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Dr Sabina Hulbert completed her undergraduate degree at the University of Padua (Italy) with a specialization in Work and Industrial Psychology followed by a PhD in Social Psychology from the University of Kent in 1999. She has since been a lecturer and then senior lecturer at the University of Greenwich and at Canterbury Christ Church University. Lately, she has been appointed as an Academic Research Lead at Canterbury Christ Church University and has recently joined RDS SE as a Research Adviser. During this period she has developed significant experience in quantitative data analysis and advanced statistical techniques collaborating in number of research projects.
Sabina has been involved in a number funded projects in applied health research looking, for instance, at the positive effects that singing, manipulating artefacts in a museum context, looking at art, etc. can have on the wellbeing of Alzheimer patients and their carers. She is currently collaborating on a large scale multicentre international study testing the effectiveness of educational programs on the way Type 2 Diabetes patients manage their illness. In terms of health promotion, she has experience with large scale studies evaluating the role of physical activity in reducing the risk of Type 2 Diabetes in residents of a high risk south London area and the role of health screening in improving the wellbeing of patients with severe mental health problems. All of her research activities in applied health settings have had an element of PPI which typically results in improved measurement tools, research design and overall significance and reach.
She is an experienced supervisor having successfully supervised at Master, Clinical Doctorate, Educational Doctorate and PhD level.
Sabina has also collaborated on research projects more focussed on methodological aspects of research, like validation of measuring scales and instruments (e.g. Risk of Gang Affiliation in teenagers; assessment of cognitive abilities after brain injuries; Italian WISC-IV and WAIS equivalent) and the psychometric properties of diagnostic tools.
Her expertise focuses on quantitative research designs, construction of attitude measurement tools, validation studies, data management of large scale datasets, psychometrics, cohort studies and survey design in general.
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Articles
Eisl, U., Woolley, M., Hulbert, S., Casson, A. and Bowie, R. A. (2023) 'Pupil-centred spiritual leadership: an empirical study of thirteen church primary school headteachers in England', International Studies in Catholic Education. Taylor & Francis. doi: 10.1080/19422539.2023.2171622.
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The place of Church school headteachers as spiritual leaders of the school community is rarely highlighted. This article investigates how 13 Church primary school headteachers (Catholic Church of England, and Methodist) interpret this role. It draws on the Faith in the Nexus research which investigated how church primary schools nurtured pupils' spiritual development and facilitated faith activity in the home. The head teacher interviews revealed several recurring themes, such as empowering children, collective worship, relationships with church and parents, and the visibility of faith in school. This research brings together a comparison of leadership approaches from Catholic and Anglican headteachers. Evidence of differences emerged; Catholic headteachers tended to use 'overtly religious' language while many Anglican headteachers employed a more 'secular' language to express their vision of spiritual leadership. A comparison with Shaw's (Citation2015, 2017) model of 'ethotic leadership', highlighted much in common. The headteachers' ethos was pupil-centric and shaped by a focus on the spiritual development of the child. An adaptation of Shaw's model is offered which places the child at the centre.
Woolley, M., Bowie, R. A., Sabina, H., Thomas, C., Riordan, J.-P. and Revell, L. (2022) 'Science and RE teachers' perspectives on the purpose of RE on the secondary school curriculum in England', Curriculum Journal. Wiley. doi: 10.1002/curj.191.
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Renewed interest in curriculum in English schooling over the past decade has emanated from a particular focus on the place and role of knowledge in the class-room. Significant changes in policy and examination specifications have led to changes in religious educa-tion (RE). However, little is known about teachers' perspectives on the purpose of RE. We asked teach-ers of science and RE what they understood as the purpose of RE on the school curriculum. Data from 10 focus groups and a survey with 276 secondary teachers demonstrated that many secondary teach-ers of science have a different understanding to RE teachers of the purpose of RE on the school curricu-lum. Findings also show a lack of consensus from RE teachers on the purpose of RE, suggesting the impact of the knowledge turn in RE is not as strong as the Ofsted Research Review implies. Findings are signif-icant as little is known about how knowledge works across disciplinary boundaries in schools. If students are to come to a full understanding of how knowledge works, teachers need to have some understanding of how knowledge is being constructed and utilised in other curriculum subjects. Knowledge of the intended purpose of RE is important for respectful co-existence of subjects on the curriculum and essential when RE is declining as a subject in secondary schools.
Newman, W., Parry-Williams, G., Wiles, J., Edwards, J., Hulbert, S., Kipourou, K., Papadakis, M., Sharma, R. and O'Driscoll, J. (2021) 'Risk of atrial fibrillation in athletes: a systematic review and meta-analysis', British Journal of Sports Medicine. doi: 10.1136/bjsports-2021-103994.
Objective A systematic review, meta-analysis and meta-regression were performed on selected studies to investigate the incidence of atrial fibrillation (AF) among athletes compared with non-athlete controls. Design Meta-analysis with heterogeneity analysis and subsequent meta-regression to model covariates were performed. The mode of exercise (endurance and mixed sports) and age were the a priori determined covariates. Data sources PubMed, MEDLINE, Science Direct, SPORTDiscus and the Cochrane library were searched. Eligibility criteria Research articles published after 1990 and before 2 December 2020 were included if they reported the number of AF cases in athletes with non-athlete (physically active or inactive) control groups, were case–control or cohort studies and if data allowed calculation of OR. Results The risk of developing AF was significantly higher in athletes than in non-athlete controls (OR: 2.46; 95% CI 1.73 to 3.51; p<0.001, Z=4.97). Mode of exercise and risk of AF were moderately correlated (B=0.1259, p=0.0193), with mixed sport conferring a greater risk of AF than endurance sport (B=−0.5476, p=0.0204). Younger (<55 years) athletes were significantly more likely to develop AF compared with older (≥55 years) athletes (B=−0.02293, p<0.001). Conclusion Athletes have a significantly greater likelihood of developing AF compared with non-athlete controls, with those participating in mixed sport and younger athletes at the greatest risk. Future studies of AF prevalence in athletes according to specific exercise dose parameters, including training and competition history, may aid further in delineating those at risk.
Smith, R., Martin, A., Wright, T., Hulbert, S. and Hatziminaoglou, E. (2021) 'Integrated dementia care: A qualitative evidence synthesis of the experiences of people living with dementia, informal carers and healthcare professionals', Archives of Gerontology and Geriatrics. Available at: https://doi.org/10.1016/j.archger.2021.104471.
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Background: In order to provide improved care provision, integrated care services are being developed. However, little is known about how people living with dementia, their families and healthcare professionals experience integrated care. Therefore, the purpose of this review of the qualitative literature was to examine the experiences and perceptions of integrated dementia care. Methods: This qualitative review synthesised findings from included studies identified from a comprehensive literature search. Searches included: five electronic databases, journal handsearching, and reference list searching of relevant literature reviews and the final included studies. Findings: Three overarching themes were identified: 1) Ways of working which facilitate the delivery of integrated dementia care; 2) Informal carers as equal partners in care provision and decision making; and 3) Challenges leading to fragmented and disjointed integrated dementia care. For integrated care to be successful, communication and collaboration between healthcare professionals, and the involvement of informal carers is needed. Multidisciplinary teams and employing case managers to coordinate care provision can improve communication and collaboration. However, distrust between healthcare professionals and a lack of a central database to access and share information often hinders the development of integrated dementia care service provision. Conclusion: Integrated dementia care can be successful and well received by people living with dementia and their families when certain conditions are met. However, given the negative consequences fragmented and disjointed care can have on people living with dementia and their families, action is needed to further support the development of integrated dementia care services.
Strohmaier, S., Homans, K. M., Hulbert, S., Crutch, S. J., Brotherhood, E. V., Harding, E. and Camic, P. M. (2021) 'Arts-based interventions for people living with dementia: Measuring "in the moment" wellbeing with the Canterbury Wellbeing Scales', Wellcome Open Research. doi: 10.12688/wellcomeopenres.16596.3.
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Background: There is growing acknowledgement for the need to move beyond exclusive biomedical understandings of dementia and also focus on how to improve the lives and wellbeing of people living with dementia. A mounting body of research advocates for the benefits of arts-based interventions for this population. The purpose of this study was to explore the links between multiple components of arts-based interventions and subjective wellbeing in order to help assess if these activities might contribute to meaningful community-based dementia care initiatives. Methods: Using previously collected data across different intervention sites, a within- and between- participants design was used that assessed wellbeing through the Canterbury Wellbeing Scales (CWS) in people with mild-to-moderate dementias (N = 201) who participated in various community arts-based interventions (ABI). Data were analysed using non-parametric statistical analyses and bootstrapped moderation models. Results: Increases in subjective wellbeing were associated with all forms of ABI. Co-creative sessions significantly strengthened the relationship between number of sessions attended and overall wellbeing as well as optimism. No significant moderating effect was observed between number of sessions attended and carer presence. Conclusions: In the largest study of its kind to date to assess wellbeing using arts activities in a community-based dementia sample, findings support the use and acceptability of the CWS as a measurement tool for people with early-to-middle stages of dementia and suggest that the CWS can reliably measure wellbeing in this population. In addition, the positive effect of arts-based interactions on specific aspects of wellbeing were found, which provide a better understanding of the conditions under which these effects can be prolonged and sustained. Further research is needed to better understand the environmental, social, and psychological mechanisms through which these improvements operate [version 2; peer review: 1 approved]
Hulbert, S., Cooling, T. and Bowie, R. (2020) 'Measuring the Effectiveness of Virtuous Pedagogy: A Quantitative Study of the What If Learning Approach in Church of England Schools', Education Sciences. MDPI. doi: 10.3390/educsci10110315.
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What If Learning is a pedagogical approach that allows teachers to deliver traditional content, as prescribed by national curricula, while at the same time promoting character virtues fundamental to Christian ethos. It encourages teachers to present topics from a different perspective, which shapes understanding through the lenses of cooperation, coaching or hospitality. What If Learning reframes 'how' to teach rather than changing 'what' to teach. This study tested the effects of a three-months-long What If Learning intervention which reshaped the delivery of lessons to reflect values of hospitality and welcome in twenty schools across five dioceses in the United Kingdom. Four hundred and seventy-four pupils and 198 of their teachers filled in online surveys presenting implicit and explicit measures of intergroup attitudes adapted from the existing literature to reflect our operationalisation of tolerance as the Christian virtue of hospitality or welcome. Data were collected from all participants at three time points: before and after the intervention and then again three months later. Analyses of variance revealed a pattern of answers largely supportive of the positive effect of the proposed pedagogical approach, although not always consistent with the hypotheses. Teachers report overwhelming positive effects of the intervention on several aspects of pupils' behaviour and flourishing potentials. The discussion focuses on the widespread implications of these findings while acknowledging the need for additional research to strengthen our conclusions and promote the approach even further.
Bressington, D., Li, Y., Hulbert, S. and Mak, Y. W. (2020) 'Physical fitness and activity levels among Chinese people with schizophrenia: A cross-sectional study with matched case-control comparison', International Journal of Environmental Research and Public Health. MDPI, p. 3564. doi: 10.3390/ijerph17103564.
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People with schizophrenia have an increased risk of developing cardiometabolic diseases and a reduced life expectancy. Studies conducted mainly in Western settings report low amounts of activity and poor levels of fitness in this population. This study aims to compare physical fitness and activity levels between people with schizophrenia/healthy matched controls and investigate potential associations between these variables. A cross-sectional study was conducted with 57 community-dwelling people with schizophrenia and 57 age-, gender- and BMI-matched controls. Participants completed the International Physical Activity Questionnaire and the YMCA Fitness Assessment Protocol with accompanying cardiovascular/lung function tests. Cardiorespiratory fitness was significantly better in healthy matched controls than individuals with schizophrenia in all areas (all p<.05, d=0.38 to 1.06). Performance in best trunk flexion, half sit-ups and one-minute pulse recovery following the 3-minute step test were significantly worse in the schizophrenia group (all p<.001, d=0.76 to 1.04). Higher levels of weekly moderate activity (t=-2.66, p=.009) and total weekly activity levels (t=-2.013, p=.047) were reported by the healthy controls. Levels of vigorous activity were significantly correlated with some areas of lung functioning in the schizophrenia group (all p<.05). The findings show that Chinese people with schizophrenia have significantly poorer fitness than matched healthy controls, demonstrating the need to provide timely effective exercise-based interventions as a matter of routine to attenuate the risk of developing chronic physical illnesses.
Hulbert, S. (2017) 'Museum activities in dementia care: Using visual analog scales to measure subjective wellbeing', Dementia. SAGE Publications, pp. 591-610. doi: 10.1177/2F1471301215611763.
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Abstract Introduction Previous research has shown that people with dementia and caregivers derive wellbeing-related benefits from viewing art in a group, and that facilitated museum object handling is effective in increasing subjective wellbeing for people with a range of health conditions. The present study quantitatively compared the impact of two museum-based activities and a social activity on the subjective wellbeing of people with dementia and their caregivers. Methods A quasi-experimental crossover design was used. People with early to middle stage dementia and caregivers (N = 66) participated in museum object handling, a refreshment break, and art viewing in small groups. Visual analog scales were used to rate subjective wellbeing pre and post each activity. Results Mixed-design analysis of variances indicated wellbeing significantly increased during the session, irrespective of the order in which the activities were presented. Wellbeing significantly increased from object handling and art viewing for those with dementia and caregivers across pooled orders, but did not in the social activity of a refreshment break. An end-of-intervention questionnaire indicated that experiences of the session were positive. Conclusion Results provide a rationale for considering museum activities as part of a broader psychosocial, relational approach to dementia care and support the use of easy to administer visual analog scales as a quantitative outcome measure. Further partnership working is also supported between museums and healthcare professionals in the development of nonclinical, community-based programs for this population.
Hulbert, S. (2015) 'A retrospective observational study of the effectiveness of paliperidone palmitate on acute inpatient hospitalization rates', International Clinical Psychopharmacology, pp. 230-236. doi: 10.1097/2FYIC.0000000000000077.
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This retrospective mirror-image observational study aimed to establish the effects of the long-acting antipsychotic injection paliperidone palmitate (PP) on acute inpatient hospitalization rates. We utilized routinely collected clinicaldata to compare the number and length of acute patient admissions 1 year before and 1 year after initiation of PP. A single cohort of 66 patients with a diagnosis of schizophrenia and who had received monthly injections of PP for at least 1 year were included in the analysis. The mean number of acute inpatient admissions fell from 0.86 in the year before PP initiation to 0.23 in the following year(P = 0.001), and there was a numerical but non significant decrease in the number of bed days from 32.48 to 31.22 over the study duration. The median number of bed days in the year before PP initiation was 20, and in the year after initiation it was 0. The median number of admissions also fell from 1 to 0 during the same period. The results of the study should be treated cautiously because of the limitations of the study design but suggest that patients with a diagnosis of schizophrenia who continue treatment with PP over 12 months experience a significant reduction in hospital admissions compared with the previous year
Bressington, D., Mui, J., Hulbert, S., Cheung, E., Bradford, S. and Gray, R. (2014) 'Enhanced physical health screening for people with severe mental illness in Hong Kong: results from a one-year prospective case series study', BMC Psychiatry. doi: 10.1186/1471-244X-14-57.
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Background: People with severe mental illness have significantly poorer physical health compared to the general population; previous health screening studies conducted outside Asian countries have demonstrated the potential in addressing this issue. This case series aimed to explore the effects and utility of integrating an enhanced physical health screening programme for community dwelling patients with severe mental illness into routine clinical practice in Hong Kong. Method: This study utilises a consecutive prospective case series design. The serious mental illness Health Improvement Profile (HIP) was used as a screening tool at baseline and repeated at 12 months follow-up. Results: A total of 148 community-based patients with severe mental illness completed the study. At one year follow-up analysis showed a significant improvement in self-reported levels of exercise and a reduction in the numbers of patients prescribed medications for diabetes However, mean waist circumference increased at follow-up. In addition to the statistically significant results some general trends were observed, including: a lack of deterioration in most areas of cardiovascular risk; a reduction in medicines prescribed for physical health problems; and general improvements in health behaviours over the 12 month period. Conclusions: The findings demonstrate that using the HIP is feasible and acceptable in Hong Kong. The results of the enhanced physical health-screening programme are promising, but require further testing using a randomised controlled trial design in order to more confidently attribute the improvements in well-being and health behaviours to the HIP.
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