Three times a year, Richmonder Diane Stone travels to a remote facility in Powhatan County to help adults cope with chronic health problems. The 15 participants of each six-week workshop are unfailingly polite, respectful men who arrive on time for class, complete their workbook assignments and take the class very, very seriously. “They’re a joy to teach,” she says.
Donna Frazier and Darrell Estes (right) lead a workshop at Coffeewood Correctional Center in Culpeper County. (Photo courtesy: The Virginia Department of Corrections)
Nevertheless, these men are understandably nervous at first. They live in a world where trust is foolish and failure can be a necessary survival technique. Success makes you stand out — and that can be dangerous. But as Stone, a registered nurse, watches the incarcerated men at the Deep Meadow Correctional Facility relax around a table and brainstorm ways to help a classmate drink more water every day, or walk three times a week, something remarkable occurs. The men begin to help each other achieve their goals.
“I’ve seen it happen over and over again,” says Stone. “Someone will say, ‘I’ll wake you up for breakfast,’ or ‘I’ll make sure you skip dessert in the evening.’ And they do. They buddy up and help each other. And that’s something that doesn’t usually happen in this kind of environment.”
Since 2012, the Virginia Department for Aging and Rehabilitative Services (DARS) has partnered with the Virginia Department of Corrections to bring this wellness educational program for adults with chronic health conditions into the prison system. It’s funded by a three-year, $1.4 million grant DARS received through the Affordable Care Act. First introduced in Virginia for older adults in the general population, the Chronic Diseases Self-Management Education Program is designed to help people manage their conditions — and keep them out of hospitals and emergency rooms.
Developed by Stanford University, the program consists of a six-week workshop focusing on illnesses such as asthma, arthritis, diabetes and heart disease. Trained volunteers facilitate the
2 1/2-hour sessions, focusing on providing mutual support to build participants’ confidence in their ability to manage their health and maintain active lives. In a 12-month follow-up with nearly 1,000 participants, Stanford found that they had achieved a 13 percent improvement in a more active lifestyle, a 21 percent improvement in depression, and savings of $714 per person in emergency room visits and hospital utilization.
The decision to introduce the program into Virginia’s correctional facilities made perfect sense. Health care costs there are soaring. In 2013, the Department of Corrections spent more than $58.1 million on off-site medical care. Offenders who are 50 and older accounted for more than 45 percent of those costs.
“We know that the offenders that come to us are plagued by chronic disease,” says Elisabeth Thornton, the department’s corrections operations administrator. “They come to us with higher rates of chronic disease than the general public, and they get chronic disease problems while they’re incarcerated with us.”
The program’s emphasis on responsible self-care steered Virginia officials to target offenders who are within six to 10 months of release. April Holmes, DARS’ coordinator for prevention programs, who originally proposed the partnership, explains: “I think the workshop provides a model of healthy peer support for people. If you’re going to be returning to the community, I thought it would start you off on a good foot if you could find a way to relate to your peers in a supportive, healthy and accountable manner.”
Nearly 300 male offenders in Virginia have participated in the program so far. The workshops complement the Department of Corrections’ multi-pronged approach to managing the health of offenders. That approach also includes the operation of a farm that produces much of the food eaten by inmates. Explains Thornton: “If you can control your diet and your disease, you can control other areas of your life. That may sound small, but for some of our offenders, this is the only success they’ve actually ever had. It’s the idea of accountability with responsibility. And where better to start than with food?”
In prisons, the workshops are led by trained facilitators who themselves struggle with a chronic disease. (Stone, a master trainer facilitator, copes with asthma.) Each week, participants develop plans to improve their lifestyle, say by walking half a mile three times a week. At the end of every session, the participants are asked to write about their experience. One offender wrote, “The lessons you all have taught me will last a lifetime.”
That’s what matters to Stone. “These are guys who never thought they could have success in their lives. When I see the light go on and they start to get it that they can do simple things to help themselves, it’s amazing. What happens after the class, I don’t know. But after six weeks, I see their progress and
watch them learn to trust themselves and each other.”