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Social identity and the prison health worker

Implications for practitioner satisfaction and turnover intentions

Stephenson, Amber L.; Bell, Nicolette

doi: 10.1097/HMR.0000000000000179

Background: Delivering health care within the prison walls poses distinct and arduous challenges to the practitioner. Correctional health workers regularly face issues of overcrowding, increased prevalence of infectious disease, advancing age, deteriorating conditions, and patients with an inclination for violence. Still, regardless of the sizeable workforce, costs, and impact on community well-being, correctional health is often overlooked in health services delivery research.

Purpose: The aim of this study was to better understand the unique nature of delivering services in the prison context through the lens of social identity theory and further explore practitioner satisfaction and retention.

Methodology/Approach: A survey design was used in this study, sampling clinicians in a state department of corrections in the United States. Using the data from 317 respondents, the study explored the relationship between professional identification and perceived organizational support as they impact job satisfaction and turnover intention and while controlling for burnout.

Results: Using nested ordinary least squares regression and nested logistic regression, the results showed that professional identification and perceived organizational support were positively associated with job satisfaction. Perceived organizational support was negatively and significantly related to turnover intentions.

Conclusion: This article adds originality and value to the literature by using social identity theory to address the occupational perceptions of a large, yet often underrepresented and underexplored, subsector of the health workforce.

Practice Implications: The results highlight several areas where health care managers, whether from correctional or noncorrectional environments, could implement policy and procedure changes to further engage and retain the clinical workforce. To engage and retain the health worker population, managers must consider identification-reinforcing interventions that align with the self-concept and visibly display gestures of organizational support.

Amber L. Stephenson, PhD, MPH, is Assistant Professor, Health Care Management MBA, Clarkson University, Schenectady, New York. E-mail:

Nicolette Bell, PhD, is Special Assistant to the Secretary of Corrections, Pennsylvania Department of Corrections, Mechanicsburg, Pennsylvania.

The authors have disclosed that they have no significant relationship with, or financial interest in, any commercial companies pertaining to this article.

Online date: August 24, 2017

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