Managing Chronic Illness Inside Virginia’s Prisons | Community Idea Stations


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Managing Chronic Illness Inside Virginia’s Prisons

Thousands of Virginians have taken workshops sponsored by the state that help people self-manage chronic disease. Conducted at hospitals, health clinics and community centers, the program is also offered in some state prisons. Virginia Currents Producer Catherine Komp recently sat in on a class and brings you this report.

Learn More: Find details about the Commonwealth’s You Can! Live Well, Virginia! Chronic Disease Self-Management initiative and the researchers who developed the program at Stanford University.


At Deep Meadow Correctional Center, inmates gather in a multipurpose room for their weekly wellness class. Registered Nurse Diane Stone gets things started.

Diane Stone: Who would like to volunteer what they did for their action plan and if it was accomplished, partially accomplished or if you changed it to something else.

Student: I guess I’ll start, my action plan was to try to incorporate more back stretches into my workout…

Developing weekly goals to improve physical and psychological health is an important part of this program. Some pledged to be more productive and cut out foul language; others committed to drinking more water and increasing exercise. If a goal wasn’t fully achieved, fellow students offer suggestions for doing better. And some shared success.

Student: My action plan was to walk five days for an hour, Monday through Friday. I exceeded it, on two of those days I walked an extra fifteen minutes.

Based on practices developed at Stanford University and now taught all over the world, the six week program helps empower people with heart disease, arthritis, diabetes and other chronic illnesses. Using the book Living a Healthy Life with Chronic Conditions, participants learn how to take charge of their own health. They learn how to understand symptoms and how diet and exercise can reduce pain and fatigue. Stone says the action plan is a big part of self-management.

Stone: They set their own goals and an action plan would be something that they would use to break down the goal based into achievable steps. There’s a definite process in doing the action plan. It is one of the very important aspects of the program along with decision-making and problem-solving.

(Ambient: Wellness class)

Part of today’s workshop covers healthy eating - not easy to do inside a prison where there’s limited choices and a lot of processed food. Co-teacher and registered nurse Gwen Fulmore guides the group as they look at food labels. They study calories, fat and sodium for chocolate kisses, cheesy refried beans and BBQ flavored chips.

Student: So is the saturated worse?
Fulmore: Yes.

They also take up another issue related to chronic conditions: depression.

Diane: Depression can affect fatigue, it can affect sleep, it can affect pain, so it can affect many of the different symptoms on the cycle.

The group brainstorms symptoms and comes up with solutions:

Stone, Students: Talk to someone...Get rid of self-pity… Eliminate the negative.

Others suggest meditation, counseling and acts of kindness.

Student: Do something nice for somebody else.

Devon Branham: My name is Devon Branham, I am an inmate at Deep Meadows Correctional Center.

Thirty-one year-old Brahnam has chronic back pain he’s trying to address, but he also signed up for the class because of his family’s medical history.

Branham: My mother, she passed away from stomach cancer a few months ago and I was really interested in wanting to know how to deal with these problems but prevent further injuries or harm to myself that might come in the future or family members maybe I could help in anyway. I just wanted to be of service not only myself but to others around me.

Christopher Williams: My name is Christopher Williams and I’m a Richmond native and I, like Mr. Branham over here, I took class because I have arthritis but also my mom passed away from breast cancer and cancer runs pretty deep in my family along with other diseases like high cholesterol and stuff like that. So personal education and also being able to educate my family members when I get around them as to what to look out for and also how to prevent them.

Inmates say they’re learning practical things, like exercises to build strength and foods that reduce inflammation and cholesterol. But the trust that’s built and supportive environment are also beneficial, says Williams.

Williams: A lot of the people in here too, if you look around, it’s not your average inmate that’s taking this class. There’s a lot of helpful guys in here that have insight and are willing to share it and that’s something you rarely find in here so it’s not just about the class, I feel a certain amount of camaraderie with the people who take the class along with me.

That mutual support, developed through the participatory nature of the workshop, helps feed positive thinking, which nurse Gwen Fulmore says is key to self-management

Gwen Fulmore: Believing that you can, that work around your disease whatever it is, you can succeed, you can live as normal a life as possible, if there’s such a thing as normal. But you do the best you can with what you got.

The wellness program is a collaboration between the Department of Corrections and Department for Aging and Rehabilitative Services.  In addition to Deep Meadow, workshops have been offered at Bland, Coffeewood, Pocahontas and the former Powhatan prison. With an aging prison population where about one-third of inmates have at least one chronic condition, the state aims to reduce millions in medical costs. Outside of the prison system, more than 650 wellness programs have taken place across Virginia, some in Spanish, Arabic, Chinese and other languages. Federal support for the initiative, called You Can! Live Well Virginia!, runs out this year. The Virginia Division for the Aging says they’re applying for more funding to continue the program.

For Virginia Currents, this is Catherine Komp, WCVE news.