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bfee6430-aafd-44b2-bd89-074b9c7bf0b9 COMPLETED ADOPTED PROJECT: ADAPT: The cross-sector implementation of NICE-recommended CBT-based interventions for young people in care: Framework Chief Investigator: Dr Rachel Hiller– University of Southampton Project Team Members: Dr Gretchen Bjornstad– University of Exeter, Dr Tim Clarke – Norfolk & Waveney Children and Young People Care Group, Dr Kristian Hudson– Improvement Academy Bradford Teaching Hospital NHS Foundation Trust, Professor John Macleod– University of Bristol, Dr Ruth McGovern– Newcastle University, Dr Hugh McLeod– University of Bristol, Professor Richard Meiser-Stedman– University of East Anglia, Dr Sara Morgan– University of Southampton, Dr Beverley Slater– Bradford Institute of Health Research, Professor Paul Stallard– University of Bath, ProfessorJohn Wright– Bradford Institute of Health Research, Dr Patrick Smith– King’s College London. Organisations Involved: Swindon Borough Council, Bath and North East Somerset (BaNES) Children’s Services, Thinking Allowed specialist-service, Bristol, Newcastle City Council Children’s Social Care, Child and Adolescent Mental Health Services (CAMHS) (East) Background: Young people in care (care-experienced young people; CEYP) have substantially higher rates of mental health difficulties compared to their peers. Their unaddressed mental health needs have been identified as a key driver of a range of poor outcomes that categorise this group. For example, CEYP they are five times more likely than peers to be excluded from school, comprise 50% of the young male prison population, and 25% of the homeless population. Such outcomes are not inevitable. Yet services are often struggling to effectively address the mental health needs of this group, and thus prevent some of these wide-ranging consequences. To begin to address this complex issue, we are proposing a pilot implementation project, working with CAMHS, social care and third- sector mental health services across four target ARCs. Our pilot project aims to address this via overlapping stages that form the essential framework for a full-scale implementation trial. These are: (1) A scoping review and consultation with CEYP, carers, and services to develop an initial implementation framework, based on the consolidated framework for implementation research (CFIR) (2) The development of our implementation resources, including training materials What did we find out? We found that young adults aged 18-25 did not engage with the RADAR/ADAPT programme, and may not engage with perpetrator services, if they do not have motivation to do so. The implications are that this poses a risk to victims, particularly if perpetrators have high risk behaviours. To address this, more work should be done to disrupt high risk individuals and refer them on to workshops that require less time commitment; in order to initiate self-awareness around their behaviors and their impact on others. Given that children were a strong motivation for completing a programme, it seemed almost paradoxical that there were no specialist services made available for children within the DAPP model. Although there is compelling evidence to suggest that men changed their behaviours following the programme, police reoffending data suggests that, for a minority of individuals, more work is required to fully embed positive behaviours. A mentoring service may support such aims. To further support evidence on behavioural change, long term outcomes related to victim harm should be measured; for example, through a short questionnaire filled out by current or former partners. The RADAR/ ADAPT programme is specific to the domestic abuse experienced between intimate partners within heterosexual relationships. The implications are that a number of individuals may not find the programmes appropriate to their context. Therefore pilot programmes should be developed to tackle different relationship dynamics and types of abuse, including lesbian gay bisexual transgender queer (LGBTQ) relationships, and Elder Abuse. Finally, to full achieve a community coordinated response, and make the most of the resources available, pathways of referrals and a mutual understanding of roles and responsibilities should be clearly set out, to cover both statutory and non-statutory organisations. What did we do with this knowlege? •The findings from the research were communicated with the commissioners of future services in Domestic Abuse in Hampshire. •The next commissioned service considered the findings of the research in the tender. •For example, given the risk of non-engagement of younger adults, a specific service for 18-24 year olds, was set up that working on the specific needs of this population group. •The findings added to the limited knowledge around voluntary community perpetrator programmes. •It was published in the Open Access journal PloS ONE https://doi.org/10.1371/journal.pone.0218408 •Dr Sara Morgan was interviewed alongside Tracy Rutherford (Hampton Trust) on the Patrick Sisson show (BBC Radio Solent) Where next? •The work on ADAPT has led to further research in this area through existing partnerships, including a national evaluation of CARA •We have continued relationships with police partners who were interested in further evaluation work, which led to co-funding of other projects including Operation Foundation and MASP •Personally, Chief Investigator is interested in the findings around younger perpetrators, and how to engage them better in the health and social care system, and improve their life-chances. •Where many perpetrators on ADAPT have experienced domestic abuse as children, and they themselves have children, I’m interested in pursuing work around preventing the intergenerational transmission of domestic abuse. Publications Baseline characteristics and outcomes of the main perpetrator programme within the Hampshire Domestic Abuse Prevention Partnership, UK: A mixed methods study | PLOS One

45c5bd14-475f-4afa-ac9a-403f77123c69 CHAMPION: Children whose mothers are involved in the criminal justice system in Dorset & Hampshire: developing health and social care outcome indicators Chief Investigator Professor Julie Parkes Professor in Public Health Head of School of Primary Care, Population Sciences and Medical Education Faculty of Medicine University of Southampton, South Academic Block, Southampton General Hospital, Tremona Road, Dr Emma Plugge Associate Professor in Public Health School of Primary Care, Population Sciences and Medical Education Faculty of Medicine University of Southampton, Co-Investigators Dr Donna Arrondelle , Research Fellow, University of Southampton Dr Naomi Gadian, Public Health Specialist Registrar, University of Southampton Donna Gipson, Director EP:IC Consultants Ltd, West Malling, Kent Dr James Hall , Associate Professor of Educational Psychology, University of Southampton Paula Harriott , Head of Prison Engagement, Prison Reform Trust Professor Kathleen Kendall , Professorial Fellow of Sociology as Applied to Medicine, University of Southampton Dr Sara Morgan , Associate Professor in Public Health, Faculty of Medicine, University of Southampton Professor James Raftery , Faculty of Medicine, University of Southampton, Dr Lucy Wainwright , Director of Research, EP:IC Consultants Ltd, West Malling, Kent Starts: 1st April 2023 Ends: 30th September 2024 Summary In this study, we will identify important features of children’s health and wellbeing that are affected when their mother is sent to prison. For example, it might be their mental wellbeing or their behaviour. If we know what the important features are, then researchers and organisations providing services (such as the NHS) can monitor these for change; this is important to see how the child is but also to see if services are helping him or her. In the past, researchers have not looked in depth at the health and wellbeing of these children. We want to look at all the studies conducted so far to see what areas of their health have been looked at and also to find out areas of their health where the evidence is lacking. We will also speak with adults who were children when their mother was imprisoned to hear their views about what health issues are important and what would have helped them at that time. We will also speak to children who are living with their mother in a prison alternative in the community to find out from them about their health and what has helped them in this particular place. Finally, we will speak with a range of professionals, from doctors to teachers, who work with children whose mother has been imprisoned. We will ask them to tell us about the aspects of these children’s health and wellbeing that they think are important and likely to be affected by the child’s mother going to prison. When we have the information from published studies, from the children themselves and from the professionals, we will bring together a group of people with experience of their mother being imprisoned and also professionals. We will work with them to agree the most important features of children’s health and wellbeing that are affected when their mother is sent to prison. These ‘outcome measures’ are helpful to developing services for these children. People with experience of their mother being imprisoned have helped design the project. They will also be important in spreading the word about the study. This will enable us to reach not just academic audiences and policy makers through publishing in journals or presenting at research conferences, but also people with lived experience and charities that work in this area. Informing a wide range of people will be important in ensuring that the findings from this study are acted on.

f5788d42-1d65-4ac1-a9d5-00a8fcb316fd Improving support for self-management (WASP) Using the Wessex Activation and Self-Management and Personalisation (WASP) Tool to design and implement system wide improvements in self-management support for people with long-term conditions Principal Investigator: Professor Mari-Carmen Portillo Team members: Professor Mari-Carmen Portillo (Professor of Long-Term Conditions, School of Health Sciences, University of Southampton), Dr Hayden Kirk (Consultant Physiotherapist & Clinical Director Adults Southampton, Solent NHS Trust), Dr Chris Allen (Lecturer, School of Health Sciences, University of Southampton), Stephanie Heath (WASP Clinical Lead, Royal Bournemouth & Christchurch Hospitals NHS Foundation Trust), Dr David Culliford (Senior Medical Statistician, School of Health Sciences, University of Southampton), Dr Louise Johnson (WASP Project Manager, Royal Bournemouth & Christchurch Hospitals NHS Foundation Trust), Dr David Kryl (Director, Centre for Implementation Science, University of Southampton), Professor Alison Richardson (Professor of Cancer Nursing and End of Life Care, University of Southampton) Start: 1 October 2019 Ends: 30 September 2024 Project Partners: Solent NHS Trust, Royal Bournemouth & Christchurch Hospitals NHS Foundation Trust, University Hospital Southampton NHS Foundation Trust, Hampshire and Isle of Wight ICS Lay summary The NHS wants to achieve better health outcomes, improved experience for patients, and more effective use of services and resources for people living with a long-term health condition. Helping people to self-manage their condition helps improve people’s health and their experience of managing the condition in everyday life. Increasing people’s knowledge, skills and confidence may help them to be more actively involved in self-management of their condition. This is sometimes referred to as ‘patient activation’. The Wessex Activation Self-Management Programme (WASP) Self-Assessment Tool has been developed to help health teams understand where their service could do more to help people be more active in the management of their condition. The tool can be used by people who use services and people who plan, manage and deliver care and services. It asks about behaviour – WHAT people actually do, and WHY they do (or don’t do) certain things. The answers can help health teams decide how to improve their service. We have already tested the tool in several different services. Early findings show differences across health services. For example, managers reported ways in which their services helped people to be more active in the management of their condition, but frontline staff (such as nurses and doctors) and patients themselves often had different experiences of this. The next stage is to use the tool to help teams identify aspects of support in their service that require improvement and help services to make these improvements. We will do this by: Assessing the services current practice in relation to self-management support, using the Wessex Self-Assessment Tool. Providing bespoke coaching and support (over a 10-month period) to enable teams (consisting of those who fund the service, managers, frontline staff (such as doctors, nurses and physiotherapists- those who deal directly with patient) and patients themselves) to identify areas for improvement and support them to make improvements that benefit patients. Re-assessing self-management support by repeating the WASP Self-Assessment Tool. Several ways will be used together to decide if this works, how it works and how it can be improved. These will help us understand if this coaching and support can benefit other health services. Firstly, members of healthcare team (including those who provide funding for the service, the services managers, front line staff and patients themselves) will complete a questionnaire. At the end of the study, following the teams coaching and support, this questionnaire will be completed again by all members of the team and the answers will be compared with those provided at the beginning to see if improvements have been made. We expect 8 teams to take part in this. In addition, a small number of teams will be observed during the coaching and support sessions and will be given the opportunity to share their experiences of the service in an interview at the start of the project, as well as of the coaching and support that they have received during an interview at the end of the project. This will help us understand how the coaching and support works and how it can be improved upon. We expect to work with 3 of the 8 teams in this part of the project. Now there's a series of FREE webinars to develop skills supporting personalised care, for health and care professionals in the Isle of Wight, Hampshire. More here

dc3e8b34-4159-44f6-a95e-c9d11121781c ADOPTED: Mapping pathways of response for adult and child victim-survivors of domestic abuse in Southampton City Team: Dr Sara Morgan, Associate Professor School of Primary Care, Population Sciences, and Medical Education Faculty of Medicine, University of Southampton Mrs Katerina Porter, Senior Research Assistant, Faculty of Medicine, University of Southampton Dr Eunice Aroyewun, Senior Research Assistant at the School of primary care, population science and medical education, University of Southampton Supervisor: Professor Julie Parkes, School of Primary Care, Population Sciences, and Medical Education Faculty of Medicine, University of Southampton The aim of the evaluation is to map the pathways by which victim-survivors are referred for, and receive, support for domestic abuse situations, from the Council and its partners. There are several processes to which victim-survivors can be referred in Southampton City: PIPPA and HRDA. PIPPA stands for the Prevention, Intervention, & Public Protection Alliance, and is the referral and support process for domestic abuse cases that have been assessed as standard- or medium-risk. PIPPA is a group of services working together to end domestic and sexual violence in Southampton, and comprises the following agencies: STOP Domestic Abuse Yellow Door Southampton City Council’s Independent Domestic Violence Advisor (IDVA) Service Hampton Trust South Hampshire Women’s Refuge No Limits HRDA stands for the High-Risk Domestic Abuse (process), and is the referral and support process for domestic abuse cases that have been assessed as high-risk. The process begins when someone makes the decision to refer a victim-survivor of domestic abuse to Southampton City Council, for support. The referrer could be from the Police, or Council team member from Adult Safeguarding, Children’s Services, Substance Abuse, Housing, or a member of the public, including the victim-survivor themselves. At this point, the referrer must use the DASH (Domestic Abuse, Stalking, & Honour-based violence) checklist tool to assess the risk of the domestic violence situation ( https://www.dashriskchecklist.co.uk/ , accessed 26/02/23). This tool was developed by the Association of Chief Police Officers (ACPO) and Laura Richards, in conjunction with SafeLives (formerly Coordinated Action Against Domestic Abuse (CAADA). Southampton City Council currently use a 24-question DASH checklist. The number of risk indicators (0-24) which are identified on the completed DASH suggest at which risk level the case should be assessed. The levels of risk are based on the Offender Assessment System (OASys), developed by the Prison and Probation Services definitions of what constitutes standard, medium, and high risk. For futher information email the team

18fd758f-b147-4294-acb1-07c88dc1baa9 PUNDIT – Predicting hospital Usage Numbers via a DIgital Twin Principal Investigator: Dr Carlos Lamas-Fernandez , Associate Professor in Business Analytics/ Management Science in Southampton Business School / Faculty of Social Sciences, University of Southampton. Team : Professor Christine Currie , School of Mathematics, Faculty of Social Sciences, University of Southampton. Dr Dan Burns , Innovation Centre, Electronics & Computer Science, University of Southampton. Dr Chris Duckworth , Innovation Centre, Electronics & Computer Science, University of Southampton. Professor Michael Boniface , I nnovation Centre, Electronics & Computer Science, University of Southampton. Professor Peter Griffiths , School of Health Sciences, University of Southampton. Dr Mark Wright , University Hospital Southampton NHS Foundation Trust. Starts: 1 April, 2024 Ends : 30 September 2024 Summary Hospitals in the UK are in crisis with high levels of occupancy. The percentage of occupancy in England during July-September was 88%, and in UHS it reached 92.2% . These levels exceed the safety threshold for hospital occupancy, which sits at around 85%. Together with difficulties to ensure a smooth patient flow across the hospital, this results in adverse effects for patients: elongated hospital stays, increasing the backlog of elective procedures, increasing delays in ambulance handovers and increased mortality. In practice, hospitals try and control high occupancy levels by certain interventions, such as dedicated discharge teams, re-scheduling or cancelling elective procedures or repurposing hospital wards. These measures, however, are reactive, i.e. when the occupancy is already reaching unsafe levels, rather than proactive, that is, when anticipating a high occupancy in the near future. Further, it is not clear whether occupancy levels have an effect on treatment and discharge times, but from frontline clinicians at UHS, there is the hypothesis that higher occupancy could make them longer (as clinicians are busier prioritising the sick over the well patients who could go home), compounding the occupancy issues. Higher occupancy also decreases likelihood of patients being in the optimal location. A related research project (PROCED) has shown early evidence that frequent ward/team changes increase delays in patient discharge. The aim of this project is to investigate the feasibility and build the foundations of a simulation model that can predict accurately future, short-term, hospital bed occupancy to inform interventions. The project will have a special focus on investigating the feasibility of a model to be tailored to use in practice as a “Digital Twin” (DT), which can anticipate hospital occupancy under different scenarios, some of which can reflect proposed interventions.

27d064e4-2601-492e-b882-a0ef85373d44 ADOPTED: (SIFT) Sensors in Fatigue Tracking in Parkinson’s. Exploring the relationship between perception of Fatigue and the performance of physical activities in people with Parkinson's with fatigue using wearable sensors Fatigue is one of the three most debilitating symptoms in Parkinson’s. Fatigue is difficult to diagnose, it often goes unrecognised, and is challenging to treat. The SIFT-PD study is exploring how fatigue impacts physical activity in people with and without Parkinson’s over a 3-day period. It asks participants to fill in fatigue diaries and uses wearable sensors to monitor the how people move over a period of three days. The sensors are small and light and worn on a belt. The sensors track activity (the amount, type and quality of movement). This research looks at whether the sensors can reveal how people’s movements change over the course of three days when they are fatigued. Furthermore, information from sensors might help understand what makes people fatigued and allow it to be measured. Knowing more about fatigue will help to recognise its impact and help develop ways of managing it better.

About us At the NIHR Applied Research Collaboration (ARC) Wessex, we conduct applied health research with our partners and others in the health and care sector, alongside patients and members of the public. Applied health research aims to address the immediate issues facing the health and social care system. We also help bring research evidence into practice and provide training for the local workforce. NIHR Applied Research Collaborations (ARCs) support applied health and care research that responds to, and meets, the needs of local populations and local health and care systems. The NIHR ARC Wessex is one of 15 ARCs across England, part of a £135 million investment by the NIHR to improve the health and care of patients and the public. Before 1 October 2019 we were known as NIHR CLAHRC Wessex . The ARC Wessex programme of research addresses four areas related to the health and social care needs of our community. We are hosted by the School of Health Sciences at the University of Southampton and University Hospital Southampton NHS Foundation Trust. NIHR ARC Wessex is acting as the national lead on research for Ageing, dementia and Frailty. Want to get in touch? - jump to our contact details below About us Our mission to improve outcomes for patients and public; improve quality, delivery and efficiency of health and care services; increase the sustainability of health and care systems locally and nationally. National Institute for Health and Care Research Our mission Our collaboration Our collaboration Each NIHR ARC is made up of local providers of NHS services, local providers of care services, NHS commissioners, local authorities, universities, private companies and charities. These collaborations work together to conduct high quality, generalisable, applied health and care research that addresses the specific health or care issues in their region. NIHR ARCs act to increase the rate at which research findings are implemented into practice. The 15 ARCs work collaboratively to address national research priorities, with individual ARCs providing national leadership in their areas of expertise. Our partners At NIHR ARC Wessex we are a collaboration of organisations working together to carry out the most relevant and best quality health and care research with real-life impact. Read more About NIHR The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. Read more Contact Southampton Science Park, Innovation Centre, 2 Venture Road, Chilworth, Southampton SO16 7NP 023 8059 7983 arcwessex@soton.ac.uk First Name Last Name Email Message Thanks for getting in touch Send

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3163bb6a-69ec-4161-8433-72a5810416ad POST DOCTORAL PROJECT: Understanding, addressing, and meeting the complex needs of people living with long term physical and mental health conditions: a qualitative study POST DOCTORAL PROJECT: Understanding, addressing, and meeting the complex needs of people living with long term physical and mental health conditions: a qualitative study Chief Investigator: Dr Leire Ambrosio – University of Southampton Project Team Members: Professor David Baldwin – University of Southampton. Professor Mari Carmen Portillo – University of Southampton, Dr Kate Lippiett – University of Southampton, Dr Lindsey Cherry – University of Southampton, Dr Pritti Aggarwal – Living well partnership – NHS Southampton CCG, Mr Barney Williams Jones – University Hospital Southampton NHS Foundation Trust, Dr Sara Mckelvie – University of Southampton, Ms Linda Lamond – PPI co-applicant Organisations Involved: University of Southampton, Hampshire and Isle of Wight Integrated Care System, Living well Partnership – Southampton CCG. Oxfordshire Primary Care System, Anxiety UK, Mind, Oxfordshire. Background: People with long term physical conditions are 2-3 times more likely to experience mental health problems than the general population, particularly depression and anxiety. At least 30% of all adults with long term physical conditions also have mental health problems. People living with long term physical and mental conditions not only experience hardships relating to health but also have complex psychosocial, environmental, economic, and spiritual needs. Healthcare professionals find it difficult to deliver fully integrated care for these populations, partly due to systematic barriers and the fragmentation of health and social services. The advent of social prescribing link workers as a priority for the NHS provides an opportunity to address some of these hardships and needs. Social prescribing link workers aim to connect people to community local services to address their complex needs through a person- centred approach. However, approaches to social prescribing link worker implementation are variable, with potential pathway gaps, and there is unclear guidance for primary care networks about how to integrate this novel workforce into efforts to address and meet the complex needs of people living with long term physical and mental conditions.

Outcomes and Impact Project Outputs This domain helps you consider the outcomes and impact of your project output(s) for patients, service users, health and social care professionals, third sector organisation professionals and health and social care systems. No FAQs yet This category doesn't have any FAQs at the moment. Check back later or explore other categories. What should I consider for my project? Adoption and Spread Project Outputs Buy-in and Engagement Fit with Health and Social Care Systems Alignment with Health and Social Care Priorities Outcomes and Impact Project Outputs Buy-in and Engagement Fit with Health and Social Care Systems Alignment with Health and Social Care Priorities Outcomes and Impact Adoption and Spread Checklist, webinar and resources Quick links: Case study Stroke awareness Action Learning Sets for health and social care professionals Project (SALs) team “ Upon reflection, thinking about the potential benefit or outcomes of our project to different stakeholder groups has been essential to increasing the impact of our project. We thought about what we wanted to achieve during the lifetime of the project in terms of improving awareness of stroke in clinical and community settings, but also longer-term and how this may improve patient and service user experiences of accessing stroke care. We knew that our stakeholder groups would be patients, social care users and health care professionals, social care professionals and third sector organisation professionals, as well as the wider health and social care system. At the beginning of the project, we considered how we would measure or evaluate the impact of the project outputs with these stakeholder groups. Closure of a local stroke awareness information support centre during the project, was devastating to the local community. It also meant that we wanted to adapt the aims of the project to accommodate the needs of those directly affected. Had we not been engaged with different stakeholder groups; this would not have happened. It made us realise the importance of engagement with stakeholders throughout to ensure that what we needed to measure or evaluate was closely aligned to their needs and priorities.” Take away tips Potential outcomes and impact of implementation should be considered at the outset of a project Engagement with stakeholders is essential to determining outcomes and impact for individuals, organisations and the wider health and social care system

3ace18ec-d7ab-47b5-898a-8030d0eb53f7 POST DOCTORAL PROJECT: Early detection of chronic liver disease in community settings Chief Investigator: Dr Kate Glyn-Owen – University of Southampton Project Team Members: Julie Parkes – University of Southampton, Dr Richard Aspinall – Portsmouth University Hospitals NHS Trust Organisations Involved: British Liver Trust, Portsmouth Football Club (Pompey In The Community), Portsmouth City Council public health team Background: Liver disease is the third biggest cause of early death in the UK. Two of the main causes of liver disease are drinking too much alcohol, which directly damages the liver, and being overweight, which can lead to fat building up in the liver and causing damage. If liver disease is detected early, it is possible to prevent disease progression, and in some cases to reverse damage done. This benefits patients and reduces impact on the healthcare system. The best way to detect liver disease early is not known. Tests and risk scores are available which use a simple blood test and information about the patient. These were developed in hospital settings, for people with known liver disease. They have not been used sufficiently in general population settings and we do not know how good they are at detecting liver disease in these settings. This project is investigating how these tests and scores perform in general population settings, using data from the UK Biobank, a big dataset from general population volunteers. We are exploring whether combining tests/scores with information about people’s risk factors, may improve detection of disease.We are going out to community settings, performing a risk assessment and simple scan for liver disease in populations at high risk. We are working with Portsmouth Football Club, the British Liver Trust and Portsmouth City Council public health team, to target populations at risk and to find out how effective we can be at early detection of disease in these settings.