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- Identifying the knowledge gaps of paramedics managing patients with mental health issues
08639c2e-864e-4386-adf6-510fcbb59d49 Identifying the knowledge gaps of paramedics managing patients with mental health issues Chief Investigators: Dr Ursula Rolfe. Faculty of Health and Social Sciences. Bournemouth University, Dr Natasha Campling, School of Health Sciences, University of Southampton. Implementation lead: Kirsty Lowery-Richardson, Head of Education, College of Paramedics Partners: Bournemouth University, University of Southampton, College of Paramedics CLASS Professional Publishing, Mental Health Education leads in all 11 ambulance Trusts including West Midlands Ambulance Service. Start: 1 October 2024 End: 31 March 2026 Aim of the research: To identify the knowledge gaps of paramedics when responding to people with mental health issues. Background to the research: Many people experience mental health issues in their lives and about 1 in 6 adults in England have a diagnosed common mental health illness. Mental health issues are rising, but rates are rising most for young people. Amongst 17- to 19-year olds rates of mental health illness rose from 10% in 2017 to 26% in 2022. Rising rates of mental health issues combined with pressure on community services mean that that over 1.2 million people are waiting for support and treatment from NHS community mental health services. The result of such high-level unmet demand has fallen on ambulance services and paramedics. England’s ambulance services received 524,485 mental health related 999 calls in 2018-19, but by 2021-22 this increased to 652,720, a rise of 24%. Across England, ambulance staff spend 1.8 million hours annually (or 75,000 days), responding to people with mental health issues. Paramedics express concerns attending to patients experiencing mental health issues because of a lack of education. However, the specific nature of their knowledge gaps that underpin these concerns are not known. Therefore, this research will identify these gaps and make recommendations to inform the future design of effective educational provision, to better support the paramedic workforce in delivering quality care for the rising population of individuals with mental health needs. Design and methods: The study is designed in two phases. First, university-level education (prior to paramedic qualification) and in-practice training (once qualified) from all England’s ambulance services regarding mental health care provision will be analysed. Second, interviews with up to 20 paramedics regarding their knowledge when managing patients with mental health issues will be undertaken. The interviews will use patient cases, informed by real-life examples, to explore paramedic decision-making. Patient, public and community involvement: We have worked with a dedicated group of individuals with lived experience of mental health issues who have received care from ambulance services and paramedics to design the study. The group have all backed the importance of the study, highlighting the need for “ more caring ” by paramedics when attending those with mental health needs. We will continue to work with this group throughout the study. The group will help co-design study documents, such as the interview guide and patient cases for the paramedic interviews. The group will also be given the opportunity if desired to review and input into data analysis during both study phases. Dissemination: Findings will be shared with healthcare commissioners, ambulance services and Universities. The project’s findings will form the basis of recommendations on educational delivery via both ambulance services and Universities, and further research on how best to provide education solutions to the knowledge gaps identified.
- 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
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.
- Qualitative Data Preservation and Sharing (Q-DaPS)
fa252260-9b08-4bee-8ac4-2e68a124d401 Qualitative Data Preservation and Sharing (Q-DaPS) Principal Investigators: Prof. Fiona Stevenson ,, Professor of Medical Sociology, University College London, Head of the Research Department of Primary Care and Population Health; Prof. Geraldine Leydon-Hudson , , Professor of Primary Care Research, University of Southampton . Co-applicants: Dr Barbara Caddick Senior Research Associate in Primary Care and Honorary Senior Research Associate Department of History, University of Bristol; Dr Rebecca Barnes , Senior Qualitative Researcher, University of Oxford; Prof Carolyn Chew-Graham , Professor of General Practice Research, Keele University; Prof Sue Latter , Professor of Health Services Research, University of Southampton; Dr Emma Pitchforth , Senior Lecturer & Senior Research Fellow in Primary Care, University of Exeter. Prof. Catherine Pope , Professor of Medical Sociology, University of Oxford; Dr. Benjamin Saunders , Lecturer in Applied Health Research, Medical Sociology, University of Keele; Prof. Katrina Turner , Professor of Primary Care Research, University of Bristol; Prof Sue Ziebland Professor of Medical Sociology and Co-Director of the Medical Sociology and Health Experiences Research Group (MS & HERG) in the Nuffield Department of Primary Care Health Sciences, University of Oxford. Colaborators: Dr Ian Maidment , Reader in Clinical Pharmacy at Aston; Lynn Laidlaw is an experienced public contributor involved in UK wide and international research projects; Ali Percy, public co-applicant. Start: 1 June 2022 End: 31 May 2024 Background: Researchers may use different types of data to increase understanding of issues in relation to health and social care. Data may include audio or video recordings of interviews, focus groups (group discussions), and consultations between professionals and patients / service users, as well as written data, such as notes about research. These types of data are referred to as qualitative data. Funders of research increasingly encourage researchers to make their data available to be reused by other research teams. This is in part because qualitative data collection takes a lot of time and costs a great deal of public money. It is also considered ethical to make maximum use of data. Importantly, many people who participate in research tell us it is important to them that their contribution to research is used as much as possible. The project: Despite the increasing need and wish to safely store and share qualitative data, there is no central place to store and provide access to qualitative research data collected about health and social care. We will work with a company that specialises in keeping data secure and has a track record of working with university and health care organisations to develop secure digital storage (a repository) for qualitative data about health and social care. Part of the work will involve taking account of the views of members of the public about consent and use of data as well as data security. This will make sure the guidelines we put in place for people putting data into the repository or using data from the repository are acceptable to both researchers and participants in research. We will publicise the repository to encourage researchers to store their study data and allow access for researchers to answer their research questions. We will also provide a description of what is in the repository on a website so researchers can plan if they could use data from the repository rather than collecting new data. We will charge for use of data so the repository can be self-funding and sustainable in the long term. Expected impact : Increasing access to existing qualitative data from research projects in health and social care will make better use of what we already know about health and social care, saving time and money that would otherwise be spent on collecting new data. It will also satisfy the expectations of funders of research that data should be reused where possible. This project is particularly important as the COVID 19 pandemic has made data collection even more challenging in health and social care sites meaning we need to make the best use of the data we already have.
- ADOPTED: A Study to Evaluate the Introduction of new Staffing Models in Intensive Care: a Realist evaluation (SEISMIC-R)
f6f0f7ec-ab98-4c5c-9b52-2674a93b8c90 ADOPTED: A Study to Evaluate the Introduction of new Staffing Models in Intensive Care: a Realist evaluation (SEISMIC-R) Prinicipal Investigator: Professor Natalie Pattison, University Of Hertfordshire Team: Professor Peter Griffiths, Dr Chiara Dall'Ora, Dr Christina Saville, Dr Lisa Whiting, Dr Melanie Handley, Dr Susie Pearce, Dr Marion Penn, Dr Paul Mouncey, Professor Thomas Monks, Mrs Clare Leon-Villapalos, Professor Suzanne Bench, Professor Ruth Endacott, Mr Jeremy Dearling, Mrs Jennifer Gordon. University of Southampton, University of Hertforshire, University of Plymouth, Intensive Care National Audit & Research Centre, University of Exeter, Imperial College Healthcare NHS Trust, Guys & St Thomas' NHS Foundation Trust/London South Bank University, NIHR Clinical Research Network. Start Date: 01 May 2023 End Date: 31 August 2024 Background Staffing in intensive care units (ICU) has been in the spotlight since the pandemic. Having enough nurses to deliver safe, quality care in ICU is important. There is national guidance, re-issued in April 2021, on how many nurses should care for ICU patients. However, what the skill mix should be (how many should be qualified nurses or have an ICU qualification) is unclear. Very little research has been done to look at which nursing staff combinations and mix of skills works best in ICU to support patients (described as ‘staffing models’). Across ICUs in UK, various ratios of qualified and unqualified nursing staff are being tried (staff ratios refer to the number of nurses caring for a set number of patients). Hospitals vary; some use a high proportion of non-registered nurses and others a low proportion of ICU qualified nurses. Research shows that there is a link between the quality of nurse staffing and poor patient outcomes, including deaths. Aim : Our research plans to look at different staffing models across the UK. We aim to examine new staffing models in ICU across six very different Trusts. We will use a research technique called Realist Evaluation that examines what works best in different situations and helps us to understand why some things work for some people and not others. The design of this approach will help us to better understand the use of different staff ratios across different ICU settings. We will examine what combinations of staff numbers and skills result in better patient care and improved survival rates. Our aim is to produce a template that every ICU unit can use. To do this, we will compare staffing levels with how well patients recover, and seek to understand the decisions behind staffing combinations. Publications Nurse staffing configurations and sickness absence in English intensive care units: A longitudinal observational study - ScienceDirect ICU staffing and patient outcomes in English hospital Trusts: A longitudinal observational study examining ICU length of stay, re-admission and infection rates - ScienceDirect
- This is a Title 01 | NIHR ARC Wessex
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- COMPLETED: PARTNERS Project: Development and implementation of a digital tool for multisectoral support and management of long-term condition
894e3c82-d20e-4fbc-a56a-7d96277ba61e COMPLETED: PARTNERS Project: Development and implementation of a digital tool for multisectoral support and management of long-term condition PARTNERS Project: Development and implementation of a digital tool for multisectoralsupport and management of long-term condition Principal Investigator: Professor Mari-Carmen Portillo Co Applicants : Line Bragstad, Dr Dorit Kunkel, Dr Kat Bradbury, Dr Lindsay Welch, Hayden Kirk, Dr Caroline Barker, Sandra Bartolomeu Pires, Christopher Edwards, Lindsay Cherry, Francesca White, Caroline Aylott, Cathal Doyle. Partners: University of Southampton, University of Oslo, Hampshire and Isle of Wight NHS Foundation Trust, University Hospital Southampton NHS Foundation Trust, Hampshire and Isle of Wight ICS, Versus Arthritis, and Parkinson’s UK. Lay Summary Background to the research : Self-management is an approach to help people with long term conditions manage their health daily. Existing NHS self-management tools focus on healthcare (medication management, appointments) and fail to capture aspects of how people live with and adjust to long-term conditions. This includes social support (family/friends) and other resources and networks available like the voluntary sector, industry and community groups.We have created an intervention (an action to improve a situation or prevent it getting worse) to support self-management for people with Parkinson’s Disease and their family/carers. This intervention recognises the role of social support, voluntary sector, industry, and community groups in adjusting to living with a condition. Our next step is toadapt this intervention to the needs of people living with other conditions like Arthritis and for those living with more than one condition and create a digital tool. Aim of the research : To develop, implement and evaluate a digital tool that supports the management of people with Parkinson’s Disease and/or Arthritis. The tool will support professionals and other organisations to connect, share resources and optimise communication and referrals, leading to more personalised and cost-effective use of resources (beyond healthcare) in the community. Design and methods: The research will take place in community settings in Wessex. We will prioritise disadvantaged groups (those less comfortable using technology and less able toaccess available resources and support). We will : 1. Work with our patient and public involvement (PPI) representatives, relevant voluntary organisations, health and social care providers, and key people involved in policy making and NHS strategy. They will have a voice ineach decision to ensure our tool is relevant and acceptable to those using it. 2. Host discussion groups with people with Parkinson’s Disease and/or Arthritis and theirfamily/carers to understand the positive and negative aspects of existing digital tools, from a patient perspective. 3. Design our self-management tool. 4. Test the tool through two primary care surgeries (GP) and voluntary organisations (Parkinson’s UK and Versus Arthritis).Testing will help understand how the tool is used and what helps or hinders its success. Deliverables : The research will generate: a digital tool to support more effective self-management of Parkinson’s Disease and/or Arthritis, recommendations for policy development, evidence for how to improve NHS services. Public Patient Involvement: We willwork with people with Parkinson’s Disease and/or Arthritis and their families/carers. We will work together as equal partners to define their level of involvement, roles, methods to input and training needs. We will also explore what works best or what we should do differently intheir involvement. Dissemination : We will share our learning across the different groups involved. This will include presentations, policy briefings, newsletters, and public events. What did we find out? We found that people with Parkinson’s and/or arthritis, their carers and professionals involved in their care wanted a digital app that was: • Simple • Easy to navigate • Hybrid – in person contact also signposted Included: • Community resources from voluntary/charity sector • Free or inexpensive resources • Links to peers/buddy for support What next? PARTNERS 2 has evolved, as a continuation project. This allowed time for: A suitable digital company to be found with previous experience of working with people with health condition Full briefing of the digital company about what was required of the digital web app. Development of a 'Life Boost' app Trade marking 'Life Boost' Real-world evaluation of the app with Social Prescribers in Hampshire Linking 'Life Boost' to MyMedical Record (University Hospital Southampton NHS Foundation Trust) The PARTNERS 2 project will now: Ga in full exposure by having it adopted onto the My Medical Record platform at the University Hospital Southampton NHS Foundation Trust Be used in the real-world and a business/company/organisation will be sought to adopt the app for further development and management
- CHAMPION: Children whose mothers are involved in the criminal justice system in Dorset & Hampshire: developing health and social care outcome indicators
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.
- ADOPTED: DASA - Domestic abuse and housing: local authorities' provision of safe accommodation for adults living with disabilities and/or long-term/life-limiting illness: a mixed-methods study
596abb82-50f3-40e1-8d8d-a89073038260 ADOPTED: DASA - Domestic abuse and housing: local authorities' provision of safe accommodation for adults living with disabilities and/or long-term/life-limiting illness: a mixed-methods study Principal Investigator: Dr Michelle Myall , School of Health Sciences, University of Southampton. Team: Dr Sophia Taylor and Dr Susi Lund , School of Health Sciences, University of Southampton. Professor Julie McGarry and Professor Parveen Ali University of Sheffield. Mrs Samantha Dawson, Body Positive Dorset - Public and Patient Contributor Summary In 2022 an estimated 2.4 million adults experienced domestic abuse in England and Wales. Some people are at increased risk because of additional inequalities, vulnerabilities, and other factors. This includes adults with complex health and social care needs such as those living with physical disabilities and long-term/life-limiting illnesses. In April 2021 the Domestic Abuse Act was introduced in England. This created a new definition of domestic abuse to include any incidents of controlling, coercive, or threatening behaviour, violence or abuse between those aged 16 or over, who are or have been, intimate partners or family members regardless of gender or sexuality. Domestic abuse also includes psychological, physical, sexual, financial and emotional abuse. Domestic abuse can happen to anyone and is a leading cause of homelessness. In England, the Domestic Abuse Act has changed housing law to give priority accommodation to a person made homeless because of domestic abuse and requires local authorities to offer support in safe accommodation and alternatives to refuge provision. Refuges are notsuitable for all victim-survivors, particularly those who have additional and specific health and care needs. There is little research on the housing needs of domestic abuse victim-survivors with physical disabilities, longterm conditions or life-limiting illnesses. Understanding the requirements of these groups and how local authorities are meeting their responsibilities under the Domestic Abuse Act is important and timely. What are the study aims? Working with people with lived experience, local authorities, and domestic abuse organisations we aim to: 1) identify and explore the experiences of victim-survivors living with a physical disability and/or long-term/life-limiting illness affected by domestic abuse and 2) understand how local authorities are meeting their responsibilities in providing safe accommodation and prioritising those made homeless because of domestic abuse. We will explore what local authorities already provide and how they are responding to the requirements of The Domestic Abuse Act. We will review published research and policies, map existing housing provision, and undertake interviews with key stakeholders. To ensure the voices of people with lived experience are included and listened to, we will hold creative workshops, using art, poetry or stories to explore their experiences. Findings will be used to develop a toolkit for local authorities and their partners to inform practice and improve user experience. What will happen to the study findings? We will work with our project partners and people with lived experience to identify who we need to engage and how to reach them. We will hold an event at the end of the study to share findings with stakeholders. Findings will be reported on social media for the wider public, and attendance at conferences and publications in academic and professional journals.
- COMPLETED: The Wessex FRIEND Toolbox (Family Risk IdEntificatioN and Decision)
7982ebd7-aab7-4e3f-8493-b1caebcd4bea COMPLETED: 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.
- COMPLETED ADOPTED PROJECT: The Gateway Study a randomised controlled trial, economic and qualitative evaluation to examine the effectiveness of an out-of-court community-based Gateway intervention programme aimed at improving health and well-being for young adult offenders; victim satisfaction and reducing recidivism
0ff85ad2-7ff5-49d4-b71c-0a912cb8f020 COMPLETED ADOPTED PROJECT: The Gateway Study a randomised controlled trial, economic and qualitative evaluation to examine the effectiveness of an out-of-court community-based Gateway intervention programme aimed at improving health and well-being for young adult offenders; victim satisfaction and reducing recidivism Completed A single-site pragmatic Randomised Control Trial to examine the effectiveness of an OCBI known as ‘Gateway’ on improving health and well-being of offenders aged 18-24, as well as reducing recidivism and improving victim satisfaction Chief Investigator: Professor Julie Parkes – University of Southampton Project Team Members Dr Sara Morgan – University of Southampton, Dr Inna Walker – University of Southampton, Professor Catherine Hewitt – University of York, Professor David Torgerson – University of York, Professor Jenny Fleming – University of Southampton, Professor James Raftery – University of Southampton, Inspector Stu Baker – Hampshire Constabulary Sergeant Caroline Chapman – Hampshire Constabulary, Dr Alison Booth – University of York, Mrs Ann Cochrane – University of York, Mr Alex Mitchell – University of York, Mrs Valerie Wadsworth – University of York, Mrs Megan Barlow-Pay – University of Southampton, Ms Lana Weir – University of Southampton. Organisations Involved: Hampton Trust charity, No Limits charity, Aurora New Dawn, Hampshire and Isle of Wight Constabulary Started: 1/3/2018 Ended: 31/8/2022 Background Young adult offenders commonly have a range of health and social needs, making them vulnerable to mental health problems. If you are aged between 18-24 years old and have committed a crime, you may need to attend court and face convictions or prison. However, many believe that more should be done to prevent young adults from entering the criminal justice system in the first place. The study aims to determine whether a new out of court programme, named Gateway, improves the health and wellbeing of young adult offenders aged 18-24, and influences their chance of offending again, and gives victim satisfaction. The Gateway programme is issued as a conditional caution and has been developed by Hampshire Constabulary (HC), in partnership with local community groups, with an aim to improve the life chances of young adult offenders. In the programme, a mentor assesses the needs of each adult and develops a care pathway with referrals to healthcare. The young adult offenders then participate in two workshops about empathy, and the causes and consequences of their behaviour. Such intervention programmes are believed to improve the health and well-being of young offenders and reduce criminal behaviour. However, there is currently little information about the extent of this improvement. To find out whether the programme works, this research study compares a group of young adult offenders taking part in the Gateway programme as a conditional caution with a group of non- participants who are required to appear in court or given a different conditional caution. Publications An out-of-court community-based programme to improve the health and well-being of young adult offenders: the Gateway RCT | NIHR Journals Library
- COMPLETED: Understanding psychosocial determinants of alcohol use disorder (AUD) in older adults: exploring the role of social networks and loneliness in living with AUD (OLA study 2).
1f1252b1-cfe9-4800-b5dd-f3b53069d91a COMPLETED: Understanding psychosocial determinants of alcohol use disorder (AUD) in older adults: exploring the role of social networks and loneliness in living with AUD (OLA study 2). Project partners (charities, Universities, NHS trusts, care providers etc): University of Southampton, University Hospital Southampton NHS Foundation Trust Full team listing including PPI Professor Julia Sinclair – Chief Investigator Professor Jackie Bridges – Co-applicant Dr Becky Band – Co-applicant Dr Steph Hughes – Research Fellow Zara Linssen – Medical Student Sophie Crouzet – Medical Student Stephen Lim – Implementation Champion Melinda King – PPI advisor Start: 01/01/2023 End: 01/07/2024 Summary Alcohol use disorders (AUD) in older adults is a growing problem which is currently under-recognised and under-treated. With little research into this area, there is no in-depth understanding about the factors that may contribute to AUD in older adults, nor the lived experiences of this group. Some have suggested that factors such as social isolation, loneliness and loss associated with older age may be important in understanding alcohol use. We know that in general, limited social contact and loneliness have a negative impact on both mental and physical health. One way to understand the amount and types of social connections someone has is to map their personal social network. This might include a whole range of people such as important family, friends, neighbours and acquaintances, pets, community places, groups or activities. This helps people to think about who is important in their daily lives, the roles that different relationships play, how this might have changed over time and how this might be improved, for example, by exploring ways to obtain additional support in the future. In this study we will invite older adults who have participated in a linked study to take part in an interview. The linked study will follow-up older adults with AUD for 6 months after being admitted into hospital. The people invited to this study will be selected based on lots of different factors, such as their age, how many people they live with, or how lonely they are, to ensure we are able to capture a variety of experiences within this group. Only those who have given permission to be contacted will be approached. The interviews will be 1:1 with a researcher and might happen in person, over the phone or through an online video call. Participants will first be guided through the process of mapping their current social network with the researcher. The interview will then discuss the support received from the person’s social network, as well as talking about the participants’ daily lives (including daily routines, physical and mental wellbeing and valued activities) and additional support needs. Interviews will last around 1 hour. They will be audio-recorded, transcribed and anonymised before analysis. Plain English summary of findings Recruitment to the study was difficult. Many patients who were identified as drinking at increasing or possibly dependent levels did not have mental capacity to take part. Of those who were eligible, a large percentage declined to participate. This resulted in a small sample size of 30, 16 of which completed their follow-up questionnaire, and 7 interviews. 20% of the sample died during the study window. Results indicated: Over 50% participants showed some level of cognitive impairment Participants had an average of 4 people in their social network; usually family members Interviews revealed links between social isolation, loneliness and drinking alcohol Those who were housebound reported drinking alcohol all day long Participants stated alcohol is not, and never has been a problem for them 50% participants met the threshold for depression Participants often provided conflicting information for the follow-up questions and in the interviews Participants had poor diets; of 32 nutrients measured 22 were not consumed in-line with the government recommendations 93% participants were taking 5 medications or more What did we do with this? As a small preliminary study the new knowledge has been used to inform future research. Impact on patient care and population health will come from the future research. Recruitment was harder than expected. This learning point has informed recruitment and retention procedures in future research applications. Other findings, for example, the link described qualitatively between social isolation and increased alcohol consumption, has shaped ideas for intervention development. What's next? We have formed a stakeholder group to discuss our findings and what the most appropriate next steps should be. We are preparing an application to undertake the planning and developmental work for an intervention aimed at reducing alcohol consumption in a general population of adults aged 65 and over. We plan to test the feasibility of this intervention in a feasibility study.
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