Participation as Health Education: Co-creating Health Literacy in Italian Prisons

Abstract People living in prison (PLP) face profound health inequities, with disproportionately high rates of mental health conditions, communicable diseases, and limited access to health-related knowledge. These challenges are exacerbated by social exclusion, institutional constraints, and a lack of training for custodial staff. This presentation explores a participatory intervention carried out in a correctional centre in Pisa, Italy, as part of a broader European initiative (EU-funded PARTNER project) to promote health literacy as a tool for agency, inclusion, and reflection. Using participatory co-creation methods, the programme created safe and inclusive spaces where participants could explore their own definitions of health, share experiences, and contribute to the development of culturally and contextually appropriate health education materials. These sessions prioritised relational reciprocity and fostered conditions for emotional and cognitive engagement, recognising participants not just as learners, but as contributors to a shared understanding of health. Through peer dialogue, storytelling, and interactive techniques, participants were encouraged to reflect critically on their present and imagine future trajectories. This process of personal and collective authorship helped restore a sense of continuity in environments often defined by fragmentation, disempowerment, and institutional control. The intervention also involved correctional staff, highlighting the importance of relational dynamics in shaping health behaviours and attitudes within carceral environments. By positioning health literacy as both a right and a relational process, this intervention shows how participatory methods can support empowerment and inclusion in structurally excluded settings. The experience highlights the transformative potential of engaging people not just as targets of education, but as active co-creators of meaning, identity, and care.