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42074b03-6b8a-4374-ab92-19ec23c313f3 ADOPTED PROJECT: Happier Feet ADOPTED PROJECT: Happier Feet Disrupting the vicious cycle of healthcare decline in Diabetic Foot Ulceration through active prevention: The future of self-managed care Chief Investigator: Dr Andrew Weightman – University of Manchester Project Team Members: Dr Katherine Bradbury – University of Southampton, Professor Helen Dawes – University of Exeter, Mr Andrew Eccles – University of Strathclyde, Dr Safak Dogan – Loughborough University, Dr Glen Cooper – University of Manchester, Professor Frank Bowling – University of Manchester, Dr Xiyu Shi, Loughborough University, Professor Ahmeet Kondoz– Loughborough University Organisations Involved: Diabetes UK Background: There is a significant unmet clinical need for an adaptable, acceptable and adoptable technology to identify and prevent diabetic foot ulcer (DFU) formation, to enable self-management and timely clinical intervention to improve outcomes and reduce the economic burden of healthcare provision. Our primary purpose is to develop and implement an adaptable, acceptable, and cost- effective smart sensing insole technology which can detect when a DFU is likely to occur and can adapt plantar tissue loading to prevent formation, thus enabling self-management. This project proposes to build and expand on current smart insole technologies for the detection of DFUs, utilising a sensor fusion approach for their identification. A smart insole with integrated pressure (normal, shear), temperature, gait (IMU) and mechanomyography (acoustic) sensors will identify early indicators of ulceration and when movement is appropriate/inappropriate. The smart insole will respond to these inputs and adjust the foot (and gait), through an array of artificial muscles, to support better (safe/ comfortable) movement. This project aims to co-develop this new smart sensing insole with people living with diabetic foot ulcers. We hope to establish: What patients think of the idea of a smart sensing insole for early detection of DFUs which includes the provision to adjust the foot to reduce pressure on areas of likely ulceration. A prototype insole and optimised this with patient feedback. Early safety testing of this device. Security protocols to enable secure storage and sharing of data from this insole (e.g., between patient and clinicians). Publications Journal of Participatory Medicine - Developing a Smart Sensing Sock to Prevent Diabetic Foot Ulcers: Qualitative Focus Group and Interview Study In-shoe plantar temperature, normal and shear stress relationships during gait and rest periods for people living with and without diabetes | Scientific Reports

7a002421-31aa-4897-bd4d-da37a8b4cf6a Avoiding care escalations through targeted care coordination for people with multiple long-term conditions – a knowledge mobilisation project Chief Investigator: Simon Fraser, Professor of Public Health, University of Southampton Team: Nisreen Alwan, Professor of Public Health, University of Southampton, Lead for the Healthy Communities theme (from 1st Oct 2024), NIHR ARC Wessex. Robin Poole, Consultant in Public Health, Southampton City Council. Michael Boniface, Professorial Fellow of Information Technology, Director of the IT Innovation Centre, University of Southampton, and lead for the Workforce and Health Systems theme, NIHR ARC Wessex. Kelly Cheung, PPI lead, NIHR ARC Wessex and University Hospitals Southampton. Emilia Holland, Public Health Registrar, University of Southampton. Seb Stannard, Research Fellow, MELD-B project, University of Southampton. Claire Sheikh, Senior Pharmacist, Living Well Partnership, Southampton. Kelly Hislop Lennie, Principal Academic in Adult Nursing, Bournemouth University. Lynn Laidlaw, Patient and public contributor and researcher, PPI contributor MELD-B Sally Dace, PPI contributor MELD-B and Wessex ARC James McMahon, PPI contributor MELD-B, School of Primary Care Research UoS, South West Genomic Medicine Service. Lead PPIE for DIALOR, a digital intervention addressing frailty in Bournemouth University Partners: Hampshire and Isle of Wight Integrated Care Board, University Hospital Southampton NHS Foundation Trust, Bournemouth University, Southampton City Council, Living Well Partnership. Start: 1 October 2024 End: 31 March 2026 Summary This project is about taking knowledge that has been learned from two ongoing research studies about living with multiple long-term health conditions to see if we can apply it in a ‘real life’ setting in a large general practice in Southampton. Two research projects called ‘MELD-B’ and ‘the ARC Treatment Burden study’ have identified many aspects that make living with multiple long-term conditions challenging for people. This ‘workload’ might make it more likely that people feel overwhelmed by their health conditions. If people have a high workload, and particularly if they are frail, this can end up with them needing to be admitted to hospital. We have also identified that some aspects of people’s early life can make it more likely that they are admitted to hospital in middle age. If such challenges are recognised in advance and appropriate help provided, such unplanned admissions might be avoided. Care coordinators are people working in NHS settings, including GP surgeries, to identify and support people at risk of such admissions. They have a lot of people on their books and it can be challenging to know who needs what help, and who needs it most urgently. We want to see if the things we have learned from our previous research study can help the care coordinator make these decisions. In this short project we plan to do this in a large practice in Southampton, the Living Well Partnership, which looks after about 45,000 people. We plan to: · collate all the aspects identified in these studies that might make people more vulnerable · make sure we understand the current way care coordinators identify and engage with patients · work with all the relevant people in the practice to make sure we take people on this journey with us · undertake some workshops, co-led by PPI contributors, to co-develop the strategy for adding new aspects (such as the ‘workload’ and early life aspects mentioned above) to current approaches · test the addition of adding these in Living Well Partnership and evaluate the process We will share our findings at an event involving as many of the team from the Living Well Partnership as we can and get their feedback. This event will also include other relevant interested parties, such as those from the Integrated Care Board. PPI contributors have been deeply involved in the work of MELD-B, have helped to shape this proposal and will continue as co-investigators. They will be reimbursed for their contributions according to NIHR guidance. Read the public policy briefing

db9893e3-6d77-4b0c-aeda-4931a448eef5 A national evaluation of Project Cautioning And Relationship Abuse (‘CARA’) awareness raising workshops for first time offenders of domestic violence and abuse Health Inequalities National Priority Project in conjunction with ARC West, ARC NENC, ARC WM, ARC Y & H Principle Investigator: Dr Sara A Morgan , ARC Wessex, Lecturer in Public Health, School of Primary Care, Population Sciences and Medical Education Faculty of Medicine, University of Southampton Email: s.a.morgan@soton.ac.uk Co Investigators: Dr Steph Scott, NIHR ARC NENC Senior Research Fellow, ARC North East and North Cumbria, Email: steph.scott@newcastle.ac.uk Dr Jessica Roy, Lecturer in Child and Family Welfare, ARC West, Email: jessica.roy@bristol.ac.uk Professor Kate Jolly, Professor of Public Health & Primary Care, ARC West Midlands, Email: c.b.jolly@bham.ac.uk Professor Rachel Armitage Professor of Criminology and Crime Prevention School of Human and Health Sciences University of Huddersfield Huddersfield HD1 3DH Email: r.a.armitage@hud.ac.uk Dr Joht Singh Chandan, NIHR Academic Clinical Lecturer in Public Health, Murray Learning Centre University of Birmingham Edgbaston Birmingham B15 2TT Email: j.s.chandan.1@bham.ac.uk Dr David Culliford, Senior Medical Statistician NIHR CLAHRC Data Science Hub School of Health Sciences University of Southampton Southampton General Hospital (Room AA71, MP11) Southampton SO16 6YD Email: djc202@soton.ac.uk Dr Tracey Long, Professor in Health Economics and Outcome Measurements School of Health and Related Research 208, West Court 2 Mappin Street Sheffield S1 4DT Email: t.a.young@sheffield.ac.uk Mrs Fiona Maxwell Public Health Registrar, School of Primary Care, Population Sciences and Medical Education Faculty of Medicine, University of Southampton Email: f.maxwell@soton.ac.uk Dr Ruth McGovern, Lecturer in Public Health Research/NIHR Post Doctorate Fellow Population Health Sciences Institute, Newcastle University Baddiley-Clark Building Richardson Road Newcastle upon Tyne NE2 4AX Email: r.mcgovern@newcastle.ac.uk Dr Will McGovern Senior Lecturer, Social Work, Education and Community Wellbeing M005 Manor House, Coach Lane Campus (West) Northumbria University, Newcastle upon Tyne NE7 7TR Email: william.mcgovern@northumbria.ac.uk Dr Jessica Roy, Lecturer in Child and Family Welfare School for Policy Studies, University of Bristol 8 Priory Road Bristol BS8 1TZ Email: jessica.roy@bristol.ac.uk Background: Over one year, nearly 1,200,000 incidents relating to domestic violence and abuse (DVA) in England and Wales were documented by police, with almost half recorded as criminal offences. DVA leads to an adversity package of poor health and social outcomes, such as alcohol misuse and poorer reproductive health. Stakeholder consultation suggests that the criminal justice system (CJS) are struggling to constructively support victims, deter offenders or reduce reoffending, by means of an early intervention. Victims have voiced dissatisfaction and, collectively, professionals feel that they could do better. Furthermore, recent evidence suggests that COVID-19 has had a huge impact on the CJS, creating a backlog of up to 10 years. Hampshire Constabulary were ambitious to test an alternative response via an early intervention that would improve outcomes for victims and their families. Project CARA was developed in 2011 as a conditional caution offered by the police to first time adult offenders of DVA of standard risk. Offenders are required to undertake two mandatory workshops that increase awareness of their abusive behaviour and the safety of partners and children. In contrast to restorative justice, CARA is an awareness raising intervention for offenders, that utilises a trauma informed approach and motivational interviewing techniques across the pair of workshops. In these workshops offenders are further signposted onto services that support improvements in the wider determinants of their offending behaviour, such as to their GP, drug and alcohol services or onto a community perpetrator programme. An initial randomised controlled trial of CARA was undertaken in Southampton custody suite, showing a reduction in the frequency of re-arrest and prevalence of domestic abuse in the intervention arm, one year following randomisation. What we found out We found that CARA is likely to reduce the likelihood of reoffending both in the long term and immediate term, using domestic arrests as the outcome. Further evidence indicates that CARA led to immediate changes in the number of overall re-arrests and their severity. As involvement in CARA led to a reduction in the likelihood of rearrests for domestic abuse, CARA can be cost effective: with an estimated £5402 additional spending avoided (per domestic abuse offence). When comparing risk categories of standard, medium and high risk, there was no difference in the DVA arrests between categories. Whilst policy discussions indicate that medium risk cases may not be offered to CARA, they were commonly included (50%) and findings from qualitative work indicate that CARA was the best option for such cases, where there was no alternative available. Despite being a condition, victims may not be informed, nor consented, during the CARA process. •Through our participation with the CARA National Oversight Group, we are informing future service/commissioning of CARA through our recommendations. •We are also informing the Joint Justice Plan that is due to be developed by contacts with the National Police Chiefs Council in October. •We have also been approached by commissioners in New South Wales (Australia) for emerging evidence as they develop their DVA strategy. Publication: A national evaluation of Project Cautioning And Relationship Abuse (‘CARA’) awareness raising workshops for first time offenders of domestic violence and abuse: protocol for a concurrent mixed-methods evaluation design - read

3832ef1c-ee61-4cdf-8362-5cdbe7212017 Wessex NHS Insights Prioritisation Programme Project (NIPP) Wessex NHS Insights Prioritisation Programme Project (NIPP) National Institute of Health and Care Research (NIHR) Applied Research Collaboration (ARC) Wessex and Wessex Academic Health Science Network (AHSN) Digital innovations for people living with frailty Read the Health Innovation Network report Project team Nicola Andrews (NIHR ARC Wessex), Cindy Brooks (NIHR ARC Wessex), Cheryl Davies (Wessex AHSN), Linda Du Preez (Wessex AHSN), Richard Finley (Wessex AHSN), David Kryl (NIHR ARC Wessex and Wessex AHSN), Susi Lund (NIHR ARC Wessex), Michelle Myall (NIHR ARC Wessex), Rebecca Player (Wessex AHSN) and Phoebe Woodhead (Wessex AHSN). Background to the project NIPP was funded by NHS England’s Accelerated Access Collaborative to enable ARCs and AHSNs to work together to accelerate the evaluation and implementation of innovations that support post-pandemic ways of working, build service resilience and deliver benefits to patients. The Wessex NIPP project focused on the use of digital interventions to support the care of people with frailty. We worked collaboratively with stakeholders from across the Integrated Care Systems in Dorset and Hampshire and Isle of Wight to identify system priorities in this area. The project had several components: 1 – Evaluation of uptake and use of the myCOPD app by older people We undertook a mixed methods evaluation of the myCOPD app , a digital monitoring and self-management tool, in relation to its use by older people. The findings showed a higher prevalence of COPD in the myCOPD eligible population than the general population, highlighting the importance of understanding the impact of frailty on uptake and use of the app. Those aged 75 and over, or living with moderate or severe frailty, were less likely to register with and more likely to decline the app. There was also evidence that follow-up support to promote use of the app could increase activation and help overcome technical barriers. Evaluation of myCOPD app - Summary of findings (ARC Wessex) .pdf Download PDF • 180KB Evaluation of myCOPD app - Full Report .pdf Download PDF • 368KB 2 – Development of a Theory of Change on use of data to enhance care of people with frailty Theory of Change is a method to develop understanding of how an initiative can achieve impact. This is displayed in a Theory of Change map. The development and refinement of the Theory of Change map drew on a review of the evidence and individual discussions with a wide range of stakeholders. Participants were from primary care, community services and acute care working in digital health or care, frailty, commissioning and population health management. Stakeholders identified that a lack of availability of routinely collected data from across organisations to inform decision-making impacted the care provided to people with frailty. Theory of Change map - Use of data to enhance frailty care .pdf Download PDF • 176KB Theory of Change Report - Use of data to enhance frailty care .pdf Download PDF • 461KB 3 - Investigation of the use, applicability and acceptability of digital remote monitoring for older people a) Listening activities with older people’s community groups to understand perceptions of digital remote monitoring We held face-to-face events at six older people’s community group meetings, including a carers’ group, an exercise class and a community group serving a majority black ethnic population. At these events we discussed benefits, concerns and barriers to the use of digital remote monitoring (the ability to monitor aspects of an individual’s health remotely using technology). We also asked group members how they thought their views might change as their health or abilities declined. b) Research study investigating use and acceptability of digital remote monitoring for older people with frailty in the community This mixed methods research study investigated digital monitoring at home approaches among older people with frailty, using Artificial Intelligence (AI)-facilitated sensors to monitor daily activities and routines. c) Evaluation of digitally enabled care within frailty virtual wards The evaluation used qualitative data from two frailty virtual wards ( NHS England » Virtual wards ) to explore the use, decision-making and impact of digital remote monitoring. We combined the qualitative data from the above three work packages (a, b and c) for thematic analysis. We found that a personalised approach is important, with a need to consider practicalities (such as cost and sensor positioning) and design of the technology. Face-to-face care is highly valued and should not be replaced by digital remote monitoring. Users and carers need to know what to expect, how the technology works, who is monitoring and when; this would aid trust. NIPP 2022-23 summary report .pdf Download PDF • 624KB NIPP 2022-23 Full report .pdf Download PDF • 838KB 4 - Co-production, piloting and evaluation of an online Implementation Toolkit Implementation is a complex process. For those tasked with introducing an innovation or a change to practice, service provision or delivery, there are a range of models, frameworks and tools to choose from to support the implementation journey. However, these can be inaccessible, specific to particular user groups, or fail to take implementation considerations into account at the outset. The Web-based Implementation Toolkit (WIT) was co-produced with a range of stakeholders by NIHR ARC Wessex. It is a user-friendly and accessible guide on what needs to be considered when implementing and how to achieve this. WIT can be accessed at: Helpful resources | NIHR ARC Wessex More details can be found at: Implementation | NIHR ARC Wessex Rapid Insights Guide for 2022/23 work A Rapid Insights Guide (with project highlights) was produced for NHS England at the end of the 2022/23 projects (work packages 3 and 4 above). Rapid insights report NHS E_for submission .pdf Download PDF • 322KB

Dr Preeti Dhuria (University of Southampton) and Professor Christina Vogel (The Centre for Food Policy, City St George’s, University of London) discuss how weak enforcement lets retailers bypass UK obesity regulations < Back Chocolate at the checkout Weak enforcement of obesity regulations is undermining public health Dr Preeti Dhuria (University of Southampton) and Professor Christina Vogel (The Centre for Food Policy, City St George’s, University of London) discuss how weak enforcement lets retailers bypass UK obesity regulations It’s far too easy to choose unhealthy options in retail stores in the UK. This isn’t just a personal challenge for citizens, it’s a public health crisis. The places we shop shape our food choices and quite frankly, the odds are stacked against us in selecting healthy food. There is a growing momentum for strong policies to rein in the aggressive promotion of unhealthy foods, and that’s a positive step. In fact, the UK government introduced a ban on placing unhealthy foods at checkouts, aisle-ends and store entrances in 2022. But you wouldn’t necessarily know it as a shopper. Our research shows there is a significant lack of resources for adequate enforcement. This situation means we still see chocolate at checkouts in some stores and alcohol at the aisle-ends in others because stores are either breaking the rules or using loopholes to continue making money at the expense of the country’s health. Regulating the food retail environment is an important part of the solution to lower levels of obesity but weak enforcement can undermine health goals. The Food (Promotion and Placement) Regulations 2021 are designed to limit the promotion of unhealthy foods in most retail stores and online equivalents in England. When 22 local government officers were asked about their approach to enforcement before the regulations came into effect, the clear narrative was that these regulations would not be robustly enforced because of a lack of staff and training. Our research showed the key obstacles to enforcing these regulations include: Staffing Constraints : There is limited capacity within local authority enforcement teams to enforce these regulations. Their scarce resources are used for immediate threats to life like knife crime rather than assessing breaches, issuing notices and processing fines for these anti-obesity regulations. Inadequate financial support: Funding constraints further hinder enforcement because only £281k in funding has been allocated across the 317 local authorities in England to support these enforcement tasks, leading to inconsistencies across regions. Minimal training: Enforcement officers are likely to rely on personal judgment and experience due to limited training and guidance on how to interpret the definitions in the regulations, leading to significant variations in the interpretation and enforcement of the rules across regions. Despite the regulations’ long-term health goals, it is clear that they are ranked as a low priority and the process of issuing infringement notices is cumbersome. This situation is leading to patchy enforcement, and businesses not being held accountable uniformly. The processes for reporting breaches are also unclear meaning even action by the public is usually difficult. A freedom of information request covering a three-month period showed that no improvement notices had been issued despite instances of non-compliance being observed. A Call for Stronger Enforcement Our research outlines actions at the national and local levels that could help to improve the level of enforcement being undertaken. National-level actions Provide adequate and dedicated funding to local authorities to recruit and allocate staff specifically for compliance assessment of these regulations. Provide centralised training and detailed guidelines for enforcement officers to ensure consistency and build confidence among enforcement teams. Streamline compliance assessments by requiring manufacturers to disclose nutrient profile scores for their products and retailers to provide key details, such as store square footage and employee count, to their local authorities. Local-level actions Instigate linkages within local authorities by supporting cross departmental activity between trading standards, environmental health and public health officers to make enforcement efficient. Raise regulations’ priority by incorporating into joint strategic needs assessment within local authorities to increase buy-ins from councillors and Directors of Public Health. Lack of enforcement compromises impact Investing in enforcement is essential to securing regulation compliance and achieving the level playing field that food businesses and public health advocates called for. Early enforcement ensures that businesses fully understand their obligations, comply with the rules, and help build a precedent for healthier retail environments. Proactive enforcement sends a clear message- the regulations are here to stay, and compliance is non-negotiable. But local authorities cannot achieve strong compliance without adequate funding and the right tools. A lack of enforcement risks being misinterpreted as a sign of regulatory failure and withdrawal of the regulations. This outcome would be detrimental to the health of British children and families. Here are a few instances recently where our research team have spotted non-compliance but do not know how to effectively report the instances, and even approaching the store manager has not led to an immediate removal of products from restricted areas. To truly make an impact, future food policies must incorporate robust enforcement strategies and dedicated funding from the outset to maximise the regulations’ impact and safeguard public health. Previous Next

03ec3658-b736-400b-ba5c-c0762b7b0f06 Understanding, addressing, and meeting the complex needs of people living with long term physical and mental health conditions: a qualitative study Lead applicant: Prof Mari Carmen Portillo and Dr Leire Ambrosio Co-applicants: Prof David Baldwin, Dr Lindsey Cherry, Dr Kate Lippiett, Dr Pritti Aggarwal, Mr William Barnaby Jones, Dr Sara McKelvie What problem will the research address and what evidence do you have this is a major concern for the public and health and care providers of Wessex? People with long term physical conditions are 2-3 times more likely to have mental health problems than the general population: at least 30% of adults with such conditions also have mental health problems (like anxiety and depression). People living with physical and mental long term conditions experience hardships relating to health, and have complex psychosocial, environmental, financial, and spiritual needs. Healthcare professionals find it difficult to provide fully integrated care for these populations, due to systematic barriers and fragmentation of services. The NHS has incorporated an initiative involving Social Prescribing Link Workers (SPLW) in response to these complex needs. SPLWs connect people to community local services to meet needs through a comprehensive person-centred approach. However, the way in which this initiative occurs in different areas and services is variable, and there is unclear guidance for primary care services about how to integrate this novel workforce into wider efforts to address and meet the complex needs of people living with long term physical and mental conditions. Where will the research take place and who will you involve? The project will be undertaken in primary care practices in Hampshire, the Isle of Wight and Oxfordshire, and with a range of local third sector organizations (e.g., Anxiety UK, Mind). Semi-structured interviews will be undertaken with people living with long term physical and mental health conditions. Subsequent focus groups will explore the range of care provider perspectives (e.g., social prescribing link workers, GPs, nurses, practice managers). We expect to interview 20-25 individuals and conduct 4-6 focus groups with 6-8 participants per group. Maximum variation sampling will focus on sociodemographic characteristics (age, sex, ethnicity, socioeconomic background), with a sharp focus on disadvantage and deprivation. Overall aim: To determine the barriers and facilitators to successful implementation of the SPLW role in primary care for individuals living with long term physical and mental conditions. Specific objectives. Identify the range of health and social needs of people living with long term physical and mental conditions. Explore provider perspectives about social prescribing link workers role implementation and effectiveness for people living with long term physical and mental conditions. Explore user perspectives about social prescribing link workers role implementation and effectiveness Explore how, SPLW implementation methods can be adapted to better meet the needs of culturally diverse populations including those living within deprived areas. Explore potential limitations of SPLW model for people living with long term physical and mental conditions. Co-produce recommendations to enable effective implementation of social prescribing link workers to address health and social needs of people living with long term physical and mental conditions. A qualitative design, utilising semi-structured interviews and focus groups will be conducted. Patients and the public will contribute to all aspects of the research process. How will the findings inform improvements in population health and patient care. Following this study, a comprehensive tailored programme will be developed to address the complex needs of people with long term physical and mental conditions including those living in deprived areas. Plans for its implementation will be explored involving key stakeholders from and integrated Care System (ICS), Primary care Networks (PCNs), Local Authorities and any other organizations/sectors that may benefit from the findings. Publications https://doi.org/10.1155/2023/7191247

16c59677-d7b2-4332-b74a-b4b17ed064ed How to Support children with cancer, or another serious condition, and their parents during the COVID-19 outbreak How to Support cHildren with cAncer, or another serious condition, and theiR parents during the COVID-19 outbreak?: understanding Experiences, information and support needs, and decision-making – the SHARE study Research team Chief Investigators: Professor Anne-Sophie Darlington- Professor of Child and Family Psychological Health- University of Southampton Dr Bob Philips- Senior Lecturer and Honorary Consultant in Paediatric / Teenage-Young Adult Oncology-The Leeds Teaching Hospital NHS Trust Dr Jess Morgan- Senior Research Fellow & Paediatric Oncology Trainee- University of York Mr Ashley Ball-Gamble- CEO of Children’s Cancer and Leukaemia Group (CCLG)- CCLG Project team members: Dr Nicole Collaço- Research Fellow- University of Southampton Dr Luise Marino- Clinical Academic Paediatric Dietitian- University Hospital Southampton Dr Arvind Nagra- Paediatric Nephrologist- University Hospital Southampton PPI group Organisations involved: University of York, Children’s Cancer and Leukaemia Group, University of Southampton, University Hospital Southampton, The Leeds Teaching Hospital NHS Trust, Kidney Research UK, Kidney Care UK, British Heart Foundation, Children’s Heart Foundation ,Cystic Fibrosis Trust, Together for Short Lives, The Martin House Research Centre, Harry’s Hat, Shine. Summary Children and young people with cancer may be particularly vulnerable. Those undergoing treatment have a weakened immune system, meaning they will find it more difficult to fight infections. [1] Comprehensive advice for parents has been compiled by experts and disseminated through the UKs Children’s Cancer and Leukaemia Group (CCLG).[1] However, we urgently need to increase our understanding of evolving experiences, information needs and decision-making of these families under these extraordinarily stressful circumstances. Only through investigating parents’/main carers’ experiences and needs will we be able to tailor and provide the right support, in terms of guidance, information updates, and online interventions to reduce distress and anxiety. What did we find out? We found that the impact of COVID-19 on different populations shared some common experiences: Disruption to healthcare services- all populations faced challenges due to disruptions in healthcare services which affected access to necessary medical care and treatments Increased anxiety and stress- COVID-19 brought about increased anxiety and stress levels in all populations, particularly amongst caregivers who had specific concerns about their child’s health and safety Limited social interactions- the pandemic led to limited social interactions for all populations, resulting in feelings of isolation and loneliness Social support networks: families in general faced amplified challenges due to limited social support networks, emphasizing the importance of community resources in managing the pandemic’s effects. Reassurance gained that certain populations may not be at significantly higher risk of adverse outcomes or psychological distress. Findings emphasised the need for tailored support services, clear communication, education and psychological support to address challenges faced by these populations during the COVID-19 pandemic. What difference will this make? Insights provided valuable information for healthcare providers and relevant charities organisations to make informed decisions about how to support people and allocate resources effectively. In addition the information can be used to develop targeted strategies and interventions that address the specific challenges faced by different populations such as disruption to healthcare services, increased anxiety and stress and limited social interactions. By understanding the impact of COVID-19 on various populations, policies can be developed to address the specific needs and concerns of different groups. Findings emphasised the importance of prioritising clear communication, education and psychological support to ensure the wellbeing of these populations. Why is this important for patients, health and care providers and policy makers? Patient care: understanding the impact of COVID-19 on different populations helps healthcare providers tailor their services to meet specific needs; including ensuring access to healthcare services, managing increased anxiety and stress and providing psychological support. Health & Care Providers: the findings provide valuable insights for healthcare providers to address the challenges faced by different populations. This includes adapting healthcare services, clear communication and providing education to effectively support patients. Policymakers: Knowledge of the impact of COVID-19 on various population helps policymakers make informed decisions, including allocating resources, developing tailored support services, and implementing policies to address the specific needs of different populations. Research outputs: COVID-19: experiences of lockdown and support needs in children and young adults with kidney conditions Yincent Tse, Anne-Sophie E. Darlington, Kay Tyerman, Dean Wallace, Tanya Pankhurst, Sofia Chantziara, David Culliford, Alejandra Recio-Saucedo & Arvind Nagra COVID‐19 and children with cancer: Parents’ experiences, anxieties and support needs Anne‐Sophie E. Darlington, Jessica E. Morgan, Richard Wagland, Samantha C. Sodergren, David Culliford, Ashley Gamble, Bob Phillips https://onlinelibrary.wiley.com/doi/full/10.1002/pbc.28790 https://journals.sagepub.com/doi/full/10.1177/21501351211007102 https://link.springer.com/article/10.1007/s00467-021-05041-8 https://onlinelibrary.wiley.com/doi/full/10.1002/ppul.25537 https://onlinelibrary.wiley.com/doi/pdf/10.1111/apa.16229 https://link.springer.com/article/10.1007/s00381-023-05980-7 https://adc.bmj.com/content/108/3/198.abstract https://www.thesun.co.uk/news/11968084/coronation-street-mitochondrial-disease/ https://www.togetherforshortlives.org.uk/forgotten-families-families-feel-more-isolated-than-ever-under-lockdown/ https://www.southampton.ac.uk/news/2021/04/share-study-results.page https://www.ncri.org.uk/areas-of-interest/cancer-covid-19/ 11-share-study | Institute for Life Sciences | University of Southampton Life Sciences Annual Reports | Institute for Life Sciences | University of Southampton Conferences/presentations: SIOP (International Society of Pediatric Oncology)- E-poster discussion (2021) Royal College of pediatrics and child health- poster presentation (2021) 53rd ESPN Annual Meeting- oral presentation (2021) 7th King John Price pediatric respiratory conference- poster presentation (2021) Webinar- Nutricia- What's next for improving nutrition & growth outcomes in infants with congenital heart disease? (2021) Webinar- University of Surrey: Impact of Covid-19 on families: a focus on new parents, children, and people with learning disabilities, with reflections from professional practice (2021) Webinar: Pediatric Oncology Educational meetings (2021) Webinar: European Paediatric Psychology Network (EPPN) – background and mission (2020)

663cd08e-9825-45c9-8e1b-c94d485206ee SOCIAL CARE: Building capacity in social care through co-produced research and a research learning partnership between University of Portsmouth and Portsmouth City Council Background Social care is facing many challenges and, in a time where staff are stretched and resources are low, research can feel like a luxury rather than part of daily activities. Yet research is crucial for improving practice and finding innovative ways to overcome challenges. To increase capacity in social care research, academia and social care need to work together to understand each other and co-produce a programme that will fit with the workplace demands of social care and focuses on issues that hold meaning and value to those we are seeking to engage. The work that we co-produce will therefore lead to tangible practice change and/or a strengthening of the evidence for existing practice. The University of Portsmouth (UoP) and Portsmouth City Council (PCC) do not currently have a research learning partnership established, however our civic partnership agreement provides a strong impetus to build a learning partnership that will inspire, engage, and provide professional development for social care professionals in research, whilst providing academics with direct experience of co-producing research in complex public service contexts. Through this project we aim to develop such a research learning partnership. Contributors: Amy Drahota, Reader in Health & Social Care Evidence & Evaluation, University of Portsmouth Carole Fogg, Senior Research Fellow, University of Southampton Patricia Gilbert, Lecturer (Sociology), University of Portsmouth Patryk Jadzinski, Senior Lecturer (Paramedics), University of Portsmouth Gail Mann, Research Development Lead, Portsmouth City Council Nils Niederstrasser, Senior Lecturer (Psychology), University of Portsmouth Lucy Porteous, Senior Lecturer (Social Work), University of Portsmouth Clare Rachwal, Deputy Head of Service, Adult Social Care, Portsmouth City Council Jenny Roddis, Associate Head (Research & Innovation), University of Portsmouth Sharon Smith, Principal Social Worker, Adult Social Care, Portsmouth City Council Annabel Tremlett, Senior Lecturer (Social Work), University of Portsmouth Aims and Objectives Our overall aim is to build research capacity in social care through establishing a research learning partnership between the University of Portsmouth (UoP) and Portsmouth City Council (PCC) adult social care team, the public and other key partners, and develop co-produced research relevant to PCC social care practice and national issues. We will achieve this via the following four objectives: A. To establish a research learning partnership for social care between UoP and PCC which will provide learning opportunities for both partners and their associated stakeholders around the development, design, and delivery of research. B. To identify and prioritise research topics for development for further grant funding opportunities, within social care and also in collaboration with other health and care delivery partners. C. To undertake preliminary research activities (e.g. a systematic review, public involvement activities, and potential data gathering) on a prioritised topic in adult social care, which will underpin a funding application for further primary research. D. To develop guidance on increasing capacity in social care research via co-production in collaboration with wider ARC Wessex social care research partnerships. Research Plan / Methods We will begin this project with a three-month exploratory process with social care teams, that will be about relationship-building and working together to devise a programme of activities that will meet the needs of social care, establish what a learning partnership would look like, and how this will fit with the expertise of academics. We envisage that we will co-develop some activities that centre around relevant topic(s) of importance to social care, and that the academics can support based on their expertise. Our focus will be adult social care, to tie in with the School of Health & Care Professions’ thematic strength in older adults, PCC’s adult social care team, and the ‘ageing and dementia’ research area of ARC Wessex. The project will involve a researcher-in-residence, employed by UoP but embedded within PCC, to work alongside adult social workers and build a culture of joint research across the organisations. We will be seeking to integrate research into current processes, for example through senior social worker team meetings and practice support forums that would be happening anyway. Throughout the project we will be seeking to establish a legacy of ongoing work and practice, through the development of funding applications for future projects and the development of a community of practice that will outlive the duration of the funding, nurture an affinity for research, and help demonstrate the value of research to social care. Summary of findings This project had four strands: 1: Growing a research culture and working together We helped six people at Portsmouth City Council (PCC) to become research active or develop their research skills; four were awarded ‘Visiting Researcher’ status at the university, and two were social workers employed on the joint social work project as research assistants. Of the four visiting researchers: One social worker received mentorship to undertake their own small research project; One Mental Health Practitioner developed their research ideas, and applied for research funding; Two individuals independently completed a research project and were supported to develop their analysis and findings through collaboration with University researchers. All individuals are pursuing further research and supporting each other. 2: Joint social work project A research question was developed through discussions and shadowing within adult social work teams at PCC. This led to a review of the evidence on how and why different features of collaborative working may impact the outcomes of older adults receiving services. We found 28 relevant studies that helped develop three theories on collaborative working. The theories relate to: how multidisciplinary team meetings are managed; how staff can learn from each other and feel safe to speak out; how new solutions for older adults can arise when staff feel safe to speak out. These theories can be used to develop recommendations and new interventions to improve how social workers can work with other professionals to provide the best care for older adults. 3: Research learning programme A 6-part seminar series, Research Skills in Social Care , was delivered in-person for colleagues at PCC and online for wider audiences. The series gave an overview of the six stages of conducting a literature review to grow research knowledge and encourage discussions. Team members also gave seminars on their research projects through the Applied Research Collaboration Wessex online seminar series. 4: Reflecting on what we have learnt about growing research The process of growing research has been rewarding and challenging. Success has come from mentorship and individual relationships where trust and rapport are developed, and confidence is built at a steady pace. Arranging rooms and technology in a different organisation for the seminar series was difficult, however the in-person nature of the seminars was beneficial for sparking informal conversations and removing barriers between research and practice, presenting an “accessible” face. What we did with this Knowledge The knowledge from the joint research project is being shared with the wider adult social work team to inform team development. Additionally, we are working the Health Determinants Research Collaboration (HDRC) at Portsmouth City Council to establish how the activities to grow research can be expanded to other areas of the city council and local authorities wider afield. We are working together to develop a report for publication and continue to work with the adult social work team to grow research. Where next? • A funding application has been submitted by an Approved Mental Health Professional to conduct a literature review around racial disparities in coercive mental health treatment •A social worker is planning small research project evidencing the need for a larger autism/neurodivergence support service for adults •Further collaboration with Health Determinants Research Collaboration initiative •Discussing development of interventions based on the findings of the joint research project. This will form the basis of a future funding proposal. Koren Luddington – Visiting Researcher & Social Worker “I was matched with a mentor from the University, who was empathic and reassuring of my self-doubts. She made me feel as though all questions were valid and she was able to provide explanations that felt personalised and relevant to my field of work” Taken from Koren’s blog post on NIHR ARC Wessex Supporting capacity building in this project has been really eye opening - throughout this project I have met incredible, passionate people that are doing everything they can to provide support. There is such a wealth of knowledge and innovation happening in Adult Social Care, and it’s up to us in research to support and encourage that. Dr Leah Fullegar Leah.Fullegar@port.ac.uk

a7ea3c51-ca08-45ba-a500-e478bca6eb43 Motivating and sustaining engagement of young people in improving their health and that of their communities Prinicpal Investigator: Professor Mary Barker Team: Kathryn Woods-Townsend, University of Southampton, James Toop, Bite Back 2030, Matthew Ryan, University of Southampton, Joanna Sofaer, University of Southampton, Pathik Pathak, University of Southampton Start Date: 1 April 2023 End Date: 30 September 2024 Background Calls by young people for increased involvement in decisions about their health and futures are echoed by WHO and UNICEF. These reflect threats to their health from inequalities and climate change, exacerbated by COVID-19. To be “architects of their own future” and have decision-making power, young people need training and opportunities to build confidence, and structures and processes that allow them to be involved in decision making. Aims We aim to explore how best to engage and maintain engagement of young people in these activities with a view to improving their health and well-being and that of their communities Our specific objectives are to: develop and test a training course for young people in skills to support participatory action research into health and well-being; test the effectiveness of arts-based approaches in engaging young people in health improvement; understand how to create a reliable, scalable and sustainable model for effective youth activism; evaluate democratic innovations to engage young people in decision making processes to influence health policy. What did we find out? Through our project we found that young people can meaningfully participate in decision making on topics that are important to them. During the year young people were engaged in two separate ways: Firstly, BiteBack 2030’s youth advocacy programme was analysed and essential components of its success extracted. Those factors included establishing open two-way channels for communication, Working to create an environment where young people’s and staff views are equally valued, Supporting staff to develop excellent facilitation skills, Investing in young people’s skills, Campaigning on issues that young people feel are important and current and Reviewing success and challenges of each campaigns and adapt activities in response. Secondly, young people were successfully trained in research skills, advocacy and democracy during a 12-week Young Researcher Training Programme. The training programme allowed young people to investigate a health topic that was important to them and collect data from their peers and community. Their projects ranged from looking at exam stress, vaping, benefits of youth participation, to women’s health issues, failures in the PSHE curriculum and vaccine hesitancy. The results from their research went towards creating a set of health recommendations that young people felt should be prioritised for the improved health and wellbeing of young people in Southampton. A Youth Jury was held in July 2024 where the recommendations were refined based on collaboration with the Hampshire and Isle of Wight Integrated Care Partnership. The 12 amended recommendations formed the basis of a manifesto for health which included the following points to be addressed by decision makers: 1.Expand Extra-Curricular Wellness Activities. 2. Improve our methods of handling young people’s mental health by creating accessible services. 3. Respond to Vaping Proactively. 4. Deliver a comprehensive digital health platform for young people. 5.Review the PSHE Curriculum. 6. Encourage the mixed teaching of Sexual and Reproductive Education (SRE) . 7. Cultural & Religious Sensitivity . 8. Information to Parents. 9.Deliver Youth Engagement. 10. Diversify and Expand Work Experience and Financial Support for Prospective Professionals. 11. Establish Panels to Honestly Inform Young People about NHS Careers. 12. Produce Youth- Led Marketing. Evaluation of the effectiveness of the training programme, Youth Jury and Assembly at engaging young people in decision making and the resultant responses from decision makers is still ongoing. Final results will be available from spring 2025. You can see Young People talking about their recommendations here What did we do with this Knowledge? • The recommendations created by the young people within the manifesto for health were presented to the Integrated Care Partnership (ICP) and wider stakeholders in health and wellbeing at the Hampshire and IoW ICP Youth Assembly on 13th November 2024. An action plan was drawn up in collaboration with decision makers to implement the recommendations in practice. These recommendations will go towards informing the delivery of health services for young people In Hampshire and the IoW. • The criteria for a successful youth advocacy/ activism programme provide BiteBack with evidence-based conclusions that they can use to replicate and grow the success of their programmes. The links between youth health and wellbeing and participation in activism programmes was highlighted The findings from this investigation also went towards informing how we run the Young Researcher Training Programme to make sure young people are getting the most out of the experience for their health, wellbeing and future quality of life. See the BiteBack poster image BiteBack poster[83] .png Download PNG • 1.08MB BiteBack visual report (PDF What Next? The learning from this project will go towards informing how future YRTP sessions will be structured and run. For example, the advocacy and links to decision making in this project will be replicated in the next iteration. The next iteration of YRTP begins in December 2025, with a focus on developing a Southampton Youth Voices service. The learnings from BiteBack’s youth activism programme will aid other youth organisations to successfully engage young people in improving their health. This work adds to the growing body of research around the importance of youth participation and its long-term health and wellbeing benefits. Talitha McCleery, 17, took part in the programme and said: "Young people want to and deserve to be, involved in decisions that impact their health and futures. We believe that the people who sit in positions of power must prioritise consulting with young people if they want their decisions to have real change and make a positive impact." Libby Tickner, 17, who also took part, added: "We must all work together - school boards, local government, local charities and national non-governmental organisations - to ensure no opportunity is left wasted." Source: Hampshire youth assembly shares health and wellbeing ideas | Daily Echo

d6d7fb08-5eb7-4cab-afcf-359d64b8fe12 ADOPTED PROJECT: Young people’s barriers to mental health services Lead: Dr. Corine Driessens Co-Investigator: Professor Peter W F Smith Kim Markham Jones & Fiona Lacey – YoungMinds Nicole Davenport, Mahdi Hassan, Shahrbano Iqbal, Friday Skelton – young researchers recruited by and in employ of YoungMinds Starting date: October 2022 Ended: July 2025 Published in journal of psychiatric research online: Use or no use? Young People's engagement with mental health services https://doi.org/10.1016/j.jpsychires.2026.01.034 Many young people in the UK experience anxiety or depression, but most can’t get mental health support when they need it. From the very beginning of this project, young people, both as young researchers and as participants in four co-production workshops, played a central role in shaping our questions, interpreting the findings, and explaining what the results mean in real life. Their insight guided every stage of the work. This study looked at what affects whether young people use mental health services and what happens to those who don’t. The biggest factor in getting help was whether health care professionals recognized the young person’s distress was a mental health disorder. Other things like, severity of symptoms, being a female, having fewer supportive people around, or having unemployed parents played a smaller role. Young people who didn’t use services were less likely to be female, come from single-parent families, have caring responsibilities, or have been bullied. They were also more likely to have good relationships with their parents. Those who did use services had poorer outcomes later in adulthood, suggesting they faced greater difficulties overall. Because specialist mental health services are overstretched, responsibility has shifted to GPs and teachers, who often feel under-resourced and not fully trained to meet these needs. The GPs we spoke to faced strict referral rules, long waiting lists, short appointments, and limited mental health training. The teachers we spoke to also felt pressure to support students without the resources or guidance they need. After hearing these findings, a group of young people from the “missing middle” (those struggling but not qualifying for specialist care) recommended: Training all school and college staff in mental health. Better support for apprentices at work. Peer support groups in schools, colleges, and universities. Safe spaces and housing support for LGBTQIA+ students. More help for young carers and fairer benefits. Better training for all health workers to support diverse communities. Looser referral rules so young people don’t have to be “ill enough” to get help. Youth hubs offering safe spaces, activities, and mental health support. Overall, the findings show the need for more inclusive, preventative, and joined-up mental health support for young people. Reflections on Young People involvement with shaping analysis framework for mental health .docx Download DOCX • 2.37MB What did we find out? Presented the findings at national and international conferences (e.g. MQ/DATAMIND, ADRUK, NIHR Statistics Group, EPA Epidemiology & Social Statistics, International Congress of the European Society for Child and Adolescent Psychiatry) Presented the findings at ARC Wessex webinar Presented findings on ARC Wessex website Where next? The young people who took part in our workshops were very clear about one thing: we need to start much earlier. They told us that helping children learn emotional skills, like understanding their feelings, managing stress, and asking for help, before stigma takes hold could make a big difference in preventing mental health problems later on. Taking this guidance seriously, our team has now grown to include experts who know how to design effective mental health programmes for primary schools, as well as researchers who can identify exactly which elements such a programme should include. Our next step is to develop a primary school–based intervention shaped by what young people told us matters most. Because this type of work sits outside ARC Wessex’s remit, we are now seeking external funding to take the project forward and bring this early-intervention programme to life. https://video.wixstatic.com/video/6fe132_c8aa61002b864940a8aac2b8d7754c07/480p/mp4/file.mp4 https://video.wixstatic.com/video/6fe132_ee6a84e1cd6a4745a6de0f05e2034688/480p/mp4/file.mp4 https://video.wixstatic.com/video/6fe132_fc53aac3539f4f839ea71adcfb34b517/720p/mp4/file.mp4 Olly Parker, Head of External Affairs and Research at YoungMinds , said: “This research from YoungMinds and the University of Southampton shines a vital light on the record numbers of young people needing mental health support. Growing up today is incredibly tough. Many young people are experiencing multiple pressures which impact their mental health, including poverty, inequality, intense academic pressure and the online world, so it’s no wonder so many are struggling. One of the clearest recommendations from the young people involved is the urgent need for early support hubs in every community. We know many young people face long waits for mental health support and become more unwell while waiting, which can lead to needing more urgent care. We need major reforms to address the root causes of poor mental health and for the Government to focus on reducing waiting lists so young people can get the support they need. The recent 10 Year Health Plan showed promising commitments with Young Futures Hubs and Mental Health Support Teams. These initiatives are vital to reducing pressures on the system, improving support and reducing waiting times - their rollout must be a political priority. But more is needed to tackle the scale of need - we need radical solutions that will address the reasons why so many young people are struggling in the first place.” Corine Driessens, one of the researchers based in Southampton, said: “It has been a truly wonderful and positive experience working with these groups of young people. Their innovative and fresh ideas across a wide range of ways to help others get the mental health support they need have been inspiring.”

894e3c82-d20e-4fbc-a56a-7d96277ba61e PARTNERS Project: Development and implementation of a digital tool for multisectoral support and management of long-term condition PARTNERS Project: Development and implementation of a digital tool for multisectoralsupport and management of long-term condition Principal Investigator: Professor Mari-Carmen Portillo Co Applicants : Line Bragstad, Dr Dorit Kunkel, Dr Kat Bradbury, Dr Lindsay Welch, Hayden Kirk, Dr Caroline Barker, Sandra Bartolomeu Pires, Christopher Edwards, Lindsay Cherry, Francesca White, Caroline Aylott, Cathal Doyle. Partners: University of Southampton, University of Oslo, Hampshire and Isle of Wight NHS Foundation Trust, University Hospital Southampton NHS Foundation Trust, Hampshire and Isle of Wight ICS, Versus Arthritis, and Parkinson’s UK. Lay Summary Background to the research : Self-management is an approach to help people with long term conditions manage their health daily. Existing NHS self-management tools focus on healthcare (medication management, appointments) and fail to capture aspects of how people live with and adjust to long-term conditions. This includes social support (family/friends) and other resources and networks available like the voluntary sector, industry and community groups.We have created an intervention (an action to improve a situation or prevent it getting worse) to support self-management for people with Parkinson’s Disease and their family/carers. This intervention recognises the role of social support, voluntary sector, industry, and community groups in adjusting to living with a condition. Our next step is toadapt this intervention to the needs of people living with other conditions like Arthritis and for those living with more than one condition and create a digital tool. Aim of the research : To develop, implement and evaluate a digital tool that supports the management of people with Parkinson’s Disease and/or Arthritis. The tool will support professionals and other organisations to connect, share resources and optimise communication and referrals, leading to more personalised and cost-effective use of resources (beyond healthcare) in the community. Design and methods: The research will take place in community settings in Wessex. We will prioritise disadvantaged groups (those less comfortable using technology and less able toaccess available resources and support). We will : 1. Work with our patient and public involvement (PPI) representatives, relevant voluntary organisations, health and social care providers, and key people involved in policy making and NHS strategy. They will have a voice ineach decision to ensure our tool is relevant and acceptable to those using it. 2. Host discussion groups with people with Parkinson’s Disease and/or Arthritis and theirfamily/carers to understand the positive and negative aspects of existing digital tools, from a patient perspective. 3. Design our self-management tool. 4. Test the tool through two primary care surgeries (GP) and voluntary organisations (Parkinson’s UK and Versus Arthritis).Testing will help understand how the tool is used and what helps or hinders its success. Deliverables : The research will generate: a digital tool to support more effective self-management of Parkinson’s Disease and/or Arthritis, recommendations for policy development, evidence for how to improve NHS services. Public Patient Involvement: We willwork with people with Parkinson’s Disease and/or Arthritis and their families/carers. We will work together as equal partners to define their level of involvement, roles, methods to input and training needs. We will also explore what works best or what we should do differently intheir involvement. Dissemination : We will share our learning across the different groups involved. This will include presentations, policy briefings, newsletters, and public events. What did we find out? We found that people with Parkinson’s and/or arthritis, their carers and professionals involved in their care wanted a digital app that was: • Simple • Easy to navigate • Hybrid – in person contact also signposted Included: • Community resources from voluntary/charity sector • Free or inexpensive resources • Links to peers/buddy for support What next? PARTNERS 2 has evolved, as a continuation project. This allowed time for: A suitable digital company to be found with previous experience of working with people with health condition Full briefing of the digital company about what was required of the digital web app. Development of a 'Life Boost' app Trade marking 'Life Boost' Real-world evaluation of the app with Social Prescribers in Hampshire Linking 'Life Boost' to MyMedical Record (University Hospital Southampton NHS Foundation Trust) The PARTNERS 2 project will now: Ga in full exposure by having it adopted onto the My Medical Record platform at the University Hospital Southampton NHS Foundation Trust Be used in the real-world and a business/company/organisation will be sought to adopt the app for further development and management

Research Fellow < Back Stephanie Hughes Research Fellow Ageing and Dementia Steph Hughes is a Research Fellow in the ARC Wessex Mental Health Hub at The University of Southampton conducting research into alcohol use disorder in older adults. Steph has a PhD from The University of Southampton where she explored the impact of significant others on men undergoing active surveillance for prostate cancer. Steph has expertise in qualitative research, self-management of illness and intervention development. Past projects span topics such as irritable bowel syndrome, chronic pain, weight management and primary care communication. Previous Next