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  • COMPLETED: Development, evaluation and provision of an intervention for primary and community NHS staff to help carers and homecare workers supporting people living at home with dementia with their continence.

    f6a3bc9c-cb06-4577-8723-be7beaceddc2 COMPLETED: Development, evaluation and provision of an intervention for primary and community NHS staff to help carers and homecare workers supporting people living at home with dementia with their continence. Principal Investigator: Dr Catherine Murphy, Senior Research Fellow, School of Health Sciences, University of Southampton. c.murphy@soton.ac.uk Team: Jane Ward: former carer, Alzheimer’s Society Research Network Member, co-founder of Dementia Friendly Hampshire, Patient Research Ambassador: Prof Miriam Santer: Professor of Primary Care Research, Faculty of Medicine, University of Southampton: Prof Jill Manthorpe: Professor of Social Work, Director of NIHR Policy Research Unit in Health & Social Care Workforce, King’s College London – Associate Director of NIHR School for Social Care Research: Prof Mandy Fader: Professor of Continence Technology, School of Health Sciences, University of Southampton: Dr Leanne Morrison: Lecturer in Health Psychology, School of Psychology & Primary Care Research Centre, University of Southampton. Partners: Health Innovation Wessex, Alzheimer’s Society, Homecare Association, Carers UK, Queen’s Nursing Institute, Dementia UK, King's College London. Start: 1/06/2022 End: 1/4/2024 Plain English Summary of Findings We found that Healthcare professionals wanted an easy and quick to use intervention to sign-post carers to continence care guidance. Homecare workers would welcome resources aimed at having difficult continence conversations The findings led us to develop the first evidence-based website to support healthcare professionals to provide continence advice to the carers of people living with dementia. The intervention also provides carers with detailed, practical self-management guidance. The website is www.demcon.org.uk A summary of the work can be found in this article: C Murphy, B Bradbury, M Fader, L Morrison, M Santer, J Ward, H Chester. Supporting continence care for people living at home with dementia. 22 APRIL, 2024. Nursing Times What Next? The project has provided foundational findings for the next phase of work which includes developing a new intervention to support homecare workers to initiate continence conversations with people living at home with dementia. This work (DemCon2) is being funded by NIHR Three School’s Dementia Research Programme and will start Autumn 2024. Initial Summary (2022) Most of the 850,000 people living with dementia in the UK live in their own homes with support from family or friend carers. Dementia puts people at much greater risk of developing continence problems (with urine/wee or faeces/poo) than people without dementia of the same age. Continence and toilet-use difficulties cause many problems for both people living with dementia and carers, for example, sore skin, infections, embarrassment, anxiety, fear of going out, relationship breakdown, and expenses such as cleaning carpets or laundry. Dementia can mean that using pads or reminders do not work well for people as time goes by. Many carers find dealing with incontinence hugely distressing. They describe feeling poorly prepared and alone. Many find it difficult to talk about and want better support from health and care professionals. Recently we asked people living with dementia, carers and nurses to tell us what information and support they would find useful. From that, we developed a detailed, practical handbook specifically for carers, covering: · understanding why someone with dementia might become incontinent · helping people keep ‘dry’ · managing incontinence · talking about incontinence · continuing with daily activities and socialising. The handbook contains many ‘real-world’ quotes from carers and will be made freely available on www.continenceproductadvisor.org (an NHS endorsed website). This is a good start but requires carers to find and use the handbook by themselves. Most carers want proactive support from the professionals they see (either healthcare or homecare workers), but healthcare professionals often feel ill-equipped to help carers or advise homecare workers. Therefore, in this study, we will develop a new resource that will build on the handbook and equip healthcare professionals to: · start conversations with carers and homecare workers · discuss continence problems and help people choose goals · deliver practical advice to carers and homecare workers. To do this, first we will review research on similar resources and speak to up to 45 primary and community healthcare professionals and homecare workers to fully understand their needs and how a new resource could be used and useful. We know that many people living with dementia and carers have regular contact with homecare workers who often help with washing and going to the toilet. Then, we will work with carers, people living with dementia, healthcare professionals, homecare workers, care commissioners or funders, voluntary groups and professional bodies to develop the resource. We will ask up to 60 people living with dementia, carers, homecare workers and healthcare professionals to use the resource and tell us what they think. We will then make changes to improve the resource. We want this resource to be used by as many primary and community healthcare professionals as possible so that they can support homecare workers and family carers. So, throughout this project, we will ask people about the best way to make it both useful and accessible. It will be freely available via www.continenceproductadvisor.org and we expect adopted and recommended by a range of organisations such as the Alzheimer’s Society, Skills for Care, Homecare Association and professional groups.

  • COMPLETED: Shift Pattern Feasibility

    e3705a45-1f6d-4b9b-9466-a536d5b062ff COMPLETED: Shift Pattern Feasibility Feasibility of collecting and using nursing shift patterns data in acute, community and mental health wards Principal Investigator: Dr Chiara Dall’Ora Team members: Dr Chiara Dall'Ora (Senior Research Fellow in Nursing Workforce, School of Health Sciences, University Of Southampton), Professor Peter Griffiths (Chair of Health Services Research, School of Health Sciences, University of Southampton), Ms Nicky Sinden (Head of Nursing Workforce at Portsmouth Hospitals NHS Trust), Dr Sarah Williams (Associate Director of Research & Improvement, and Academy Lead at Solent NHS Trust), Ms Catherine Smith (Associate Director Workforce Research and Innovation, Southern Health NHS Foundation Trust), Professor Jane Ball (Deputy Head of School (Research & Enterprise), School of Health Sciences, University of Southampton), Dr David Culliford (Senior Medical Statistician, School of Health Sciences, University of Southampton), Mr Anthony Austin, PPI contributor Start: 1 October 2020 Ended: 31 December 2022 Partners: University of Southampton, Portsmouth Hospitals NHS Trust, Solent NHS Trust, Southern Health NHS Foundation Trust. UNISON, Royal College of Nursing Lay summary Nurses and care assistants form the largest group of NHS staff. Most work in services that provide care across 24 hours of the day. Research indicates that the organisation of nursing shift patterns might affect the productivity of health services. The introduction of long shifts in nursing was offered as a strategy to maintain service levels while eliminating overlaps. However, research has found that long shifts are associated with higher rates of sickness and poorer patient care. So far, there has been little research exploring individual factors influencing shift work experiences among nurses, and research has been largely confined to acute hospitals. What did we learn/find out? Working long shifts (12-h or longer) leads to more burnout for nursing staff Having little choice around shift patterns leads to more nursing burnout Nurses working 12-h shifts reported lower choice around shift patterns than nurses working 8-h shifts When wards in Mental Health and community hospitals operated with high proportions of long shifts, there were higher rates of patient incidents This was particularly the case for self-harm incidents and incidents of patient disruptive behaviour What difference can this new knowledge make? It will help nurse managers and those in charge of creating nursing rotas It will help nurses working in inpatient settings choose their shift patterns It will keep patients safer because they will be cared for by nurses who are less tired Why is this important for patients, health and care providers and policy makers ? Nursing burnout is at an all time high, and we provided evidence that can help alleviate burnout Improving patient safety is of paramount importance for any health organisation, and our findings support changes to work organisation to improve patient safety What we are going to be doing next? We will keep disseminating our findings by publishing further papers We are now co-developing feasible changes to shift patterns with nursing staff and their managers as part of our new project We have applied for further funding to maximise analysis of datasets we have created as part of this study Publications https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-022-00731-2 Shift work characteristics and burnout among nurses: cross-sectional survey | Occupational Medicine | Oxford Academic https://onlinelibrary.wiley.com/doi/10.1155/2023/6626585 https://onlinelibrary.wiley.com/doi/10.1111/jocn.16974

  • COMPLETED: Mental health Burden of Increased Living costs: Local Support (My BILLS)

    87b19b27-d8c8-4f33-9da0-73ea106dac3c COMPLETED: Mental health Burden of Increased Living costs: Local Support (My BILLS) Principal investigators: Dr. Dianna Smith, Associate Professor, School of Geography and Environmental Science, University of Southampton and Dr Thomas Richardson, Associate Professor of Clinical Psychology, School of Psychology, University of Southampton. Co-investigator: Prof Nisreen Alwan, Associate Professor in Public Health, School of Medicine, University of Southampton. Partners: Southern Health Foundation NHS trust, iTalk (Hampshire IAPT), Talking Change (Portsmouth IAPT Solent NHS Trust), Southampton Citizens Advice Bureau, Portsmouth Citizens Advice Bureau, Southampton City Council, Portsmouth City Council, Hampshire County Council. Starts: 01/01/2023 Ends: 30/09/2024 Background: Poverty can have a significant impact on health. There is lots of research which suggests that being in debt or struggling to pay the bills can lead to poor mental health such as problems with depression and anxiety. There is currently a cost-of-living crisis with record inflation and energy bills. Aim: This research will analyse the impact of the cost-of-living crisis on the mental health of the adults in Hampshire. It will also identify the best pathways for support for people struggling with both mental health and financial problems. Design & Methods: There will be several methods used here. We will interview staff at local financial advice and NHS mental health services for their views. We will use existing data from the NHS and other services about demand for services and if this has changed over recent months with the cost-of-living crisis. We will also interview patients with lived experience about their views. We will conduct new questionnaire-based survey to try to look at the impact of financial problems on mental health over time. Finally, we will look at what the existing research tells us about how the relationship between financial problems and mental health, and if this impacts certain groups of people more strongly than others. Patient & Public Involvement: We will involve those with lived experience and members of the public in the design of our research. They will also form part of a steering group to oversee our work. Finally, they will help us to develop recommendations about local support and how to share the outcomes of our research. Dissemination: We will write up our findings in academic journals and present them at conferences. We will present our finding to the public at an open free event. We will also have a free report summarising the findings, and flyers and videos summarising the research in an accessible way. What did we find out? • We found that people who were more worried about the cost of living had worse symptoms of depression and anxiety. However, these worries did not cause their symptoms to get better or worse over time. • Interviews with staff and service users showed that financial stress caused feelings of hopelessness and frustration. Many people found it harder to get the health care they needed because of money problems. The cost-of-living crisis also increased pressure on the NHS and its staff. • Those who are having therapy for Post-Traumatic Stress Disorder don’t benefit as much if they live in a deprived neighborhood. • An analysis of 86,000 NHS Talking Therapies referrals from 2021 to 2023 is ongoing. What did we do with this Knowledge? Qualitative interviews have given practical suggestions to improve the link between financial and money advice support locally. • Quantitative analysis is ongoing and will be published soon. What are we doing next? • Conference presentations completed. • 3 papers under review. • Working on submitting several other papers from the findings for publication. • Planning webinar or local event to feedback to stakeholders. Publications Neighbourhood socioeconomic deprivation associated with poorer psychological therapy outcomes for PTSD: an audit of a single NHS Talking Therapies (IAPT) service | the Cognitive Behaviour Therapist | Cambridge Core

  • Deprescribing and Optimisation of Medicines IN Older people with Heart Failure and Frailty (DOMINO-HFF)

    402a4c2a-6e60-4ba0-ab22-b08ca49f80a9 Deprescribing and Optimisation of Medicines IN Older people with Heart Failure and Frailty (DOMINO-HFF) Chief Investigator: Dr Eloise Radcliffe, Senior Research Fellow School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton Team: Dr Kinda Ibrahim, Associate Professor, School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton Dr Sara Mckelvie, Clinical lecturer, School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton. Dr Stephen Lim, Principal Clinical Research Fellow, Consultant Geriatrician, Medicine for Older People, University Hospital Southampton, Southampton General Hospital. Dr Chris Young, Consultant Geriatrician, Medicine for Older People, University Hospital Southampton, Southampton General Hospital. Dr Nina Fudge, Lecturer, Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary University of London. Dr James Sheppard, Associate Professor, Nuffield Dept of Primary Care Health Sciences, Medical Sciences Division, University of Oxford. Mrs Clare Howard, Clinical Lead for Medicines Optimisation, Health Innovation Wessex. Prof Simon Fraser, Professor of Public Health, School of Primary Care, Population Sciences and Medical Education,Faculty of Medicine, University of Southampton. Dr Peter Cowburn, Consultant Cardiologist, University Hospital Southampton, Southampton, General Hospital. Ms Rajneesh Kaur, Patient and carer representative . Partners: University Hospital Southampton NHS Foundation Trust, University of Southampton, Health Innovation Wessex, Queen Mary University of London, University of Oxford. Start: 1 October 2024 End: 31 March 2026 Background Heart failure ( HF) is a long-term disease with symptoms including breathlessness, tiredness and leg swelling. HF is more likely to affect older people and is the leading cause for hospital admission in the UK for those aged over 65 years. Most people with HF have other health conditions therefore taking multiple medication is common. Guidelines for doctors to treat HF recommending multiple medications to help improve symptoms and help people live longer, have led to concerns about further increases in numbers of medication for patients. The application of these guidelines in older adults has had the unintended problem of more complex medication regimes, and possible impacts on physical ability and quality of life. More generally, taking multiple medication can increase risk of side-effects, hospital admission and death for older people. The research studies used to decide guidelines for doctors to treat HF, may underestimate the risks of taking multiple medicines as they do not include populations most vulnerable to potential harms such as older adults and those with frailty. This leads to uncertainty about the long-term benefits and risks of HF medications in the very old and frail populations who are, nonetheless, still treated based on the guidelines. Prescribing should ideally be tailored to each patient’s health condition and their preferences. These factors will change over time, supporting the need for regular medication reviews, and where appropriate, the need for reducing, stopping, or switching drugs in order to improve outcomes. However, this may be challenging due to the lack of research studies, as patients and multiple health care professionals involved in caring for older patients with HF, may experience uncertainty and have differing approaches to the application of the guidelines. Aim To examine research studies on prescribing and deprescribing of HF medication in older people, including those living with frailty. This will inform current guidelines for doctors to treat HF. It will also identify gaps in the research on this vulnerable group commonly prescribed HF medication, but at the greatest risk of experiencing harms linked with taking multiple medications. Design and methods Two literature searches will be carried out, guided by an information specialist librarian, following the established guidelines. Patient, public and community involvement This study has patient and public involvement (PPI) throughout. We will have PPI group of older people and carers living with HF, chaired by our PPI lead who is also a research team member and has contributed to study development. The group will contribute to the interpretation andcommunication of findings on a wider scale. Dissemination Findings will be promoted to the wider research and local clinical community through ARC Wessex networks and our links with Health Innovation Wessex , and in journal publications and conference presentations. We will also promote findings through the links that we will make with local and national charities such as Age UK Southampton, Wessex Heartbeat and the British Heart Foundation.

  • COMPLETED: Testing the effects of food product placement on customers’ visual attention and intended product purchases: a randomised trial in a virtual supermarket setting (Phase II)

    00ac00f7-6a45-413d-9354-92f1eb973632 COMPLETED: Testing the effects of food product placement on customers’ visual attention and intended product purchases: a randomised trial in a virtual supermarket setting (Phase II) Principal Investigators: Janis Baird and Christina Vogel, Professor of Public Health and Epidemiology and Principal Research Fellow in Public Health Nutrition respectively, MRC Lifecourse Epidemiology Centre, University of Southampton Team: Dr Sarah Muir, Senior Research Fellow, University of Southampton Dr Sarah Crozier, Senior Statistician, MRC Lifecourse Epidemiology Centre, University of Southampton Dr Hayward Godwin, Associate Professor of Psychology, University of Southampton Professor Marcus Munafo and Dr Olivia Maynard, Bristol University Ravita Taheem, Southampton City Council, Sure Start Children’s Centres Started: 1st March 2022 Ends: 30th September 2024 Background Poor diet is linked to an increased risk of obesity, diabetes and heart disease. Most adults in England consume too much salt, saturated fat and free sugar, and do not eat the recommended five daily portions of fruit and vegetables. People with lower education and income levels are more likely to have poor diet and to experience health problems as a result. Women of childbearing age are primarily responsible for domestic food tasks such as shopping and cooking, and their diets are closely linked to those of their children. Most families buy their food from supermarkets and their food choices can be influenced by placement of items in-store and by promotions. Our research This project follows on from COMPLETED: Testing the effects of food product placement on customers’ visual attention and intended product purchases: a randomised trial in a virtual supermarket setting (Phase I) We want to find out how the placement and packaging of healthy and unhealthy foods influence the foods that women choose to buy. We will do this by creating a ‘virtual’ supermarket layout that participants will interact with on a computer screen. We will recruit women attending Sure Start Children’s Centres in Hampshire and those whose children attend early years settings. Hampshire is a county within the Wessex region with some relatively deprived areas. We will choose centres and early years settings located in areas of higher deprivation. Local data suggests that 70% of families with young children are engaged with the centres. Women using the virtual supermarket will be shown images of healthy and unhealthy foods and non-food items that are placed in noticeable locations in the supermarket like checkouts. We will measure the specific aspects of the images women look at using experimental techniques such as eye tracking, which records their gaze point and gaze duration. The eye tracker is positioned close to the computer screen allowing it to record where women look. We will then ask women to tell us the products that they saw for sale, the name of the products they considered purchasing, and aspects of the supermarket that took their interest, and why. Our findings will tell us how people respond to the placement and packaging of different types of food products and whether these reponses differ if families are poorer or more wealthy. These findings help us to design ways to layout supermarkets to help all families eat more healthy foods. Our research will begin in March 2022 and end in late 2022. We will share the findings from our study with local families attending Sure Start Children’s Centres and early years settings. We will inform local and national government employees about our findings which could help to refine current government policies to address childhood obesity. The Study • 68 mothers took part in an eye-tracking study at the University of Southampton. •The women viewed scenes from a virtual supermarket which showed healthy, unhealthy and non-food products. •Scenes focused on the areas in a store where most shoppers usually pass through including the store entrance, end-of-aisles and checkouts. •Eye tracking software captured their eye movements to measure their attention. Participants were also asked to click on items on the screen that they wanted to purchase. •Twelve women also took part in interviews. mothers took part in an eye-tracking study at the University of Southampton. What did we learn? •We compared women’s attention to healthy, unhealthy and non-food items by showing them images of products side by side. Women showed higher levels of attention to healthy products over unhealthy and non-food items. Healthy products were viewed for 0.10 more seconds than unhealthy products and 0.15 more seconds than non-food items. The eye-tracking study also showed that the women had higher intention to purchase healthy foods over unhealthy and non-food items. Interviews with the women showed they used strategies like shopping lists and avoiding aisle ends to avoid unhealthy purchases. They wanted more healthy snacks or products they might have forgotten (such as paracetamol or batteries) at checkouts. What difference can this new Knowledge make? Supermarkets usually place unhealthy foods in noticeable places to make profits. Replacing these unhealthy foods with healthy or non-food items will just as likely, if not more successfully, lead to purchases. This can help families lead healthier lives. Why is this important for patients, health and care providers and policy makers? Placing unhealthy foods in noticeable locations can lead to impulse purchases of foods that can lead to obesity. Our study shows that women do not intend to buy these foods and would prefer healthier alternatives. Since 2022, UK policy has banned the placement of some unhealthy foods at noticeable locations in supermarkets. This research provides evidence that customers are likely to support this policy as they would like to buy healthy and non-food items from these locations. What Next? We are creating an infographic to share our findings with families via Sure Start Children’s Centres, Facebook and local schools. These results support our ongoing evaluation of the Food (Promotion and Placement) Regulations. Data will be shared in ongoing conversations with local authorities and via an academic publication. We have received funding to expand our study from mothers to young people. Adolescence is a time when young people may start to make independent food purchases. We aim to further understand what environmental factors influence young people’s purchases on their journey to and from school.

  • Gambling and Alcohol Use Addiction in Military Veterans

    c8454e17-14f6-4e3b-b8ba-8a5db14fcdcd Gambling and Alcohol Use Addiction in Military Veterans Chief Investigator: Professor Sam Chamberlain , Department of Psychiatry, Faculty of Medicine, University of Southampton; Sam.chamberlain@soton.ac.uk Co-Investigator: Dr Konstantinos Ioannidis , Department of Psychiatry, Faculty of Medicine, University of Southampton and Hampshire and Isle of Wight Healthcare NHS Foundation Trust [NHS]; k.ioannidis@soton.ac.uk Partners: Dorset Integrated Care Board, Hampshire and Isle of Wight Integrated Care Board, Hampshire and Isle of Wight NHS Foundation Trust, University Hospital Southampton NHS Foundation Trust, Southampton City Council, Health Innovation Wessex, CNWL NHS Trust, National NHS Gambling Clinic London, Avon and Wiltshire Partnership NHS Foundation Trust, South West NHS Gambling Service, Swansea University, Gambling in Armed Forces research group, Royal Navy, Southampton City Council, Stronger Communities, Southampton Armed Forces Covenant, Eling Royal British Legion branch, Southampton Voluntary Services, HIOWH NHS Armed Forces Network, The Society of St James, Parent Support Link. Start: 1 December 2024 End: 31 March 2026 Background to the research Military veterans face a number of challenges including being at elevated risk of Alcohol Use Disorder and Gambling Disorder, in comparison to the general population. In the Wessex region there are over 100,000 serving/retired military personnel, yet, our regional addiction services report levels of veteran personnel referrals below the expected numbers. Aims of the research Informed by extensive stakeholder consultation with regional addiction services, a need has emerged to carry out explorative research and community partnership building on understanding the extent of engagement in accessing treatment and formal support for gambling and/or alcohol problems for military veterans and learn how this knowledge can enable improvement . Design and methods used This research will consist of one-to-one interviews with military veterans and multiple stakeholder workshops with key multidisciplinary partners and collaborators. Both work packages (WPs) will utilise robust methodological approaches and will build on findings from interviews, PPIE input and views of wider stakeholders. Patient, public and community involvement Public and service user representation is an embodied element throughout this study that will guide decision making and will support multidisciplinary partnership building in the wider community. The PPIE group will consist of members with experience in gambling and/or alcohol use disorders to ensure that research activities and recommendations for the improvement in support pathways reflect the needs of those affected in local communities. Dissemination By identifying common thematic experiences of military veterans affected by gambling and/or alcohol use, and conducting a series of collaborative stakeholder workshops, a consensus set of recommendations will be constructed. This new knowledge will be mobilised amongst key Wessex region stakeholders (e.g. VCSE, military NHS pathways, regional NHS treatment services for gambling disorder) that will enable knowledge identification and exchange, both of which are necessary for informing the planning of further work in this area.

  • COMPLETED ADOPTED PROJECT: Young people’s barriers to mental health services

    d6d7fb08-5eb7-4cab-afcf-359d64b8fe12 COMPLETED ADOPTED PROJECT: Young people’s barriers to mental health services Lead: Dr. Corine Driessens , Professor Peter W F Smith Kim Markham Jones & Fiona Lacey – YoungMinds Nicole Davenport, Mahdi Hassan, Shahrbano Iqbal, Friday Skelton – young researchers recruited by and in employ of YoungMinds Starting date: October 2022 Ended date: September 2024 Many young people in the UK experience anxiety or depression, but most can’t get mental health support when they need it. From the very beginning of this project, young people, both as young researchers and as participants in four co-production workshops, played a central role in shaping our questions, interpreting the findings, and explaining what the results mean in real life. Their insight guided every stage of the work. This study looked at what affects whether young people use mental health services and what happens to those who don’t. The biggest factor in getting help was whether health care professionals recognized the young person’s distress was a mental health disorder. Other things like, severity of symptoms, being a female, having fewer supportive people around, or having unemployed parents played a smaller role. Young people who didn’t use services were less likely to be female, come from single-parent families, have caring responsibilities, or have been bullied. They were also more likely to have good relationships with their parents. Those who did use services had poorer outcomes later in adulthood, suggesting they faced greater difficulties overall. Because specialist mental health services are overstretched, responsibility has shifted to GPs and teachers, who often feel under-resourced and not fully trained to meet these needs. The GPs we spoke to faced strict referral rules, long waiting lists, short appointments, and limited mental health training. The teachers we spoke to also felt pressure to support students without the resources or guidance they need. After hearing these findings, a group of young people from the “missing middle” (those struggling but not qualifying for specialist care) recommended: Training all school and college staff in mental health. Better support for apprentices at work. Peer support groups in schools, colleges, and universities. Safe spaces and housing support for LGBTQIA+ students. More help for young carers and fairer benefits. Better training for all health workers to support diverse communities. Looser referral rules so young people don’t have to be “ill enough” to get help. Youth hubs offering safe spaces, activities, and mental health support. Overall, the findings show the need for more inclusive, preventative, and joined-up mental health support for young people. Reflections on Young People involvement with shaping analysis framework for mental health .docx Download DOCX • 2.37MB What did we find out? Presented the findings at national and international conferences (e.g. MQ/DATAMIND, ADRUK, NIHR Statistics Group, EPA Epidemiology & Social Statistics, International Congress of the European Society for Child and Adolescent Psychiatry) Presented the findings at ARC Wessex webinar Presented findings on ARC Wessex website Where next? The young people who took part in our workshops were very clear about one thing: we need to start much earlier. They told us that helping children learn emotional skills, like understanding their feelings, managing stress, and asking for help, before stigma takes hold could make a big difference in preventing mental health problems later on. Taking this guidance seriously, our team has now grown to include experts who know how to design effective mental health programmes for primary schools, as well as researchers who can identify exactly which elements such a programme should include. Our next step is to develop a primary school–based intervention shaped by what young people told us matters most. Because this type of work sits outside ARC Wessex’s remit, we are now seeking external funding to take the project forward and bring this early-intervention programme to life. Olly Parker, Head of External Affairs and Research at YoungMinds , said: “This research from YoungMinds and the University of Southampton shines a vital light on the record numbers of young people needing mental health support. Growing up today is incredibly tough. Many young people are experiencing multiple pressures which impact their mental health, including poverty, inequality, intense academic pressure and the online world, so it’s no wonder so many are struggling. One of the clearest recommendations from the young people involved is the urgent need for early support hubs in every community. We know many young people face long waits for mental health support and become more unwell while waiting, which can lead to needing more urgent care. We need major reforms to address the root causes of poor mental health and for the Government to focus on reducing waiting lists so young people can get the support they need. The recent 10 Year Health Plan showed promising commitments with Young Futures Hubs and Mental Health Support Teams. These initiatives are vital to reducing pressures on the system, improving support and reducing waiting times - their rollout must be a political priority. But more is needed to tackle the scale of need - we need radical solutions that will address the reasons why so many young people are struggling in the first place.” Corine Driessens, one of the researchers based in Southampton, said: “It has been a truly wonderful and positive experience working with these groups of young people. Their innovative and fresh ideas across a wide range of ways to help others get the mental health support they need have been inspiring.”

  • Adolescent Resilience to OVercome Adversity: EmpoweRment and intervention development – the ROVER study

    fb112e5b-f7be-4ada-a37c-8e959119e1c3 Adolescent Resilience to OVercome Adversity: EmpoweRment and intervention development – the ROVER study Lead applicant: Anne-Sophie Darlington Co-applicants : Professor Graham Roberts , Professor Mary Barker , Dr Ivo Vassilev University of Southampton, Dr Catherine Hill Associate Professor in Child Health at the University of Southampton, Dr Jana Kreppner Associate Professor in Developmental Psychopathology within Psychology at the University of Southampton , Dr Luise Marino , Abigail Oakley Project Summary: Mental health conditions and symptoms in children and young people are increasing. Children and young people (CYP) with a chronic physical health condition often report having mental health problems such as feelings of anxiety and depression. A lot of research has focused on risk – circumstances that make it more likely for young people to experience mental health problems. In this project we want to focus on resilience - the young person’s ability to use their strengths and support from family and friends to overcome challenges in their life. Resilience has not often been a focus of support programmes for CYP with a physical condition. We would like to find out what experiences are common for young people living with physical health conditions, so that we can develop a support programme that applies across Child Health. We will use knowledge from these shared experiences to co-create the support programme with young people – called ‘tools for life’ (suggestion by CYP). We will also partner with national charities (partnerships have already been developed) who have worked with us before and who are very interested in supporting CYP around their mental health. The charity partners could help us to develop support components that are very specific to the condition (for example, fear of cancer coming back), which can be included in the overall support programme. Finally, work with young people has taught us that flexibility is very important: flexibility in when they access support, the way they access it and how it is offered to them. We will work together with young to shape this flexibility in support. The project will have four parts: Part 1 – Finding out what might work: List successful support components from 15 existing summaries of the evidence (reviews of the literature) to date and a report from Wellcome (an independent global charitable foundation which focuses on research), and identify the support elements (e.g., building confidence) which work well, and are acceptable to young people. Part 2 – Developing partnerships: Develop a partnership with local stakeholders (e.g., Paul Hughes and Laura Renishaw-Villier – Hub stakeholders; SolentMind, No Limits) and national charities (e.g., Children’s Cancer and Leukaemia Group, Kidney Care UK, Asthma UK). who can support the development of the support programme, both the general as disease-specific elements. We will hold several workshops with stakeholders to develop the partnership and agree on the goals of the partnership and ways to work together. Part 3 – Developing the support programme: We will co-create (develop together with young people) the support programme– ‘tools for life’ - to increase resilience. We will focus on flexibility in the way the programme is offered to young people, and when young people access the programme, to suit their needs. This flexibility will make young people more likely to use the programme. Part 4: Testing the support programme: We will test the support programme with 30 young people, to find out how many young people use the programme, if the programme is acceptable, how they use the programme, and how much they use the programme. We will also find out what the most important indicators of success are for the programme, such as young people experiencing less symptoms of anxiety and depression, and a better quality of life. What did we find out? The problem: Children and young people with a physical health condition are at a higher risk of developing mental health problems. Existing support programmes do not focus on building resilience – the ability to bounce back and stay mentally strong by using available resources and support networks when facing challenges. Also, many programmes fail to keep young people engaged. This project aimed to explore the support needs of young people and the best way to deliver a programme that builds resilience. What we did: We reviewed existing support programmes from the literature. Then we interviewed young people (32 with a physical health condition, and 25 without, ages 11-18 years), 12 parents of young people aged 11-17 years, and 5 healthcare providers from hospitals, charities and schools across the UK. A range of health conditions were represented, including cancer, heart disease, type 1 diabetes, and asthma. The interviews explored key stressors young people face, the support they need, and preferences for how support should be delivered. What we found: Priority stressors were related to managing the health condition, school/social life, and the future. Key support strategies identified included: 1) Normalisation through connection with other young people (e.g. chat forums), peer training (e.g. ‘living with a health condition’ in school curriculum); 2) Coping, including practical methods (e.g. knowing what to expect during hospital visits), and skills for navigating changes in peer relationships; 3) Prompt reassurance from healthcare providers during hospital visits, via text messaging service, and access to youth workers. Participants preferred a flexible approach that combined online resources with in-person support. Potential impact: Based on our findings, we have developed a prototype support programme that combines online resources with access to healthcare providers for timely reassurance and problem-solving. We are now seeking feedback from young people on this prototype and will use their input to create a full-scale version. If the support programme proves effective, it could help improve the mental health of young people with a physical health condition. What is the impact of this knowledge? • Relationship building: We established strong links with key stakeholders, including clinical colleagues across paediatric specialties at University Hospital Southampton (UHS), representatives from Hampshire and Isle of Wight ICB, Dorset HealthCare, and national and regional disease charities. These collaborations supported participant recruitment and informed intervention development. In the long-term, these relationships will be crucial in ensuring the widespread implementation of the intervention across the health and care system. • Embedding of EDI and PPIE: We conducted extensive PPIE work with community groups, including Winchester Youth Council, Breakout Youth, and Yellow Brick Road, ensuring that the voices of children and young people (CYP) from diverse backgrounds, including those from the LGBTQIA+ community and socioeconomically disadvantaged areas, were represented in the study. • Empowerment of young people: CYP gained a strong sense of empowerment and an enhanced awareness of their own resilience and well-being while contributing to the study. This impact was far-reaching, as the study included patients from UHS paediatric units, and students from local schools (Toynbee and Applemore) and colleges (Eastleigh College and Sparsholt College). • Novel insights into well-being: This study provided novel insights into resilience and well-being for CYP, enriching the broader narrative on CYP mental health. We also co-developed several prototype intervention proposals, which will pave the way for creating an intervention to improve resilience and mental health for young people within healthcare settings. What Next • We are currently: seeking feedback from young people on the prototype resilience intervention preparing a manuscript for submission to a high-impact a peer-reviewed journal. The findings from this study will be inform the development of a grant application, aimed at co-creating the full-scale resilience intervention with input from young people and their support networks. If the intervention proves effective, it will be implemented in practice to bolster mental health outcomes for young people with a physical chronic condition, while also reducing the burden on health and social care services.

  • ADOPTED PROJECT: Breast Cancer Choices: Evaluation and implementation of a digital patient-centred decision aid to support genetic testing in mainstream care.

    e8875589-cdeb-4504-8e6c-2c5922e46645 ADOPTED PROJECT: Breast Cancer Choices: Evaluation and implementation of a digital patient-centred decision aid to support genetic testing in mainstream care. ADOPTED PROJECT: Breast Cancer Choices: Evaluation and implementation of a digital patient-centred decision aid to support genetic testing in mainstream care. Principal Investigator: Dr Katherine Morton, Senior Research Fellow Team: Dr Gillian Crawford, Consultant Genetic Counsellor, University Hospital Southampton NHS Foundation Trust, Dr Lucy Side, Consultant and Lead Clinician in Clinical Genetics, University Hospital Southampton NHS Foundation Trust, Dr Jackie Chandler, Evaluation Programme Manager (Qualitative), Wessex Academic Health Science Network, Dr Kate Lippiett, Senior Research Fellow, Wessex Cancer Alliance, Prof Diana Eccles, Dean of Medicine, Professor of Cancer Genetics, Faculty of Medicine, University Hospital Southampton, Prof Claire Foster, Professor of Psychosocial Oncology, University of Southampton, Mrs Lesley Turner, Patient and Public Involvement contributor, Ms Kelly Kohut, Consultant Genetic Counsellor, St George’s University Hospitals NHS Foundation Trust Start date: 1 May 2022 End date: 1 May 2024 Background The demand for genetic testing for inherited cancer susceptibility is rising and services are increasingly being provided in mainstream care. In Wessex last year, more than 180 genetic tests were offered to cancer patients in mainstream care, and this will increase in 2022 as more genetic services become mainstreamed and eligibility criteria are expanded. This means that genetic testing is offered by clinicians such as oncologists, surgeons and cancer nurse specialists rather than Clinical Genetic services. It is part of a move to routinely offer genetic testing to all cancer patients where there may be clinical benefit. The results of genetic testing can improve health outcomes by informing optimal treatment pathways and facilitating cancer prevention or early detection in family members. However, deciding whether to have genetic testing is a complex, personal decision with potentially life-changing implications for the patient and family. Many people with cancer are faced with this decision shortly after diagnosis, at an already stressful time. Without the support of specialist genetic counsellors to discuss the medical, psychological and social consequences of genetic testing, it is essential that these patients are given accessible and appropriate support as a complement to clinical conversations. Mainstream clinicians feel they lack the necessary skills and time to support patients in this complex decision process. Web-based decision aids could offer an effective solution, giving patients the flexibility to reflect on and discuss information about genetic testing in their own time, in light of their own personal values. Breast Cancer Choices is one such web-based decision aid which was developed through a two-year research project funded by Breast Cancer Now involving extensive patient input and a review of evidence. By evaluating the implementation of Breast Cancer Choices in mainstream services, we would not only provide improved support to breast cancer patients currently undergoing this difficult process, but also identify wider-reaching implications regarding how best to support patients with other cancers in the national move towards genetic testing. As 1 in 2 people in the UK are expected to develop cancer in their lifetime, with 5-10% of these cancers estimated to be due to inherited predisposition, a clear implementation strategy for mainstream genetic testing is essential. Overall, the project aims to evaluate the impact of Breast Cancer Choices on patient’s decision making and clinician experiences in mainstream care, and to understand how web-based decision aids can be effectively implemented across mainstream cancer care.

  • ARC Wessex programme of research on Medicines Optimisation (MODIFY SPiDeR STOP-DEM)

    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

  • Understanding the Networks, Effects and Teams involved in Community Alternatives to ACute Hospitalisation for Older People in Hampshire and Isle of Wight Region – CAtCH-NET

    aeb3153c-5d74-4046-b64a-afed7e369f76 Understanding the Networks, Effects and Teams involved in Community Alternatives to ACute Hospitalisation for Older People in Hampshire and Isle of Wight Region – CAtCH-NET Chief Investigator: Dr Natalie Cox, NIHR Academic Clinical Lecturer Geriatric Medicine, Academic Geriatric Medicine, Faculty of Medicine, University of Southampton Team: Dr Stephen Lim, Principal Clinical Research Fellow, Academic Geriatric Medicine, Faculty of Medicine, University of Southampton & Honorary Consultant Geriatrician University Hospital Southampton NHS FT Dr Sara McKelvie, NIHR Clinical Lecturer Primary Care Research, Primary Care Research Centre, Faculty of Medicine, University of Southampton Dr Carole Fogg, Senior Research Fellow, School of Health Sciences, University of Southampton Start: 1 October 2024 End: 31 March 2026 Partners: Hampshire and Isle of Wight NHS Healthcare Foundation Trust, Isle of Wight NHS Trust, Portsmouth Hospitals University NHS Trust, University Hospital Southampton NHS Foundation Trust, University of Southampton Background Many older people within Hampshire and Isle of Wight (HIOW) live with several health conditions. These may suddenly worsen, requiring rapid assistance from healthcare professionals. Often it is best to provide this in the person’s own home, so urgent community-based services have expanded. Despite this, many older people attend hospital within HIOW. Some are discharged within 24 hours, indicating they too might be better managed at home. Therefore, increasing home support is a priority. To achieve this, we need to understand how urgent care services for older people are currently working. Aim To understand current use of urgent care services for older people in HIOW ICS, alongside factors that promote or hinder provision. Objectives 1. To establish the priorities of key stakeholders. 2. To describe the attributes of older people who are discharged within 24 hours from hospitals, who are seen by specialist teams for older people early in their arrival. 3. To explore experiences of healthcare professionals and patients regarding urgent care services for older people. 4. To learn the type and amount of data routinely collected within urgent community-based care services for older people within HIOW and whether we can link this together, to understand care pathways older people may experience. Design We will initially conduct workshops to engage and discuss with key people who commission and plan healthcare, to identify the key regional priorities within the scope of the project. We will use routinely collected information from the hospitals with urgent specialist services for older people and perform statistics to describe the service use and the types of patients supported by them. Working together with data analysts, we will scope out and report on the types of data collected by community services. We will interview healthcare staff who refer into, or work within, the urgent services and patients who have used them. We will analyse the transcripts to give an account of their experiences of the services. Patients and public Members of the public have advised on the initial study outline and will be members of the study group. They will give input on study materials and interview questions and aid in interpreting results, as well as guiding the best ways to share our findings for a public audience. Dissemination Our results will describe the older people aided by urgent community-based services and those attending hospital who might be managed at home. It will describe factors that promote or hinder support at home. We will share findings within the region, topublicisethe healthcare work in urgent care for older people. This will improve knowledge and aid in service design and delivery.

  • Job Vacancies | NIHR ARC Wessex

    Job Vacancies Nothing new yet - but keep your eyes open and we'll let you know when something comes up

© NIHR ARC Wessex  contact arcwessex@soton.ac.uk

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