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80c8b1b5-2419-49ee-b01f-71cd4ac37e9f ARC Wessex programme of research on Medicines Optimisation (MODIFY SPiDeR STOP-DEM) For further information please see the links below MODIFY : The development and iMplementation Of a multidisciplinary medication review and Deprescribing Intervention among Frail older people in primarY care SPiDeR Social Prescribers In Deprescribing Role STOP-DEM : Development of a structured deprescribing intervention for people with dementia or mild cognitive impairment in primary care

Koren Luddington - Social Worker Autism and Neurodivergence Team - Portsmouth City Council < Back How I found my way S A L T to social worker Koren Luddington - Social Worker Autism and Neurodivergence Team - Portsmouth City Council Becoming a Social Worker was a slightly unexpected career path for me. After qualifying with a degree in Speech and Language Therapy at university, I fully intended on having a life-long career as a Speech and Language Therapist. During my training, I took a real interest in Learning Disability and Autism and got my initial post-qualification experience in this area. Being young and responsibility free, after a couple of years of working, I spontaneously decided to leave the country and explore the world for a year. Unfortunately, in this time the UK went into recession and when I returned home, there were limited opportunities arising in the NHS. Koren Luddington is a Social worker in Portsmouth At this point, the novel pilot scheme 'Step Up to Social Work' was brought to my attention. At first, I was only paying the idea lip service, as Social Work didn't really appeal to me - albeit, I knew very little about it. However, my skills and qualifications did tally with the requirements of this employment-based route into Social Work, which would also secure me a Masters degree upon completion. As I progressed through the stages of the application process, I began to find the subject varied and interesting. Through the 18 months of on-the-job training and studying, I felt more and more passionately about Social Work ideology and that this was in fact the most suitable career choice for me. I worked for 10 years in Children's Services, giving me an excellent foundation to build and hone my Social Work skills. When I saw a job advertised specialising in autism, I felt like this would be a great opportunity to return to this area of interest as well as improving my knowledge and experience of working in Adult Services. Since my initial experience of working in this area, there has been enormous progression in the understanding and approach towards Autism as a cognitive variance within the wider context of neurodivergence. I have enjoyed refreshing and updating my understanding of this shift in thinking and find it fascinating that there continues to be a tussle between whether autism should be considered via a social model or medical model framework. Listening to the lived experiences of the neuro-divergent people that I am working with, really got me thinking about many facets and themes that recurringly have impacted on these young people's lives. For example, is a diagnosis beneficial? If so, why is it needed and what support is inaccessible for those without a diagnosis? For what reason are autistic people 6 times more likely to experience mental health crisis than the general population?How well do universal services understand and accommodate the neuro-divergent needs of individuals? I found these kinds of questions sparking my curiosity and I was keen to explore whether there may be some responses to these questions. So, when the opportunity was presented to link with Portsmouth University as a visiting researcher, I was interested to find out more. Never having associated myself with 'academia', I was unsure whether my skills and knowledge would meet the necessary requirements for the role. It seemed like a completely different world from my day-to-day working experience; a world that I had perceived as being elusive and exclusive. My concerns were alleviated as 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. Practically, my mentor has helped me to get set up on the University computer system, showed me how to access the library journals, search facilities and introduced me to new referencing software (which was not a 'thing' when I was last studying!) Crucially, my mentor has helped me to structure and narrow down my thought processes to identify a focus and objective for my research ideas. She has encouraged me to begin to critically analyse relevant topics and to identify and categorise themes in research. Undertaking training in realist evaluation has taught me the theoretical and structural basis that I needed to be able to consider the functionality of neurodivergent support services, within the importance of contextual systems and environments. It's inspiring to feel that researching the intricacies of service implementation can help provide much needed information; going some way to begin answering those initial stirring questions. My aim is to continue refining my ideas and learning from the wealth of research available in this area. If this could lead to working on a research project that would demonstrate an evidence base for useful and valuable support services for the neurodivergent community, then this would be hugely worthwhile progress towards improved opportunities and outcomes for autistic and neurodivergent people. Previous Next

bc679d13-74ba-4311-9808-713cccad3190 ADOPTED PROJECT: DIGNIFIE Gender-seNsitive evaluatIon oF a prIson alternativE DIGNIFIE: Gender-seNsitive evaluatIon oF a prIson alternativE - (intervention is known as Hope Street) Chief Investigator: Dr Emma Plugge – University of Southampton Project Team Members: Ms Donna Gipson – Empowering People: Inspiring Change, Ms Paula Harriott – Prison Reform Trust, Dr Kathy Kendall – University of Southampton, Professor Julie Parkes – University of Southampton, Dr Sara Morgan – University of Southampton Professor James Raftery – University of Southampton, Dr Lucy Wainwright Revolving Doors, Dr Naomi Gadian – University of Southampton, Dr James Hall – University of Southampton Organisations Involved One Small Thing, Prison Reform Trust, Ministry of Justice, Her Majesty’s Prison and Probation Services, Vivid Housing, Crown and Magistrates Courts, Southampton City Council, Adult Services, Southampton, Children Services, Southampton, Housing and Community Inclusion, Change Grow Live (CGL) Southampton, Southern Health NHS Foundation Trust, Hampshire County Council, Portsmouth City Council, Society of St James Background: This evaluation seeks to determine whether women’s health and wellbeing, social and criminal justice outcomes are improved when they are placed in a community based residential facility (Hope Street) rather than being imprisoned. The Ministry of Justice’s 2018 Female Offender Strategy sets out plans to improve outcomes for women in the community and custody. It aspires to ensure that fewer women are imprisoned and recommends the move to community management of women in contact with the criminal justice system (CJS), including residential women’s centres with places for women to bring their children. It is in this context that Hope Street, the community alternative to imprisonment, has been developed in Southampton. Women in contact with the CJS are some of the most disadvantaged people in society. One third of them will have been in care as children, two thirds live with ongoing domestic abuse and most will have experienced poverty. They have lower basic skills attainment than the general population, are more likely to be unemployed and to be in insecure housing. Their health is considerably poorer than that of women in the community; for example, the standardised mortality ratio for suicide is 20 times higher in imprisoned women than in the general population. This mixed methods study comprises qualitative research, a prospective cohort study and health economic evaluation. It started in 2021 and will be completed in 2027.

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 See the WASP website https://www.wasp.soton.ac.uk/ 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 Summary Good health and health care are key to a flourishing society. Focussing on what matters most to patients is essential for accessible, equitable and efficient care. In an NHS that is facing many challenges - including an increasing prevalence of multimorbidity and high levels of workforce burnout - this is easier said than done. The Wessex Academy for Skills in Personalised Care (WASP) has developed a programme to facilitate adoption of personalised care in practice. Led by the University of Southampton in partnership with NHS organisations across the Southeast, this programme supports health and social care services to embed personalised care practices – through rigorous evaluation, training, and bespoke improvement initiatives. Research is underway to evaluate the impact of the programme, and to understand how it could be spread and scaled. If adopted nationally, this programme has potential to be the catalyst for changing how we deliver and sustain services across the NHS. Impact People with multiple long-term conditions (MLTC) represent a significant proportion of the primary care population; with an estimated 14 million in England living with two or more chronic conditions. Many experience high treatment burden, fragmented care and reduced quality of life. While national policy promotes personalised care, implementation at scale has proved challenging. Services often lack the tools, skills and system support needed to embed personalised approaches into everyday practice. Difficulties in defining and measuring personalised care, add further challenge. The Wessex Academy for Skills in Personalised Care (WASP) was established to address this gap. Funded and commissioned by Hampshire and Isle of Wight and Dorset Integrated Care Boards (>£710K), WASP has developed an evaluation and training approach, focused on cultural and system-level change rather than isolated interventions. Led by the University of Southampton and working in close partnership with NHS organisations, WASP supports health and social care services to embed personalised care in a sustainable way. Training is accredited by the Personalised Care Institute and WASP is a partner with the Coalition for Personalised Care. Being hosted within NIHR ARC Wessex has enabled WASP to bring together research expertise, service improvement skills and frontline clinical experience. This collaboration underpins a structured programme built around three core elements: evaluating current practice, building skills through accredited training, and supporting services to make sustained improvements. A co-produced service evaluation tool enables teams to reflect on how personalised care is experienced by staff, service users and the wider system; enabling understanding of not just what happens in practice, but why. Training builds staff confidence and capability, while improvement support helps translate learning into measurable change. This work has had broad impact. To date, 45 clinical services across Hampshire, the Isle of Wight, Dorset and Sussex have completed the WASP programme. Over 1,400 healthcare staff have taken part in training, and more than 2,000 people, including clinicians, managers, commissioners and service users, have engaged with the service evaluation. Teams report shifts in mindset, with greater focus on “what matters” to individuals and increased confidence in delivering flexible, responsive care. People using services benefit from care that better reflects their priorities and circumstances, while staff gain shared language, clearer frameworks and practical tools. Commissioners and system leaders benefit from robust evidence to guide investment and improvement. WASP has also influenced practice beyond participating services, contributing to NHS England South East guidance; providing regional leadership on Patient Activation Measure use for NHS England; and contributing to ICB values-based care steering boards. NIHR ARC Wessex has been critical in enabling this impact by supporting programme development, evaluation and dissemination. ARC infrastructure has provided methodological and statistical expertise, mentorship, impact capture guidance and communications support, enhancing credibility and enabling scale-up. Through ARC Wessex, WASP accessed expertise across the University of Southampton, including business intelligence and the Business School, securing two development grants in 2023: the Southampton Enterprise Development Fund (£8,550) and Higher Education Innovation Fund (£10,000). Engagement has also taken place through WASP conferences in 2023 and 2024, with over 100 delegates including clinicians, commissioners and national policy stakeholders. The team is now collaborating with colleagues from UCL, Bristol, Leeds and Exeter to develop a programme grant focused on a scalable and sustainable personalised care intervention. This partnership demonstrates how NIHR investment can translate evidence into meaningful improvements for people living with long-term conditions. “It was good that we were able to focus on how shared decision making can work for continuing healthcare joint working on assessing challenges and positives- in a structured way. The idea of the need was there, and it helped to provide the framework to address the need ” [Programme Participant] https://www.wasp.soton.ac.uk/ We have now held 3 regional conferences, with attendance from 100+ delegates and a range of regional and national speakers – photos can be found on the conference page of our website. https://www.linkedin.com/company/wessex-academy-for-skills-in-personalised-care A scoping review followed this project to provide the rationale for the WASP assessment tool of personalised care practices – this has now been published: Johnson et al (2025) Next? WASP II is now evaluating and collecting evidence of the impact of the Wessex Academy for Personalised Care programme. We are conducting a secondary data analysis on existing WASP survey data, to better understand the behavioral factors impacting personalised care practices. We are seeking for further NHS teams to complete the training beyond Wessex. We are planning an NIHR PGfAR Submission in April 2026 – focussing on sustainable and scalable development and national evaluation of the programme. We are collaborating with UCL, Bristol, Leeds and Exeter, as well as the Personalised Care Institute. 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

4f21e11e-3fe7-460c-9bc0-113a56eec7a5 The ImPACt study - Improving physical activity of older people in the community Club members at Brendoncare joining in group exercise Principal Investigator: Dr Stephen Lim Team members: Dr Stephen Lim (NIHR Clinical Lecturer in Geriatric Medicine, Academic Geriatric Medicine, Faculty of Medicine, University of Southampton), Professor Helen Roberts (Professor of Medicine for Older People, Academic Geriatric Medicine, Faculty of Medicine, University of Southampton), Dr Samantha Meredith (Research Fellow, Academic Geriatric Medicine, Faculty of Medicine, University of Southampton) , Dr Kinda Ibrahim (Senior Research Fellow, Academic Geriatric Medicine, Faculty of Medicine, University of Southampton), Esther Clift (Consultant Practitioner in Frailty, Hampshire and Isle of Wight Healthcare NHS Foundation Trust, Lymington New Forest Hospital), Samantha Agnew (Head of Clubs Services, The Brendoncare Foundation , Winchester), Pam Holloway (Patient representative) Start: 1 February 2020 Ended: 31 October 2021 Project Partners: University of Southampton, University Hospital Southampton NHS Foundation Trust, Hampshire and Isle of Wight Healthcare NHS Foundation Trust, Brendoncare. Lay summary Physical activity is important for older people. It has many benefits including maintaining older people’s ability to perform activities of daily living, be independent, and improve their well-being. However, many older adults living in the community do not engage in regular physical activity. Findings We found that we could train volunteers to support older people during the COVID-19 pandemic to stay active by performing exercises that help strengthen their muscles. Trained volunteers from Brendoncare led the online group exercises for older people who attended online community clubs during the COVID-19 pandemic. This was a challenging time when social distancing and lockdown rules were in place, which limited opportunities for older people to stay active. We recruited 19 volunteers, and 15 volunteers completed the training. The volunteers were mainly female (78%), with an average age of 68 years. The exercises were seated exercises and older adults were given exercise bands to increase the exercise intensity. Halfway through the study, lockdown restrictions were lifted, and some groups continued the group exercise in a face-to-face setting. The volunteers led 184 group weekly exercise sessions (127 online and 57 in-person). Thirty older adults participated in the group exercises. We interviewed volunteers, older adults and Brendoncare staff to find out more about what they thought of the online group exercise. The older adults enjoyed the intervention and understood the benefits of exercising. Additionally, they felt that they could exercise in a relaxed way with their peers without fear of being judged. The group exercises helped reduce social isolation and motivated older adults to engage with the exercises. Volunteers were enthusiastic to support the exercise groups. They appreciated the training and opportunity to lead the group exercises. One volunteer reported that the role gave her a sense of purpose by playing an active role the community club. Brendoncare staff members were a great help to the older adults and supported them with any issues, in particular those who were less familiar with the internet. At six months, we found that older adults who participated in the group exercise had an improved physical activity level. The time spent in light physical activity per week improved from an average of 1530 minutes per week to 1620 minutes per week. Only two minor incidents happened during the group exercises. Two participants experienced worsening of old injuries while performing the exercises. The programme trainer ensured the participants were safe and adapted the exercise for them. Overall, we found that volunteers can be trained to lead online group seated exercises. The exercises were safe and older adults enjoyed the exercises as well as the social interaction in the group setting. What we did with the new knowledge We supported Brendoncare in continuing the exercise groups after the study had ended. We presented our study findings to the board of trustees and demonstrated the exercises. Brendoncare has since employed an activity coordinator to continue to role of training volunteers and supporting volunteer-led exercise groups within Brendoncare. We trained the activity coordinator and shared our exercise sheets and other study materials to help Brendoncare develop their own training package. They are now actively recruiting more volunteers to lead group exercises in their community clubs. https://www.brendoncare.org.uk/get-involved/support-us/volunteering/#:~:text=Chair%20Based%20Exercise%20Volunteer,improving%20their%20health%20and%20wellbeing . We have developed a volunteer toolkit which is available to share with other volunteer organisations. The toolkit has recently been shared with Valley Leisure Ltd, a charitable leisure organisation, who have developed their offer of volunteer-based community clubs in Test Valley. Where next? Having explored how we can train volunteers to engage with healthy community-dwelling older adults to stay active through online group exercises, we collaborated with researchers from the Southampton Biomedical Research Centre and Bournemouth University to further develop this volunteer-led online intervention. We successfully secured research funding (£51,000) from University Hospital Southampton NHS FT to conduct a study to explore a multimodal intervention consisting of exercise, nutrition and behaviour change support, to engage with older people living with frailty who have been discharged from hospital, to stay active and eat well. This research has now been completed (10/01/2024) and we showed that it was feasible to translate the programme to support older people living with frailty ( COMPLETED: Wessex Frail2Fit – A feasibility and acceptability study of a virtual multi-modal intervention delivered by volunteers to improve functional outcomes of older adults with COVID-19 discharged from hospital ). What did people say about the work? Volunteer : “We do it because we want to help others…. we enjoy it. I'm gonna go back to belonging again, I feel that I'm benefiting from the group. Because again, I feel like I belong to that group….. I get so much out of it.” Club member: ‘We are not self-conscious when they (volunteers) are around. We have a laugh as well.’ Club member: ‘I’ve really enjoyed it because it keeps you in touch with people, especially during this COVID….. I still feel as if I’m part of a group.’ NEWS: ImPACT volunteers recognised for their wor k ImPACt exercise video IMPACT Exercise with Steve and Esther from NIHR ARC Wessex on Vimeo . Impact Exercise video using Resistance bands - Dr Sam Meredith watch the video on Vimeo Publications doi.org Volunteer-led physical activity interventions to improve health outcomes for community-dwelling older people: a systematic review - Aging Clinical and Experimental Research Background Physical activity (PA) is important for older people to maintain functional independence and healthy ageing. There is strong evidence to support the benefits of physical activity interventions on the health outcomes of older adults. Nonetheless, innovative approaches are needed to ensure that these interventions are practical and sustainable. Aim This systematic review explores the effectiveness of volunteer-led PA interventions in improving health outcomes for community-dwelling older people. Methods Five databases (MEDLINE, Embase, CINAHL, PEDro, Cochrane library) were systematically searched for studies using trained volunteers to deliver PA interventions for community-dwelling older people aged ≥ 65 years. Meta-analysis was not conducted due to included study heterogeneity. Results Twelve papers describing eight studies (five papers reported different outcomes from the same study) were included in the review. All eight studies included strength and balance exercises and frequency of PA ranged from weekly to three times a week. Volunteer-led exercises led to improvements in functional status measured using the short physical performance battery, timed up and go test, Barthel Index, single leg stand, step touch test, chair stand test, and functional reach. Frailty status identified by grip strength measurement or the use of long-term care insurance improved with volunteer-led exercises. Interventions led to improvement in fear of falls and maintained or improved the quality of life. The impact on PA levels were mixed. Conclusion Limited evidence suggests that volunteer-led PA interventions that include resistance exercise training, can improve outcomes of community-dwelling older adults including functional status, frailty status, and reduction in fear of falls. More high-quality RCTs are needed to investigate the effects of volunteer-led PA interventions among older people. https://doi.org/10.1007/s12603-020-1442-0 https://doi.org/10.7861/clinmed.2022-0283 doi.org Detecting low-intake dehydration using bioelectrical impedance analysis in older adults in acute care settings: a systematic review - BMC Geriatrics Background Dehydration is a frequent cause of excess morbidity and poor health outcomes, particularly in older adults who have an increased risk of fluid loss due to renal senescence, comorbidities, and polypharmacy. Detecting dehydration is key to instigating treatment to resolve the problem and prevent further adverse consequences; however, current approaches to diagnosis are unreliable and, as a result, under-detection remains a widespread problem. This systematic review sought to explore the value of bioelectrical impedance in detecting low-intake dehydration among older adults admitted to acute care settings. Methods A literature search using MEDLINE, EMBASE, CINAHL, Web of Science, and the Cochrane Library was undertaken from inception till May 2022 and led to the eventual evaluation of four studies. Risk of bias was assessed using the Cochrane tool for observational studies; three studies had a high risk of bias, and one had a low risk. Data were extracted using systematic proofs. Due to insufficient reporting, the data were analysed using narrative synthesis. Results One study showed that the sensitivity and specificity of bioelectrical impedance in detecting low-intake dehydration varied considerably depending on the total body water percentage threshold used to ascertain dehydration status. Other included studies supported the technique's utility when compared to conventional measures of hydration status. Conclusions Given the scarcity of literature and inconsistency between findings, it is not possible to ascertain the value of bioelectrical impedance for detecting low-intake dehydration in older inpatients. https://bmjopen.bmj.com/content/13/3/e069533 https://www.sciencedirect.com/science/article/pii/S2260134125000854[SM1] doi.org Evaluating the feasibility and acceptability of virtual group exercise for older adults delivered by trained volunteers: the ImPACt study protocol Introduction Physical activity is important for healthy ageing. Despite strong evidence on the benefits of physical activity for health and well-being, physical inactivity remains a significant problem among older adults. This study aims to determine the feasibility and acceptability of implementing an online volunteer-led group exercise for older adults. Methods A quasi-experimental mixed-methods approach will be used in this study. A training programme will be developed to train volunteers to deliver online group exercises to older adults aged >65 years (n=30). The primary outcome is the feasibility of implementing the intervention. This will be assessed by the number of volunteers recruited, trained, and retained at the end of the study, and the number of exercise sessions delivered and completed by participants. Secondary outcomes include physical activity levels measured using the Community Health Model Activities Programme for Seniors questionnaire, Barthel Index, EQ-5D-5L as a measure of health-related quality of life, SARC-F to determine sarcopenia status, and PRIMSA-7 to determine frailty status. Outcomes will be measured at baseline and at 6 months. Qualitative interviews will be conducted with volunteers(n=5), older adults (n=10) and family members (n=5) to explore their views on the intervention. Analysis Simple descriptive statistics will be used to describe participant characteristics, the feasibility of the study and the impact of the intervention on health outcomes. Parametric(t-test) or non-parametric(Mann-Whitney U test) statistics will be used to analyse continuous variables. χ2 test will be used for categorical variables. Qualitative data will be analysed using an inductive thematic analysis approach. Ethics and dissemination This study received ethical approval from the University of Southampton Faculty of Medicine Ethics Committee and Research Integrity and Governance committee (ID: 52 967 .A1). Study findings will be made available to service users, voluntary organisations and other researchers who may be interested in implementing the intervention. Trial registration number [NCT04672200][1]. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT04672200&atom=%2Fbmjopen%2F12%2F2%2Fe052631.atom · 40 Faces of Brendoncare - Sharon Green · 40 Faces of Brendoncare - Dr Sam Meredith · 2022 Winners | Pride of Andover Awards · https://www.linkedin.com/posts/karen-lewis-6b009665_ahpsday-activity-7385000352397385728-8v1K?utm_source=share&utm_medium=member_android&rcm=ACoAAGAmYqMBCL-wtu3ZnECr4UsylRfjAyKeGFY · https://youtu.be/nMSQR7kp9ec · https://youtu.be/6vxyL4OenmQ?si=RiOBz-yU7tO09fwX

283829ae-0e8e-40ad-96e6-9c01fa950327 SOCIAL CARE: Local Authority Adult Social Care Recruitment and Retention research project (BCP/Dorset) Lead: Dr Andy Pulman Post Doctoral Researcher and Professor Lee-Ann Fenge Contact: apulman@bournemouth.ac.uk Background Within the Wessex region, we have been working to support the development of social care research over the past few years. In 2022, we completed a year-long study examining social care research enablers and barriers which might prevent or limit a positive research environment for practitioners ( Pulman and Fenge, 2023 ). This built the foundation for four projects across Wessex – funded by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) Wessex – which aimed to build research partnerships across local authorities (LAs) and universities in the region. As part of these projects, separate funding was available to support research champions embedded within local authorities, to support activities such as lunch time research discussions, journal clubs and the development of practitioner focused research. To encourage buy-in from the LAs we developed research in partnership with them to respond to key priority areas. Aims The aims of our project were: •Explore local recruitment and retention issues in adult social care and adult social work •Helping to inform future workforce development activities undertaken by two local authorities (LAs) •Contributing research data to both the regional and national picture of adult social care recruitment and retention issues How did we do this? Data for our project was collected between February 2023 and October 2023 and explored local recruitment and retention issues in Adult Social Care (ASC) from the perspective of four populations of interest. We collected data from n=131 participants across the four populations of interest: •Social care practitioners - social workers, allied health professionals, unregistered social care practitioners - working in adult social care at two local authorities (LAs) •Social care staff performing exit interviews with staff working in the two local LAs •Social work students (undergraduate and postgraduate programmes) in Wessex •Service users receiving services in either LA and advocates drawn from Wessex LA contracted services es Pos Positive Outcomes • Practitioner demand to participate in this study was very high and we exceeded our initial recruitment targets. • Being able to shine a light on some of the current issues facing advocacy – a currently under-reported research area – as a part of our qualitative data collected from POI 4 was an enlightening and beneficial bonus. • Being able to involve and co-write with both the PPI collaborator and the two research champions from a local authority to produce two separate academic articles from the project was another highlight. • Reaching a national newspaper (both print and online in the Telegraph) with research findings from practitioners regarding hybridization and hotdesking was a very positive development in reaching an external audience. Practioner findings - Data on Staying Reasons for staying with LAs included: • Flexible working – place of work and hours worked • Love of the job and engaging with the service users supported • Supportive management • Supportive team • Training and CPD - via continuing professional development or an apprenticeship. A number of outputs from this project can be viewed below. We have also submitted a number of journal articles describing findings from the project data to the peer review process, which will hopefully be available later this year. Practioner Challenges Challenges to Retention highlighted include: Hybridisation and Hot desking Stress and Burnout Negative Perceptions of Social Care Student Reflections on Social Care • There is always focus on recruitment, but not on retention. • Social care is hugely underfunded but money is not the only answer –a place where people want to be. • Awareness that SW not seen as a fully sustainable career. Some already planning exit strategies before they started work - a perceived shelf life for a social work career. • Worries about excessive caseloads/increased admin burdens and bureaucracy. • Pay level was deemed inadequate for the demands of the job. • On placement students noticed issues with team churn, attrition and a lack of stability – one had 8 different managers over a 12 months. • Staff shortages – some vacancies can’t even be filled by locums. • COVID-19 had been the prompt for a lot of staff to move on. • Agency usage is an issue (for example, out of county managers). This is helping to create a ‘perfect storm’. • Risk of stress and burnout inherent in profession was noted: Ethical Dilemmas / Job related / Questioning of their decision making / Resilience / Coping strategies / Travel issues Students reflected on Cost of Linving Impacts that: • Increased numbers seeking hardship support / more working alongside study • Social work bursaries frozen since 2014 – more earning whilst learning • Some HEI staff do not appreciate hardships experienced or demands faced • Burnout - feeling stressed/lacking in energy after working full-time alongside course. • Longer term, reductions in students entering the profession have major implications for meeting rising level of vacancies in social work. • Cost of living issues an increasingly influential factor for prospective students when choosing route/retraining as mature student. Service User reflections on Social Work Relationships • Changing role - onus now on the carer more to be the lead professional though not through choice. • Biggest issue is lack of money in the system. • Money over empathy – it often feels like carers and SUs cost money. • Inertia - one participant described this feeling as : “It doesn't matter how I am, you're not going to do anything about it”. • Whole structure needs an overhaul. Social work/social care is a societal issue and priority Service User reflections on staff turnover • Previous continuity of same worker no longer exists. Rapid changeover / staffing issues causing upset for carers and SUs. • Churn obliterates previous working relationships • Depersonalisation – team rather than individual; now you don’t usually have a designated social worker. It's a group. • Less frequent contact. • Out-of-hours - service is overstretched and doesn’t cover the whole area effectively for time precious situations. Impact on Advocates · Safeguarding caseloads for advocates have increased. Crisis situations due to lack of early intervention. After discharge there is no pick-up or continuity from the community – loss of advocate, a new LA social worker or unqualified social care practitioner assigned, or the case is closed as it is classified as ‘not in crisis’. · Increased caseloads now have greater complexity. There are more Section 21A challenges – a review under a Deprivation of Liberty Safeguards (DoLS) as SUs unable to care package in the community. · Community advocacy - which prevents crisis in a lot of cases - has been reduced as statutory work always comes first. SUs need be in receipt of an LA commissioned service or NHS secondary care before they can get issues-based advocacy. · Increased complexity causes settled cases to be visited less regularly as advocates now deal with more complex court proceedings and safeguarding issues. Increased caseloads - Social work / NHS overflow · Social work seems to be moving away from relationship-based practice to procedurally driven form-filling with advocates picking up some of this work instead. · “ Hold on, this is not actually my role” - Advocates are doing part of the social worker’s job because, for whatever reason, they are not able to. · There is a greater expectation of monitoring conditions done by the supervising body, when actually it’s not their role as an advocate, but it has become their role. · Less time for IMHA within hospitals as advocates now have little or no time to do it. Further reading – blogs: A blog for World Social Work Day (19/03/24) Further reading – reports: Recruitment and retention in adult social care Executive Summary. Bournemouth: NCCDSW, Bournemouth University. Recruitment and retention in adult social care. Bournemouth: NCCDSW, Bournemouth University. Further viewing: NIHR ARC Wessex Social Care Lunchtime Seminar – Realities of adult social care recruitment and retention in 2023 (18/01/24) Publications Full article: Advocacy in Practice: Who Advocates for the Advocates? Evolving Workplace: The Possible Impacts of Hybrid Working and Hotdesking on Retention of Social Workers | The British Journal of Social Work | Oxford Academic Full article: Impacts of Workplace Stress on the Retention of Social Workers: A Qualitative Study Full article: Struggling with studying and earning – realities of the UK's cost-of-living crisis on students on social work programmes

Senior Research Assistant < Back Gabrielle Palermo Senior Research Assistant Ageing and Dementia Gabrielle Palermo is a Senior Research Assistant at the NIHR ARC Wessex Mental Health Hub, University of Southampton. She supports quantitative research on alcohol use disorder in older adults and contributes to other Hub projects involving complex routine datasets, including the OLA study. With over 20 years of experience in applied statistics, Gabrielle specialises in quantitative methods for epidemiological, socioeconomic, and public health research, particularly in the analysis of survey and administrative data. Her expertise includes multilevel modelling, complex survey design for cross-sectional and longitudinal data, data cleaning and linkage, and the treatment of missing data. She holds an MSc in Population Studies and a BSc in Statistics from ENCE–IBGE (Brazil). Her doctoral research focuses on statistical methodologies for unbalanced longitudinal data in sample-based educational panel studies, with emphasis on school effectiveness and pupil mobility. Since 2022, she has worked across multiple departments within the Faculty of Medicine at the University of Southampton, contributing to research in epidemiology and clinical trials. Previous Next

28e06f68-57c1-47e6-a549-0943eeae5264 OPTIM Park - Optimization of community resources and systems of support to enhance the process of living with Parkinson’s Disease: a multisectoral intervention COMPLETE: Optimization of community resources and systems of support to enhance the process of living with Parkinson’s Disease: a multisectoral intervention (Linked to PARTNERS) Chief Investigator: Professor Mari Carmen Portillo – University of Southampton Funder : The Optim Park, April 2019-December 2022, aimed to establish the feasibility and acceptability of an intervention that will enhance the process of living with PD for patients and family-carers by building multisectoral care pathways, with a special focus on how to optimize the use of resources and systems of support in the community in disadvantaged populations of different European countries. The Optim Park consortium was composed of 4 countries (Denmark, Norway, Spain and UK (coordinators)). running according to plans considering we are reporting a period of 9 months (the project starting in April 2019). The consortium has worked efficiently and important professional and personal links have been established across partners. A total of 6 WPs were completed: 1. Patient and public involvement 2. Evidence on systems of support and integrated care for people with PD 3. Roles and working relationships between agencies and levels of care 4. Feasibility trial 5. Dissemination and 6. Management. The research design of the Optim Park project included reviews of evidence and statutory documents, qualitative research (166 interviews with people with PD, carers, stakeholders and professionals), and quantitative research (feasibility trial of a designed intervention with 220 participants including people with PD and family carers). Our findings led to the design of an intervention that consisted of introducing the PD coordinator role and personalised assessment of needs, prioritisation of needs and referral to community resources with follow up. We have developed a very strong and sustainable PPI plan for this project, and we have liaised with key national and international voluntary organisations for PD and clinical sites, which were essential for the delivery and implementation plans of our work. Dissemination of the project took place through scientific and lay routes. Additional funding has been secured throughout the life of the Optim Park project for next research steps, the PD Coordinator role in the UK, exchange opportunities for PhD candidates and the development of young researchers and postdoctoral mobility. These are our published papers Portillo, M.C. , Anita Haahr, Navarta-Sánchez, M.V. (2021). Management, levels of support, quality of life, and social inclusion in Parkinson’s disease: interventions, innovation, and practice development, Parkinson's Disease, DOI: 10 1155/2021/4681251. Portillo, M. C., Haahr, A., & Navarta-Sánchez, M. V. (2021). Management, levels of support, quality of life, and social inclusion in Parkinson’s disease: interventions, innovation, and practice development . Parkinson´s Disease , https://doi.org/10.1155/2021/4681251 . Soilemezi, D. , Palmar-Santos, A., Navarta-Sánchez, M.V., Roberts, H., Pedraz-Marcos, A., Haahr, A., Sørensen, D., Bragstad, L., Hjelle, E., Bjørnsen Haavaag, S., Portillo, M.C . (2022), Understanding support systems for Parkinson's disease management in community settings: A cross-national qualitative study. HealthExpectations, https://doi.org/10.1111/hex.13691 . Soilemezi, D. , Roberts, H., Navarta-Sánchez, M.V. Kunkel, K., Ewings,S., Reidy, C., Portillo, M.C. (2022). Managing Parkinson’s during the COVID-19 pandemic: perspectives from people living with Parkinson’s and health professionals. Journal of Clinical Nursing , DOI: 10.1111/jocn.16367. *Nielsen, T. , Kruse, N., Haahr, A., Hjelle, E.G., Bragstad, L.K., Palmar-Santos, A., Navarta-Sánchez, M.V., Pedraz-Marcos, A., Bartolomeu Pires, S., Roberts, H., Portillo, M.C . (2022). Exploring health and social services in Denmark, Norway, Spain and the United Kingdom for the development of Parkinson's care pathways. A document analysis. Health and Social Care in the Community, doi:10.1111/hsc.13970. Vester, L.B. , Haahr, A., Nielsen, T.L., Bartolomeu, S., Portillo, M.C. (2023), A Parkinson care-coordinator may make a difference: A scoping review on multi-sectoral integrated care initiatives for people living with Parkinson's disease and their caregivers. Patient Education and Counselling, doi: 10.1016/j.pec.2023.107931. Hjele, E.G. , Rønn-Smidt, H., Haahr, A., Haavaag, S., Sørensen, D., Navarta-Sánchez, V. Portillo, M.C., Bragstad, L.K. (2024). Filling the gap in service provision Partners as family carers to persons with Parkinson’s disease: A Scandinavian perspective. Chronic Illness, DOI:10.1177/17423953231174470. Navarta-Sánchez, M.V. , Palmar-Santos, A., Pedraz-Marcos, A., Reidy, R., Soilemezi, D., Haahr, A., Sørensen, D., Rønn Smidt, H., Kildal Bragstad, L., Gabrielsen Hjelle, E., Bjørnsen Haavaag, S., Portillo, M.C. (2023). Perspectives of people with Parkinson's disease and family carers about disease management in community settings: a cross-country qualitative study. Journal of Clinical Nursing, https://doi.org/10.1111/jocn.16636 . Pedraz-Marcos A, Palmar-Santos AM, Portillo MC, Navarta-Sánchez MV. Management of Parkinson's in the Community: Interests and Expectations of People Living with Parkinson's, Family Carers, Healthcare Professionals and Stakeholders in Spain. Glob Qual Nurs Res. 2025 Nov 3;12:23333936251384434. Who did we work with? Coordinator/chief investigator of the project: United Kingdom : University of Southampton, Professor Mari Carmen Portillo Country leads : Spain: Autonomous University Madrid, Dr Victoria Navarta Sanchez Spain, Fundación La Princesa, Dr Lydia López Denmark: VIA University College, Dr Anita Haahr Norway: University of Oslo, Dr Line Kildal Partners: Parkinson’s disease associations in the four countries

dcd0d821-4fe8-4cdb-b80d-1d7503b45f61 Wessex DIET: Determining the Impact of covid-19 on food sEcurity in young families and Testing interventions Joint Lead: Professor Nisreen Alwan and Dr Dianna Smith . Co Applicants : Nida Ziauddeen , Tim Lloyd, Dr Marta Disegna , Ravita Taheem, Sally Shillaker, Fran Richards, Duncan House, Sara Crawford. Partners: Southampton City Council, University of Southampton, Bournemouth University, Solent NHS Trust. starts: 1 November 2021 Ends: 31 March 2024 Publications: Household food insecurity risk indices for English neighbourhoods: Measures to support local policy decisions News: New map shows regions in the UK with a higher risk of food insecurity Lay Summary Aim of the research : We will explore the impact of system shocks on food security, diet quality and health in young families across Wessex, using the covid-19 pandemic and lockdowns as an example of such shocks. We will find out if Council-supported food aid initiatives to counter difficulties around adequate and healthy diet are acceptable, well taken-up and impactful in local populations. This will lead to a toolkit that can be used by Councils to decide which initiatives are best for their populations. Background: The covid-19 pandemic restrictions are likely to have negatively impacted UK families in many ways, including food insecurity (not having enough food because of cost or other barriers, or not having good quality food). Food insecurity has negative health impacts in the short-term including weight gain, malnutrition, poor mental health; these may lead to longer term health outcomes including obesity, diabetes, anxiety, and depression. Local Councils in Wessex have a range of initiatives to help this situation, including food pantries, where eligible families can purchase a range of items at a greatly reduced price, and recipe boxes. Design and methods During this 2-year project we will: Use statistical modelling to explore the effect of the covid-19 pandemic on important aspects of health and wellbeing in Wessex’s families with children under age 12, including their diet quality, food availability, weight status and mental health. Interview families to explore how they coped with the changing social and economic circumstances during the pandemic particularly in relation to their food quality and purchasing behaviours, Work with the local Councils in Southampton and Dorset to evaluate the initiatives to improve diet in disadvantaged families including food pantries. Public Patient Involvement: We involved public contributors in the design of this research through three meetings with 12 contributors overall. We have a public contributor as a co-applicant. Our PPI activities will ensure the interventions reflect the individual needs of young families in the target groups, and that the outreach activities to support the interventions are properly communicated. We already have ongoing public engagement activities involving Sure Start within our existing ARC project which we will continue to utilise. We have and willcontinue to actively involve people on the frontline of food aid systems in shaping this research. Dissemination: We will produce an implementation toolkit for Councils to aid decision-making on food-aid initiatives. Non-academic outputs will be specific to the audience and will include videos, presentations, social media posts and flyers. For public health/councils, short reports on the findings in the form of policy briefs will add to academic content and presentations. We will follow successful models like the oral health posters to Family Hubs delivered by Solent Health. What did we find out? We explored the impact of system shocks on food security, diet quality and health in young families across Wessex, using the covid-19 pandemic and lockdowns as an example of such shocks. We used statistical modelling to explore the effect of the covid-19 pandemic on diet quality, food availability, weight status and mental health in England. We wanted to find out if food aid supported by local councils to counter difficulties around adequate and healthy diet are acceptable, well taken-up and impactful in local populations. We carried a review of the literature on the impact of food aid initiatives in households with children and found that accessing food aid was linked to reducing food insecurity and improving diet quality in some studies. Food aid initiatives that allow users to choose food items and provide other support services are most effective. We also carried out a review of the literature on the impact of the COVID-19 pandemic on food insecurity in households with children and found that most studies showed that the pandemic worsened food security. We assessed the impact of food clubs (a type of food aid initiative that charges a small fee for a set number of items) on food security, diet quality and wellbeing in households accessing these clubs. We did this by recruiting people accessing food clubs to our study and asking them to complete a survey at recruitment and after at least three month of using food clubs in Southampton and Dorset. 97 people took part in the study and 49 people completed a follow-up survey. 11 participants also took part in a semi-structured interview that explore how they coped with the changing circumstances during the pandemic and their views on food clubs. We found that only 12 people (16%) were food secure (had reliable access to sufficient nutritious food) when they first started accessing food club. Among the 49 people who completed a survey after using the food club for at least 3 months, we found that 16 people (42%) were food secure. Diet quality increased in 22 people (45%) and mental wellbeing in 30 people (61%). We found that people’s food security diet and mental wellbeing improved after accessing food clubs. What did we do with this new Knowledge? We have produced a toolkit to aid decision-making on food aid initiatives, to allow them to assess the impact of the interventions and consider how best to implement new interventions. This can be used by local councils to plan new initiatives or by the interventions themselves to monitor impact. We visited the food clubs we recruited participants from and shared the study results with the people accessing the clubs, as well as the staff and volunteers there. What Next? Future research will evaluate the process and impact of food aid interventions using the toolkit. We have applied for further funding to explore how to improve the quality of food provided through aid. Publications The impact of food aid interventions on food insecurity, diet quality and mental health in households with children in high-income countries: a systematic review | Public Health Nutrition | Cambridge Core . The COVID-19 pandemic and food insecurity in households with children: A systematic review | PLOS One A mixed methods study exploring food insecurity and diet quality in households accessing food clubs in England | BMC Public Health

7982ebd7-aab7-4e3f-8493-b1caebcd4bea The Wessex FRIEND Toolbox (Family Risk IdEntificatioN and Decision) Identifying high risk groups early to improve health in young families in Wessex Principal Investigator: Professor Nisreen Alwan and Dr Dianna Smith Team members: Professor Nisreen Alwan (Professor in Public Health, School of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton), Dr Dianna Smith (Lecturer in Geographic Information Science, Geography & Environment, University of Southampton), Professor Paul Roderick (Professor of Public Health, School of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton), Dr Ivaylo Vassilev (Principal Research Fellow, School of Health Sciences, University of Southampton), Dr Grace Grove (Clinical Research Fellow, School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton), Dr Nida Ziauddeen (Research Fellow, School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton),Dr Lauren Wilson (Research Fellow, Geography & Environment, University of Southampton) Read report: Food Insecurity Risk Indices for Neighbourhoods 2021 Food Insecurity Brief LSOA Level Estimates Sept2021_online[2] .pdf Download PDF • 363KB Start: 21 October 2019 Ended: 30 September 2022 Project Partners: University of Southampton, Solent NHS Trust, Southampton City Council, Portsmouth City Council, Hampshire County Council, Health Education England, Oxford Brookes University Lay summary We know that prioritising health is complex, particularly for families living in social and economic disadvantage. The SLOPE CORE tool estimates the future risk of childhood overweight at the start of primary school. It can be used by health professionals in consultation with the families they are working with to help facilitate various interventions towards the prevention of childhood obesity. We have tested the acceptability and feasibility of this tool in the first phase of the Wessex FRIEND project, as part of a broader programme of work, aiming to improve the health of children and families in Wessex. We have trialled it with health visitors in the first instance, just so that we can get some initial feedback and improve it before combining it with other components of interventions. We have also been refining and tailoring area-based child poverty, food poverty and greenspace access measures to the local and regional context and population, so that our risk tool takes into account the area profile and resources where the family lives. These area-based measures, which represent neighbourhoods, may also be used independently by local governments and civil society/third sector to help in targeting resources to better support people living in areas of higher risk for food and child poverty, or with poorer access to greenspaces. What have we found out? We tested a digital tool called SLOPE CORE which predicts if preschool children are likely to be overweight by the time they start school. Health visitors and parents found the obesity prediction tool quick and easy to use. Using the tool provided the opportunity for health promotion, and may facilitate difficult conversations by giving an objective result and removing the perception of professional judgement. This may encourage conversations on healthy weight and could influence health visitor practice by increasing provision of anticipatory support on feeding. Health visitors felt that, when using the tool, the healthcare professional should have sufficient time to have a sensitive discussion and explain a conceptually difficult concept (risk). Parents felt that the tool provides an opportunity for behaviour change and potential to improve health for the child but can also provide reassurance. They appreciate the provision of additional resources and support with the results. However, before using the tool the healthcare professional should consider whether the tool is appropriate, as it may be unsuitable for some parents. We refined and tailored area-based child poverty, food poverty and greenspace access measures to the regional context and population. These provide improved tools for better planning and targeting of services by the local councils. These area-based measures are combined with the individual childhood obesity estimation provided by the SLOPE CORE Tool on one platform, which can be utilised by frontline professionals dealing with disadvantaged families. We also tested the feasibility of the Generating Engagement in Network Involvement (Genie), a facilitated social network intervention, as a means towards reducing risk of adverse family health outcomes. We tested this with Home-Start in Portsmouth which is a voluntary organisation. Staff found Genie simple to use, really liked the concept and found that familiarity with the system meant the process was much smoother for later entries. Staff felt that being able to fill out Genie on a phone or app would be quite useful. The option of other languages or built-in translation could also make it easier to use. Staff felt that Genie was particularly good for families feeling isolated or new to the area but was unlikely to be relevant for all. However, staff thought it was less realistic for them to use it within the timeframe of visits and other things that need to be done during a visit but they could potentially facilitate the use of Genie by encouraging people to do so themselves. The network mapping was useful as it made people realise what they have and what they need. Staff found it an interesting exercise to start the conversation and find out what was going on in the lives of individuals/families they were supporting. A potential barrier to the use of both tools is lack of wi-fi/internet connectivity. What difference can this make? Using the obesity prediction tool could provide the opportunity for health promotion and facilitate discussions by giving an objective result and removing the perception of professional judgement. This could encourage conversations on healthy weight and potentially influence health visitor practice by increasing provision of anticipatory support on feeding. Using the tool antenatally, or with a younger infant may allow for an easier conversation, allowing the healthcare professional to focus on prevention, as opposed to ‘correcting’ a parent’s current behaviour. Health visitors felt that parents were more likely to be receptive to a preventative approach. The refined area-based measures provide improved tools for better planning and targeting of services by the local councils. Network mapping using Genie made people realise what they have and what they need and help staff start the conversation to find out what was going on in the lives of individuals/families they were supporting. Why in this important? The Childhood Obesity Risk Estimation Tool has the potential to focus targeted intervention for the early prevention of childhood obesity. The updated food insecurity risk index has enabled local government to target available resources to those with greatest need. It has been included in the Joint Strategic Needs Assessment (JSNA) for Hampshire County Council. It has also contributed to food aid planning in Dorset, Hampshire and further resource planning in districts across the country. What’s next? The SLOPE CORE tool combined with the area based measures will require further testing to establish how it can be best used in practice, and any impact it may have on childhood obesity. This could be as part of a new or existing pathway which includes interventions designed to reduce risk of childhood obesity. Healthcare professionals using the tool should be trained in risk commination, be able to advise the parent on next steps, and have time to discuss what can be a sensitive topic. As SLOPE CORE only requires routinely collected data, it may be possible to build the tool into existing systems - such as healthy weight pathways, routine health visiting contacts and relevant GP consultations, which could save time and support existing work rather than further adding to workload for healthcare professionals. If internet access is unreliable, then a paper data collection sheet could be used to capture data required to use the tool at another time. After determining optimum timing and setting for tool use, a longer term evaluation is necessary to explore the impact of the tool on parents and healthcare professionals behaviours in the short term, and childhood obesity in the longer term. Publications: Ziauddeen, N., Roderick, P., Santorelli, G., Wright, J., & Alwan, N.A. (2022). Childhood overweight and obesity at the start of primary school: external validation of pregnancy and early-life prediction models. PLOS Glob Public Health. 2(6): e0000258. Ziauddeen, N., Roderick, P., Santorelli, G., Wright, J., & Alwan, N.A. (2020). OP55 Childhood overweight and obesity at the start of primary school: external validation of pregnancy and early-life prediction models. Journal of Epidemiology & Community Health, 74(Supplement 1), A26. https://doi.org/10.1136/jech-2020-SSMabstracts.54 Smith, D.M., Rixson, L., Grove, G., Ziauddeen, N., Vassilev, I., Taheem, R., Roderick, P., & Alwan, N.A. Household food insecurity risk indices for English neighbourhoods: measures to support local policy decisions. MedRxiv 2022:22273530. https://doi.org/10.1101/2022.04.06.22273530 (preprint and minor revisions requested at PLOS ONE) Smith, D. and Thompson, C. (2022) Food Deserts and Food Insecurity in the UK. Routledge. Further funding because of this research: ARC Wessex - Wessex DIET: Determining the Impact of covid-19 on food sEcurity in young families and Testing interventions MRC Clinical Research Fellowship (Dr Grace Grove) - Investigating the impact of food vouchers on diet composition and the prevention of childhood obesity Other impacts: The food security risk index has been included in the JSNA for Hampshire and has contributed to JSNAs and food aid planning in Dorset, Hampshire and further resource planning in Lancaster, Hull Hertfordshire and Greater Manchester to name a selection of Local Authorities, demonstrating the wider reach beyond Wessex.

d7cea2fb-fab3-4e8d-86f6-e2d2952f0404 ADOPTED: Nurture-U (Southampton): A longitudinal survey for student metal health and wellbeing Principal Investigator: Lucy Dorey Start Date: 1 July 2021 End Date: 1 July 2025 Background: Promoting good mental health within university students is a priority. Anxiety, depression and self-harm are rapidly increasing. University mental health services report demand beyond their capacity. Effective ways to prevent student mental difficulties are urgently needed. Further, university should be a positive life experience and promote students' emotional fitness and ability to thrive. Research and student feedback recommend changing university culture, environment and teaching to promote wellbeing. Stepped care in which students move through different steps based on need is also suggested to improve student wellbeing and service capacity. This starts with wellbeing promotion and prevention for all students, steps up to self-help for those with mild symptoms and to professional support for those with elevated symptoms. However, these approaches have not been rigorously tested in universities. We don't know which elements best promote good student mental health. We don't know what approaches work best for the diverse student body across gender, ethnicity, sexuality, sociodemographic background. We will test initiatives within the university environment and at each of the steps, see which initiatives students use, how well they work, and identify which work best for which students across diverse groups. Students will be active partners in shaping, delivering and evaluating all research. We will use repeated twice-yearly online surveys across 6 universities (110k undergraduates) to assess student wellbeing and mental health and understand what helps or hinders students seeking and getting help. A digital self-monitoring tool allows students to track their wellbeing, stress, and what support they use over time so we can map how they move through stepped care and how different steps interact with each other. To test whether changing university environment promotes wellbeing, first we will evaluate embedding compassion into education: teaching about diversity and mental health, practising kindness and understanding for self and others, and making assessment more flexible and responsive to students. Focus groups will explore how students experience this approach. Second, we will introduce a voluntary online mental health literacy course for first year undergraduates that teaches what influences mental health, how to promote wellbeing and how to seek help. Surveys before and after the course will test if it increases students' knowledge, healthy behaviours, helps-seeking and wellbeing. To better understand how to make self-help work for students, randomised trials will test book-based guided self-help to build personal strengths, unguided digital self-help to prevent depression in high-worrying students and digital self-help for depression and anxiety. We will compare supported versus unsupported digital cognitive-behavioural therapy, meditation and peer support apps to find out which app(s) students find most acceptable and explore which students most benefit from. We will test self-help with and without support because unsupported self-help can reach vastly more people and there is uncertainty about whether and for whom supported self-help is more effective. To improve the efficiency of student mental health services, we will test if adding a digital self-monitoring tool shared between student and clinician improves student experience and time to recovery by enabling care to be more proactive and responsive (e.g., more frequent meetings if symptoms rise). From this research, we will develop an evidence-based integrated model of inclusive and acceptable student wellbeing and mental health support. In partnership with students and university leaders, this model will inform policy recommendations. We will develop guidance, courses and tools to promote student wellbeing that are easily added to existing systems or that use tried-and-tested low-cost technology to ease their adoption and ongoing use.

0962122f-1175-4112-bec9-7327da6e0e5a Work lives and Wellbeing of Mental Health Nursing Workforce Lead applicant: Prof Jane Ball Co-applicants: Dr Gemma Simons, Prof David Baldwin, Prof Peter Griffiths, Dr Catherine Smith, Dr Emma Wadey Project Summary: Read a long project summary Read a short project summary We have a growing demand for mental health care and nurses are key to meting this demand. Each year roughly 10,000 NHS staff in England leave mental health services. 22% of nursing posts in mental health are vacant. Across the NHS it is recognised that work pressures impact on staff wellbeing, their ability to deliver care well, and likelihood of staff staying in the NHS. Despite being a priority area, most research related to nurses’ work engagement, retention and positive staff outcomes focuses on staff in general acute hospitals. Very little attention has been paid to mental health nurses’ work lives and wellbeing. Where will the research take place and who will it in involve This study focusses on mental health nurses. It will take place in Wessex but also includes desk research to collate workforce data, and a national survey of nurses in a range of mental health settings (community, hospitals, specialist units). The project will be led by the mental health workforce team at Southampton, in collaboration with the Hampshire & Isle of Wight Staff Support Hub, and the national lead for mental health nursing. An advisory group and patient public group will support the research. Aim & Design The aim is to examine the work lives and wellbeing of mental health nurses, in order to improve wellbeing and retention of these staff. This study will map what is known about the mental health nursing workforce, identify modifiable workplace factors that impact on staff experience, wellbeing and outcomes, and work collaboratively to identify solutions. The companion project will identify metrics that we can use to assess the wellbeing of the mental health workforce. Methods Labour market and workforce review - analyse data on the mental health nursing workforce, to create an overview. Survey nurses working in mental health (in Wessex NHS Trusts and a national sample). The questionnaire includes measures of: burnout, job satisfaction, intention to leave, workloads and practice environment. We will include open-ended questions so staff can give their views of work-life challenges, how they impact on their health, and what helps. The RCN Mental Health Forum will be main gateway for the national survey. Interview and focus groups with mental health nurses in Wessex NHS Trusts to explore experiences and views of working in mental health and issues related to wellbeing. These will be both before and after the survey (to help with survey design, and afterwards, to enrich interpretation). Coproduction workshop . Preliminary findings will be shared with a wide range of people with vested interest in, or responsibility for, the mental health workforce (e.g. nurses, managers, workforce leads) at a Wessex based co-production workshop, to identify actions and next steps. How will the findings inform improvements in population health and patient care? Services will run better and care quality will be improved if the workforce is healthy, happy and there are enough staff to provide care to the expected standards. Publications doi:10.12968/bjmh.2023.0037