV (& other infectious diseases)

Peer support

“Healing Lodge” – a small (28 bed) minimum/medium security prison for Aboriginal women, incorporating Aboriginal healing practices, meaningfulness and cultural-connection. Most women are serving sentences of 3 years or less.

Strengths of programme listed.

Not reported

3b

Staff perceptions.

Betts-Symond 2011 [76]

Ireland

Qualitative

Health, hygiene and cleanliness

Peer education

700 prisoners in Wheatfield prison, Dublin Ireland (medium-high security male prison) and their immediate family members

Personal development and changed outlook of the volunteers; results presented under 6 themes: Environment, behaviours, capabilities, beliefs and values, identity & goals.

Relationship between operational health services and inmate IRC volunteers.

3c

Blanchette 1998 [58]

Canada

Mixed Qualitative& Quantitative

General emotional/ mental health, psychological support and counselling

Peer support

Women resident in one of four small prisons in Canada: Nova Institution; Etablissement Joliette; Grand Valley Institution; Edmonton Institution.

Self-esteem;

Staff and prisoners’ awareness and perceptions of the role and functioning of the PST (surveys);

2b

Sociometric tests for understanding personal and group dynamics;

Perceptions of the prison environment (correctional environment status inventory);

Staff and prisoners’ views, feelings and ideas about PST (interviews).

Boothby 2011 [53]

UK

Qualitative

General health/ support

Peer support

Male prison in the UK.

Insiders perceptions of role and themselves.

Numbers of prison staff

1a

The scheme supports prisoners who are new to the prison system.

prisoners’ mood; suicide rates

Boyce 2009 [59]

UK

Mixed

Housing/resettlement

Peer advisors

Serving prisoners in:

skills and self-confidence, work ethic,

Effects on ‘professional’ time.

2a

3 category B prisons (male), 1 Youth Offending Institution (male)

sense of control over their lives, work experience and qualifications.

Staff concerns: potential for bullying or intimidation and breaches of confidentiality.

Brooker & Sirdifield 2007 [54]

UK

Mixed Qualitative & Quantitative

Multiple health issues

Health Trainers

Serving prisoners in 4 adult prison, one Young Offenders Institution and one probation setting

Perceptions of tutors of the Health Trainers re. confidence; knowledge of services; communication skills; ability to assess someone’s readiness to change; self-esteem; self-worth.

Perceptions of prison-based trainees re. their role.

1a

Perceptions of health trainers re. knowledge of health issues and attitude; confidence in sign-posting individuals to services; changing own behaviour.

Perceptions of stakeholders re:

Perceptions of health trainer clients; issues discussed; services referred on to.

-workload for prison PE departments

-training sessions

-Raising risk issues

- engagement with health services

-Change of focus for the gym

-Highlighting a lack of health services in some areas

-Raising staff awareness of health issues and/ or services available

Bryan 2006 [60]

USA

Quantitative

Pre-test post-test design (one group only).

HIV prevention

Peer education

196 serving prisoners in maximum and minimum security prisons. 90% male, mean age 30.4y.

Knowledge; Perceived risk; Condom attitudes; Condom norms; Condom self-efficacy; Condom intentions; Attitudes for not sharing needles; Norms for not sharing needles; Self-efficacy for not sharing needles; Intentions to not share needles; Peer education attitudes; Peer education norms; Peer education self-efficacy; Peer education intentions; Peer education behaviour.

Not reported

2b

Chen 2006 [29]

Israel

Quantitative Pre & Post

General emotional/ mental health, psychological support and counselling

Peer counselling

93 male repeat offenders in three prisons in Israel. (Two maximum security and one minimum security).

Sense of coherence; Meaning in life;

Not reported

2b

Mean age 36 years (SD = 6.35).

Anxiety; Depression; Hostility:

Cichowlas & Chen 2010 [77]

USA

Qualitative

General health/ support

Prison hospice volunteers

Ill/dying prisoners at Dixon Hospice in Illinois

Perceptions of peer deliverers

Not reported

3c

Collica 2007 [78]

USA

Quantitative & Qualitative

HIV/AIDS and HCV (& other infectious diseases)

Peer education

All prisoners in USA were covered by the survey.

Facilities were asked to report on:

Not reported

3c

1. Number of HIV positive inmates in their custody;

2. If they mandated HIV testing;

3. If they provided prison-based peer programming on HIV.

If answer to Q3 was YES:

Extent of HIV peer education, and other services.

If answer to Q3 was NO:

How HIV education was provided and why inmate peers were not used.

Collica 2010 [55]

USA

Qualitative

HIV/AIDS and HCV (& other infectious diseases)

Peer education

Aimed at women in prison with HIV/AIDS.

Role of peers

Not reported

1b

One maximum and one medium security prison for women

Correctional Service of Canada 2009 [79]

Canada

Quantitative & Qualitative

General emotional/ mental health, psychological support and counselling

Peer Support

Women prisoners “in distress”

From interviews: predominant mental health issues of women prisoners; how these are addressed in training sessions; benefits to trained peer counsellors

Trust between staff and prisoners

3c quant/3b qual

From survey: whether prisoners value the PST; reasons for asking to see a peer counsellor; benefits to service recipients; helpfulness of peer counsellors; recommendations for improvements

Staff becoming part of peer support team

Recommendations for improvements.

Daigle 2007 [24]

Canada

Not applicable

Suicide/Self harm

Peer support

Canadian prisons (no further details reported).

Not reported

Concerns about recruitment, security and responsibility

N/A

Davies 1994 [32]

UK

Qualitative

Suicide/Self harm

Listeners

HMP Swansea (adult prison)

Attempted suicide rate.

staff time.

2b

use of the strip cell or care room.

Prison atmosphere.

Listeners’ perceptions (benefits to Listeners)

Delveaux & Blanchette 2000 [80]

Canada

Quantitative & Qualitative

General emotional/ mental health, psychological support and counselling

Peer support

Small women’s prison.Women prisoners, all serving sentences of two or more years and classified as minimum or medium security.

Self esteem; Sociometric tests for understanding personal and group dynamics; Perceptions of the prison environment (correctional environment status inventory)

Staff and prisoners’ awareness and perceptions of the role and functioning of the PST (surveys)

3c

Staff and prisoners’ views, feelings and ideas about PST (interviews).

Dhaliwal & Harrower 2009 [61]

UK

Qualitative

Suicide/Self harm

Listeners

Vulnerable or distressed prisoners, or those at risk of suicide.

Listeners’ own experiences, the impact on them as individuals, skills and/or benefits acquired.

Presents findings in relation to what the prison service can do to support the scheme.

2b

Dolan 2004 [27]

Russia

Quantitative:

pre and post

HIV/AIDS and HCV (& other infectious diseases)

Peer education

Male colony for drug-dependent prisoners in Siberia. Mean age 24 (range 18–30), 63% first time in prison, mean years served 1.2 (SD 0.7), 66% imprisoned for drug related offence.

Whether seen the program booklet?

Access to bleach and condoms

3c

Whether participated in peer training education?

Demographic characteristics; Knowledge of HIV transmission; STI and BBVI status; Drug use; Sexual activity; Tattooing; Access to bleach and condoms.

Eamon 2012 [81]

Canada

Quantitative & Qualitative

General emotional/mental health, psychological support and counselling

Peer Support

Edmonton Institution for Women population = 65

Satisfaction with/ performance of PST;

Suggestions for improvement to number of sessions

3b

Hours per week of support provided by PST members; Time to response to inmate calls for peer response; Level of trust in PST members; Suggestions for improvement; Improving relationships.

Edgar 2011 [23]

UK

Quantitative & Qualitative:

Multiple health issues

Peer support/ Listeners

Not stated

Various, including Listeners and other peer roles.

Diverting workload away from staff.

2b

Farrin (undated) [82]

Australia

Review

Multiple health issues

Peer support

At-risk prisoner in 8 state prisons

Changes in responsibility, accountability and self-esteem (Syed & Blanchette 2000)

Reports the results from Devilly et al., 2003 on changing attitudes and behaviours; Offender preference

3c

Foster 2011 [56]

UK

Qualitative

Suicide/Self harm

Listeners

Adult category-B local male prison. Operational capacity 1103

Effect on Listeners’ personal development; Self-esteem; well-being; relationships.

Prison environment, burden on prison staff and health care professionals.

1a

Numbers of potential suicides and incidents of self harm.

Goldstein 2009 [83]

USA

Quantitative

Mental health/Substance abuse

Peer mentoring

2 correctional facilities. Incarcerated women with current or history of behavioural issues and/ or substance abuse.

Adherence to outpatient psychiatric treatment, including medication management; Medication compliance, sobriety & symptom reduction; Re-offending; Abstinence in the use of alcohol or illegal drugs or misuse of prescription drugs; Employment or enrolment in an educational program or completion of the application process for disability benefits; Secure treatment, transitional housing or a permanent place to live.

Nor reported

3c

Age range: 19 to 59 y (mean = 35 y). 15 out of the 32 participants had 5 or more prior incarcerations.

Grinstead 1997 [84]

USA

Quantitative:

RCT

HIV

Peer education

Male inmates at large (n = approx. 5600) medium-security state prison. . 45% had history of injection drug use, more than 75% of these reported having shared equipment.

HIV Knowledge; Preference for teacher;

Not reported

3b

Condom use intention; Bleach use intention; HIV antibody use intention;

Interested in taking test now.

Grinstead 1999 [25]

USA

Quantitative.

RCT

HIV prevention

Peer education

Large state prison for men. Mean age 35y, spent more than 9y of life in prison. 90% had just completed a sentence of less than 5y and <10% were imprisoned for the first time.

Risky behaviour at follow up:

Not reported

3c

used a condom the first time they had sex since release; used drugs since release; injected drugs since release; shared needles

Hall & Gabor 2004 [36]

Canada

Mixed quantitative and qualitative.

Suicide prevention

Listeners

Medium security prison with capacity 585. Inmates have committed serious crimes.

personal growth, knowledge of suicide, self-esteem, communication skills, and sense of purpose; support; general program operation; impact of training; personal development

Findings are reported related to program implementation

3c

modal age category 18-29y, followed by 30-39y. Length of sentence ranged from 2 years to life.

Hoover & Jurgens 2009 [85]

Moldova

Qualitative

HIV/AIDS and HCV (& other infectious diseases)

Peer outreach

7 prisons (6male prisons and 1 female prisons)

Not reported

Decline in HIV cases

3c

Hunter & Boyce 2009 [57]

UK

Qualitative

Housing/resettlement

Peer advisors

Prisoners requiring housing advice in 5 prisons in SE England (Three Category B prisons (male), one young offender institution (male) and one female open prison.)

social interaction with others; experience and qualifications to assist post-release; self-confidence.

Views of prisoners and staff re. staff workload and prisoners’ use of their time in prison.

1a

Jacobson & Edgar (undated) [62]

UK

Qualitative

General health/ support

Peer support

New arrivals at HMP Edinburgh

Effects on prisoners

Use of staff time

2c

Junker 2005 [86]

USA

Quantitative

Suicide/Self harm

Peer Observers

Those prisoners judged to be suicidal

Not reported.

Number of hours individuals spent on suicide watch post-IOP compared to pre-IOP (i.e. using staff for observations):

3b

Levenson & Farrant 2002 [19]

UK

Quantitative & Qualitative

Multiple health issues

Peer support/ Listeners.

Not stated

Perceptions of role ( peer supporters)

Not reported

3b quant/2b qual

Self-esteem.

finding accommodation and small amounts of money after release

Martin 2008 [63]

USA

Quantitative.

HIV/ HCV prevention

Peer education

3 sites: Delaware, Kentucky and Virginia.

The only outcome reported is condom use during sex.

Not reported

2b

RCT.

N = 343. Mean age 34y. 86% male.

Maull 1991 [64]

USA

Study design unclear

General health/support

Prison hospice volunteers

Ill prisoners at U.S. Medical Centre for Federal Prisoners in Springfield, Missouri

Effects on volunteers;

Retention/attrition of volunteers

2b

Effects on prisoners

McGowan 2006 [87]

USA

Qualitative

HIV counselling

Peer education

Male prisoners in state prisons in California, Mississippi, Rhode Island and Wisconsin. aged between 18 and 29y, incarcerated for at least 90 days, classified as minimum or medium security level, scheduled for release within 14 to 60 days.

Effect son HIV testing: mandatory testing at intake, voluntary testing at medical intake, and voluntary testing during a peer health orientation class.

Not reported

3c

Mentor 2 work [73]

UK

Study design unclear

Unclear

Peer mentoring

Prisoners with mental health problems at HMP Liverpool.

Self-esteem, confidence and motivation; Self-worth; Communication skills, reasoning and reflection skills; Mental health and treatment.

Numbers of volunteers and prisoners being mentored; effects after release.

3c

Munoz-Plaza 2005 [65]

USA

Qualitative

HIV/ AIDS and HCV (& other infectious diseases)

Peer education

A state correctional facility in California. Drug treatment program is located on a medium security prison yard that houses male inmates. age range 20–50 years

Not reported

Not reported

2b

O’Hagan 2011 [88]

UK

Quantitative

Literacy

Peer education

Serving Young Offenderss at 5 YOIs

Literacy:

Not reported

3c

Impact on learners;

Impact on mentors

Peek 2011 [89]

UK

Quantitative

Infectious disease prevention: screening and vaccination.

Peer education

Male prisoners at HMP High Down Category B male local prison.

Hep B and Hep C awareness and vaccination uptake.

signposting to healthcare,

3c

Chlamydia awareness and screening.

Effects on nurses utilising their time in the prison.

Effects on barriers between nursing staff and prisoners.

Prison atmosphere.

Changing role/perception of prisoners.

Penn State Erie 2001 [90]

USA

Mixed methods

Parenting

Peer education

Fathers in prison. State Correctional Institute at Albion (SCI Albion), in Erie county. A medium-security institution for men

contact with children per month/year;

Staff awareness and perceptions of programme

3c

Anger & Frustration; Knowledge about their child/children; Parental Locus of Control; ICAN Fathering Profile; Total Parenting score

Father’s Questionnaire: knowledge,

attitudes, skills, and behaviors.

Player & Martin 1996 [91]

UK

Study design unclear

Addictions/substance abuse

Peer counselling

Prisoners with addictions at HMP Downview

drug use; prisoner behaviour

Not reported

3c

Richman 2004 [92]

UK

Quantitative

General emotional/ mental health, psychological support and counselling

Listeners

HMP Manchester

Change in demeanour.

Effects on staff – peer worker relationship.

3b

Expected effects on release from prison (on Listeners)

Ross 2006 [66]

USA

Quantitative Pre & Post

HIV/ AIDS and HCV (& other infectious diseases)

Peer Education

36 Texas State prison units. Peer educators and students were predominantly male, aged 34–43 y.

HIV–related knowledge; self–assessed educator skills among peer educators; Diffusion of HIV–related knowledge;

impact of the peer education program on HIV testing at participating units

2b

HIV–testing behavior and intentions

Schinkel & Whyte 2012 [67]

UK

Qualitative

Housing/resettlement

Peer mentoring

Based in Glasgow – prisons not stated. Prisoners serving sentences of between three months and four years. Service offered to eligible prisoners who are returning to Glasgow, Renfrewshire and North Lanarkshire.

Effects on prisoners

Staff perceptions of life coaches’ need for support.

2b

Schlapman & Cass 2000 [93]

USA

Quantitative – pre and post

HIV prevention

Peer education

Incarcerated adolescents in North central Indiana juvenile facility.

AIDS knowledge & self reported sexual behaviours.

Not reported

3c

Scott 2004 [68]

USA

Mixed quantitative (pre and post) and qualitative)

HIV prevention

Peer education

Prisoners at 5 Texas prison facilities. A diversity of facilities was selected (small and large, short and long term, male and female prisoners)

HIV related knowledge, attitudes and beliefs among peer educators and students.

Factors affecting implementation, maintenance and overall impact of the program from the perspective of program coordinators, wardens and peer educators.

2b quant/2c qual

Sifunda 2008 [69,101]

South Africa

Quantitative Pre & Post

HIV/ AIDS and HCV (& other infectious diseases)

Peer education

4 medium-sized correctional facilities (male) in South Africa. Number housed comparable in size to UK prison..N = 263. Mean age 27 y (range 17–55). Mean period of incarceration = 2 years (range 6 m – 17 y).65% were first time offenders.

Knowledge and beliefs; Attitudes; Sexual communication, social norms about gender relations and sexual violence;

Not reported

2c

Self-efficacy; Intentions

Sirdifield 2006 [70]

UK

Qualitative

General health/ support

Health Trainer

All prisoners

Changes in Health Trainers’ attitudes and health behaviour.

demands placed on prison staff and health services as a result of the intervention.

2b

Recognising stress in other prisoners.

Snow 2002 [37]

UK

Quantitative

Suicide/ self harm

Listeners

5 prisons having a Samaritan supported Listener scheme. All prisons were local type establishments and chosen because of the comparatively high rate of suicide.

Perceived benefit from using the scheme:

Not reported

2b

Approachability of listeners

Availability of listeners

Use of listener scheme in the future.

Reasons for not using the scheme

Ways to improve the scheme

Stewart 2011 [94]

UK

Quantitative & Qualitative

General health/ support

Peer support

3 UK prisons.

Effects on prisoner-carers

communication between staff and prisoners. Training and supervision issues.

3c

Originally for older prisoners but to include those with learning disabilities, mental health problems and prisoners with physical and sensory disabilities.

Contribution to the health and social care services within the gaol.

Syed & Blanchette 2000 [95]

Canada

Quantitative & Qualitative

General emotional/mental health, psychological support and counselling

Peer Support

Small women’s prison, n = 78 at time of study. All were serving sentences of minimum 2 years and were rated at ‘minimum’ or ‘medium’ security levels.

Self esteem; Sociometric tests for understanding personal and group dynamics; Perceptions of the prison environment (correctional environment status inventory);

Staff and prisoners’ awareness and perceptions of the role and functioning of the PST (surveys);

3b quant/ 1c qual

Survey respondents, average age 34.5y (sd = 9.07, range 21–58). Average sentence length 4.39y (range 2 to 15y). Average time spent at Grand Valley = 9 months (SD = 0.62, range = 2 weeks to 2 years).

Staff and prisoners’ views, feelings and ideas about PST (interviews).

Syed & Blanchette 2000 [96]

Canada

Quantitative & Qualitative

General emotional/ mental health, psychological support and counselling

Peer Support

women’s prison in Canada. N = 56 at time of study. All were serving sentences of minimum 2 years and were rated at ‘minimum’ or ‘medium’ security levels.

Self esteem; Sociometric tests for understanding personal and group dynamics; Perceptions of the prison environment (correctional environment status inventory);

Staff and prisoners’ awareness and perceptions of the role and functioning of the PST (surveys)

3b quant/ 2b qual

All women, average age 35.1y (SD = 11.3, range = 21 to 62). Average sentence length 4.7 years (range 2y to life). Mean time served at Joliette = 13.3 m (range 2 m to 2.5y).

Staff and prisoners’ views, feelings and ideas about PST (interviews).

Taylor 1994 [97]

Australia

Quantitative and Qualitative:

Pre-post

HIV prevention

Peer education

New South Wales Correctional Centres. 90% of inmates had been in other correctional centres.

Knowledge; attitudes

Awareness of the peer education scheme.

3b

The Learning Ladder Ltd. (undated) [74]

UK

Qualitative.

Mentoring for education/to improve qualifications

Peer mentoring

HM Young Offenders Institution Reading – a small prison holding prisoners between the ages of 18 and 21y.

self-esteem; confidence; attitude to offending behaviour.

Success of scheme.

3c

Vaz 1996 [28]

Mozambique

Quantitative, pre-post

HIV/ STD prevention

Peer education

Largest prison in Mozambique (1900 prisoners incarcerated at time of study). 300 inmates sentenced to 1 year or longer, selected on entry. Mean age 26y.

knowledge around HIV/AIDS ; relationship between knowledge of HIV/AIDS and educational attainment of participants.

Not reported

3b

Walrath 2001 [71]

USA

Quantitative Pre & Post

Violence

Peer training.

Medium all-male security corrections facility in Maryland, USA, housing inmates serving sentences of 3 months or longer.

Anger; Self esteem; Optimism; Locus of Control; Behaviour

Not reported

2b

Age range: 18 to 51 y, mean age 30 y. Average sentence 20y, ranging from less than 1 year to life.

Wright & Bronstein 2007 [72,102] 2 papers

USA

Mixed Qualitative & Quantitative

General health/ support

Prison hospice volunteers

Dying prisoners in 14 prison hospices in the USA

Not reported

Impact of having a hospice (& implicitly, using prisoner volunteers) on prison environment & climate.

2c

Zack 2001 [21]

USA

Quantitative

HIV/AIDS and HCV (& other infectious diseases)

Peer education

Medium-security prison housing approximately 6000 men who stay at the prison for an average of less than two years. Men arriving at and leaving the prison, and women visitors.

Intentions to use condoms and be tested for HIV; Knowledge; HIV/AIDS testing; behaviour

Resistance from staff

3b

Institutional lockdowns

RCT

Zucker 2006 [98]

USA

Quantitative. One-group pretest - posttest.

Hepatitis C prevention

Peer education

Massachusetts county jail . 25 men who spoke and wrote in English.

Changes in self-reported behaviour, knowledge, relationship with teacher .

Not reported

3c