Participatory design of built environment strategies to enhance movement, wellbeing, and quality of life among incarcerated men

Abstract

Background The global prison population has grown by 5% since 2020, intensifying existing challenges to inmate health and well-being. Incarcerated individuals experience disproportionately high levels of sedentary behaviour (SB), which increases their risk of physical and mental health problems. Although regular physical activity (PA) can mitigate these risks, correctional settings often present environmental and institutional barriers that limit opportunities for movement. While modifying built environments has shown promise for promoting PA in community settings, limited research has explored these strategies in prisons. This study applied a community science, co-creation approach to identify inmate-informed, context-specific solutions to reduce SB and enhance PA within a prison setting.

Methods The study was conducted in a Spanish male prison with 26 adult inmates. Based on facility-use records and self-reported activity/sedentary levels, 13 highly active and 13 inactive inmates were purposively selected to capture diverse perspectives. Participants took part in structured workshops using the Our Voice community science framework. With the Our Voice Discovery Tool mobile app, they documented environmental barriers and facilitators to PA through geo-tagged photos and audio or text comments while moving through prison spaces. Data sources included workshop transcripts, facilitator notes, and app-generated digital content, which were analyzed using Braun and Clarke’s codebook thematic approach. Participants then proposed and ranked potential solutions using an Eisenhower Matrix, and these were later refined with input from prison staff and policymakers.

Results Six major themes influencing movement opportunities emerged: (1) activities, (2) spaces, (3) equipment and materials, (4) staff and support, (5) regulation-related limitations, and (6) scheduling. In total, 39 inmate-generated strategies were identified, 31 of which were rated as high priority. Low-difficulty actions included improved maintenance of activity areas, expanded access to equipment, and more flexible use of existing spaces. Participants emphasized that socially supportive environments were essential to motivation, adherence, and mental well-being.

Conclusions The study demonstrates the feasibility and value of participatory community science in correctional settings. Involving incarcerated individuals in designing PA solutions generates practical, context-appropriate strategies and supports greater health equity. This approach offers a scalable model for institutions aiming to reduce SB and promote PA through built-environment improvements.