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03ec3658-b736-400b-ba5c-c0762b7b0f06 COMPLETED: Understanding, addressing, and meeting the complex needs of people living with long term physical and mental health conditions: a qualitative study Lead applicant: Prof Mari Carmen Portillo and Dr Leire Ambrosio Co-applicants: Prof David Baldwin, Dr Lindsey Cherry, Dr Kate Lippiett, Dr Pritti Aggarwal, Mr William Barnaby Jones, Dr Sara McKelvie What problem will the research address and what evidence do you have this is a major concern for the public and health and care providers of Wessex? People with long term physical conditions are 2-3 times more likely to have mental health problems than the general population: at least 30% of adults with such conditions also have mental health problems (like anxiety and depression). People living with physical and mental long term conditions experience hardships relating to health, and have complex psychosocial, environmental, financial, and spiritual needs. Healthcare professionals find it difficult to provide fully integrated care for these populations, due to systematic barriers and fragmentation of services. The NHS has incorporated an initiative involving Social Prescribing Link Workers (SPLW) in response to these complex needs. SPLWs connect people to community local services to meet needs through a comprehensive person-centred approach. However, the way in which this initiative occurs in different areas and services is variable, and there is unclear guidance for primary care services about how to integrate this novel workforce into wider efforts to address and meet the complex needs of people living with long term physical and mental conditions. Where will the research take place and who will you involve? The project will be undertaken in primary care practices in Hampshire, the Isle of Wight and Oxfordshire, and with a range of local third sector organizations (e.g., Anxiety UK, Mind). Semi-structured interviews will be undertaken with people living with long term physical and mental health conditions. Subsequent focus groups will explore the range of care provider perspectives (e.g., social prescribing link workers, GPs, nurses, practice managers). We expect to interview 20-25 individuals and conduct 4-6 focus groups with 6-8 participants per group. Maximum variation sampling will focus on sociodemographic characteristics (age, sex, ethnicity, socioeconomic background), with a sharp focus on disadvantage and deprivation. Overall aim: To determine the barriers and facilitators to successful implementation of the SPLW role in primary care for individuals living with long term physical and mental conditions. Specific objectives. Identify the range of health and social needs of people living with long term physical and mental conditions. Explore provider perspectives about social prescribing link workers role implementation and effectiveness for people living with long term physical and mental conditions. Explore user perspectives about social prescribing link workers role implementation and effectiveness Explore how, SPLW implementation methods can be adapted to better meet the needs of culturally diverse populations including those living within deprived areas. Explore potential limitations of SPLW model for people living with long term physical and mental conditions. Co-produce recommendations to enable effective implementation of social prescribing link workers to address health and social needs of people living with long term physical and mental conditions. A qualitative design, utilising semi-structured interviews and focus groups will be conducted. Patients and the public will contribute to all aspects of the research process. How will the findings inform improvements in population health and patient care. Following this study, a comprehensive tailored programme will be developed to address the complex needs of people with long term physical and mental conditions including those living in deprived areas. Plans for its implementation will be explored involving key stakeholders from and integrated Care System (ICS), Primary care Networks (PCNs), Local Authorities and any other organizations/sectors that may benefit from the findings. Publications https://doi.org/10.1155/2023/7191247

6bd0eb74-94bb-4d5a-8743-13b5ee8c57b0 ADOPTED: Evaluation & Exploration of Multi-Agency Stalking Partnership Interventions Evaluation & Exploration of the Hampshire & Isle of Wight Multi-Agency Stalking Partnership (MASP) Team: Research Team based at University of Southampton Faculty of Medicine and ARC Wessex Partners who will collaborate on the research: Hampshire & Isle of Wight Office of the Police & Crime Commissioner, Hampshire & Isle of Wight Constabulary, Southern Health NHS Foundation Trust, Hampshire & Isle of Wight Probation Service, & STOP Domestic Abuse. Start date: 1 April 2023 End date: 1 April 2025 Hampshire & Isle of Wight (HIOW) was one of the three pilot sites of the Multi-Agency Stalking Intervention Programme (MASIP), commissioned by the Home Office in 2018. The programme identified positive outcomes from the limited number of case consultations and direct interventions delivered. Funding for MASIP ceased in March 2023 and new funding was sought to refresh the initiative and realise its potential. With two years of funding from the Home Office, from April 2023-March 2025, the partnership has been renewed to address stalking in HIOW. Key partners include the Office of the Police & Crime Commissioner for HIOW, HIOW Constabulary, Southern Health NHS Foundation Trust, HIOW Probation, and STOP Domestic Abuse. This service, called the Multi-Agency Stalking Partnership (MASP), aims to deliver a package of interventions to reduce the impact of stalking. The objective of this partnership is to reduce the risk of further stalking behaviour, and improve the psychological wellbeing of the person using stalking behaviours, whilst keeping the safety of the survivor and their dependents at the centre of this work. The service aims to help up to 160 people who have used stalking behaviours, and their victims, per year. The package to be delivered by this partnership will include: The package to be delivered by this partnership will include: - Three novel models of rehabilitation, using Psychologist-Led Stalking Interventions (PLSI), for individuals who are using stalking behaviours - Advocacy and support for individuals who have been victims of stalking, and - Professional development, support resources, and new ways of working for professionals who are working with people who have stalked Our team at the University of Southampton, Faculty of Medicine, has been asked to conduct an independent evaluation of the MASP’s activities. We will also conduct primary research to determine whether and how the interventions that MASP deliver are effective in reducing the risk of further stalking behaviour and improving the psychological wellbeing of the person who has stalked. We hope to be able to create new evidence, that can be shared with other agencies, about what works (and how and why) to reduce stalking behaviours. What are the aims? The objectives of the service evaluation and primary research are: 1. To determine whether the effectiveness of the MASP activities: have they been successful in reducing the risk of further stalking behaviour and improving the psychological wellbeing of the person who has used stalking behaviours? 2. To explore the mechanisms and outcomes of the MASP activities: how and why might they impact on the risk of further stalking behaviour? How will the study be carried out? We will analyse routinely-collected, anonymised, data from the MASP partners to determine the effectiveness of the MASP activities. We will also conduct data directly from MASP professionals, MASP clients, and SASS clients, via survey and interview, to explore further how and why the MASP activities might have any effects. What will happen to the findings? The findings will directly inform the future of stalking-related work in Hampshire & Isle of Wight, and elsewhere. We will share the results widely, through publication in peer-reviewed journals, reports to the funder, and presentations at local, national, and international conferences. Where can I get more information? Please contact MASPinfo@soton.ac.uk for more information. Service links: Southern Health Link to Police commissioner website

3832ef1c-ee61-4cdf-8362-5cdbe7212017 Wessex NHS Insights Prioritisation Programme Project (NIPP) Wessex NHS Insights Prioritisation Programme Project (NIPP) National Institute of Health and Care Research (NIHR) Applied Research Collaboration (ARC) Wessex and Wessex Academic Health Science Network (AHSN) Digital innovations for people living with frailty Read the Health Innovation Network report Project team Nicola Andrews (NIHR ARC Wessex), Cindy Brooks (NIHR ARC Wessex), Cheryl Davies (Wessex AHSN), Linda Du Preez (Wessex AHSN), Richard Finley (Wessex AHSN), David Kryl (NIHR ARC Wessex and Wessex AHSN), Susi Lund (NIHR ARC Wessex), Michelle Myall (NIHR ARC Wessex), Rebecca Player (Wessex AHSN) and Phoebe Woodhead (Wessex AHSN). Background to the project NIPP was funded by NHS England’s Accelerated Access Collaborative to enable ARCs and AHSNs to work together to accelerate the evaluation and implementation of innovations that support post-pandemic ways of working, build service resilience and deliver benefits to patients. The Wessex NIPP project focused on the use of digital interventions to support the care of people with frailty. We worked collaboratively with stakeholders from across the Integrated Care Systems in Dorset and Hampshire and Isle of Wight to identify system priorities in this area. The project had several components: 1 – Evaluation of uptake and use of the myCOPD app by older people We undertook a mixed methods evaluation of the myCOPD app , a digital monitoring and self-management tool, in relation to its use by older people. The findings showed a higher prevalence of COPD in the myCOPD eligible population than the general population, highlighting the importance of understanding the impact of frailty on uptake and use of the app. Those aged 75 and over, or living with moderate or severe frailty, were less likely to register with and more likely to decline the app. There was also evidence that follow-up support to promote use of the app could increase activation and help overcome technical barriers. Evaluation of myCOPD app - Summary of findings (ARC Wessex) .pdf Download PDF • 180KB Evaluation of myCOPD app - Full Report .pdf Download PDF • 368KB 2 – Development of a Theory of Change on use of data to enhance care of people with frailty Theory of Change is a method to develop understanding of how an initiative can achieve impact. This is displayed in a Theory of Change map. The development and refinement of the Theory of Change map drew on a review of the evidence and individual discussions with a wide range of stakeholders. Participants were from primary care, community services and acute care working in digital health or care, frailty, commissioning and population health management. Stakeholders identified that a lack of availability of routinely collected data from across organisations to inform decision-making impacted the care provided to people with frailty. Theory of Change map - Use of data to enhance frailty care .pdf Download PDF • 176KB Theory of Change Report - Use of data to enhance frailty care .pdf Download PDF • 461KB 3 - Investigation of the use, applicability and acceptability of digital remote monitoring for older people a) Listening activities with older people’s community groups to understand perceptions of digital remote monitoring We held face-to-face events at six older people’s community group meetings, including a carers’ group, an exercise class and a community group serving a majority black ethnic population. At these events we discussed benefits, concerns and barriers to the use of digital remote monitoring (the ability to monitor aspects of an individual’s health remotely using technology). We also asked group members how they thought their views might change as their health or abilities declined. b) Research study investigating use and acceptability of digital remote monitoring for older people with frailty in the community This mixed methods research study investigated digital monitoring at home approaches among older people with frailty, using Artificial Intelligence (AI)-facilitated sensors to monitor daily activities and routines. c) Evaluation of digitally enabled care within frailty virtual wards The evaluation used qualitative data from two frailty virtual wards ( NHS England » Virtual wards ) to explore the use, decision-making and impact of digital remote monitoring. We combined the qualitative data from the above three work packages (a, b and c) for thematic analysis. We found that a personalised approach is important, with a need to consider practicalities (such as cost and sensor positioning) and design of the technology. Face-to-face care is highly valued and should not be replaced by digital remote monitoring. Users and carers need to know what to expect, how the technology works, who is monitoring and when; this would aid trust. NIPP 2022-23 summary report .pdf Download PDF • 624KB NIPP 2022-23 Full report .pdf Download PDF • 838KB 4 - Co-production, piloting and evaluation of an online Implementation Toolkit Implementation is a complex process. For those tasked with introducing an innovation or a change to practice, service provision or delivery, there are a range of models, frameworks and tools to choose from to support the implementation journey. However, these can be inaccessible, specific to particular user groups, or fail to take implementation considerations into account at the outset. The Web-based Implementation Toolkit (WIT) was co-produced with a range of stakeholders by NIHR ARC Wessex. It is a user-friendly and accessible guide on what needs to be considered when implementing and how to achieve this. WIT can be accessed at: Helpful resources | NIHR ARC Wessex More details can be found at: Implementation | NIHR ARC Wessex Rapid Insights Guide for 2022/23 work A Rapid Insights Guide (with project highlights) was produced for NHS England at the end of the 2022/23 projects (work packages 3 and 4 above). Rapid insights report NHS E_for submission .pdf Download PDF • 322KB

a95fe10a-8d2a-464a-8d99-2e3067bb89e8 ADOPTED PROJECT: ExACT-CF: Exercise as an Airway Clearance Technique in people with Cystic Fibrosis – A randomised pilot trial ADOPTED PROJECT: ExACT-CF: Exercise as an Airway Clearance Technique in people with Cystic Fibrosis – A randomised pilot trial Principal Investigators: Dr Don Urquhart , Dr Zoe Saynor Co Applicants : Mrs Lorna Allen (Cystic Fibrosis Trust), Professor Steve Cunningham, Professor Ioannis Vogiatzis , Professor Steff Lewis, Ms Aileen Neilson Partners: University of Portsmouth, University Hospital Southampton NHS Foundation Trust, University of Edinburgh, University of Northumbria at Newcastle, Cystic Fibrosis Trust, CF Warriors (Charity) Starts: May 2022 Ends: 31 October 2023 Background: Cystic fibrosis (CF) is the UK’s most common inherited genetic condition and affects more than 10,500 people. The disease causes problems with the movement of salt and water in the body, resulting in sticky mucus building up, mostly in the lungs and gut. Thick mucus in the airways leads to repeated infections which, over time, damage the lungs. Chest physiotherapy is prescribed to loosen and clear sticky thick mucus from the airways and so to help to reduce lung infection. Chest physiotherapy is a routine treatment to keep people with CF healthy. However, many say it is time consuming and a burden. People with CF have asked if doing exercise could have the same effect as chest physiotherapy sessions for helping clear mucus. Exercise could be more enjoyable and less burdensome. Through a recognised priority setting partnership, the CF community recently ranked research to ‘reduce the burden of their care’ and answer ‘whether exercise can replace chest physiotherapy’, as their number 1 and 7 priorities. Surveys show that many people with CF have occasionally chosen to replace chest physiotherapy with exercise for airway clearance, and we recently confirmed this through a UK-wide survey. We now need to know if they would be willing to take part in research that asks some to stop chest physiotherapy and to exercise (with coughs and huffs) instead. New medicine (modulators) have recently become available for many people with CF, bringing dramatic improvements in their health. Some people who have started modulators are considering whether they can reduce or stop treatments – including chest physiotherapy. So, we need to know the effects of stopping chest physiotherapy and determine if exercise can be used instead - our study aims to understand this. Our recent survey in people with CF, their families, physiotherapists and doctors, showed us that many consider hard exercise with coughs and huffs to be able to clear mucus from the airways. We will study 50 people with CF (>12 years old) for 28-days. We will ask half of them to continue their usual care, and half to stop chest physiotherapy and do exercise that gets them breathing deeply (with coughs and huffs) instead. We will see if people are willing to start and continue with such a study and what they think of the study processes. We will also see how stopping chest physiotherapy and replacing it with exercise affects measurements of their lung function. Within the study we will talk with people with CF and members of their CF team to understand their experiences. This information will tell us whether a larger study can answer Publications Safety, feasibility and efficacy of exercise as an airway clearance technique in cystic fibrosis: a randomised pilot feasibility trial | Thorax

aa75ad77-b86e-4c22-9025-b483ba6076b2 COMPLETED ADOPTED PROJECT: Geospatial mapping of emergency calls from older adults to ambulance services in the South Central region, with a focus on people living with dementia: a feasibility study. Lead : Dr Carole Fogg, Senior Research Fellow, University of Southampton Team: Dr Dianna Smith, University of Southampton, Professor Bronagh Walsh, University of Southampton. Collaborators: Phil King – Senior Business Analyst, South Central Ambulance Service (SCAS) Vivienne Parsons – Specialist Business Analyst, SCAS Simon Mortimore – Assistant Director of Business Intelligence, SCAS Martina Brown – Research Manager, SCAS (and additional members of the research team – Helen Pocock – Senior Research Paramedic, Chloe Lofthouse-Jones – Education Lead, Patryk Jadzinski – Paramedic/Senior Lecturer) Nic Dunbar – Head of Community First Responder Operations, SCAS (and Operational Leads David Hamer and Jack Ansell) Starts: 13th March 2023 Ends: 31st July 2023 Summary What is the project about? This is a new project that will explore the feasibility of using geospatial techniques to map emergency 999 calls from older adults, including those living with dementia. What is the rationale for this proposal? NHS ambulance services are under intense pressure to deliver timely and safe care. Immediately life-threatening conditions have to be prioritised. Older people with falls and symptoms related to long-term chronic conditions with lower category calls may experience long delays before an ambulance arrives. Such patients often have recurring needs for emergency care due to lack of alternative care pathways or long waits for social care assessments. These patients may also have dementia, putting them at greater risk of clinical deterioration whilst waiting for their needs to be met. Geospatial projects are of particular interest to emergency services, as a single service covers a wide geographical area and a dispersed population. Currently SCAS uses mapping to identify clusters of self-harm, suicide attempts and other trauma incidents. Impacts of geospatial projects in other ambulance services include improving cardiac arrest response times and identifying vulnerable communities during Covid-19. Adults aged ≥65 represent a large proportion of SCAS demand (2022: 17% of 111 calls, 48% (21,200 per month) of 999 calls), with around 14% living with dementia [3]. Better information on the location and outcomes of these calls through applying geospatial techniques can shape service provision to meet population needs, improve patient experience and outcomes, and enable existing resources to be used to best effect. What are we currently doing? Applicant CF is leading a project collaborating with South Central Ambulance Service (SCAS) to systematise recording of dementia on the ambulance electronic patient record. Ambulance staff are now able to record data about dementia in a specific place, and initial analyses show around 70 entries daily across the South Central region (November 2022). Improved recording of dementia in ambulance data provides an opportunity to explore factors associated with service demand related to dementia, such as deprivation, and to inform configuration of emergency and associated services to meet older people’s care needs more generally. These may include attendance by Community First Responders (CFRs) with additional training regarding dementia, or referral to a social care line to organise care for older people. What are the next steps? We propose to explore the feasibility of using geospatial data to map low category calls to older adults (aged ≥65), including a subgroup of those with dementia. Data on older adults in patients with emergency 999 calls will enable understanding of understand areas of greatest need and identify areas of inequality. Geospatial mapping will also highlight areas in which there are high frequencies of calls so that multi-sector appropriately-trained resources may be focussed in particular geographical areas. Initial results can be used to design prospective studies of care models which are informed by, and evaluated using, geospatial data. How will we achieve this? Project Objectives: 1. Test feasibility and methods of data specification, extraction and aggregation from the SCAS data warehouse. 2. Produce geospatial maps representing the extracted data to identify areas of highest demand, or where Commu nity First Responders and specialist frailty cars may be most needed, and with which equipment. 3. Present the data to stakeholders and identify priorities for follow-on research grant(s). Project Methods: We will meet the objectives by: 1. Working with the SCAS Business Intelligence (BI) team to understand and define data items for specification for a combination of geospatial, administrative (interval between call time and attendance, time on scene), sociodemographic and clinical (main reason for call, record of dementia in patient record following attendance) data for low acuity calls (category 3 and 4) for people aged ≥65 over a one year period. 2. Using ArcGIS software to produce new choropleth maps (Lower Super Output Area [LSOA] scale in the SCAS region (Berkshire, Buckinghamshire, Hampshire, and Oxfordshire) of the frequency of 999 calls and ambulance attendances overall and categorised by sub-groups, e.g. patients presenting with falls / with dementia / experiencing a ‘long wait’. Using Office of National Statistics (ONS) and Census data to estimate the proportion of the population of highest risk for frailty and falls (age, ill health, living alone). Holding at least one stakeholder meeting, involving SCAS staff, CFRs, the public, representatives from services providing urgent care to older people in the community (e.g. specialist frailty cars, social care, general practitioners, fire and police services) to share results, identify immediate impacts and agree areas for further research. What did we find out? •Making maps of who uses healthcare services and where they live is a technique previously used by emergency services to understand patterns in ambulance response times and to identify vulnerable communities. The growing older population and increased demand for emergency care presents an opportunity to use these maps to better understand how the level of patient need for ambulance services varies by geographical area, and if there are differences in what happens to patients after they are seen. •Our study involved developing an academic-healthcare collaboration which included people with the relevant skills and abilities to identify the data that was needed, extract and collate it from healthcare data systems, translate it into geographical maps, and then interpret what the maps could tell us about older people’s use of emergency services in the area. We discussed maps which included the way older patients were distributed across the South Central region, the number of calls, response times, falls, dementia cases and hospital conveyance rates. •We found that there are large geographical differences in the number and type of emergency calls and ambulance requirements for older adults, particularly in how many people were then taken to hospital (“conveyance rates”). The geographical distribution of falls and calls to people living with dementia corresponded with patterns of where older people live in the region. Response times varied by location. Stakeholders recommended adding more information on other available services, including community first responders, to help map interpretation, and identified areas to be explored in more detail, particularly in addressing conveyance rate disparities for falls. What did we do with this new Knowledge? We are continuing discussions with stakeholders to see how the methods and results of this initial study can be incorporated into practice and into future research. We will take on board the suggestions from the SCAS staff on how to improve the maps, and include these in our next analyses. We will collate this information and present it to the SCAS Board to see how the methods may be used in practice now, and what further improvements could be made. The publication from the study provides a clear framework and methods so that other organisations providing emergency care and the Integrated Care Boards that they are a part of so that they can also consider these techniques to evaluate their provision of care to older people. What next? We are going to discuss the results in two workshops at the SCAS 2025 Volunteer Conference to see what volunteers think should be done next in using this data to improve emergency care of older people. We are going to share the results with external stakeholders such as those in the healthcare improvement Q Community Special Interest Group on emergency care to seek wider collaboration for further work. We have submitted a grant application to NIHR HSDR to further explore potential explanatory factors for the differences in response times and hospital conveyance rates between geographical areas for older people with non-life-threatening calls, which may identify modifiable factors which could improve the care older people receive in these situations. This has involved partners from SCAS, the public, Southampton Geospatial (GeoData and WorldPop) and HIOW ICB.

3020cd35-d002-4b24-bc53-5ac051771722 Adopted Project: Paramedic delivery of end-of-life care: a mixed methods evaluation of service provision and professional practice (PARAID) Chief Investigator: Dr Natasha Campling, University of Southampton Funder: Marie Curie Research Grants Scheme Start Date: 1st March 2023 End Date: 7th October 2025 Partners: Research & Development Department, South East Coast Ambulance Service, University of the West of England, University of Southampton Summary Paramedics are often important to patients in the last year of their life (end-of-life). We know that 999 calls are increasing for individuals and their families at end-of-life, which may be because services in the community are under pressure e.g. those provided by family doctors and community nurses. Little wide scale research has been carried out to understand the contribution played by paramedics in these situations and how this might be improved. From practice it is known that paramedics attending patients at end-of-life face complex issues such as: not knowing the patient or their family, lack of availability of patient history, fear of doing wrong, issues with family conflict and a lack of healthcare professionals to hand over to out-of-hours if the patient is to remain at home. These issues can mean people are admitted to hospital when circumstances mean they could be cared for at home. The purpose of the study is to evaluate services and care provided by paramedics to people in the last year of life. We will survey paramedics throughout England to understand their professional practice and what factors influence this and conduct in-depth case studies (collecting information from patients, carers and healthcare professionals) to examine different ways of delivering services and how these shape paramedic decision-making and management of risk. It is important to evaluate service delivery and understand how the best service features can be incorporated into other services to improve the quality of care and support provided to patients and their families. This may prevent unnecessary hospital admissions at end-of-life, which often leads to people dying in hospital when most people state they would prefer to be cared for, and die, at home. The research will describe, characterise and evaluate paramedic delivered end-of-life service provision to answer the research question: how do different models of service provision shape paramedic practice and influence experiences and outcomes for individuals at end-of-life? The evaluation will enable service delivery models, their features, and effective risk management by paramedics to be distinguished to facilitate sharing of best practice and improve the quality of care and support for people at end-of-life.

Glossary of Terms Accessibility Accessibility is about making sure that things can be accessed and used by as many people as possible. This includes people with impaired vision, motor difficulties, cognitive impairments, learning disabilities and deafness or impaired hearing. APIF The ARC Public Involvement Forum - this is our strategic PPIEP group. It is composed of Theme Public Advisors, the PPIEP team and staff links for each research theme. ARC funded or ARC supported studies Our research may be directly financed by our ARC ('ARC funded') or we may provide support, such as by providing staff resource ('ARC supported'). ARC or Applied Research Collaboration ARCs support applied health and care research that responds to, and meets, the needs of local populations and local health and care systems. They are funded by the NIHR. There are 15 funded across England. ARC Partnership Board This is a decision-making body for ARC Wessex. It meets quarterly to set priorities and directly contribute to, support delivery and monitor performance of our programme. The board membership has two public representatives. BRC or Biomedical Research Centre BRCs bring together academics and clinicians to translate lab-based scientific breakthroughs into potential new treatments, diagnostics and medical technologies. There are 20 NIHR funded BRCs in England. Our Strategic Lead for PPI/E also leads PPI for the Southampton BRC. Our researchers also work closely with staff in the BRC. CCF or Clinical Commissioning Facility They manage and administer the ARC funding scheme. We report to them annually and will have to report our progress against this strategy. CLAHRC or Collaborations for Leadership in Applied Health Research and Care This is the term for the organisations which preceded the ARCs. They were also funded by the NIHR and had a similar function. This funding scheme closed in Sept 2019 when the ARC scheme succeeded them. Communications and Partnership Manager This role has responsibility for shaping and delivering our communications, and supporting productive relationships across our partners. This post is currently filled by Jamie Stevenson. CRF or Clinical Research Facility CRFs are purpose built facilities in NHS hospitals where researchers can deliver early-phase and complex studies. There are 22 NIHR funded CRFs in England. Our Strategic Lead for PPI/E also leads PPI for the Southampton CRF. Engagement Where information and knowledge is provided and shared with the public. Equality impact assessments The equality impact assessment is a systematic and evidence-based tool, which enables us to consider the likely impact of work on different groups of people. They help ensure that activities do not discriminate against anyone and that, where possible, we promote equality of opportunity. Executive Leadership Group This group operationalises strategy, policy and the research programme. The group is led by the ARC Director; the Strategic Lead for PPI/E and Communications and the Partnership Manager are members. Fellowship Fellowships are a type of research funding which are awarded to individuals. For example, a fellowship may enable a person to complete the next stage of their academic career training. Higher Education Institutes This term describes any institution that provides education post-secondary education level, for example Universities. INCLUDE This guidance provides a suggested framework of questions to guide the deliberations of funders, researchers and delivery teams as they design and assess clinical research proposals to improve inclusion of under-served groups in clinical research. Read more . INVOLVE INVOLVE was a national coordinating centre for public involvement in health and care. It was funded by the National Institute for Health Research between 1996-2020. A new Centre for Engagement and Dissemination aims to build on the work of INVOLVE. Lifelab A unique, state-of-the-art teaching laboratory dedicated to improving adolescent health by giving school students opportunities to learn first-hand the science behind the health messages. Logic modelling and theory of change A theory of change is a description of why a particular way of working will be effective, showing how change happens in the short, medium and long term to achieve its intended impact. Logic models are a way to graphically represent this theory. Our Strategic Lead for PPI/E supervises a PhD student who has developed a PPI/E planning and impact tool, underpinned by the theory of change and a logic model. We aim to use this to capture impacts of the ARC PPI/E programme. Manager for PPI/E This role has responsibility for shaping and delivering our PPI/E strategy. They also lead PPI/E for other NIHR organisations. The post is currently filled by Annemarie Henkinson. Microsoft Accessibility Checker A free tool available in Office 365. It finds most accessibility issues and explains why each might be a potential problem for someone with a disability. It also offers suggestions on how to resolve each issue. Read more . NHS providers This term describes any organisation that provides NHS services. This includes hospitals, community trusts, GP services, pharmacies and clinical commissioning groups. NIHR or National Institute for Health and Care Research The National Institute for Health Research is funded by the Department of Health and Social Care. It funds health and care research, providing the people, facilities and technology for research to thrive. Patient and public involvement Research carried out ‘with’ or ‘by’ members of the public rather than ‘to’, ‘about’ or ‘for’ them. Members of the public can be involved at all stages of a research project and across all levels of research organisations. PhD award A PhD award is a research award which supports an individual to study for their doctorate. PPI Champions Our PPI Champions are members of the public. They have a strategic role in our organisation. This includes working closely with the leadership of one of our research themes and with our PPI/E team. We try to have two PPI Champions per research theme. PPI Officer Our PPI Officer is a member of staff dedicated to supporting good PPI/EP. PPI/EP An acronym for patient and public involvement engagement and participation. Used to describe work and projects which connect or encompass both activities. Population risk stratification and intervention to prevent childhood obesity This project aims to test the feasibility and acceptability of a childhood obesity prediction tool and online platform for health visitors to use when supporting families to lead healthier life styles. The involvement work will focus on working with the underserved, such as those from deprived or ethnic minority groups, who are most at risk of childhood obesity. Principal Investigator In studies or trials, this term is often used to describe the person who holds the research grant. They are the lead researcher for the project, Public Engagement in Research Unit This unit exists to inspire and support high quality public engagement with research across all disciplines at the University of Southampton. Public Policy Unit This unit, at the University of Southampton, helps researchers connect with policymakers to better support evidence-based policymaking. Socio economic status This term describes an individual's or family's economic and social position. It is a predictor of outcomes across the life span. Staff links Each theme has a nominated PPI/E staff link. This is a member of their research team. They are members of our strategic PPI/E group, APIF. Sure Start Sure Start is a government area-based initiative that was founded with the aim of 'giving children the best possible start in life' through improvement of childcare, early education, health and family support. Theme Public Advisors OurTheme Public Advisors are members of the public. They have a strategic role in our organisation. This includes working closely with the leadership of one of our research themes and with our PPIEP team. We try to have twoTheme Public Advisors per research theme. PPIOfficer Our PPIOfficer is a member of staff dedicated to supporting good PPIEP. Training Needs Analysis This is a process to determine all the training that needs to be completed (and when) to allow someone to complete their job as effectively as possible, as well as progress and grow. UK Standards for Public Involvement The standards are a framework for what good public involvement in research looks like. They provide clear, concise statements of effective public involvement against which improvement can be assessed. They were developed as a partnership of organisations across the UK, including the NIHR. Underserved Underserved is the term we have chosen to use to describe people who are less well included in research. We prefer this term because it highlights that the research community needs to provide a better service for these individuals. Wessex Wessex is the region covering Dorset, Hampshire, the Isle of Wight and South Wiltshire.

db9893e3-6d77-4b0c-aeda-4931a448eef5 A national evaluation of Project Cautioning And Relationship Abuse (‘CARA’) awareness raising workshops for first time offenders of domestic violence and abuse Health Inequalities National Priority Project in conjunction with ARC West, ARC NENC, ARC WM, ARC Y & H Principle Investigator: Dr Sara A Morgan , ARC Wessex, Lecturer in Public Health, School of Primary Care, Population Sciences and Medical Education Faculty of Medicine, University of Southampton Email: s.a.morgan@soton.ac.uk Publication: A national evaluation of Project Cautioning And Relationship Abuse (‘CARA’) awareness raising workshops for first time offenders of domestic violence and abuse: protocol for a concurrent mixed-methods evaluation design - read ARC North East and North Cumbria, Dr Steph Scott, NIHR ARC NENC Senior Research Fellow Email: steph.scott@newcastle.ac.uk ARC West, Dr Jessica Roy, Lecturer in Child and Family Welfare Email: jessica.roy@bristol.ac.uk ARC West Midlands, Professor Kate Jolly, Professor of Public Health & Primary Care Email: c.b.jolly@bham.ac.uk ARC Yorkshire and Humber, Professor Rachel Armitage, Professor of Criminology and Crime Prevention Background: Over one year, nearly 1,200,000 incidents relating to domestic violence and abuse (DVA) in England and Wales were documented by police, with almost half recorded as criminal offences [1]. DVA leads to an adversity package of poor health and social outcomes, such as alcohol misuse and poorer reproductive health. [2] Stakeholder consultation suggests that the criminal justice system (CJS) are struggling to constructively support victims, deter offenders or reduce reoffending, by means of an early intervention. Victims have voiced dissatisfaction and, collectively, professionals feel that they could do better. Furthermore, recent evidence suggests that COVID-19 has had a huge impact on the CJS, creating a backlog of up to 10 years. Hampshire Constabulary were ambitious to test an alternative response via an early intervention that would improve outcomes for victims and their families. Project CARA was developed in 2011 as a conditional caution offered by the police to first time adult offenders of DVA of standard risk. Offenders are required to undertake two mandatory workshops that increase awareness of their abusive behaviour and the safety of partners and children. In contrast to restorative justice, CARA is an awareness raising intervention for offenders, that utilises a trauma informed approach and motivational interviewing techniques across the pair of workshops. In these workshops offenders are further signposted onto services that support improvements in the wider determinants of their offending behaviour, such as to their GP, drug and alcohol services or onto a community perpetrator programme. An initial randomised controlled trial of CARA was undertaken in Southampton custody suite, showing a reduction in the frequency of re-arrest and prevalence of domestic abuse in the intervention arm, one year following randomisation. [3] Aims: Our aim is to evaluate the impact of Project CARA following its wider rollout nationally, including in Hampshire, Avon & Somerset, Dorset, West Midlands, Leicester, West Yorkshire, Cambridgeshire and Norfolk. This will be a mixed methods evaluation study over two years aimed at examining harm to victim and their families whose partners (or former partners) took part in CARA. Methodology: Currently 1500 offenders take part in the CARA intervention annually. Of these, approximately 50% of their victims are also engaged in the process. A longitudinal qualitative study (n=30) using thematic/inductive analysis will be undertaken with offenders and survivors to explore their perceptions and experiences of CARA [4]. This will be conducted at different time points (e.g. before and after CARA). Alongside this, interviews with police staff (n=20) will be conducted in order to explore the barriers and facilitators to implementation, and feasibility of rollout in further areas, and therefore sampling will be stratified to include wider areas that are not delivering CARA. The main quantitative outcomes will relate to reoffending of DVA. Using the IMPACT Toolkit questionnaire during victim contact, the safety of the victim will be assessed prior to completing and up to 3 months following the workshops [5]. This data will be triangulated with DVA reoffending data collected by the police, reporting incidents as suspects or charged. Alongside descriptive analysis of reoffending data nationally, the rates of DVA for eligible offenders will be compared retrospectively using historical data; between counties in the North East, where currently CARA is not being delivered, and at least two other counties including Hampshire and the West Midlands. Using regression adjustment of covariates, such as index multiple deprivation scores, the association of DVA reoffending across the two comparison groups will be examined alongside a time to first event analysis. Co Investigators: Professor Rachel Armitage Professor of Criminology and Crime Prevention School of Human and Health Sciences University of Huddersfield Huddersfield HD1 3DH Email: r.a.armitage@hud.ac.uk Dr Joht Singh Chandan, NIHR Academic Clinical Lecturer in Public Health, Murray Learning Centre University of Birmingham Edgbaston Birmingham B15 2TT Email: j.s.chandan.1@bham.ac.uk Dr David Culliford, Senior Medical Statistician NIHR CLAHRC Data Science Hub School of Health Sciences University of Southampton Southampton General Hospital (Room AA71, MP11) Southampton SO16 6YD Email: djc202@soton.ac.uk Dr Tracey Long, Professor in Health Economics and Outcome Measurements School of Health and Related Research 208, West Court 2 Mappin Street Sheffield S1 4DT Email: t.a.young@sheffield.ac.uk Mrs Fiona Maxwell Public Health Registrar, School of Primary Care, Population Sciences and Medical Education Faculty of Medicine, University of Southampton Email: f.maxwell@soton.ac.uk Dr Ruth McGovern, Lecturer in Public Health Research/NIHR Post Doctorate Fellow Population Health Sciences Institute, Newcastle University Baddiley-Clark Building Richardson Road Newcastle upon Tyne NE2 4AX Email: r.mcgovern@newcastle.ac.uk Dr Will McGovern Senior Lecturer, Social Work, Education and Community Wellbeing M005 Manor House, Coach Lane Campus (West) Northumbria University, Newcastle upon Tyne NE7 7TR Email: william.mcgovern@northumbria.ac.uk Dr Jessica Roy, Lecturer in Child and Family Welfare School for Policy Studies, University of Bristol 8 Priory Road Bristol BS8 1TZ Email: jessica.roy@bristol.ac.uk References [1] Home Office (2019) The economic and social costs of domestic abuse. [2] Golding J.M (1999) Intimate Partner Violence as a Risk Factor for Mental Disorders: A Meta-Analysis. Journal of Family Violence. Vol 14; 99- 132. [3] Strang, H., Sherman, L., Ariel, B. et al. (2017) Reducing the Harm of Intimate Partner Violence: Randomized Controlled Trial of the Hampshire Constabulary CARA Experiment. Camb J Evid Based Polic 1, 160–173. https://doi.org/10.1007/s41887-017-0007-x [4] Braun V, Clarke V (2008) Using thematic analysis in psychology. Qualitative research in psychol-ogy 3 (2):77-101 [5]Jones, C. (2015) Implementing the IMPACT Toolkit (Part II) Accessed online at https://www.work-with-perpetrators.eu/fileadmin/WWP_Network/redakteure/Expert%20Essays/Implementing_Impact_Jones.pdf [6] Hartfiel, N., & Edwards, R.T. (2019). Cost–consequence analysis of public health interventions.

Senior Research Fellow < Back Miguel Garcia-Argibay Senior Research Fellow Healthy Communities Coming soon Previous Next

42074b03-6b8a-4374-ab92-19ec23c313f3 ADOPTED PROJECT: Happier Feet ADOPTED PROJECT: Happier Feet Disrupting the vicious cycle of healthcare decline in Diabetic Foot Ulceration through active prevention: The future of self-managed care Chief Investigator: Dr Andrew Weightman – University of Manchester Project Team Members: Dr Katherine Bradbury – University of Southampton, Professor Helen Dawes – University of Exeter, Mr Andrew Eccles – University of Strathclyde, Dr Safak Dogan – Loughborough University, Dr Glen Cooper – University of Manchester, Professor Frank Bowling – University of Manchester, Dr Xiyu Shi, Loughborough University, Professor Ahmeet Kondoz– Loughborough University Organisations Involved: Diabetes UK Background: There is a significant unmet clinical need for an adaptable, acceptable and adoptable technology to identify and prevent diabetic foot ulcer (DFU) formation, to enable self-management and timely clinical intervention to improve outcomes and reduce the economic burden of healthcare provision. Our primary purpose is to develop and implement an adaptable, acceptable, and cost- effective smart sensing insole technology which can detect when a DFU is likely to occur and can adapt plantar tissue loading to prevent formation, thus enabling self-management. This project proposes to build and expand on current smart insole technologies for the detection of DFUs, utilising a sensor fusion approach for their identification. A smart insole with integrated pressure (normal, shear), temperature, gait (IMU) and mechanomyography (acoustic) sensors will identify early indicators of ulceration and when movement is appropriate/inappropriate. The smart insole will respond to these inputs and adjust the foot (and gait), through an array of artificial muscles, to support better (safe/ comfortable) movement. This project aims to co-develop this new smart sensing insole with people living with diabetic foot ulcers. We hope to establish: What patients think of the idea of a smart sensing insole for early detection of DFUs which includes the provision to adjust the foot to reduce pressure on areas of likely ulceration. A prototype insole and optimised this with patient feedback. Early safety testing of this device. Security protocols to enable secure storage and sharing of data from this insole (e.g., between patient and clinicians). Publications Journal of Participatory Medicine - Developing a Smart Sensing Sock to Prevent Diabetic Foot Ulcers: Qualitative Focus Group and Interview Study In-shoe plantar temperature, normal and shear stress relationships during gait and rest periods for people living with and without diabetes | Scientific Reports

1c23cf8b-3886-4a98-9ca5-1588bcdda392 ADOPTED PROJECT: Development of a decision aid for offloading device selection for people with diabetic foot ulceration ADOPTED PROJECT: Development of a decision aid for offloading device selection for people with diabetic foot ulceration Principal Investigator: Dr Lindsey Cherry , Associate Professor University of Southampton Research team: Dr Emma Cowley, University of Southampton; Dr Michael Backhouse, Associate Professor, University of Warwick; Dr Kate Lippiet, University of Southampton & Wessex Cancer Alliance Partners: University of Southampton & Solent NHS Trust, University of Warwick & Wessex Cancer Alliance Lay Summary: We aim to create a visual tool, called a decision aid (DA). A DA shows the good and bad points for different treatment options. A DA can help people choose the best treatment for them. Helping people choose their treatment can make them healthier and happier in the longer term. We also aim to find out what is needed to support clinicians to use the DA.Treatments to help diabetic foot ulcers (DFUs) heal include a plaster cast or removeable boot. Both treatments have good and bad points. For example, we know casts tend to heal DFUs faster than boots, but you cannot drive with them. People can drive with a boot. Driving may be a priority for some people, to collect children or get to work, but healing quickly could be a priority for others. Aim: To develop a shared decision aid (DA) for offloading device selection for people with diabetic foot ulceration; A secondary aim is to explore workforce willingness, confidence, and competence to use DAs and shared decision-making. Methods: Two parallel workstreams (WS) will be completed. WS1 DA development will be undertaken in accordance with the International Patient Decision Aid Standards. The DA will likely contain information about a) the decision to be made, b) option risks and benefits, c) related values and d) decision next steps. WS2 Workforce readiness will be evaluated through a) scoping literature review, b) national workforce survey, and c) stakeholder focus group about workforce capability development, training needs, and implementation recommendations. Expected outcomes: WS1 will produce a decision aid and the consolidation and generation of new partnerships ready for full trial evaluation. WS2 will identify priority areas to support workforce implementation of shared decision-making and DAs. This programme addresses multiple JLA priorities including PSP1, PSP2, PSP5 and PSP9. Additional benefits include research capacity growth in PSP areas through subsequent national multi-centre trial, with routes to support Advanced Clinical Practice and an embedded PhD studentship.

Who are we? Professor Alison Richardson Director Professor Catherine Bowen Deputy Director Our theme leads Dr Stephen Lim Ageing and Dementia Theme Lead Professor Nisreen Alwan Healthy Communities Theme Lead Professor Mari-Carmen Portillo Long Term Conditions Theme Lead Professor Michael Boniface Workforce & Health Systems Theme Lead Our central teams Philippa Darnton Implementation Lead Dr Michelle Myall Principal research and implementation fellow Dr Corine Driessens Principal Research Fellow (Statistics) Richard Trowbridge Chief Operating Officer Professor Catherine Bowen Academic Career Development Lead Ngianga II Kandala Principal Medical Statistician Rachael Hartup Senior Programme Manager Dr Kinda Ibrahim Academic Career Development Associate Lead Jamie Stevenson Communications and Partnership Manager Annemarie Hankinson Lead for Patient and Public Involvement Our partnership board members Professor Alison Richardson ARC Director Dr Karen Underwood Operational and Finance Lead University Hospital Southampton NHS Foundation Trust Professor Anne-Sophie Darlington School of Health Sciences University of Southampton TBC Hampshire and Isle of Wight ICS TBC Bournemouth University Nicky Judd Action Hampshire - Voluntary Sector Representative Richard Trowbridge ARC Operations Director Christine McGrath Managing Director Wessex Health Partners Dr Sarah Williams Chief Medical Officer - Hampshire and Isle of Wight Healthcare NHS Foundation Trust TBC Dorset County Hospital NHS Foundation Trust Elizabeth Davies-Ward University of Winchester Dr Chris Stock ARC Wessex PPI Strategic Lead Clare Rook NIHR Regional Research Delivery Network South Central Nicola Bent Deputy Chief Executive and Director of Innovation Adoption - Health Innovation Wessex TBC Hampshire Hospitals NHS Foundation Trust Dr Peter Wilson Chief Medical Officer, University Hospital Dorset NHS Foundation Trust TBC Hampshire County Council Richard Mandunya PPI Representative Professor Kyla Thomas South West Central Regional Research Delivery Network Philippa Darnton Implementation Lead Dr Paul Johnson Dorset ICS Professor Richard Thelwell University of Portsmouth Amy Hurst Bournemouth, Christchurch and Poole Council Sally Dace PPI representative