Centre for Health Services Studies

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Dr Catherine Marchand

Research Associate

 

 

As a research associate, I work with Professor Stephen Peckham on the General practitioner (GP) recruitment, retention and re-engagement research project (Health Education Kent Surrey and Sussex workforce planning).

The project aims to provide an analysis of the evidence and recommendations for NHS England and partners on interventions and GP workload. Using the NHS England ten-point plan to support the recruitment, retention and re-engagement of GPs, we are conducting an evidence synthesis to support actions set out in the plan and gathering evidence from wider literature on other approaches to retention and recruitment.

On a personal basis, I am also working on a research project with Dr Bogdan Negoita from the Warwick Business School at The University of Warwick on the effects of source of social support on employee well-being in a stressful situation such as IT outsourcing.

My research interests are in workplace relationships - occupational stress, health psychology, employee well-being, work group and team processes and organisational behaviour and interdisciplinary work groups in healthcare. My expertise revolves around employee’s health psychology and wellbeing, organisational and occupational health psychology and quantitative and qualitative research methods.

I studied at undergraduate and postgraduate level in Montréal (Québec, Canada), obtaining a BCom in management specialising in Organisation and Human Resource Management in 2006; and an MBA in 2009 from the Université du Québec à Montréal. My Master’s dissertation was The Role of the Team in Employee Relationships: A Multi Foci Approach to Employee Retention. My doctoral dissertation looked specifically at the effect of organisational support on stress.

While studying for my PhD I worked as a research assistant, at both the Université du Québec à Montréal and HEC Montréal. From cross-sectional research on employee attraction and retention, and team relationships to longitudinal studies on sources of organisational support and commitment, I had the opportunity to study organisational settings and employees from different professions.

I was also privileged to mentor and coach students and doctorate colleagues, mainly in research methodologies.
In 2012, I joined the Faculty of Medicine of the Université de Montréal as a member of the Patients-as-Partners initiative. I held various roles from tutor, mentor and trainer, in modules such as Health Science Collaboration, Community Health Internship, and Clinical Ethic Workshop. I am a member of the Patient expert committee and the Network of Primary Care Research at the Université de Montréal.

I successfully completed my PhD in Management in 2015 at HEC Montréal and joined CHSS in September 2015.

Memberships:
Organisational Behaviour (OB) & Human Resource Management (HR) divisions, Academy of Management (AOM)
European Association of Work and Organisational Psychology (EAWOP)
Society of Industrial and Organisational Psychology (SIOP)

Research grant:
Lussier MT, Boivin N et al Let’s Discuss Health: implementation and assessment in primary care of a web strategy to motivate patients to self-manage their health and support collaboration with health care providers (Canadian Institutes of Health Research)

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Also view these in the Kent Academic Repository

Articles
Hashem, F., Marchand, C., Peckham, S. and Peckham, A. (2022) 'What are the impacts of setting up new medical schools? A narrative review', BMC Medical Education. BioMed Central. doi: 10.1186/s12909-022-03835-4.

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Background: The growth of the UK's population together with an aging society with increasingly complex health and social care needs has placed a greater demand on statutory care services. In view of this emerging landscape, the UK Government has sought to increase its medically trained workforce in order to better respond to the demands placed on the health service. Five universities were announced as homes to new medical schools offering undergraduate places to boost the numbers of doctors training in England. The aim of this narrative review was to explore how new medical schools could improve the health outcomes of the local population and evaluate the potential contribution it may make to the local economy, workforce and to research and innovation. Methods: A narrative review was undertaken using a systematic approach for the search literature strategy. The articles were evaluated by undertaking a critical assessment evaluating the fitness of a paper for review according to results, methods used to test the hypothesis, conclusions and impact and limitations. Thematic analysis was employed to organise and summarise the findings across a heterogeneous body of literature included in the review. The analysis was developed in an inductive manner and there were not any predefined themes to guide data extraction and analysis. Results: Thirty-six articles were selected for inclusion for this narrative review. The review identified six key themes: influence of prior rural exposure, medical school environment and rural enrichment programmes, workforce, health outcomes of local populations, social accountability, economic contribution of medical schools to communities and impact on rural research. Conclusions: The studies included found a wealth of information on a wide-range of topics on the expansion of undergraduate education and its implications on the future medical workforce. It was shown that medical schools can have a positive effect on the health, social, economic and research activity of a region, but this literature tended to be heterogeneous in focus without consideration of the inter-connections between the wider societal and economic impacts arising from long-term sustainable change being brought to a region.
Saloniki, E.-C., Turnpenny, A., Collins, G., Marchand, C., Towers, A.-M. and Hussein, S. (2022) 'Abuse and Wellbeing of Long-Term Care Workers in the COVID-19 Era: Evidence from the UK', Sustainability. doi: 10.3390/su14159620.

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The UK long-term care workforce has endured difficult working conditions for many years. During the pandemic, the sector faced unprecedented challenges, which further exacerbated these conditions and brought concerns about workplace abuse and violence. Such experiences can vary by personal and work characteristics, particularly affecting minority ethnic groups. They can subsequently impact workers' wellbeing and the sector overall. Drawing on the first wave of a UK longitudinal workforce survey, this article examined the impact of COVID-19 on social care workers' working conditions, general health and wellbeing, and intentions to leave the employer and sector altogether. The analysis is based on both quantitative and qualitative responses 1037 valid responses received between April and June 2021. The respondents were predominantly female, working in direct care roles and mainly serving older adults (including those with dementia). The findings highlighted worrying experiences of abuse in relation to COVID-19, which differed significantly by nationality, ethnicity and care settings. The analysis further showcased the negative impact of experienced abuse on work-life balance and intentions to leave the current employer or the care sector altogether. The findings emphasise the need for targeted measures that promote workers' physical, emotional and financial wellbeing.
Hashem, F., Jaswal, S. K., Marchand, C., Forbes, L. J., Srinivasan, N., Bates, A. and Peckham, S. (2021) 'Incorporating the interaction between health and work into the undergraduate medical curriculum – a qualitative evaluation of a teaching pilot in English medical schools', Education for Primary Care. doi: 10.1080/14739879.2021.1914182.

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Introduction: There is a growing recognition of the impact of work on health both positive and negative. It is important that all health care professionals are equipped to understand the effects of work and worklessness on health and help patients remain in work or manage a healthy return to work where appropriate. Despite explicit reference to health and work in the General Medical Council's Outcomes for Graduates, currently, there is not a theme that is integrated across the undergraduate medical curricula. Aim: This study evaluates medical tutors' and undergraduates' perspectives of a selection of health and work topics in a teaching pilot to consider the suitability and appropriateness for delivery, integration into the curriculum, tailoring of the resources, and appropriateness and expected attainment of learning objectives. Methods: Qualitative, semi structured interviews and focus groups were carried out with five medical tutors and 36 undergraduates. Interviews and focus groups were recorded, transcribed and thematically analysed. Results: The medical tutors and undergraduates identified suitability of appropriate subject specialties and years of teaching, whether learning objectives were important and if these had been achieved, and recommendations for future delivery. Discussion: Medical tutors were committed to delivering the health and work topics with the flexibility of tailoring the resources to existing subject specialties and with respect to the year of study. Learning objectives were perceived appropriate by tutors, despite ambivalence about their importance from some undergraduates. The resources were identified as having relevance to public health undergraduate teaching and teaching during general practice placements.
Forbes, L. J., Marchand, C., Doran, T. and Peckham, S. (2017) 'The role of the Quality and Outcomes Framework in the care of long-term conditions: a systematic review', British Journal of General Practice. Royal College of General Practitioners, pp. e775-e784. doi: 10.3399/bjgp17X693077.

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Background: Improving care for people with long-term conditions is central to NHS policy. It has been suggested that the Quality and Outcomes Framework (QOF), a pay-for-performance scheme in primary care that rewards practices for delivering effective interventions in the management of longterm conditions, does not encourage high quality care for this group of patients. Aim: To examine the evidence that the QOF has improved quality of care of patients with long-term conditions. Design Systematic review Method We used electronic databases to search for peer-reviewed empirical quantitative research on the QOF published since the scheme's introduction in 2004. We searched for studies examining the effect of QOF on a broad range of processes and outcomes of care, including coordination and integration of care, holistic and personalised care, self-care, patient experience, physiological and biochemical outcomes, health service utilisation, and mortality. We carried out a narrative synthesis because the studies were heterogeneous. Results: The QOF was associated with a modest slowing of the increase in emergency admission rates, a modest slowing of the increase in consultation rates in severe mental illness, and modest improvements in certain aspects of the care of diabetes. The nature of the evidence means that we cannot be sure that any of these associations is causal. No clear effect on mortality has been demonstrated. We found no evidence to suggest that QOF influences, positively or negatively, integration or coordination of care, holistic or personalised care, self-care, or patients' experience, quality of life or satisfaction. Conclusion: The NHS should consider more broadly what constitutes high quality primary care for people with long-term conditions, and consider other ways of motivating primary care to deliver it.
Marchand, C. and Peckham, S. (2017) 'Addressing the crisis of GP recruitment and retention: a systematic review', British Journal of General Practice. Royal College of General Practitioners, pp. 227-237. doi: 10.3399/bjgp17X689929.

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Background: The numbers of GPs and training places in general practice are declining, and retaining GPs in their practices is an increasing problem. Aim: To identify evidence on different approaches to retention and recruitment of GPs, such as intrinsic versus extrinsic motivational determinants. Design and setting: Synthesis of qualitative and quantitative research using seven electronic databases from 1990 onwards (Medline, Embase, Cochrane Library, Health Management Information Consortium [HMIC], Cumulative Index to Nursing and Allied Health Literature (Cinahl), PsycINFO, and the Turning Research Into Practice [TRIP] database). Method: A qualitative approach to reviewing the literature on recruitment and retention of GPs was used. The studies included were English-language studies from Organisation for Economic Cooperation and Development countries. The titles and abstracts of 138 articles were reviewed and analysed by the research team. Results: Some of the most important determinants to increase recruitment in primary care were early exposure to primary care practice, the fit between skills and attributes, and a significant experience in a primary care setting. Factors that seemed to influence retention were subspecialisation and portfolio careers, and job satisfaction. The most important determinants of recruitment and retention were intrinsic and idiosyncratic factors, such as recognition, rather than extrinsic factors, such as income. Conclusion: Although the published evidence relating to GP recruitment and retention is limited, and most focused on attracting GPs to rural areas, the authors found that there are clear overlaps between strategies to increase recruitment and retention. Indeed, the most influential factors are idiosyncratic and intrinsic to the individuals.
Coulton, S., Stockdale, K., Marchand, C., Hendrie, N., Billings, J., Boniface, S., Butler, S., Deluca, P., Drummond, C., Newbury-Birch, D. and others. (2017) 'Pragmatic randomized controlled trial to evaluate the effectiveness and cost effectiveness of a multi-component intervention to reduce substance use and risk-taking behavior in adolescents involved in the criminal justice system: A trial protocol (RISKIT-CJS)', BMC Public Health. BMC. doi: 10.1186/s12889-017-4170-6.

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Background: Adolescence is a critical developmental stage when young people make lifestyle choices that have the potential to impact on their current and future health and social wellbeing. The relationship between substance use and criminal activity is complex but there is clear evidence that the prevalence of problematic substance use is far higher among adolescent offenders than the general adolescent population. Adolescent offenders are a marginalized and vulnerable population who are significantly more likely to experience health and social inequalities in later life than their non-offending peers. There is a paucity of evidence on effective interventions to address substance use and risk-taking behaviours in adolescent offender populations but it is clear that preventative or abstinence orientated interventions are not effective. RISKIT-CJS is an intervention developed in collaboration with young people taking account of the current best evidence. Feasibility and pilot studies have found the intervention addresses the needs of adolescents, is acceptable and has demonstrated potential in reducing substance use and risk-taking behavior. Methods: The study is a mixed method, two-armed, prospective, pragmatic randomized controlled trial with individual randomisation to either treatment as usual alone or the RISKIT-CJS intervention in addition to treatment as usual. Adolescents, aged 13 to 17 years inclusive, engaged with the criminal justice system who are identified as having problematic substance use are eligible to participate. The study will be conducted across three geographical areas; South and South East England, London and North East England between March 2017 and February 2019. Discussion: The study represents an ambitious programme of work to address an area of need for a marginalized and vulnerable population.
Vandenberghe, C. and Marchand, C. (2016) 'The Moderating role of Socioemotional Needs in the Relationship between Perceived Support and Organizational Commitment', Psychologie du travail et des organisations. Elsevier, pp. 41-59. doi: 10.1016/S1420-2530(16)30018-8.

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This paper examines the role of employees' socioemotional needs in the relationship of perceived organizational support and perceived supervisor support to affective organizational commitment. Based on a sample of 209 employees affiliated with a variety of organizations, analyses indicate that perceived organizational support and perceived supervisor support are more strongly related to organizational commitment when the need for emotional support is high but is less strongly related to organizational commitment when the need for affiliation is high. In contrast, the need for esteem and the need for approval have no moderating effects. These results offer new research perspectives on the role of individual characteristics in regard to the impact of perceived support on employees' attitudes toward the organization.
Marchand, C. and Vandenberghe, C. (2015) 'Perceived Organizational Support, Emotional Exhaustion and Turnover: Moderating Role of Negative Affectivity', International Journal of Stress Management. American Psychological Association, pp. 350-375. doi: 10.1037/str0000020.

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Using principles from conservation of resources theory (Hobfoll, 1989), this study examined the time-lagged relationship between perceived organizational support (POS; measured at Time 1), emotional exhaustion (measured 6 months later), and turnover (measured 1 year after Time 1), and included negative affectivity (NA) as a moderator. Drawing on a sample of employees from multiple organizations (N = 135), we found POS to be unrelated to emotional exhaustion but the latter to be negatively related to turnover. NA moderated the relationship between POS and emotional exhaustion and POS's indirect relationship to turnover, these relationships being stronger and positive at high levels of NA. Moreover, NA moderated the link between emotional exhaustion and turnover, this link being stronger and positive when NA was low. We discuss the relevance of conservation of resource theory as a useful framework for interpreting POS's effects.
Marchand, C. and Vandenberghe, C. (2015) 'Perceived Organizational Support, Perceived Resource Loss, and Psychological health: The Moderating Effect of Negative Affectivity', Travail Humain. Presses Universitaires de France, pp. 193-216. doi: 10.3917/th.783.0193.

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This article presents the results of an empirical study looking at the relationships among perceived organizational support, anticipated and actual resource loss perceptions, and three dimensions of psychological distress, i.e., depression, anxiety, and fatigue. Moreover, the trait of negative affectivity was used as a moderator of the effects of perceived organizational support. We used conservation of resources theory as a framework for the study. Essentially, conservation of resources theory states that individuals strive to retain resources so as to build their well-being and that stress symptoms appear when individuals perceive or anticipate resource loss and/or think they won't be able to gain resources (Hobfoll, 2002). Our reasoning in this paper is that perceived organizational support reduces employees' perception of resource loss and of being unable to gain resources, and through that psychological mechanism reduces psychological distress. We also theorized that these mechanisms would be stronger among individuals with high levels of negative affectivity, as these individuals may be more fragile and would particularly need to be supported in order for them to build their resilience. We conducted an empirical study testing the above predictions using a sample of 138 contact service employees from four Canadian organizations. Consistent with predictions, analyses revealed that perceived organizational support was negatively related to perceived actual resource loss (yet was unrelated to anticipated resource loss). Moreover, perceived organizational support acted as a reducer of depression, anxiety, and fatigue, through the mediation of a reduced perception of actual resource loss. Moreover, perceived organizational support's effects were amplified under conditions of high trait negative affectivity. This study's results (a) contribute to improve our understanding of the dynamics of personal and social resources in the workplace, (b) highlight the importance of resource loss perceptions in the stress process, and (c) clarify the process through which perceived organizational support influences employees' psychological well-being. This study's findings also have implications for practice as they suggest that organizations can reduce employee distress either by demonstrating indications of support to employees or by encouraging the development of more positive perceptions of personal resources. Finally, we also discuss the meaning of the present findings for how conservation of resources theory principles can be integrated within the theory of perceived organizational support.
Marchand, C. and Vandenberghe, C. (2014) 'Job Scope and Commitment: The Moderating Role of Support and Leader-Member Exchange', Relations industrielles / Industrial Relations. Les Presses de L'universite Laval, pp. 621-644. doi: 10.7202/1026761ar.

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This study examines the moderating effect of the relational context of jobs on the relationship between job characteristics and affective commitment towards the organization, the occupation and customers. The relational context is captured through perceived organizational support and leader-member exchange. We hypothesized that perceived organizational support would fill employees' socio-emotional needs and represent a sympathetic concern and indulgence from the organization toward employees. In contrast, leader-member exchange reflects a social exchange perspective in which the supervisor's support is associated with the aim of improving employee performance. These considerations lead to expecting perceived organizational support to act as a negative moderator of the relationships of job characteristics (job scope) to affective commitment to the three targets of interest. On the contrary, we predict that leader-member exchange will act a positive moderator of the effects of job scope on affective commitments. These hypotheses were tested in a study involving two measurement times. Job scope (i.e., a summary measure of task variety, significance, autonomy, identity, and feedback; Hackman and Oldham, 1980), perceived organizational support, and leader-member exchange, were measured at Time 1, while affective commitment to the organization, the occupation, and customers was assessed six months later. Based on a random sample of 208 employees who graduated in business, law, engineering, and basic science in a Belgian University and were employed in a variety of organizations, moderated multiple regression analyses found the (positive) relationship of job scope to commitment to the three targets of interest to be weaker at high levels of perceived organizational support. In contrast, the (positive) relationship of job scope to affective commitment to the occupation and customers was stronger at high levels of leader-member exchange. We discuss the implications of these findings.
Marchand, C. and Vandenberghe, C. (2014) 'Can Perceived Organizational Support Act as a Social Resource? An Analysis from the Perspective of Conservation of Resources Theory', Psychologie du travail et des organisations, pp. 63-90. Available at: http://revue-pto.com/articles%20pdf/Mars%202014/2010.pdf#page=65.

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This paper reports an empirical study in which perceived organizational support is considered as a social resource in a stress model conceived within the perspective of Conservation of Resources theory. A study conducted among 181 employees and their supervisors reveals that role stressors impact work outcomes through perceptions of anticipated or actual resource loss and lack of resource gains. Moreover, perceived organizational support exerts a moderating effect in the relationships between resource loss and lack of resource gains and emotional exhaustion, affective commitment, and job performance. We discuss the implications of these findings for our understanding of the psychological mechanisms associated with perceived organizational support.
Marchand, C. and Vandenberghe, C. (2013) 'Organizational Commitment, Coping, and Affect in Organizational Context: Test of an Integrative Model', Psychologie du travail et des organisations, pp. 293-293. Available at: http://revue-pto.com/articles%20pdf/Septembre%202013/1930.pdf#page=74.

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This study examines a model relating components of organizational commitment to positive and negative affect through the partial mediation of problem solving coping. The results of a study conducted among a sample of 647 employees from various organizations show that affective commitment relates positively to positive affect and negatively to negative affect, with the relation to positive affect being partially mediated by problem solving coping. Normative commitment was positively related to negative affect. Finally, continuance commitment based on few alternatives was negatively related to positive affect and positively related to negative affect, with the relation to positive affect being partially mediated by a weaker problem solving coping. Continuance commitment based on perceived sacrifice had no effects.
Monographs
Peckham, S., Catherine, M. and Peckham, A. (2016) General practitioner recruitment and retention: An evidence synthesis. Policy Research Unit in Commissioning and the Healthcare System. Available at: http://blogs.lshtm.ac.uk/prucomm/files/2016/11/PRUComm-General-practitioner-recruitment-and-retention-review-Final-Report.pdf.

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Conference or workshop items
Stevens, A., Hendrie, N., Marchand, C., Vass, R., Newbury-Birch, D., Billings, J. and Coulton, S. (2022) 'How does risk prevention (not) work? Learning from the realist, pragmatic, cluster-randomised trial of the RISKIT-CJS Programme (with a null result)', in. Lisbon Addictions Conference: European Conference on Addictive Behaviours and Dependencies. Available at: https://www.lisbonaddictions.eu/lisbon-addictions-2022/.

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Background - RISKIT-CJS was a cluster randomised trial of a multi-component risk reduction programme for adolescents (aged 13-17), involved with the criminal justice system in England. Its main quantitative finding was acceptance of the null hypothesis of no effect on alcohol and substance use. Here we report on the realist, qualitative evaluation of the RISKIT-CJS programme to explore what can be learnt about how such programmes may not produce effects for their target group. Methods - the qualitative evaluation used: records of meetings and focus groups (purposive sample), practitioner interviews and observational fieldnotes of programme delivery. Data were abductively coded, using a realist framework to identify the configurations of context, mechanisms, moderators and outcomes through which the programme worked in practice. Results - This paper presents that refined realist programme theory. Relevant contexts included: geographical and institutional setting of the intervention sites (organising group work, staff ability, motivation and capacity), and the individual participant contexts (complex needs, maturity, motivation and risk profile). The intended mechanisms included: motivation to change; learning consequences; educational engagement; better communication; improved self-efficacy; and positive peer influence. The triggering of these mechanisms was affected by positive moderators (strong local programme champions, ageing out of crime for older participants) and negative moderators (disorganised, understaffed setting, and ageing into crime for younger participants). Potential negative mechanisms, included: negative peer effects and treatment fatigue. Different combinations of contexts, mechanisms and moderators led to different outcomes for different participants which are not adequately explained by an interpretation of the null quantitative result that the programme had 'no effect'. Conclusion - The paper demonstrates how realist, qualitative research can provide useful learning for policy and practice, even when the overall, quantitative result of a trial of a preventive intervention is null.
Hashem, F., Jaswal, S. K. and Marchand, C. (2020) 'Piloting the Health and Work Curriculum in Undergraduate Medical Education in England', in. EUMASS Congress 2021.

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Background: We report on a project commissioned by the UK Government's executive agency Public Health England (PHE) to develop and pilot a set of curriculum resources on health and work that were available to six medical schools in England. This project is underpinned by the 2018 Outcomes for Graduates developed by the UK's General Medical Council (or GMC), which sets the standards for medical schools in the UK. It includes an expectation that newly qualified doctors will be able describe the principles of holding a fitness for work conversation with patients…and how to make referrals to colleagues and other agencies. The aim of this project was to improve the health and work dialogue between doctors of the future and patients. The background to this work lies within the UK Government's national vision to reduce health-related worklessness and help individuals achieve their work and health potential, which it set out in its command paper Improving Lives: the Future of Work, Health and Disability. The purpose of the pilot was to answer the question, "Is it feasible to implement the teaching of health and work topics into the medical school curriculum?" Objectives The overarching aim of the project was to design and pilot an integrated curriculum for future doctors that addresses how to communicate with service users/patients about staying in and returning to work. Methods Qualitative and quantitative methods were employed involving telephone interviews with course tutors prior to and following the teaching pilot, student surveys and focus groups in each of the six medical schools who took part in the pilot. Results The results indicated: where aspects of the curriculum improved understanding of broaching health and work conversations; helped to recognise what factors facilitated further learning; what support and advice the tutors required to teach the materials, and where additional resources were needed to help deliver the teaching resources. Lastly, the results highlighted what some of the limitation were with introducing the health and work curriculum. Conclusions This pilot study showed it was possible to introduce a set of curriculum resources on health and work in English medical schools, with course tutors welcoming the opportunity of using a range of teaching materials aimed at undergraduate medical education.
Hashem, F., Jaswal, S. K. and Marchand, C. (2019) 'Health and Work in Undergraduate Medical Education', in. Royal College of General Practitioners (RCGP) Annual Conference & Exhibition.

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Aims/Objectives/Background: We will present on a project commissioned by Public Health England (PHE) to develop a set of online curriculum resources on health and work that will be universally available to all UK medical schools. The aim of the project is to improve the health and work dialogue between doctors of the future and patients. Content of Presentation: The presentation will outline the process of co-producing curriculum resources via partnership between healthcare professionals, patient and public involvement representatives, academics and national government organisations. We will then set out the planned approach for piloting the new resources at medical schools in England to take place in autumn 2019. Relevance/Impact: The resources will help new doctors use the fit note as a practical advice system as well as a process for sickness certification. The background to this work lies within the Government's national vision to reduce health-related worklessness and help individuals achieve their work and health potential, which it set out in its command paper Improving Lives: the Future of Work, Health and Disability. Outcomes: The set of learning resources and teaching aids is intended to provide knowledge, tools and techniques to improve future doctors' confidence to start conversations with patients around health and work and the 'fit note'. Discussion: The presentation will focus on the contribution both patients and medical undergraduates representatives have provided, which has increased both the quality and rigour of the resources. The barriers and enablers encountered in piloting the resources in medical schools will also be discussed.
Jaswal, S. K., Hashem, F. and Marchand, C. (2019) 'A scoping review to map curriculum resources on health and work in undergraduate medical education in the United Kingdom (UK)', in. European Forum for Primary Care.

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Purpose: This is part of a larger study looking at improving the health and work (HW) dialogue between future doctors and patients by designing an integrated curriculum addressing communication with service users about staying in/returning to work. Before developing resources on HW, it is important to understand existing undergraduate programmes. It was through this mapping exercise of medical schools that gaps in medical education were noted. Theory: A six-step approach to curriculum development developed by physician educators helped support the theoretical framework employed. Methods: A scoping review was undertaken to identify where HW could be integrated within core teaching topics in undergraduate medical education. This information was compiled into a database, which consisted of collating online information on the 41 UK medical schools' curriculum. Findings: This exercise illustrated how teaching topics, resources and models of delivery varied across medical schools. The review identified three types of curriculum styles, with schools having a biopsychosocial, biomedical or an intermediary approach to medical education. Discussion: The disparate nature of such curriculum demonstrates how the introduction of new training/education within this realm must complement the existing design.
Hashem, F., Marchand, C. and Jaswal, S. K. (2019) 'Developing Undergraduate Curriculum Resources on Health and Work in Medical Education', in. Good Work is Good for You - Promoting Work as Health Outcome.

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To design an integrated curriculum for future doctors that addresses how to communicate with service users/patients about staying and returning to work.
Gadsby, E. W., Eida, T., Marchand, C., Hendrie, N., Vass, R. and Nizalova, O. (2018) 'Working differently for improved primary care for young people in a difficult financial climate', in.

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Purpose: To think collectively and creatively about working in different ways in order to improve our response to multiple overlapping issues that lead directly and indirectly to poor health and wellbeing in young people. Context: Difficult economic conditions for many people in Europe have been created by government measures to reduce public expenditure. Large cuts to social security, a lack of earnings growth, minimal or no job security, and high housing and living costs are leading to people becoming locked in a cycle of poverty and neglect in an era of rising inequality. In efforts to survive in a time of austerity, many local councils in the UK have made cuts to children and young people's services that have taken away some of the 'lifeline' support for vulnerable children and families, as well as some of the educational and recreational opportunities for young people. Prevention services such as preventive substance misuse, teenage pregnancy services and youth offending teams have also been reduced in many areas. This summer, analysis of the Millennium Cohort Study – a multi-disciplinary research project following the lives of around 19,000 children born in the UK in 2000-01 – found that a quarter of girls and 9% of boys were depressed at age 14. A recent Children's Society survey of 11,000 14 year olds found that 22% of girls and nearly one in 10 boys had self-harmed in a year. GPs in the UK often talk about their feeling of helplessness when faced with increasing numbers of patients presenting with poor health and wellbeing caused by adverse life circumstances. Many of these issues are not medical, but they fill up the country's surgeries nonetheless. Some GPs have coined a phrase to describe the condition of these patients: 'shit-life syndrome'. It describes a situation where someone has so many things not working out for them that even an attempt to change one thing is often wiped out by the remaining factors causing them harm. Some areas with large numbers of patients in such situations have seen anti-depressant prescribing increase significantly. State of the art: In this workshop, we will briefly introduce the problem, with the help of a short video focused on a seaside town in England, and encourage participants to think about the nature of the situation. We will then describe three very different projects that CHSS are currently working on, and identify relevant learning and key challenges emerging from them. The group will then have time to think collectively about working in different ways in order to contribute to a better future for young people. There will be opportunities for small and whole group discussion and feedback, and questions to the CHSS team.
Hendrie, N., Vass, R. and Marchand, C. (2018) 'Alcohol use: How risky is risky?', in.

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Alcohol is something that most adults use in their social life and can turn the quietest person into a party animal. Often drinking is a low risk pastime but for some it can be problematic. However, alcohol and risk management is experienced differently by young people. Today's interactive talk introduces you to RISKIT-CJS, a research project evaluating the effectiveness of an intervention that aims to equip young people involved with the criminal justice system with the skills to manage their substance use and to reduce risky behaviours. Using our tools, you will decide how risky is risky?
Gadsby, E. W., Eida, T. J., Marchand, C., Hendrie, N., Vass, R. and Nizalova, O. (2018) 'Working differently for improved primary care for young people in a difficult financial climate', in. European Forum for Primary Care 2018.

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In an environment of growing relative poverty, rising inequalities, high housing and living costs, increases in in-work poverty and cuts to social security, education, training and young people's services, GPs in the UK are often faced with patients who present with 'low mood' caused by adverse life circumstances. Many GPs have dubbed this 'Shit-Life Syndrome'. This presentation considers the potential of three different projects being delivered or evaluated by the Centre for Health Service Studies to build understanding of the complex and dynamic ways in which these issues are interconnected. These projects include: 'RISKIT' – a 'multi-component' approach to addressing alcohol and substance use and risk-taking behaviour among young offenders; 'Go Golborne' – a 'place-based' approach to improving child health by reducing child obesity; and 'EXCEPT' – policy initiatives to help young people in Europe to overcome labour market insecurities and related risks. Together they present opportunities to reject reductionism in our approaches to dealing with complexity.
Hendrie, N., Marchand, C. and McGheechan, G. (2017) 'Facilitators and Barriers to Early Recruitment: Observations from the RISKIT-CJS Pragmatic Randomised Control Trial', in.

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Pragmatic randomised control trials are recognised as high quality evaluative research of interventions in real-life settings. They are also recognised as complex, costly, and the recruitment process is often challenging. However, the findings and outcomes of such research can have important implications for the study population. Facilitators and barriers to recruitment can be experienced across the various trial stages, recruitment processes and within the relational networks required for multi stakeholder collaboration. The facilitators and barriers affecting recruitment can impact the trial, the site, the participant, the clinical team, flow of information, consent, and the research team. Working collaboratively with multiple stakeholders across multiple sites provides the potential for a wealth of recruitment opportunities. Relational networking provides a realistic view of the study population in context as well as an insight into stakeholders own challenges and demands when facilitating trial recruitment. When adding into the mix the trial requirements i.e. rigorous methods, ethics, respect of the research protocol and stringent data management and collection processes required for the trial, it is understandable that barriers will inevitably arise during the early recruitment process. We will illustrate how facilitators and barriers have impacted upon the early stages of the recruitment of young people in the criminal justice system using recent examples from RISKIT-CJS. We will present early recommendations based on our experience that fluidity and flexibility reduces barriers and encourages facilitating strategies
Marchand, C. and Vandenberghe, C. (2015) 'Perceived Organizational Support, Emotional Exhaustion and Turnover: Moderating Role of Negative Affectivity', in. Conference of the European Association of Work and Organizational Psychology (EAWOP 2015). Available at: http://eaw.pg2.at/abstracts/a1305.html?zoom_highlight=Perceived+Organizational+Support.

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The overall consensus in the literature is that perceived organizational support (POS) has positive effects on job attitudes and behaviours. However, it is plausible that under certain circumstances POS will lead to negative outcomes. Building on Conservation of Resources Theory and conceptualizing POS as a social resource, this study explores the possibility that POS leads to increased turnover through stronger emotional exhaustion when employees have high levels of negative affectivity (i.e., a dispositional variable reflecting low personal resources).
Zargar, M. S., Vandenberghe, C. and Marchand, C. (2013) 'Job Scope, Commitment, and Turnover: The Role of Motivational Traits.', in. Society for Industrial and Organizational Psychology (SIOP).

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Marchand, C., Zargar, M. S. and Vandenberghe, C. (2012) 'Task Significance and Variety, Affective Commitment, and Turnover: The Moderating Role of Goal Orientation', in. Conference of the Administrative Sciences Association of Canada (ASAC). Available at: http://www.busi.mun.ca/asac2012/ASAC2012_program.pdf.

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Showing 25 of 26 total publications in KAR. [See all in KAR]
Information obtained from the Kent Academic Repository. The University of Kent official repository of academic activity.
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Last Updated: 10/05/2019