The development and initial validation of a screening scale for frailty within prison settings

The UK prison population is ageing. The proportion of prisoners in Scotland aged 50 years or older has almost doubled in ten years (from 7.7% in 2012-13 to 14.8% in 2022-23) and is projected to continue to rise.

The majority of older prisoners have 3 or more moderate or severe health conditions and long-term imprisonment is thought to accelerate ageing by about 10 years. There is an urgent need to better identify, understand and address the needs of people living with frailty in prisons so that interventions can be put in place to maximise function where possible and plan ahead for the end of life.

There is currently no frailty scale validated for use in the prison setting. In partnership with Strathcarron Hospice and the Scottish Prison Service, this PhD study will use mixed-methods to develop a scale to 1) identify key frailty characteristics of prisoners and 2) conduct preliminary psychometric testing of the scale. 
 
Suggested research questions:

• What should be included in a construct definition of prisoner frailty to comprehensively address the core domains of frailty within prison environments?
• What items are most suitable for translating the proposed construct definition of prisoner frailty into a self-report rating scale
• Which items are deemed clear, relevant, and acceptable by prisoners and experts, and can be used to develop a brief, psychometrically sound scale for assessing prisoner frailty?
• What evidence supports the convergent and discriminant validity, internal consistency, and factor structure of the newly developed scale?
• How does the new scale compare to existing measures and expert assessment, and what are the optimal cut-off points for maximising its sensitivity and specificity?