Current research
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The CHSS team carried out an evaluability assessment of a school-based mental health promotion intervention known as the ‘Fantastic Fred Experience’. The intervention was developed as part of the Kent Local Transformation Plan for Children, Young People and Young Adults’ Emotional Wellbeing and Mental Health. Delivered in primary schools, it uses an interactive performance format to demonstrate mental health promoting behaviours across four domains: Food, Rest, Exercise and Digital Devices (‘FRED’). The Fantastic Fred Experience and a provisional logic model was developed in collaboration with professionals from clinical psychology, general practice, educational psychology, commissioning and information and from health, education and university sectors. Implementation began in May 2019 and there are plans to deliver it to half of Kent primary school children between 2019 and 2021, as part of a wider mental health promotion programme (‘Good Mental Health Matters’) for all young people. The evaluability assessment will inform strategic decisions about whether and how to evaluate the intervention, with a view to potential long-term investment and wider dissemination. Start date: 8 May 2019; End Date: 8 August 2019 Funder: West Kent CCG Funding: £11,831 -
The contribution of Multidisciplinary Meetings (MDMs) towards improving patient outcomes and preventing the need for health and social care support: A mixed-methods evaluation employing an implementation science approach
Start date: 01/01/19 End date: 31/12/20 Funder: Oxleas NHS Foundation Trust Funding: £6,500 -
PREDICT: (Pregnancy-associated progression of chronic kidney disease: development of a clinical predictive tool)
Women with advanced CKD (chronic kidney disease) have high rates of all pregnancy complications which increase incrementally according to how severe their disease is. Around one in three suffers permanent additional kidney damage during or after pregnancy, and may need dialysis to survive. This is extremely challenging for a new mother and her family, and shortens life expectancy. At the moment, there is no reliable way to work out which women with kidney disease are likely to have pregnancy-associated disease progression. Current risk estimates for progression of pregnancy-associated CKD are based on a small study including pregnancies from up to 40 years ago. They do not reflect current practice nor allow accurate individual risk prediction. Professor Chris Farmer is now working in collaboration with Kings College, London and partners on a project developing an online calculator to predict how much kidney function women with pre-existing disease are likely to lose in pregnancy. With the UK Renal Rare Diseases registry (RaDaR) and PreKid clinic, Toronto they will use data from from around 54,000 pregnancies complicated by CKD to develop this tool. Women with CKD face stressful conflict between preserving kidney function and having a family. Recent Patient and Public Involvement work shows that the women view prediction of pregnancy outcomes as a research priority. The PREDICT tool will be validated externally in individual patient data from three population cohorts from the UK, Canada and Sweden. The research team are developing the predictive tool interface in partnership with patients and it will be available on the RaDaR (UK Renal Rare Diseases registry) website for clinicians and patients to use. Start date: 01/10/2018 End date: 30/09/21 Funder: Kidney Research UK Funding: -
Alcohol Dependence and Adherence to Medicine (ADAM)
A three-arm, Randomised Controlled Trial of the effectiveness and cost-effectiveness of adjunctive medication management and contingency management to enhance adherence to medications for relapse prevention in alcohol dependence. Alcohol dependence relapse is common following conventional psychosocial interventions. Routine NHS prescription of acamprosate to maintain abstinence from alcohol is now recommended by NICE and its effectiveness in conjunction with psychosocial therapies for relapse prevention is well documented. Limited evidence exists to guide clinical practice on effective interventions and NICE have prioritised clinical trials of strategies to increase relapse prevention medication adherence. Supporting and educating patients about the role of acamprosate in relapse prevention through medication management (MM) may improve adherence and increase clinical effectiveness. Pharmacists are ideally placed to deliver MM in this context, though the effectiveness of local pharmacy delivery is currently not known. Following a simple behavioural reinforcement schedule, contingency management (CM) can be delivered at relatively low cost compared to other psycho/behavioural interventions and with greater clinical effectiveness in substance misuse. If shown to be effective CM has potential to be adopted within NHS services and the pharmacy to enhance alcohol dependence treatment. Aim of the trial: To evaluate the acceptability, effectiveness and cost-effectiveness of adjunctive MM with/without CM in improving acamprosate adherence in alcohol dependence. Objectives: To conduct an internal pilot study to assess the feasibility, recruitment and acceptability of the MM and CM interventions for pharmacists and service users. To conduct a definitive three-arm, randomised controlled trial of the effectiveness of MM with and without CM compared to standard support alone (SS) in enhancing adherence to acamprosate To estimate the cost effectiveness of MM with and without CM compared to SS alone in enhancing adherence To assess the impact of adherence to acamprosate for alcohol dependence relapse prevention on abstinence and reduced alcohol consumption. Start date: 01/12/2014 End date: 30/11/2018 Funder: NIHR Health Technology Assessment via Kings Funding: £24,112 -
Community Areas of Sustainable Care and Dementia Excellence (CASCADE)
Further information on this project on the Canterbury Christ Church University website > Start date: August 2019; End Date: December 2020 Funder: Funding: £149,786 -
Developing a public health research system to suport local government in Kent
After the Health and Social Care Act of 2012, councils took over responsibilities for public health from the NHS. This included promoting and improving health (e.g. sexual health clinics, health visitors, promoting physical activity, and promoting good health through its other activities such as transport, urban planning and education). Research is recognised to be a key part of NHS activity, with research active NHS organisations having better patient outcomes. There are concerns that councils do not use research evidence and take part in as much research, not seeing it as part of their role, or useful. Councils may not have the research knowledge, experience and culture that is generally embedded in the NHS. There are concerns that councils’ established ways of working do not always give research evidence sufficient prominence in decision-making, which tends to focus on local context and political constraints. This project aims to understand how to develop a system to support councils to use research evidence more effectively and to develop, usually in collaboration with university research departments, good quality applications for funding. We will use Kent County Council and Medway Council as study sites and have secured the collaboration of both Directors of Public Health. We will develop a questionnaire in collaboration with members of the public and the council employees. We will survey council employees to map out how research is used, what research has been carried out, and investigate what they know about research and their attitudes to it. We will then interview council employees and councillors to gain further insights into these issues and explore what they think might work to promote research culture. We will run a workshop bringing together university researchers, council employees, councillors and members of the public to identify the possible structure and function of such a research system and a plan for implementation. The outputs of this would be a design for a research system to enable better use of research evidence and to facilitate more research being carried out in Kent, an estimate of resources needed to make it happen and a framework to guide other councils to do the same with their local universities. We will work with the councils to implement the findings. In the long run we hope that this will enhance the process of council decision-making and improve outcomes for the communities served. Start date: 1/8/20; End Date: 30/11/20 Funder: NIHR Public Health Research Programme (20/30 NIHR Local Authority Research System call) Funding: £48,406 -
Developing resources and minimum data set for Care Homes' Adoption study (DACHA)
Around 420,000 people in England and Wales live in care homes. Many have multiple health problems. Care homes, commissioners and regulators collect and hold data on residents’ medical history, needs and care. Data is not linked up, so there can be difficulties in meeting care needs as residents move between health and social care settings. Without the right data it is difficult to plan future needs or find the best treatments. An agreed data set would help researchers - and those working in or funding care homes - to improve resident care and quality of life. Professor Claire Goodman (University of Hertfordshire) leads the four-year, NIHR-funded DACHA study . It aims to explore and enhance the sharing of care and quality of life data between health and social care organisations working with care homes. DACHA findings could deliver a step-change in understanding care home population needs by avoid unnecessary duplication, both by researchers and those interested in improving care-home quality. DACHA has five linked project work packages . Ann-Marie Towers (University of Kent) and Professor Adam Gordon (University of Nottingham) lead Work Package 5: Testing a Minimum Data Set (MDS) in Care Homes in England. WP5 will test a prototype Minimum Data Set (MDS) developed in work packages 1-4 by collecting resident data directly from care homes and matching it to information already held by the NHS. Longitudinal data will be collected using the prototype MDS in 40 care homes for older adults in two areas of England. Care home staff will be trained and supported to complete the MDS at baseline, 6 months and 12 months. We will give homes feedback on their data, benchmarked against other participating homes. Focus group interviews with staff will explore their experiences completing the MDS and whether they found the feedback and data helpful. Findings will inform changes and improvements to the MDS. We will assess the quality of the MDS data as well as using it to answer research questions of local importance to participating areas, such as how well the MDS predicts changes in residents’ health and social care needs. This study/project is funded by the National Institute for Health Research (NIHR) Health Service Research and Delivery programme (HS&DR NIHR127234) and supported by the NIHR Applied Research Collaboration (ARC) East of England. Start date: 01/11/19 End Date: 31/10/23 Funder: NIHR -
DOLPHIN-II: Development Of a haemophiLia PHysiotherapy INtervention for optimum musculoskeletal health in children
A three-year study looking at whether muscle strengthening helps improve the long-term health of children with haemophilia. Boys with haemophilia will be allocated at random to two groups: a group that is asked to complete the 12-week exercise routine to strengthen their leg muscles, and another group that does not do exercises. Boys will be monitored throughout the study by measuring their muscle strength, how far they can walk in six-minutes and time taken to ascend and descend 12 steps. A wrist band will be used to record how physically active the boys are as well as how satisfied they are with their health. The study will be managed by a group of health care professionals and researchers with experience and expertise in carrying out this type of research. Development Of a haemophiLia PHysiotherapy INtervention for optimum musculoskeletal health in children (DOLPHIN-II) - a randomised controlled trial Start date:October 2020 End date:October 2023 Award: £343,536 Funder: NIHR for Patient Benefit via East Kent Hospitals University NHS Foundation Trust More information on the NIHR website. -
Evaluation of Kent County Council Inactivity Pilots
Across Kent 28.1% of adults are classed as physically inactive. KCC Public Health department wants to commission a programme to reduce inactivity in high risk individuals, especially those with, or at high risk of acquiring, diseases caused or exacerbated by physical inactivity. CHSS has been commissioned to conduct an evaluation of KCC’s pilot programme targeting physical inactivity through selected GP surgeries. The evaluation, led by Dr Sarah Hotham, Chartered Psychologist and Research Fellow at CHSS will inform the design of a county-wide programme due to be rolled out in primary care in 2015/2016. The first pilot is designed to successfully deliver a programme based on ‘Let’s Get Moving’ (LGM) a Department of Health intervention based on motivational interviewing (MI) and long term support for behaviour change around inactivity. Recruitment will be in selected GP surgeries in catchment areas with high deprivation and high levels of inactivity. The focus is on high risk physically inactive individuals with conditions caused or exacerbated by their low activity levels. UK active, a not-for-profit health body for the physical activity sector, will screen and invite participants to receive 12 weeks of MI and support (with follow up at 6 and 12 months), delivered by a network of specially recruited practitioners. The programme aims to: increase and sustain regular physical activity levels county wide. reduce reliance on costly medication for conditions which could be affected by adopting an active, healthy lifestyle. ensure maximum return on existing public health Investment by linking to wider primary care services build on successes to embed scalable, replicable physical activity interventions in partner services and networks and as a preventative in disease pathways The evaluation team will gather qualitative and quantitative data, including semi structured interviews with primary care staff involved in the screening and recruitment process. A framework analysis will be undertaken to identify emerging themes from the interviews. As well as identifying characteristics in patients who changed behaviours (in order to predict future success), the evaluation will address questions around feasibility, scalability, effectiveness and cost effectiveness of patient screening, and the recruitment of practitioners to deliver the interventions. A final report will be provided when 12-month follow-up monitoring is complete. It will provide details of the findings and recommendations for future commissioning of a county-wide physical inactivity service. Start date: 03/03/2015 End date: 31/03/2017 Funder: Kent County Council Funding £4,000 Evaluation of KCC physical inactivity pilot final report here -
How general practice team composition and climate relate to quality, effectiveness and human resource costs: a mixed methods study in England
General Practice is central to the NHS, and is where people first seek non-emergency health advice. GPs deal with a wide range of health and social care issues for local people. They have traditionally employed a staff team of e.g. nurses, care assistants, receptionists, managers and liaise with community services such as midwives and health visitors. Many GPs are retiring or leaving the NHS. More newly-trained doctors work in hospitals and there is a shortage of GP practice nurses. NHS general practice is under pressure. At the same time, more people with long-term conditions need regular care from GP teams. Tasks formerly done in hospital are being transferred to general practice. It is vital that GPs organise teams efficiently to treat as many patients as possible. General Practices’ staffing arrangements vary widely. Practices have tended to become larger over time, and include a wider range of staff (e.g. physiotherapists, pharmacists). Some GPs have combined into ‘super-practices’. There is little evidence to show GPs and service commissioners what size or structure of practice, or professional staff mix, works best for patients. This NIHR Health Services & Delivery Research-funded project aims to provide such evidence, exploring how the composition of GP teams and team relationships (‘climate’) affects quality of care and health outcomes for patients, and practice costs. Professor Stephen Peckham leads the project team, who will: Survey the literature to learn about skill mix in countries with healthcare systems resembling our NHS. Analyse existing big data sets and use statistical methods to investigate the relationship between differences in the organisation and skill mix of practices in England and quality of care and effectiveness. Quality measures will be based on inspection data. Effectiveness will be measured using number of patients hospitalised for conditions that should be general practice managed. Conduct a staff survey in a nationwide sample of practices to explore how workforce issues affect staff wellbeing and job satisfaction Observe/interview staff to investigate how team climate affects daily working and patient experience. Work with GPs and commissioners to review project findings and create guidelines for all practices on optimum professional staff mix and good team working. Find novel ways to publicise research results to GPs, NHS managers, government organisations, academics and the public. Patient and public opinion provided valuable input to the research application and a service user group will contribute at all stages of the project. Start date: 01/10/2018 End date: 30/09/21 Funder: NIHR Funding: £404,316 -
Identifying and Improving the Capacity of Health Service Staff to Conduct Research
Studies suggest that clinician engagement in research has the potential to improve healthcare processes and performance .Where research is led by the professionals who will use it, the resultant research has the potential to improve clinical practice. Eengagement in research can enhance job satisfaction, professional confidence and contribute to enhanced attitudes towards research. Building research capacity and supporting research engagement are key strategic goals for many healthcare organisations. While clinical engagement is seen as beneficial there are concerns that many health care practitioners are unable to be engaged in as much research as they would like. This Cancer Research UK-funded project is aimed at meeting the challenge of boosting research capacity in the NHS workforce. CHSS Director Professor Stephen Peckham leads a multi-disciplinary research team at CHSS in collaboration with the Kent Surrey and Sussex Clinical Research Network. It aims to find out what barriers and facilitators help or hinder health service staff to conduct research. It will propose practical solutions to improve and boost capacity within the current workforce, optimise the NHS research environment and support research at individual, organisational and systemic levels. Start date: February 2017 End Date: January 2020 Funder: Cancer Research UK Funding: £101,961 -
Improving the effectiveness and efficiency of health and social care services for vulnerable older Brazilians
Professor Jenny Billings will be working with lead investigator Professor Peter Lloyd-Sherlock at the University of East Anglia (School of International Development) on this timely and valuable research project. Brazil’s large public healthcare system aims to provide good care to all, but in common with the UK is facing mounting financial pressures due to the needs of a rapidly ageing population. This MRC-funded project aims to support policy and practice to reduce unneeded admissions of older Brazilians to hospital and care homes, and reduce unnecessarily long stays. This will improve efficiency of service provision and optimise the health of the older population. Unnecessary hospital stays expose older people to new risks such as acquired infections. Drawing on studies and experiences in other countries, such as the UK, and talking to Brazil’s policymakers and practitioners, the study will develop a clear strategy to identify whether admissions could have been averted or length of stay reduced. A new national survey (ELSI) will produce data showing which older people are most likely to experience these problems and identify which situations trigger unnecessary admissions/lengthy stays. As well as analysing the data, the research team, working closely with social care practitioners, will develop detailed case studies of two Brazilian cities in different regions, talking to selected ELSI survey participants and their families about their experiences to gather a clear picture of the problem and focus on solutions. They will carry out a review of a pilot project offering temporary homecare services for frail people and carefully assess this, considering how well it has worked (in the eyes of practitioners, as well as older people and families) and any impact on unneeded admissions/long stays. The project represents an excellent opportunity for CHSS to apply extensive research expertise gained in the UK and elsewhere, to a Brazilian context. Specifically, the aspects of our work relating to the development of new models for integrated health and care provision for older people are highly relevant to similar challenges now facing Brazil’s health system. Funder: The Newton Fund, Medical Research Council (MRC) £32,000 -
Innovate: optimising the depression pathway through novel digital assessment technology
More than a million people in the UK seek or receive treatment for depression at any given time. Finding the right treatment can be difficult and for many, can take weeks or months to work. Professor Jenny Billings leads the evaluation of a digitally-enabled precision medicine approach to diagnosing and treating depression accurately and quickly. The two year project aims to reduce referrals to scarce secondary and crisis care services, freeing up GP time. ‘Wrapping’ care from GPs, specialist professionals and charities around the patient helps them return to healthy, productive lives. Specially designed web-based App; ‘i-spero’ helps patients assess their response to treatment and monitor their depression. It uses validated questionnaires and assessments including facial expression recognition testing. Developed by Oxford-based P1vital Products Ltd, i-spero will be piloted at selected GP practices in Canterbury and Coastal CCG. An improved triage style patient pathway adopted alongside the technology, will give greater choice and quicker access to quality care. Mental health charity MIND is supporting crucial patient involvement in this project. Start date: 01/01/19 End date: 31/12/20 Funder: Innovate UK Funding: £201,599. Read the Final Evaluation Report 30/11/20. Read the Lay Summary Report Read the Executive Summary Report -
Migrant Health Project Evaluation
This evaluation of an innovative three year Kent Community Health Foundation Trust project focuses on migrant communities who have settled in Kent, living predominantly in Dover, Folkestone and Margate and Gravesend. The aim is to reduce barriers and increase access to health services by local migrant families to address inequalities and encourage take-up of preventive services. Evidence shows particularly low engagement by Roma communities with family planning, dental care and general practice. KCHFT will employ and train staff largely from the Roma community as community based health advisers. The evaluation will be supported by 'Roma in the Lead', a project managed by Red Zebra which is working closely with Roma families to build trusting relationships. Led by Prof Sally Kendall, the CHSS research team will use realist evaluation and social justice frameworks. In the first project year they will work with community representatives and other key partners to develop a logic model and research methodology, and start data collection to find what works best for whom and in what context. Start date: 07/01/19 End date: 31/10/20 Funder: Kent Community Health Foundation Trust Funding: £20,000 -
Optimum Hospice at Home services for end of life care
What are the features of Hospice at Home models that work, for whom, and under what circumstances? Offering people a choice about where they receive their care at the end of life is central to UK policy and the numbers of people wishing to die at home is increasing. We also know from work undertaken with the general public that care at home is an important concern for many people. Much effort has been invested in health services to support care at home, including services called “Hospice at Home” (HAH) which aim to offer hospice care in the individual’s home. The aim of hospice care is to improve the quality of life of people who have an incurable illness up to the point of death. This includes medical, emotional, social, practical, psychological, and spiritual care, as well as addressing the needs of the person’s family and carers. Currently a range of different HAH services exist in the UK and it is unclear which features of these services enable better care and outcomes at the end of life for patients and families. Professor Claire Butler based at CHSS is leading a national study to answer: What are the features of Hospice at Home models that work, for whom, and under what circumstances? The project is led by the University of Kent in collaboration with the University of Cambridge, University of Surrey, Oxford University Hospitals NHS Foundation Trust, Pilgrim’s Hospice and the National Association for Hospice at Home. The project is spearheaded by a team of post-doctoral researchers based at the University of Kent and the University of Cambridge. Start date: 01/02/2017 End date: 22/03/2021 Funding: National Institute for Health Research: Health Services and Delivery Research (project 14.197.44) £760,162 More about this project: 1. Study Design The study started with a national telephone survey of all HAH services to find out about the services they provide. We contacted hospice at home service managers identified through the Hospice UK and National Association of Hospice at Home directories to take part in a survey. We asked the service managers to provide information on how they are funded, which health care professionals work for them and what kind of roles they have, and whether they provide care overnight and at weekends. We had a fantastic response to our phase 1 survey with 70 HAH services taking part (see map of survey responders left). The results of this survey helped us to understand the different types of HAH services running nationally and to select a number of HAH services as case study sites for in depth investigation in Phase 2 of the project. A method called ‘realist evaluation’ is being used to gain an understanding of how the services delivered within the different models impact on patients and carers and whether they are supported and cared for as well as possible. We will also compare the costs of delivering services in the different models, and talk to providers of services about local issues that help or hinder the delivery of a good service. The final phase of the project (Phase 3) will involve presentation of our initial findings and discussion with stakeholders in two workshops to validate interpretation of the data and to refine our understanding of what works, for whom, and under what circumstances. These consensus events will help to develop our findings into guidelines for services and commissioners for developing HAH services matched to local needs. 2. How will we make sure the research is on the right track for patients and families? We are aware that the project needs to be conducted sensitively and we are experienced in undertaking research with bereaved people. We are working closely with patients and members of the public to advise us on the most sensitive approaches. Our team includes two lay co-applicants who are members of the project team and involved in co-producing the research with us. Both have experienced bereavement as a carer and they have a key role in the team to ensure a thoughtful and ethically sound approach. One of our lay co-applicants recently presented with Charlotte Brigden (Pilgrims Hospice), at the RDS South East/INVOLVE UK event in London. They showcased the OPEL H@H study as an example of public co-production in research. The project also benefits from input from independent experts and public members who sit on the Project Oversight Group for the study. This group oversees the project progress and ensures the study delivers on its objectives, produce findings relevant to the public and national healthcare services. It also ensures that the study has involved public and patient input throughout. Throughout the project we have been reviewing and documenting the PPI input in to the project and how this has changed the project and our approach over time. See a link to this overview below. PPI feedback Year 1 PPI feedback Year 2 3. How will we make the research findings available? Publication of the full and complete account of the research will be in the NIHR HS&DR Journal. This will allow the research to be freely and publically available via the NIHR journals library website. We will also publish our findings as they arise in peer reviewed journals such as BMJ, Social Science and Medicine and British Journal of General Practice to reach broad audience coverage in community services, and Health Services Journal to reach service commissioners. See below for links to what we have published so far. We will present our findings through presentations or posters at existing research forums such as the European Association of Palliative Care Congress; Clinical Research Network forums; Cicely Saunders Institute, King’s College, London; Hospice UK annual conference; National Association for Hospice at Home (NAHH) conference. See posters we have already below. Guidelines will be developed for services to help plan HAH services in the future. We also aim to engage with commissioners through the links and influence of our commissioner co-applicant, Professor Bee Wee as National Clinical Director for End of Life Care for NHS England. At the end of the project, a report and summaries for lay audiences will be produced. The draft report was submitted to NIHR on 22/3/21 and we expect it to be publicly available in early 2022. The study data will also be available to researchers and the NHS on completion in line with national and international recommendations to benefit wider society. This will also be disseminated to our research participants. In addition, dissemination of findings aimed at the public will be facilitated through links with specific organisations including the National Council for Palliative Care, Hospice UK and the National Association for Hospice at Home (NAHH). These links with National organisations may also assist with bringing the results of the research to the attention of National Policy makers. Case Study Site Newsletters: Feb 2018 May 2018 July 2018 Sept 2018 Dec 2018 Mar 2019 May 2019 June 2019 Study Publications: Hashem, F., Brigden, C., Wilson, P. and Butler, C. (2020) "Understanding what works, why and in what circumstances in Hospice at Home Services for End of Life Care: applying a realist logic of analysis to a systematically searched literature review", Palliative Medicine. Sage, pp. 16-31. doi: 10.1177/0269216319867424. Abstract | View in KAR Rees-Roberts, M., Williams, P., Hashem, F., Brigden, C., Greene, K., Gage, H., Goodwin, M., Silsbury, G., Wee, B., Barclay, S., Wilson, P. and Butler, C. (2019) "Hospice at Home services in England: a national survey", BMJ Supportive and Palliative Care. BMJ Publishing Group, pp. 1-7. doi: 10.1136/bmjspcare-2019-001818. Abstract | View in KAR Butler, C., Brigden, C., Gage, H., Williams, P., Holdsworth, L., Greene, K., Wee, W., Barclay, S. and Wilson, P. (2018) "Optimum hospice at home services for end-of-life care: protocol of a mixed-methods study employing realist evaluation", BMJ Open. BMJ. doi: 10.1136/bmjopen-2017-021192. Abstract | View in KAR Selected Conferences, posters and presentations: Abrahamson V, Butler C, Wilson P, Mikelyte R, Brigden C, Silsbury G, Goodwin M. 2021 International Conference for Realist Research, Evaluation and Synthesis. Feb 2021. Optimum Hospice at Home Services for End-of-Life care: realist evaluation and co-production. https://www.youtube.com/watch?v=fQX6-ka1VwU&feature=youtu.be Brigden C, Goodwin, M, Silsbury, G, Rees-Roberts M, Butler C, Greene K, Hayes C, Hashem F, Gage H, Williams P, Wee B, Barclay S, Wilson P, Mikelyte, R. Oct 2018. National Association for Hospice at home Annual Conference 2018. Patient and public involvement in hospice research: an example of co-production in action. PPI poster Brigden C and Silsbury G, July 2018 NIHR Research Design Service South East / INVOLVE. Co-production in the OPEL Hospice at Home Study Slides from RDS/INVOLVE UK co-production event – OPEL study project presentation Rees-Roberts M, Mikelyte R, Hayes C, Hashem F, Brigden C, Gage H, Williams P, Greene K, Wee B, Barclay S, Wilson P, Butler C. 2017. National Association for Hospice at Home annual conference 2017. Poster & presentation. Phase 1 poster Phase 1 findings A4 summary 4. Consensus Events 2020 Dates Leeds – 16 January 2020 Venue: The Met, King Street, Leeds, LS1 2HQ London – 23 January 2020 Venue: Wellcome Collection Event Spaces, 183 Euston Road, London NW1 2B Our findings were presented at two national workshops. At these workshops, we sought feedback on the implications of our findings from the audiences including members of the public, carers, HAH providers and health service commissioners. We combined all this information to assess which models of service provision are likely to lead to the best outcomes, represent best value for money and create guidelines for planning HAH services in the future. A summary of the consensus events can be found in the Phase 3 summary (pdf). -
Realist Evaluation of Autism Service Delivery
Realist Evaluation of Autism Service Delivery: (RE-ASCeD) How should child development and child and adolescent mental health teams provide timely and cost-effective, high quality diagnostic assessments of children with possible Autism? Autism is a complex neuro-behaviour condition. People with autism have difficulty with social interaction and in communication with others. They may struggle with change, and repeat actions over and over. Life may be very anxious or stressful. The signs of autism can occur at any age but often appear in the first two years of life. There is no one type of autism, but many, so the condition is now called autism spectrum disorder (ASD). Autism is lifelong but this study is only about children. Caring for a child with autism can be difficult and can sometimes be tough on the whole family. Specialist doctors diagnose autism. When general practitioners think a child might be on the autism spectrum, they refer them to a specialised team. These specialist teams carry out assessments. The number of children referred for assessment has been increasing recently. Diagnosing autism is not easy. One reason is that different specialist professionals might need to assess children. Another reason is that professionals might assess children for more than one condition. Our recent survey found some families spend over one year waiting for a diagnosis. The 2019 NHS England Long Term Plan made services for people with autism a priority. The Long-Term Plan aims for more families to get the right help, quicker. To do this, waiting times need to be shorter so children will get the right support sooner. This project aims to guide the people who plan services for families and children. Different teams and services that do autism assessments will help us. We will ask teams and services: What speeds up diagnosis? What delays diagnosis? The study comprises four work packages: 1. We will review research in the UK and abroad to find evidence and ideas that will help speed up diagnosis. 2. We will survey professionals who work for the specialist teams who diagnose autism. The survey will be about each step in the process and ask which professionals get involved. We will ask about the number of children they see and the time it usually takes to reach a diagnosis. This will give us a picture of the national situation. 3. After the national survey, we will select around six or eight teams. These teams will be using different and innovative approaches. We will study those approaches. We will talk to clinical staff, managers, referrers, parents and young people. Parents and young people will have gone through the diagnostic process. We will ask parents and young people about their experiences and views. We will review the steps in the diagnosis process for about 70 children in each service. We will find out how long each assessment takes, how much clinical time it takes, and how much it costs. We will compare findings across teams and services. 4. We will have national meetings with autism experts and patient groups. We will show them our findings. These groups will agree recommendations for practice. Clinical teams, service managers, commissioners, parents’ groups, and NHS England will receive recommendations. The research team has specialist expertise in autism, health services, economics, and statistics. The team includes public and NHS England partners. This will ensure we take account of the needs of families and we send the findings to people who plan services. This study is a collaboration with University of Surrey, Newcastle University, Council for Disabled Children, Autistica and others. See https://www.sussexcommunity.nhs.uk/get-involved/re-asced-research.htm for details. Research Team: PI: Dr Ian Male, Consultant Community Paediatrician, Sussex Community NHS Trust, Honorary Senior Lecturer Brighton and Sussex Medical School Co-PI/project manager: Dr William Farr, Senior Research Fellow in Paediatric Neurodisability, Honorary Clinical Research Fellow Brighton and Sussex Medical School Methodological expertise, realist evaluation: Tricia Wilson, Professor of Primary and Community Care, CHSS, University of Kent Start date: 31/10/19 End Date: 30/6/22 Funder: Sussex Community NHS Foundation Trust Funding: £66,463 Publication: Abrahamson, V., Zhang, W., Wilson, P., Farr, W. and Male, I. (2020). A Realist Evaluation of Autism ServiCe Delivery (RE-ASCeD): Which diagnostic pathways work best, for whom and in what context? Protocol for a rapid realist review. BMJ Open [Online] 10:1-8. Available at: https://bmjopen.bmj.com/content/10/7/e037846. -
Retention and sustainability of social care workforce (RESSCW)
Funded by the Health Foundation's Efficiency Research Programme, this project aims to tackle persistent high staff turnover in social care, to help the industry meet growing demand for high-quality and sustainable services. Working with Dr Eirini Saloniki and PSSRU colleagues, (project lead) Dr Florin Vadean and Professor Shereen Hussein, Ann-Marie will compare social care with other low-wage industries and explore staff characteristics, job commitment and retention. This will help commissioners, providers and policy-makers to understand the drivers behind staff leaving their jobs and influencing choices of subsequent jobs. As well as defining 'quality jobs' in social care, the research will help to develop pathways to achieve these nationally. More information on the Health Foundation website > -
SUSTAIN - sustainable tailored integrated care for older people in Europe
Integrated care (IC) is defined as those initiatives that proactively seek to structure and coordinate care in home environments and improve health outcomes while constraining health care expenditures. ‘Older people’ are defined as European citizens aged 65+ with multiple health and social care needs. The focus on this group reflects the general increase in complexity of care with age. SUSTAIN’s overall aims are to improve established IC initiatives for older people living at home with multiple health and social care needs and to ensure that these improvements can be adapted and applied to other health systems and regions in Europe. Core elements are: a well-coordinated and proactive approach to health and social care needs; patient-centredness involving older people in decision-making and taking their individual needs into account delivery of multiple interventions at the same time involvement of professionals from multiple disciplines. The project will Identify established integrated care initiatives and conduct baseline assessments to examine their patient-centredness, prevention orientation, efficiency, resilience to crises, safety and sustainability; Improve established integrated care initiatives based on the outcomes of the baseline assessments in co-creation with local key stakeholders and implement these improvements; Evaluate the implementation process and identify how the established integrated care initiatives have improved; Assess the applicability and adaptability of improved integrated care initiatives; design and implement dissemination strategies. Start date: 01/04/2015 End date: 30/03/2019 Funder: EC Horizon 2020 Funding: €584,119 -
The contribution of Multidisciplinary Meetings (MDMs) towards improving patient outcomes and preventing the need for health and social care support: A mixed-methods evaluation employing an implementation science approach.
Start date: 01/01/19 End date: 31/12/20 Funder: Oxleas NHS Foundation Trust Funding: £6,500 -
Undergraduate Curriculum Resources on Health and Work
CHSS and partners will design an integrated curriculum for health care professionals that addresses how to communicate with service users/patients about staying in and returning to work. To increase health professionals’ confidence in discussing health and work with patients, having acquired the skills, knowledge, tools and techniques to undertake this activity. To increase the uptake of health professionals broaching the issue of Health and Work in their patient consultations, including giving professionals the capability and confidence to use the fit note as a system for practical advice as well as a process for sickness certification To increase patients’ experience of feeling more supported by health professionals. To increase the number of patients understanding the value of work to their own health and well-being, including their expectations of the fit note, by receiving advice from health professionals. An external academic and professionals steering panel will include the following representatives: CHSS GMC Health Education England Academic Occupational Health Physician National Occupational Health Network Medical Schools Council Start date: 19/10/18 End date: 31/12/17 Funder: Public Health England Funding: £149,871
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'Go Golborne': evaluation of 'whole place' community health lifestyle project
This is a collaboration with the Public Health Team of the London Triborough Authorities (Hammersmith and Fulham, Kensington and Chelsea and City of Westminster) on the design and delivery of a research evaluation of a new pilot project aimed at preventing obesity in childhood. The project forms part of a wider programme in the three boroughs to halt and reverse levels of childhood obesity and improve associated outcomes for children and their families. ‘Go Golborne: eat happy, move and play’ was launched in May 2015. With many schools, preschools, youth clubs and parks, Golborne - one of London’s most deprived wards – offers potential to reach large numbers of children and young people and explore the environment’s role in supporting healthy behaviours. This pilot takes a ‘whole place’ community approach through a local network of individuals and organisations. Using training opportunities, environmental improvements, consistent messages, community development and a series of social marketing campaigns, Go Golborne encourages children and their families to ‘eat happy, move and play’ by helping to create supportive environments that make healthier choices around eating and physical activity easier. Their themed campaigns will focus on simple messages such as sugar swaps, snack checks, active travel, and reduced screen time. CHSS is taking a ‘theory of change’ approach to the four-year evaluation, which will study the links between activities, outcomes and contexts of the initiative. It will incorporate a detailed process evaluation, as well as evaluating outcomes on healthy weight, changes in behaviour, awareness of and attitudes to physical activity and healthy eating, and changes in home, school and community environments. Evidence suggests that healthy lifestyles initiatives work best when targeted at a local level to respond to the unique needs of communities. Learning from other areas also highlights the importance of taking a ‘whole system’ approach where everyone who lives and works in a community plays their part to make it a healthier place for children to grow up. This pilot, as part of a multi-agency approach to tackling child obesity, will test the feasibility of replicating the intervention in other areas. The research team will: Assess impact and costs of the pilot at child and family, community and local authority level, Identify the least and most effective elements of the project - for who, in what contexts, and how. Inform the progress of the project over the three years to maximize the likelihood of greatest impact. Make recommendations on whether and how the intervention could be rolled out in or adapted for other wards. Start date: 25/05/2015 End date: 31/03/2019 Funder: Royal Borough of Kensington and Chelsea Funding: £189, 653 -
Disturbances of Sleep in Dementia (DOSID): A study to evaluate whether light therapy can help people with dementia to sleep better.
Two thirds of people with dementia have problems with sleep and this can negatively affect their health. The hormone Melatonin is released from the brain in dim light, causing sleep. Bright light inhibits melatonin release and helps us stay awake. Without sufficient exposure to light, people may naturally sleep at different times of the day. Those with dementia often find it difficult to get outside and may not be exposed to enough light. Using a bright light box may help people with dementia to stay awake during the day and improve their sleep during the night. Results from previous studies have been mixed, but may be unreliable. Funded by a grant from the University of Kent Faculty of Social Sciences, the researchers will conduct a small pilot of a study to test if a light box used during the day helps people with dementia sleep better at night. Working with Surrey and Borders NHS Foundation Trust, the team will identify participants and run the pilot in spring of 2016. The pilot results will help to establish whether a full trial can be undertaken. -
Ageless Thanet
CHSS, as part of a multi-agency collaboration, is evaluating the five year 'Ageless Thanet' project (as part of the Big Lottery's national 'Ageing Better' programme) to reduce social isolation and ensure a better old age for Thanet residents. The evaluation design draws on the RE-AIM framework which explores impact on process and individual outcomes. A mixed methods approach will be used, gathering data from individuals accessing services and the agencies delivering them. The evaluation will be dynamic with continuous assessment and testing of the initiatives to determine which work in having a meaningful impact on social isolation. There is a strong emphasis on stakeholder involvement and empowering the community. The project will equip local community researchers with the requisite skills to take forward the evaluation process beyond 2020. The project, led by SEK (Social Enterprise Kent) will deliver services and activities across five project workstreams: wellbeing - educational, fitness, social and craft activities to enhance health and wellbeing active citizenship - volunteer 'ageing better' champions target and help isolated people in the community planning for later life - advice, support, guidance and life coaching from 'life planners' older entrepreneurs - helping those 50+ to set up or develop small businesses age-friendly businesses - 'Ageless Thanet' kite mark to be developed for display. Start date: 01/04/2015 End date: 31/03/2020 Funder: Big Lottery Fund via Social Enterprise Kent Funding: £199,172 -
Becoming Breastfeeding Friendly in Britain
PROJECT NOW COMPLETED. CHSS is working with Yale School of Public Health as part of a global project to promote breastfeeding in Britain. Sally Kendall, Professor of Community Nursing and Public Health, is leading the Becoming Breastfeeding Friendly (BBF) programme for England, Scotland and Wales. The BBF programme involves a five-step process, including application of a suite of benchmarks to accurately assess barriers to successful breastfeeding on a country-wide level. It also provides case studies to assist decision-makers in implementing it most effectively. The BBF programme helps countries identify gaps in their own breastfeeding programmes, thus enabling focused resource allocation, ultimately leading to improved breastfeeding results. Breastfeeding rates must improve around the world to meet the WHO’s 2025 global target of increasing the rate of exclusive breastfeeding in the first six months to at least 50%. As well as Great Britain, Germany, Myanmar, Samoa, Mexico and Ghana, have accepted the challenge to reach this target by implementing the BBF programme. Start date: 1/11/2017 End date: 28/02/19 Funding (joint): Public Health England, Wales and Scotland (£42,500) and the Family Larsson Rosenquist Foundation (unrestricted grant to Yale University) ($32,000) -
COV-VOL: Community-based volunteering in response to COVID-19
How can a community-based volunteer workforce be rapidly and safely implemented? What is the impact of a community-based volunteer workforce on providing support for self-isolating and vulnerable older members of the community during the COVID-19 pandemic? This project, led by Tricia Wilson, is funded by the NIHR ARC KSS. Research Team: CHSS, University of Kent: Professor Patricia Wilson (CI), Dr Julie MacInnes (Project Manager), Sabrena Jaswal (RA), Dr Vanessa Abrahamson (advisory group), BSMS Kat Frere-Smith (RA), Dr Priya Paudyal (advisory group), University of Surrey Prof Heather Gage (health economics), Dr Bridget Jones (RA), Dr Jo Armes (advisory group) ARC/AHSN Rebecca Sharp (implementation lead) Project Objectives: Conduct a rapid review of existing evidence on the implementation and impact of community-based volunteers supporting older vulnerable people. Map the range of approaches to organising and supporting volunteers within the statutory and third sector organisations working in the community across Kent, Surrey, Sussex (KSS). Ascertain how Covid-19 has impacted on pre-existing volunteer services supporting older vulnerable people. Explore the experience and impact of KSS COVID-19 volunteers through undertaking qualitative telephone interviews with health and social care practitioners, those organising and supporting volunteers, volunteers and recipients of their support. Identify how organisations and volunteers identify and communicate with recipients of support, particularly those who do not use digital (excluding phones) methods. Develop a set of key messages for KSS local authority (community hubs), local resilience forums, health and social care providers, voluntary organisations and community groups in order to facilitate safe implementation of a COVID-19 volunteer workforce. Start date: 4 May 2020; End Date: 4 September 2020 Funder: NIHR via Sussex Partnership NHS Trust Funding:£24,339 -
Developing a scale of work-related wellbeing at work for adult social care staff (ASCOT-STAFF): Phase One
Ann-Marie will work with PSSRU colleagues Shereen Hussein, Sinead Palmer, Nadia Brookes and Barbora Silarova Start date: September 2019; End Date: September 2020 Funder: NIHR Research for Patient Benefit Funding: £15,665 -
DOLPHIN-II: Development Of a haemophiLia PHysiotherapy INtervention for optimum musculoskeletal health in children
A three-year study looking at whether muscle strengthening helps improve the long-term health of children with haemophilia. Boys with haemophilia will be allocated at random to two groups: a group that is asked to complete the 12-week exercise routine to strengthen their leg muscles, and another group that does not do exercises. Boys will be monitored throughout the study by measuring their muscle strength, how far they can walk in six-minutes and time taken to ascend and descend 12 steps. A wrist band will be used to record how physically active the boys are as well as how satisfied they are with their health. The study will be managed by a group of health care professionals and researchers with experience and expertise in carrying out this type of research. Development Of a haemophiLia PHysiotherapy INtervention for optimum musculoskeletal health in children (DOLPHIN-II) - a randomised controlled trial Start date:October 2020 End date:October 2023 Award: £343,536 Funder: NIHR for Patient Benefit via East Kent Hospitals University NHS Foundation Trust More information on the NIHR website. -
Evaluation of eight week mindfulness course for GPs
Dr Kate Hamilton-West and Tracy Pellatt-Higgins are working with GP Dr Neil Pillai to conduct an evaluation of an 8-week mindfulness course for GPs. The evaluation is funded by the Royal College of General Practitioners - South East Thames Faculty. Analysis will focus on change in measures of wellbeing from baseline (before the course) to follow-up (after the 8 week course). GPs will also be asked to report on their experiences of the course. Start date: 01/04/2016 End date: 29/07/2019 Extended date: 1/4/19 to 31/3/20 Funder: RCGP Funding: £1,498 -
How general practice team composition and climate relate to quality, effectiveness and human resource costs: a mixed methods study in England
General Practice is central to the NHS, and is where people first seek non-emergency health advice. GPs deal with a wide range of health and social care issues for local people. They have traditionally employed a staff team of e.g. nurses, care assistants, receptionists, managers and liaise with community services such as midwives and health visitors. Many GPs are retiring or leaving the NHS. More newly-trained doctors work in hospitals and there is a shortage of GP practice nurses. NHS general practice is under pressure. At the same time, more people with long-term conditions need regular care from GP teams. Tasks formerly done in hospital are being transferred to general practice. It is vital that GPs organise teams efficiently to treat as many patients as possible. General Practices’ staffing arrangements vary widely. Practices have tended to become larger over time, and include a wider range of staff (e.g. physiotherapists, pharmacists). Some GPs have combined into ‘super-practices’. There is little evidence to show GPs and service commissioners what size or structure of practice, or professional staff mix, works best for patients. This NIHR Health Services & Delivery Research-funded project aims to provide such evidence, exploring how the composition of GP teams and team relationships (‘climate’) affects quality of care and health outcomes for patients, and practice costs. Professor Stephen Peckham leads the project team, who will: Survey the literature to learn about skill mix in countries with healthcare systems resembling our NHS. Analyse existing big data sets and use statistical methods to investigate the relationship between differences in the organisation and skill mix of practices in England and quality of care and effectiveness. Quality measures will be based on inspection data. Effectiveness will be measured using number of patients hospitalised for conditions that should be general practice managed. Conduct a staff survey in a nationwide sample of practices to explore how workforce issues affect staff wellbeing and job satisfaction Observe/interview staff to investigate how team climate affects daily working and patient experience. Work with GPs and commissioners to review project findings and create guidelines for all practices on optimum professional staff mix and good team working. Find novel ways to publicise research results to GPs, NHS managers, government organisations, academics and the public. Patient and public opinion provided valuable input to the research application and a service user group will contribute at all stages of the project. Start date: 01/10/2018 End date: 30/09/21 Funder: NIHR Funding: £404,316 -
How to strengthen leadership and the workforce through the re-design and implementation of a pay for performance program in primary health care in Brazil
This BA Newton Advanced Fellowship award-funded study focuses around primary care in Brazil. The research will yield new evidence on PMAQ, the Brazilian National Programme for Access and Quality Improvement in Primary Care. Academics from Brazilian universities, governmental and other organisations are collaborating with the project. The researchers will conduct a rapid review, interview policymakers, implementers and front-line staff in Goiás and Pernambuco, and examine related documentation. Data analysis will take into account relevant themes from Public Policy, the politics of performance and Health System literature. The UK/Brazil partnership will involve research collaboration, reciprocal visits and knowledge transfer. Professor Peckham will give two special open lectures at UFG in partnership with Dr Fabiana da Cunha Saddi, post-doc researcher at the Faculty of Social Sciences, Federal University of Goias in Brazil. They will teach on a policy analysis module for the University’s Political Science Masters Course. Fabiana will spend time in England at CHSS over the next two years. Read more on the UFG website > Start date: 01/03/18 End date: 28/02/20 Funding: British Academy (Newton Fellowship) £53,941 -
Improving Choices for Care
The difference between formulating a policy and making it work in practice, the ‘policy-implementation gap’, has long been recognised as a problem by policy makers and those responsible for putting policy into practice. To date, little attention has been paid to identifying the best ways of improving successful implementation in practice. The Department of Health, together with other central and local government organisations and professional bodies, developed a partnership programme for the Care Act 2014 involving innovative implementation support systems at national and regional levels to ensure local areas were well-placed to deliver the changes required. We will evaluate the extent to which these support arrangements have been successful and identify those elements that supported successful implementation and explore how they can be replicated for other major government policy programmes and initiatives. We will review what has been done previously in other national programmes to assess their respective strengths and weaknesses. We will consider what constitutes good practice across a range of centrally driven national programmes designed to support the introduction of new social care related policy initiatives. We will also undertake research in a number of local authorities to examine the experiences and impact of the Care Act implementation support arrangements. We will examine evidence at four levels – national, regional, local strategic and local frontline, including the views of users and carers – in order to build a comprehensive picture of what works under what circumstances when viewed by policy makers, local service providers and the users of services and their carers. Finally, we will pull all this evidence and learning together to develop guidance for central and local governments for supporting new policy initiatives in social care and health. We are especially keen to establish links between the Care Act support and the early experience of NHS Improvement – the new NHS agency for supporting service improvement in the healthcare sector. We recognise that any framework will have to be adapted to specific contexts and issues, but anticipate that the components will serve as a guide to governments on actions most likely to bring about favourable results. The CHSS team is working with Newcastle University partners Professor David Hunter and Samantha Redgate on this project, along with CHSS Visiting Professor Bob Hudson. Start date: 01/10/2016 End date: 30/09/2018 Funder: Department of Health Funding: £212,653 Interim report -
Improving the quality of care in care homes by care home staff (Mi CARE HQ)
More information on PSSRU website -
Measuring the social care outcomes of people with dementia and their carers
Currently over 767,000 people live with dementia in England and Wales. Two thirds live in their own home but this is expected to increase to over 1 million people by 2030. The ability to stay at home, in familiar surroundings, is important to people with dementia and their families. For many, community-based social care services, like personal care in the home, enable them to maintain their independence, stay connected to their local community, and to live well with dementia. For families and friends who care for someone with dementia, these services may also help them. An important question is what type(s) of community-based services, like personal care in the home and day activities, best support people with dementia and their carers. The Adult Social Care Outcomes Toolkit (ASCOT) is a questionnaire that asks people about aspects of their life that might be affected by social care services (for example, having control over everyday life). This questionnaire has already been used by researchers and care providers to review how well services support people. It is, however, difficult to collect this information from people who have memory or communication difficulties, including people with moderate to severe dementia. To work around this, we have developed a new version of ASCOT, the ASCOT-Proxy. This version is completed on behalf of a person by someone who knows him/her well – such as, a close friend or relative. There is also another version of the questionnaire called the ASCOT-Carer, which looks at aspects of life that are important to friends and relatives who look after someone. This includes things like feeling supported and encouraged in their caring role. This study will test the ASCOT-Proxy and the ASCOT-Carer with 300 carers of people with dementia living in their own home. People will be invited to complete the survey as a paper questionnaire or online. The study will be advertised with the help of others interested in this work. These will include local authority adult social care departments, carers organisations and care providers. We will advertise the study on social media. The information collected will be used to assess whether the questionnaires are easy to complete and measure what they are intended to measure – aspects of people's lives that might be affected by social care services – in a way that is stable over time. Ann-Marie will work with PSSRU colleagues (Chief Investigator) Stacey Rand, Dr Karen Jones and Professor Julien Forder Start date: September 2019; End Date: September 2021 Funder: NIHR Research for Patient Benefit Funding: £149,786 -
Novel use of combined hospital datasets to provide clear insight into patient clinical and social care needs
Project information to follow. Start date: 25/9/2017 End date: 24/12/2018 Funder: Health Foundation (via East Kent Hospitals University Foundation Trust) Funding: £37,017 -
Provision and evaluation of training and support on sport and physical activity for the Social Prescribing sector
London Sport have commissioned CHSS, led by Research Fellow Dr Sarah Hotham, to design and deliver a pilot training programme for social prescribers (SP) around sport and physical activity. The aim is to improve prescribers' knowledge and understanding of how physical activity affects health. London Sport - a County Sports Partnership funded by Sport England - believes that upskilling this workforce (usually originating from a ‘non-fitness’ background) is an ideal way to target efforts to boost physical activity among people referred by their GP with non-medical problems, to social prescribers within the community. This is a potentially inactive population with problems requiring help through voluntary sector providers. The training programme aims to build confidence among social prescribers when discussing health and physical activity with these clients. CHSS will deliver the training in January, and Research Fellow Dr Rowena Merritt will conduct an evaluation of the programme in spring. London Sport hope to obtain funding to enable roll-out of the training across all London boroughs, and possibly nationwide in future. Start date:19/11/18 End date: 30/04/19 Funder: London Sport Funding: £14,369 -
Redesigning outdoor space to support people with dementia
More information on the PSSRU website: https://www.pssru.ac.uk/research/1022/ -
RISKIT-CJS evaluation of a multi-component intervention to reduce substance use and risk-behaviour in adolescents engaged with the criminal justice system
Adolescence is a critical developmental stage when young people make behavioural and lifestyle choices that have the potential to impact on their health and wellbeing into adulthood. While risk-taking is important for healthy psychological development, for many, inappropriate risk-taking is significantly associated with health and social harm during adolescence and these harms persist well into adulthood. Young people involved in the criminal justice system are a particularly vulnerable group with a greater propensity to take risks that are likely to have long term impact on their future health and wellbeing. The RISKIT-CJS programme is a multi-component intervention encompassing both individual and group work and includes elements of motivational enhancement, psycho-education, psychosocial approaches, cognitive behavioural therapy and mindfulness. The study is a major multi-centre evaluation of RISKIT-CJS. The methodological approach is a mixed method, prospective, pragmatic randomized controlled trial with individual allocation, combining both quantitative and qualitative evidence. The study will be conducted across three geographical areas; South East England, South London, North East England, covering a diverse socio-economic and ethnic population. Start date: 01/09/2016 End date: 31/08/2019 Funder: NIHR Public Health Research Funding £892,675 -
Tackling Obesity in Medway
Public Health Collaboration. CHSS has been commissioned to conduct an external evaluation of Medway Public Health Department’s weight management projects. This collaborative project will assess how Medway’s initiatives and programmes could be built on and improved. In 2014 Medway Council hosted an Obesity Summit attended by private, public and voluntary sector partners, to help develop a framework for tackling obesity. Medway Council’s dedicated ‘Supporting Healthy Weight’ team (SHW) works with adults, families, children and young people to help them in achieving healthy weight. Within the National Child Measurement Programme (NCMP) classification, 23.3% of 4-5 year olds and 32.7% of 10-11 year olds in Medway are overweight or obese. The SHW team provide and commission a diverse range of interventions across Medway to help prevent and manage overweight. These include four MEND programmes (2-4, 5-7, 7-13 and Graduates) and Fit Fix, a programme for 13 – 17 year olds. The team work across the Council to maximise opportunities to support obesity prevention in all aspects of the Council’s work, and in the revised Medway Local Plan. The evaluation will also focus on raising awareness of the SHW portfolio and developing its media profile to get the message out to a wide audience about obesity and public health initiatives in Medway. Start date: 15/01/2015 End date: 14/01/2017 Funder: Medway Council Funding: £67,187 Poster presentation: Evaluability assessments as part of a ‘whole systems approach’ to evaluating Medway Council’s interventions to tackle obesity. -
The new models of care Vanguard programme in England:national programme evaluation
Health and care services are usually provided by different types of organisations, which operate separately and do not communicate well together. This harms patient experiences and can lead to unnecessary costs. The 2014 NHS England Five Year Forward View saw the beginning of an ambitious programme to develop new models of care to address longstanding problems in the UK health system. Integration of health and social care services will ultimately meet patients’, service users’ and carers’ needs more effectively. 50 ‘Vanguard’ sites were established around the country piloting new ways to organise health services. They have been developed, implemented and evaluated locally, helped by a national support team. They aim to improve: population health and wellbeing; quality of and access to care; service efficiency. The Government has now commissioned a national programme evaluation of the Vanguards. Working with the University of Manchester (lead organisation), The London School of Hygiene and Tropical Medicine and PSSRU at the University of Kent, CHSS will be part of the evaluation team. It will investigate the overall effects of the Vanguards on the NHS. How well have they been able to implement changes? What are the major barriers and facilitators? What are effects on service users and NHS costs. There are four stages to the evaluation: explore the national backdrop, interviewing members of the national support team and regulators and build a picture of economic issues, analyse the local evaluations, conduct an in depth analysis of six chosen Vanguards’ experiences and carry out a national evaluation of outcomes, costs and cost-effectiveness, after combining data, clear messages about this approach to service improvement will emerge which the team will share to ensure rapid learning from the evaluation. Start date: 01/06/2017 End date: 31/05/2021 Funder: Department of Health, Policy Research Programme (via University of Manchester) Funding: £285,901