Search Results

dcda912e-45e2-47ca-a777-aad1c26161d1 ADOPTED PROJECT: Supported remote rehabilitation post Covid-19 COMPLETED: Development, deployment, and evaluation of a digitally enabled rehabilitation programme Chief Investigator: Professor Elizabeth Murray – University College London, Dr Henry Goodfellow – University College London Institute of Epidemiology & Health Care Project Team Members: Dr Katherine Bradbury – University Of Southampton, Dr Stuart Linke – Camden & Islington NHS Foundation Trust, Mr Chris Robson – University College London, Professor Fiona Stevenson – University College London Institute of Epidemiology & Health Care, Dr Manuel Gomes – University College London Institute of Epidemiology & Health Care, Dr Fiona Hamilton – University College London Institute of Epidemiology & Health Care, Professor Ann Blandford – University College London, Professor John Hurst – University College London, Professor Delmiro Fernandez- Reyes – University College London, Professor William Henley – University of Exeter Medical School, Dr Melissa Heightman – University College London Hospitals NHS Foundation Trust, Dr Paul Pfeffer – Barts Health NHS Trust, Dr William Ricketts – Barts Health NHS Trust, Ms Hannah Hylton – Barts Health NHS, Trust Dr Richa Singh – Barts Health NHS Trust, Ms Julia Bindman – Patient and Public Involvement contributor based in England. Publication: October 2025 - D esign and deployment of digital health interventions to reduce the risk of the digital divide and to inform development of the living with COVID recovery: a systematic scoping review Organisations Involved: Living With, NHS England, various NHS trusts, AHSN Wessex, UCL Partners. Start Date: 1st October 2020 End Date: 30th September 2023 Background: Covid-19 had affected nearly 300,000 patients in the UK by 6/7/20. Many remain symptomatic with breathlessness, fatigue, and anxiety for weeks or months. These symptoms can be improved with rehabilitation, but traditional, face-to-face models of service delivery will struggle to cope with these large numbersof patients. A digital approach is likely to be needed, but there are numerous challenges with this approach, including failures of implementation; anxieties around the digital divide/health inequalities; and concerns around low engagement with such programmes. Aim: To refine, deploy and evaluate a digitally- mediated, remote, supported rehabilitation programme for patients affected by Covid-19.Methods: We will combine research methods common to engineering and computer science (focused on developing a product that is safe, stable and meets user requirements) with those familiar to biomedical and health service researchers (focused on effectiveness and population impact). Thus, we will apply the Medical Research Council (MRC) Framework for development and evaluation of complex interventions (Phases 1, 2 and 4) Publications Experiences of user-centred design with agile development for clinically supported self-management of Long Covid Trajectories of functional limitations, health-related quality of life and societal costs in individuals with Long COVID: a population based longitudinal cohort study Additional funding The work from this project led to an additional Grant from NIHR SPCR Do community-based digital health inclusion programmes contribute to tackling health inequalities in disadvantaged population groups?

About NIHR The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by: Funding high quality, timely research that benefits the NHS, public health and social care; Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services; Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research; Attracting, training and supporting the best researchers to tackle complex health and social care challenges; Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system; Funding applied global health research and training to meet the needs of the poorest people in low and middle income countries. NIHR is funded by the Department of Health and Social Care. Its work in low and middle income countries is principally funded through UK Aid from the UK government.

< Back Our journey in partnership Why Pat and Julia became involved in research Pat Walkington and Julia Burton have been working with researchers from across England as part of a National Priority Research Programme in Ageing, Dementia and Frailty . The programme is a collaboration between ARCs which has been working to improve care for people with dementia and prevent falls in older people. Pat and Julia were supported in their work with researchers by Vikki and Naomi from the University of Exeter as part of ARC South West Peninsula, The overall programme had been initially led by Professor Helen Roberts based in Southampton as part of the ARC Wessex. Five years later, Pat and Julia have reflected on their continuing work: Pat writes: I have been a member of the public and community involvement and engagement panel for the Applied Research Collaboration (ARC) for Greater Manchester for about 12 years and later also became a member of the Health Innovation Greater Manchester panel. I have worked on many different health research projects where I have been able to offer a public/patient perspective. This includes writing plain English summaries for funding bids, sitting on advisory panels, being involved in different workshops and focus groups in my community as well as advising on information leaflets for the public. In November 2020, I was asked to review funding bids for Healthy Ageing, Dementia and Frailty National Priority Areas. Normally my involvement would end here but then in 2022 when a public panel member for the ongoing projects retired, I was invited to join the Programme Management Group overseeing the 3 projects. I was welcomed by the team, helped to be brought quickly up to speed with progress so that I felt comfortable and valued as part of the team. The meetings were well-managed and, like Julia, I felt comfortable about asking questions, asking for clarification if there was something that I didn’t understand, and being able to give a patient/public perspective. I valued the support of Vikki Goodwin and Naomi Morley , the PPI lead members of staff, who offered to meet with Julia and me before and after the Programme Management Group meetings so that we could get to know each other, discuss progress, ask questions and share ideas. This was a positive experience which I have now asked to be introduced to similar work Greater Manchester. I had never heard of a Community of Practice so this was a new and interesting learning experience for me. Like Julia, I found this so valuable in being able to openly discuss project progress, ideas and issues with other PPI teams working on similar projects across the ARCs in different areas of the country. I was disappointed when funding for this ended and our work could not continue. However, now that I know that Communities of Practice can be so valuable I would not hesitate to encourage these to be set up for other research projects. Finally, I am also involved as a PPI member/research partner in one of the 3 projects, the Flexi (Falls Exercise Implementation) Study, in Greater Manchester. This has been another learning experience for me from writing the plain English summary and working on the funding bid, being an equal partner, to now being involved in PPI workshops with members of the public who have taken part in the exercise classes. This morning we were listening to their ideas for public leaflets for the project extension and the positive experiences of how much stronger, fitter and confident that they felt from doing the exercises. They also said how much they had enjoyed the social aspects of exercising together. Pat Walkington public contributor I feel that as a PPI member I have made a difference and I have been able to give something back to the society and health service that has supported me. Julia: I have been involved as a patient/public contributor since the very start and, supported by Vikki Goodwin and Naomi Morley (Exeter), have been enabled to contribute at every stage. I attended all the very regular management team meetings where it was very clear that Helen Roberts valued our input and ensured that the meetings were run in a way that made the content accessible to non-academics like me. Julia Burton public contributor I do have some years of public patient involvement and co-production in research, initially volunteering with the Alzheimer’s Society with lived experience of my mother’s dementia, but terminology, acronyms and on occasions, scientific content can need explanation. It was very interesting to be involved in the programme of three research projects that are aimed at providing interventions for my age group. In my opinion, a very valuable and positive experience was the Community of Practice where the three funded project leaders and PPI leads met outside of the Management Group. Set up by the Management Group and facilitated by Naomi Morley we had regular meetings where issues involved in the progression of the research were discussed together and information, support, contacts and ideas shared. This community became more useful as time went on and resulted in cooperation and problem solving across the ARC s as the three projects were addressing the same NIHR priority. I was disappointed when the funding for this was not extended although Pat Walkington and myself are still involved in the management group. PPI contribution can be seen as a respected part of the entire programme. This was highlighted when Naomi, Pat and I spoke about patient and public involvement across the programme and development of a community of practice at the British Geriatrics Society Autumn Conference in November 2023. We were the only public contributors at the conference and I hope we were pioneers to be followed by others in the future. Previous Next

5464c879-04a7-47dc-8751-6ab5a9ad6d1c ADOPTED: Incidental Interaction: Novel Technology to Support Elders-as-Athletes through Augmenting Everyday Interactions Lead: Professor M.C Schraefel Team: Professor C T Freeman, Dr M B Warner Start date: October 2022 End date: January 2024 Partner organisations: Abri Different Strokes Southampton Solent NHS Trust Z-Health Performance Solutions Background Elders classically are framed as people who are inevitably getting weaker, losing muscle and bone mass, cognitive capacity, and inevitably requiring care to manage simple "activities of daily living" such as walking, feeding, toileting and bathing. These effects limit their capacity to live independently and healthily in their own homes.To address this decline, research in even just the past five years has been looking for new molecules and therapies to slow or reverse aging, to provide if not longer life, then better quality of life throughout the life course. While these advances in science and technology promise wonders (for those who will be able to afford them), there is already established science that demonstrates how we can all improve our life quality over our lifespan. This same science can, today, improve the life quality of our elders - starting these interventions at any age. It's building strength:a well understood, human practice. No technology is required to build and maintain strength; only to move against gravity. Repeatedly. Research has repeatedly shown that resistance training for elders can improve quality of life while mitigating if not eliminating age associated co-morbidities. And yet, for all its proven effective, cheap - even free - benefits for healthful longevity, many elders are simply too weak to take care of themselves. According to a 2019 report from AgeUk on the State of Elder health, 15% of those aged 65-69, rising to 1 in 3 citizens over 85 in the UK require care.Some of the well-documented challenges to strength building are that, unlike a pill or garment or augmentation, to achieve the benefits of strength, one has to do the work oneself, actively. That takes time, effort, as well as the knowledge, skills and practices to support it. Mustering the effort can be even harder to achieve when one is already feeling weak, recuperating from an injury, a hospital stay, or from loneliness of isolation.The research in this project is specifically designed to address the challenges that keep elders from actively engaging in strength work. Our approach is to co-create interactions to help build the knowledge skills and opportunities to practice to build and preserve the strength needed to maintain healthful independence at home. Our approach is simple: design interactive technology and gestures to leverage what we - including elders - do every day that is already strength work: stand, sit, grip, pull, push, reach, balance - and translate these into activities for building strength. We call it this novel protocol "do it twice." Stand from sitting? That's strength. Do it twice. That's strength building - and that supports the knowledge skills and practice of "elder athletes" building capabilities rather than requiring assistance.Our approach is interdisciplinary: experts in Human Computer Interaction, Sensors and Physiotherapy, developing novel, affordable interactive technologies to make strength practice accessible effective and enjoyable with support to guide these activities, reflect progress, and share with friends. We call the approach "incidental interaction for everyday strength."So far, we have tested the approach for feasibility. In this small project, with our partners in sustainable, assisted living housing, NHS Trusts, professional therapy and coaching, and with participating elders as co-designers, we will be refining the interaction, the sensors and the exercise protocols. We will be able to tune our work at each stage to ensure best engagement. In three phases from design, to testing, to in-home evaluations we will together be validating the accessibility and efficacy of our approach.By realizing with this project the potential our preliminary work indicates and that our partners anticipate, we will contribute a new affordable breakthrough approach to help transform elder health and care, to enable longer, stronger elder independence@home.

13151434-a7e4-409a-b026-23a834ceed8f COMPLETED: IDA: Implementing a Digital physical Activity intervention for older adults Principal Investigator : Dr Kat Bradbury Project team : Dr Max Western , Dr Stephen Lim , Linda Du Preez , Fay Sibley , Dr Judith Joseph , Professor Lucy Yardley , Dr Chloe Grimmett , Dr Neil Langridge , Christian Brookes , Helen Fisher, Cynthia Russel, Asgar Electricwala, Tom Stokes, Professor Maria Stokes , Dr Paul Clarkson , Cherish Boxall, Dr Katherine Morton , Sara Bolton , Dr David Attwood. Partners: Hampshire and Isle of Wight Healthcare NHS Foundation Trust (Southern Health NHS Foundation Trust), Dorset County Hospital NHS Foundation Trust , Oxford Health NHS Foundation Trust, Health Innovation Wessex (Wessex AHSN), University of Southampton, NHS England, Energise Me, Active Partnerships, Live Longer Better. Publication: Implementing a Digital Physical Activity Intervention for Older Adults: Qualitative Study Summary This Active Lives website has been shown to help older people to increase physical activity. This study aimed to roll out Active lives to make it available to older people living in the community. The steps involved in the project included: Identify, approach and influence organisations interested in helping older people to be active in order to find places that could help us roll out Active Lives. Monitor how many people used active lives and how many were actively engaged enough to have what we think was a sufficient ‘dose’ of the intervention to be likely to change their behaviour. Interview people implementing Active Lives and study what happens in meetings to formulate a list of barriers and facilitators to the roll out of active lives. Results We worked with a wide range of organisations including AHSNs/HINs, charities which serve older people, physical activity organisations, NHS trusts and NHS England. The website reached 5002 people. 1306 people were engaged enough to view the core content necessary to lead to behaviour change. NHS England were instrumental in us achieving traction in several NHS trusts. Six NHS trusts and one charity agreed to help us roll out active lives. One physical activity partnership was helpful in facilitating relationships with their local NHS trust. Their support helped influence local trusts, build clinician confidence in Active Lives and help put in place strategies to maximise uptake of older people to Active Lives. Other physical activity partnerships and the physical activity sector more broadly chose not to support the implementation of Active Lives. Barriers here were especially focused on the belief that older people are not digitally engaged, that older people will only benefit from in person groups, and some viewed this as a threat to the groups that they were locally facilitating or supporting themselves. We appeared in competition with these organisations and it prevented uptake of several NHS trusts that appeared interested at our initial meetings with us (i.e. the physical activity partnerships became a barrier to NHS uptake as they had influence in these NHS trusts). Facilitators to uptake included confidence in the team, believing in an evidence-based approach, the team being able to allay concerns around digital accessibility, providing organisations with figures on how many people used the website and providing support with how to maximise uptake to active lives. Endorsement by NHSE was also very useful in persuading some NHS trusts to take on Active Lives. Things that slowed roll out down: Complexity in the NHS trusts’ chain of command slowed the sign up to Active Lives, this was problematic in a 12-month project. NHS trusts also required complex and nuanced data security and other digital health forms to be completed and trusts were overly cautious with regards to the perceived digital security risks of the intervention. This caused long delays and used valuable resources. What have we done? We implemented Active Lives in practice across 6 NHS trusts, having direct impact on older people. 5002 used it, of which 1306 were actively engaged to a level which we believe is a sufficient ‘dose’. We’ve written a paper on the barriers/facilitators https://aging.jmir.org/2025/1/e64953 What have we learned? Despite the short nature of this project, it achieved good impact and was able to support a large amount of people in a short amount of time Support from all partners is needed to overcome barriers to implementation. Further roll out would require continued engagement work to allay concerns among the NHS and partner organisations

Role of patient-assessed functioning as a predictor of health service use in patients with long term mental health conditions Lead applicants: Prof David Baldwin, Prof Mari Carmen Portillo Co-applicants: Dr Leire Ambrosio, Dr Bethan Impey Project Summary: Treatments for patients with long term medical conditions are often disappointing in their effectiveness and acceptability in clinical practice. This is perhaps because they tend to be targeted at reducing troublesome symptoms rather than directed at improving everyday functioning. We have previously shown that self-assessed functioning (using a self-report scale known as the PARADISE-24) was a better predictor of health service use than is anxiety and depressive symptom severity, among a group of patients attending a Mood Disorders Service in Southampton. That research was undertaken with patients with a primary diagnosis of an anxiety or depressive disorder, and we are now interested in conducting a similar study of functioning in patients with other long-term health conditions in which anxiety and depressive symptoms are common, to understand if functioning will also be a useful predictor of health service use in these conditions. Hearing function is not one of the measures included within PARADISE-24, however, hearing loss is associated with increased likelihood of anxiety and depression and increased use of health services and our PPIE representatives highlighted sensory function as an important measure. We will therefore also include a self-report measure of hearing difficulties as well as some further questions about hearing function to see whether they also are useful in predicting use of health services in our cohorts. The long-term conditions we are going to study are gambling disorder, alcohol use disorder, ‘long-covid’ and hearing loss (those attending the University of Southampton Auditory Implant Service, USAIS). We have chosen these populations since anxiety and depression are common in all of them, and because these populations are available to us (large convenience samples). These groups would have a variety of functional symptoms: for example, memory problems might be more likely in those with alcohol use disorder, attention deficit might be common in those with gambling disorder, sleep and energy problems common in those rehabilitating after Covid-19, and independence might be relevant for those with hearing loss in later life (in addition to the hearing loss itself). Participation in the research should not be too onerous for patients. Clinical diagnoses will be identified from the medical records, and participants will report the severity of anxiety and depressive symptoms and other symptoms associated with the condition and whether they have hearing difficulties and will report on their everyday functioning using the PARADISE-24 scale at Baseline. They will be followed-up twice (at three and six months after the Baseline assessment), with further queries relating to symptom severity and functioning. The use of health services will be ascertained by self-report and through inspection of electronic health records. The findings from this study could influence clinical practice. It should help to better understand the burden of illness and could ascertain the relative importance of symptom severity and degree of functioning in predicting health service use by groups of patients with a range of long-term conditions. It could therefore result in more targeted delivery of health and social care interventions, to both improve the patient’s quality of life and reduce their need for health service use. It would also contribute to addressing the objectives of the National Institute of Health Research Applied Research Collaborative Mental Health Infrastructure programme. Read all Mental Health Hub projects

Events Coming up Wed, Mar 11 CRED Talk: In conversation, thoughts and reflections from early career social care researchers / Microsoft Teams Webinar Learn more Mar 11, 2026, 3:00 PM – 4:00 PM Microsoft Teams Webinar Date and time is TBD Social Care Lunchtime Seminar | Event postponed until a later date / Via Zoom Learn more Date and time is TBD Via Zoom Health inequalities of ethnic minorities groups in the UK Wed, Feb 11 ARC Wessex Healthy Communities Theme Meeting / Microsoft TEAMS Learn more Feb 11, 2026, 11:00 AM – 12:30 PM Microsoft TEAMS Join us to learn more about the Healthy Communities Theme projects and activities Mon, Nov 24 ARC Wessex Webinar: Living with Multiple Long Term Conditions / Microsoft Teams Webinar Learn more Nov 24, 2025, 12:30 PM – 1:30 PM Microsoft Teams Webinar Wed, Nov 05 CRED Talk: The Characteristics of the Social Care Workforce in England and Australia / Microsoft Teams Webinar Learn more Nov 05, 2025, 3:00 PM – 4:00 PM Microsoft Teams Webinar Mon, Nov 03 ARC Wessex Webinar: Young People in Research / Microsoft Teams Webinar Learn more Nov 03, 2025, 12:30 PM – 1:30 PM Microsoft Teams Webinar Wed, Oct 22 ARC Wessex Healthy Communities Theme Meeting / Microsoft TEAMS Learn more Oct 22, 2025, 11:00 AM – 12:30 PM Microsoft TEAMS Join us to learn more about the Projects and work of the Healthy Communities Theme Thu, Oct 16 Understanding why, who and when people decline an offer of accommodation in Portsmouth and continue to rough sleep / Online Seminar Learn more Oct 16, 2025, 12:00 PM – 1:00 PM Online Seminar Understanding why, who and when people decline an offer of accommodation in Portsmouth and continue to rough sleep - A realist informed evaluation' Mon, Oct 13 ARC Wessex Webinar: Supporting the Workforce / Microsoft Teams Learn more Oct 13, 2025, 12:30 PM – 1:30 PM Microsoft Teams Tue, Oct 07 ARC Event 2025 / Southampton Learn more Oct 07, 2025, 9:15 AM – 2:30 PM Southampton Applied Research, Real Lives, Change that matters Mon, Oct 06 ARC Qualitative Network Meeting | “Autoethnography” presented by Dr Becki Nash / Online seminar MSTeams Learn more Oct 06, 2025, 1:00 PM – 2:00 PM Online seminar MSTeams Cycles of Consideration, Judgement, and Slippage: Autoethnographic Accounts of Researching Medical Cosmetic Procedures Wed, Sep 17 ARC Wessex Ageing & Dementia Theme Meeting / Microsoft TEAMS Learn more Sep 17, 2025, 10:00 AM – 11:30 AM Microsoft TEAMS Join us to learn more about the Projects and work of the Ageing & Dementia Theme Mon, Sep 15 ARC Wessex Webinar: Empowering People to use Digital Solutions / Microsoft Teams Learn more Sep 15, 2025, 12:30 PM – 1:30 PM Microsoft Teams Find out how our researchers are improving digital healthcare Thu, Sep 04 Supporting Health Professionals Research Development / The ARK Conference Centre Learn more Sep 04, 2025, 9:30 AM – 12:30 PM The ARK Conference Centre, Dinwoodie Dr, Basingstoke RG24 9NN, UK Wed, Jul 09 NIHR ARCs national webinar (#ARCseminar): Creative arts for dementia / Recording available below Details Jul 09, 2025, 1:00 PM – 2:00 PM Recording available below In this year's national #ARCseminar series, we explore the healing power of creative arts. Here, in the third webinar of the series, we will be hearing from researchers on: Creative arts for dementia care. Thu, Jul 03 Research Readiness in Homecare / Bournemouth Details Jul 03, 2025, 10:30 AM – 3:30 PM Bournemouth, 89 Holdenhurst Rd, Bournemouth BH8 8EB, UK This event will focus on identifying opportunities to enhance research engagement and strengthen collaborations to drive better outcomes for people living with dementia at home. Wed, Jun 25 Empowering Ageing through Digital Health Coaching / Bournemouth University Lansdown Campus Learn more Jun 25, 2025, 12:30 PM – 4:00 PM Bournemouth University Lansdown Campus, Gateway Building, BG302, 12 St Paul's Ln, Bournemouth BH8 8GP, UK Celebrating the success of the DIALOR (DIgitAL cOaching for fRailty) project (funded by NIHR ARC Wessex) Thu, Jun 19 Social Care Lunchtime Seminar: / Via Zoom Learn more Jun 19, 2025, 12:00 PM – 1:00 PM Via Zoom Person centred approaches, advocacy and community engagement in research and social care. Tue, Jun 17 Healthy Communities Theme Meeting / Microsoft TEAMS Learn more Jun 17, 2025, 11:00 AM – 12:30 PM Microsoft TEAMS Join us to learn more about the Healthy Communities Theme projects and activities Thu, Jun 12 CRED Talk: Empowering better end of life dementia care in care homes / Microsoft Teams Webinar Learn more Jun 12, 2025, 3:00 PM – 4:00 PM Microsoft Teams Webinar Developing and implementing the EMBED-Care Framework Load More Previous events

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

d9f3030e-3acc-4dc2-87bc-c01e65471d56 FLEXI: Falls management exercise programme led by NIHR ARC East Midlands working with NIHR ARC Greater Manchester and NIHR ARC South West Peninsula The FLEXI Study (FaLls EXercise Implementation) Lay Summary Falling can cause injury, pain, loss of confidence and independence. This is undesirable for the individual and their families, and places significant demands on health and social care services. Falls are not inevitable. By improving an individual’s strength and balance, alongside skills to help getting up from a fall (should this happen), the likelihood of a fall occurring or having damaging consequences, such as a long lie on the floor, can be minimised. The Falls Management Exercise (FaME) programme is a group-based, face-to-face, six-month exercise programme specifically aimed at improving the strength and balance of people aged 65 and over. Research has shown that FaME results in fewer falls, improved confidence, and reduced fear-of-falling. Despite this, FaME is still not available everywhere across England. More needs to be understood about how best to increase its availability and ensure high quality delivery. To improve our understanding of this, we previously studied FaME’s set-up, delivery and quality in the East Midlands. We learnt a lot about how to get FaME running and showed that the programmes worked outside of a research setting. Using learning from the East Midlands, we developed a guide for implementing FaME called the implementation toolkit . This evidence-based toolkit contains all the information needed to set up and run a FaME programme, from making the initial business case to promoting it to participants. “FaME gives value. We know it's great value for money. We know it works in terms of it reduces falls, it increases physical activity, improves function, improves confidence. So many different benefits” What have we discovered? What works to foster (encourage) the adoption (initial decision to choose or take up something) and spread (roll out over a large area) of The Falls Management Exercise (FaME) programme ? Using implementation frameworks, we successfully identified key barriers and enablers of adoption, implementation and spread of the Falls Management Exercise (FaME) programme across the three localities. We found that the adoption, implementation and spread of FaME into community settings is complex and faces multiple health system challenges. In order for the FaME programme to be chosen as a community fall prevention intervention by commissioners, the programme must be able to demonstrate how successful it is in reducing falls for older adults (this is often determined by internal service evaluation). The programme was also required to fit the needs of those receiving the intervention, for example, FaME was primarily provided where there was a growing, aging population in need of fall prevention interventions. The spread of the FaME programme within organisations and into new regional areas was dependant on the input of commissioners passionate about fall prevention. Commissioners were required to support this roll out and provide funding, whilst also ensuring that there was a sufficient expert instructor workforce available to deliver FaME. The programmes were further required to be monitored regularly to evidence how successfully each programme was in reducing rate and risk of falls for older adults receiving the intervention. This was often the role of the postural stability instructor. Future funding is required to build in paid time for this to ensure that programme outcomes can support future funding cycles as often instructors are funded on an hourly basis. Does FaME work in the real world, how is it adapted (altered or changed), and does it reach the intended audience (older adults at risk of falling)? The collection of routine class data across three regions in England demonstrated that FaME was associated with benefits for participants at 12 and 24 weeks of the programme. Those benefits included improved balance and mobility and reduced falls. Programmes that provided higher ‘dose’ (i.e. ran over 24 weeks rather than 12 weeks) found that older adults experienced greater improvements in balance and mobility and were less likely to be concerned about falling again. What works to maintain the quality (the standard) and fidelity (how well something is reproduced) of the FaME programme over time? One of the key findings of the FLEXI study was that sites demonstrated a lack of clarity of essential components or key ingredients of the FaME intervention. This influenced both implementation and the providers' ability to assess adherence. The need for an understanding of central components was also clear in understanding delivery adherence and, therefore, the ability to evaluate programmes for their effectiveness. At the point of implementation, it became apparent that commissioners and managers are prioritising aspects of the intervention, with these decisions mediated by knowledge (or lack ) of the intervention, economic culture and organisational priorities. Adaptation of Evidence Based Interventions is key to improving their fit in a new context, however, essential components should not be adapted as intervention effectiveness cannot be guaranteed. We have proposed a new framework of implementation fidelity, that shows that mediators were key both in the implementation and delivery of complex interventions, as well as the mediating more of global mediators. Understanding of essential components is paramount at the point of implementation in order to ensure fidelity is implemented, maintained, and assessed. We suggest that complex interventions have a standard of evaluation (based on core components) and insights on fidelity/value negotiations within toolkits. We highlight that local fidelity evaluation is key to standardisation across programmes and delivery. What difference does this knowledge make? We have worked collaboratively with the Health Innovation Networks (HINs), local Integrated Care Systems and Combined Authorities to study ‘spread in action’. As a result, in one of our areas (Devon), where we have applied HINs spread methodology, we have seen a near trebling of available programmes from 13 to 41 (without intervention costs from the study). The study has highlighted the need for an increased frequency of local Quality Assurance to monitor delivery (instructors given the opportunity to observe each other deliver and provide constructive feedback). This has improved the quality of delivery. We have also hosted Greater Manchester-wide collaborative events, which resulted in quality improvement initiatives relating to FaME provision across GM and have established the National FaME Implementation Team (N-FIT) which is now primed and ready to work in new areas to support spread, using the methodologies we have tested. We are refining our implementation toolkit, which is ready to be tested in new areas and we want to refine and improve our quality assurance framework and costing tool using data collected from the study to support future FaME provision. What next? Our future planned work aims to address: Gaps in our understanding about what works to reach underserved communities in relation to FaME participation. We are currently working to explore the provision of FaME in ‘neighbourhood’ areas where there are good examples of reach into underserved groups (e.g. minority ethnic groups, male participants and socioeconomically deprived areas). We are conducting case-study research methodologies to further investigate this aim. The original FLEXI project highlighted that the monitoring and evaluation of programme outcomes are not captured well by local areas delivering programmes. We are, therefore, now developing a more structured evaluation framework for sites to use a legacy of the project. New data on the costs of implementing FaME have been determined and we would love to use these figures to update the national return on investment tool for FaME, developed by Public Health England and York University, to see if this improves the economic case for FaME roll-out. Lastly, we have also tested quality assurance tools for FaME and can see that improvements can be made to increase the tools’ internal and external validity. Moving forward, we would like to refine our preferred tool using academic methods to test this in new areas. FLEXI output links digital .pdf Download PDF • 616KB We would like to thank: Principle Investigator: Dr Elizabeth Orton Team members: Professor Denise Kendrick , Professor Stephen Timmons , Professor Carol Coupland , Professor Pip Logan , Professor Tahir Masud , Professor Vicki Goodwin , Professor Claire Hulme , Professor Chris Todd , Dr Helen Hawley-Hague , Dr Paul Wilson, Professor Dawn Skelton , Mrs Margaret Beetham Study researchers and study staff: Dr Fay Manning Dr Jodi Ventre Dr Aseel Mahmoud Dr Basharat Hussain Dr Michael Taylor Dr Grace Brough Dr Amar Shukla Dr Robert Vickers Ms Tina Patel Study public contributors: Mary Murphy Margaret Beetham PPIE Workshop participants from Greater Manchester, Devon and East Midlands Our Partners: NIHR ARC Greater Manchester , NIHR ARC South West Peninsula , Health Innovation South West , Royal Society for the Prevention of Accidents, Health Innovation Manchester, Later Life Training, Torbay and South Devon NHS Foundation Trust, Leicester-shire and Rutland Sport. Research sites: Devon Integrated Care System (ICS), Manchester combined authority, Leicester, Leicestershire and Rutland ICS, Derby and Derbyshire ICS Starts: 1/10/2021 Ends: 30/9/2025 Lay summary below Falling can cause injury, pain, loss of confidence and independence. This is undesirable for the individual and their families, and places significant demands on health and social care services. Falls are not inevitable. By improving an individual’s strength and balance, alongside skills to help getting up from a fall (should this happen), the likelihood of a fall occurring or having damaging consequences, such as a long lie on the floor, can be minimised. The Falls Management Exercise (FaME) programme is a group-based, face-to-face, six-month exercise programme specifically aimed at improving the strength and balance of people aged 65 and over. Research has shown that FaME results in fewer falls, improved confidence, and reduced fear-of-falling. Despite this, FaME is still not available everywhere across England. More needs to be understood about how best to increase its availability and ensure high quality delivery. To improve our understanding of this, we previously studied FaME’s set-up, delivery and quality in the East Midlands. We learnt a lot about how to get FaME running and showed that the programmes worked outside of a research setting. Using learning from the East Midlands, we developed a guide for implementing FaME called the implementation toolkit . This evidence-based toolkit contains all the information needed to set up and run a FaME programme, from making the initial business case to promoting it to participants. We now want to use this toolkit to see if FaME can be made more available in two new, and very different, regions: Greater Manchester and Devon, and assess whether FaME works in these populations too, particularly if adaptations are made because of Coronavirus. We aim to: 1) Understand how best to increase availability of FaME in two new areas and assess the role that the toolkit plays in this. Using the toolkit we will work with local experts to promote FaME to organisations that decide what health services should be funded locally. 2) Study the delivery of FaME in the new areas and see if programmes work in these populations by measuring improvements in participating individuals. 3) Test ways of maintaining the quality of FaME programmes over time. Working with Later Life Training, a national not-for-profit organisation with expertise in FaME, we will measure the quality of programmes and test what works to make them better. We will use this information to improve the implementation toolkit and develop plans to support national implementation of FaME. Publications Factors influencing fall prevention programmes across three regions of the UK: the challenge of implementing and spreading the Falls Management Exercise (FaME) programme in a complex landscape | Age and Ageing | Oxford Academic

645a116d-e831-40de-9fe9-20f74864feba < Back Top banners Previous Next

9cf70c4f-6d1c-4acf-8a29-5aa00565f951 ADOPTED (PhD): PREPARE-to-ACT study: Preparing for and Responding to Emergencies – A multi-phased qualitative investigation of Patients’ And members of their RElational networks’ decisions to use urgent and emergency care during Anti-Cancer Treatment Principal Investigator: John Defty, University Hospital Southampton NHS Foundation Trust Start: September 2022 Ends: September 2026 Background Complications of anti-cancer treatment can be life threatening . Anti-cancer treatments, including chemotherapy, radiotherapy, and immunotherapy, are increasingly provided on a day-case basis , meaning that complications occur at home and necessitate a response from urgent and emergency care services . Evidence suggests people receiving anti-cancer treatment delay seeking help despite access to dedicated emergency care (acute oncology services) . Focus of research to date has been for what reasons and when , rather than how and why, people with cancer use these services. Evidence suggests patients and informal carers rely on prior instructions from cancer specialists to identify and interpret the severity of complications but find relating to this information difficult when acutely unwell . Emergency ‘contingency planning’ was identified as a priority for improving the safety of anti-cancer treatment but, there are few studies that describe how pre-treatment emergency planning influences help-seeking for complications of anti-cancer treatment . With the number of people eligible for anti-cancer treatment expected to rise by two million by 2040, the need for research is now urgent. Results from our scoping review (completed; drafted for publication) suggest preparing for and making sense of urgent and emergency care is hard work for people with cancer. It also revealed poor understanding of how this work might differ for people receiving different types of treatment. This study aims to address these gaps by answering the question: ‘How do patients and informal carers prepare and seek help for complications of different anti-cancer treatments?’

0be5d40d-fcbc-4b27-971a-75e1967ce33d COMPLETED: Development of a core outcome set for nurse wellbeing: a Delphi study Lead applicant: Dr Gemma Simons Co-applicants: Prof Jane Ball , Prof David Baldwin , Dr Emma Wadey, Dr Catherine Smith Participant Information Sheet : Download here Project Summary: Read project summary document (short summary) Read project summary document (long summary) Background : Little attention has been paid to the work lives and wellbeing of the nursing workforce, despite it being a priority area. Currently, there is no consensus on what wellbeing is or how it should be measured. An evidence-based, positive way of measuring wellbeing is through a Core Outcome Set. What is a Core Outcome Set? Outcomes are used to measure whether a strategy, intervention or action has had the required result. There are often multiple outcomes and ways of measuring them, which makes comparison difficult. A Core Outcome Set is an agreed, or consensus, set of outcomes and measurement tools that, when used, provide consistent and comprehensive focus as everyone is measuring and reporting the same outcomes in the same way. Aim: This project aims to develop a Core Outcome Set for Nurse Wellbeing. Objectives: Produce a list of potential wellbeing outcomes and help text to describe them in that are clear and meaningful for nurses [PPI panel] Develop a consensus between nurses and nurse wellbeing experts on a core outcome set for nurse wellbeing [Delphi Study] Identify and assess for quality measurement instruments for the core outcome set for nurse wellbeing identified by the Delphi study [Critical Literature Review] Select measurement tools for the identified core outcome set and agree on a final Core Outcome Set for Nurse Wellbeing [PPI panel and Study Advisory Group]. Implications and Impact: A Core Outcome Set for Nurse Wellbeing developed by nursing and nurse wellbeing experts will provide researchers and those undertaking governance with evidence-based and meaningful tools with which to evaluate wellbeing interventions. This study is registered on the Core Outcome Measures in Effectiveness Trials (COMET Initiative) database https://www.comet-initiative.org/Studies/Details/2433 Publiations The Mental Health of Medical Students: Supporting Wellbeing in Medical Education | Oxford Academic ( oup.com ) https://doi.org/10.1002/wps.21177