Public Health Research最新文献

{"title":"Brief alcohol intervention for risky drinking in young people aged 14–15 years in secondary schools: the SIPS JR-HIGH RCT","authors":"E. Giles, G. McGeechan, S. Coulton, P. Deluca, C. Drummond, D. Howel, E. Kaner, E. McColl, R. McGovern, S. Scott, E. Stamp, H. Sumnall, L. Todd, L. Vale, V. Albani, S. Boniface, Jennifer Ferguson, E. Gilvarry, N. Hendrie, N. Howe, H. Mossop, A. Ramsay, G. Stanley, D. Newbury-Birch","doi":"10.3310/PHR07090","DOIUrl":"https://doi.org/10.3310/PHR07090","url":null,"abstract":"\u0000 \u0000 Adverse effects from young people’s alcohol consumption manifest in a range of physical and psychosocial factors, including neurological issues, cognitive impairment and risk-taking behaviours. The SIPS JR-HIGH pilot trial showed alcohol screening and brief intervention (ASBI) to be acceptable to young people and schools in the north-east of England.\u0000 \u0000 \u0000 \u0000 To conduct a two-arm, individually randomised controlled trial to evaluate the effectiveness and cost-effectiveness of ASBI for risky drinking in young people aged 14–15 years in the school setting, to monitor the fidelity of ASBI and to explore the barriers to, and facilitators of, implementation with staff, young people and parents.\u0000 \u0000 \u0000 \u0000 A baseline survey with a 12-month follow-up. Interviews with 30 school staff, 21 learning mentors and nine teachers, and 33 young people and two parents.\u0000 \u0000 \u0000 \u0000 Thirty state schools in four areas of England: north-east, north-west, Kent and London.\u0000 \u0000 \u0000 \u0000 Year 10 school pupils who consented to the study (aged 14–15 years, recruited between November 2015 and June 2016), school-based staff and parents of the young people who took part in the study.\u0000 \u0000 \u0000 \u0000 Young people who screened positively on a single alcohol screening question and consented were randomised to the intervention or control arm (blinded). The intervention was a 30-minute one-to-one structured brief intervention with a trained learning mentor and an alcohol leaflet. The control group received a healthy lifestyle leaflet (no alcohol information).\u0000 \u0000 \u0000 \u0000 The primary outcome measure was total alcohol consumed in the last 28 days. Secondary outcomes related to risky drinking, general psychological health, sexual risk-taking, energy drink consumption, age of first smoking, quality of life, quality-adjusted life-years, service utilisation and demographic information.\u0000 \u0000 \u0000 \u0000 A total of 4523 young people completed the baseline survey, with 1064 screening positively (24%) and 443 being eligible to take part in the trial. Of those 443, 233 (53%) were randomised to the control arm and 210 were randomised to the intervention arm. Of the 443, 374 (84%) were successfully followed up at 12 months (intervention, n = 178; control, n = 196). The results were that the intervention showed no evidence of benefit for any alcohol-related measure when compared with the control arm. At 12 months we found a reduction from 61.9% to 43.3% using the Alcohol Use Disorders Identification Test cut-off point of 8 and cut-off point of 4 (69.0% to 60.7%). These results were not significant. A cost-effectiveness analysis showed that the average net cost saving of the brief intervention was £2865 (95% confidence interval –£11,272 to £2707) per year compared with usual practice, with the intervention showing a 76% probability of being cost saving compared with usual practice. The interview findings showed that school was an acceptable setting to carry out ASBI among staff and young people.\u0000 \u0000 \u0000 \u0000 Recruitment of parents to take","PeriodicalId":32306,"journal":{"name":"Public Health Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49309101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A brief behavioural intervention to promote regular self-weighing to prevent weight regain after weight loss: a RCT","authors":"A. Daley, K. Jolly, C. Madigan, Ryan Griffin, A. Roalfe, Amanda Lewis, A. Nickless, P. Aveyard","doi":"10.3310/PHR07070","DOIUrl":"https://doi.org/10.3310/PHR07070","url":null,"abstract":"Although behavioural weight loss treatments can be effective, long-term maintenance of this weight loss remains a critical challenge because the vast majority of people will regain their lost weight over time. The period after initial weight loss is the time when people are at the highest risk of weight regain.The primary aim of this study was to evaluate the effectiveness and cost-effectiveness of a brief behavioural intervention delivered by non-specialist call centre staff to promote regular self-weighing to prevent weight regain after intentional weight loss.Randomised controlled trial.West Midlands, UK.Adults were recruited if they had attended a local authority-funded weight management programme and had lost ≥ 5% of their starting weight by the end of their weight loss programme.The intervention group received three brief support telephone calls, delivered by non-specialist call centre staff (from a third-sector community organisation), that encouraged setting a weight maintenance target of ≤ 1 kg of weight gain from current weight, which was to be assessed by daily self-weighing and recording weight on a record card, together with regular text messages. Participants were asked to return to their weight loss plan if they gained > 1 kg above their target weight. The usual-care group received a standard weight maintenance leaflet, the infographic EatWell Plate and a list of useful websites pertaining to weight management.The primary outcome was the difference between the groups in mean weight change (kg) from baseline to 12 months. The secondary outcomes included the proportion of participants in each group who had regained < 1 kg in weight at the 3- and 12-month follow-up points.A total of 813 potential participants were screened, 583 of whom were eligible and randomised (usual care,n = 292; intervention,n = 291). A total of 94% and 89% of participants completed follow-up at 3 and 12 months, respectively. At 12 months, the mean unadjusted weight change was +0.39 kg for the intervention group and –0.17 kg for the usual-care group, an adjusted difference of 0.53 kg [95% confidence interval (CI) –0.64 to 1.71 kg]. At 12 months, 134 (45.9%) and 130 (44.7%) participants regained ≤ 1 kg of their baseline weight in the usual-care and intervention groups, respectively (odds ratio 0.96, 95% CI 0.69 to 1.33). As the intervention was ineffective, we did not pursue a cost-effectiveness analysis.Brief behavioural telephone support delivered by non-specialist workers to promote target-setting and daily self-weighing and recording of weight does not prevent weight regain after intentional weight loss. Specifically, as target-setting and daily self-weighing did not increase conscious cognitive restraint, people may need more intensive interventions to promote the use of behavioural techniques that help people maintain lost weight.Current Controlled Trials ISRCTN52341938.This project was funded by the National Institute for Health Research (NIHR) Public Heal","PeriodicalId":32306,"journal":{"name":"Public Health Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48867755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mass media to communicate public health messages in six health topic areas: a systematic review and other reviews of the evidence","authors":"M. Stead, K. Angus, T. Langley, S. Katikireddi, K. Hinds, S. Hilton, S. Lewis, James Thomas, M. Campbell, B. Young, L. Bauld","doi":"10.3310/PHR07080","DOIUrl":"https://doi.org/10.3310/PHR07080","url":null,"abstract":"Mass media campaigns can be used to communicate public health messages at the population level. Although previous research has shown that they can influence health behaviours in some contexts, there have been few attempts to synthesise evidence across multiple health behaviours.To (1) review evidence on the effective use of mass media in six health topic areas (alcohol, diet, illicit drugs, physical activity, sexual and reproductive health and tobacco), (2) examine whether or not effectiveness varies with different target populations, (3) identify characteristics of mass media campaigns associated with effectiveness and (4) identify key research gaps.The study comprised (1) a systematic review of reviews, (2) a review of primary studies examining alcohol mass media campaigns, (3) a review of cost-effectiveness evidence and (4) a review of recent primary studies of mass media campaigns conducted in the UK. A logic model was developed to inform the reviews. Public engagement activities were conducted with policy, practitioner and academic stakeholders and with young people.The amount and strength of evidence varies across the six topics, and there was little evidence regarding diet campaigns. There was moderate evidence that mass media campaigns can reduce sedentary behaviour and influence sexual health-related behaviours and treatment-seeking behaviours (e.g. use of smoking quitlines and sexual health services). The impact on tobacco use and physical activity was mixed, there was limited evidence of impact on alcohol use and there was no impact on illicit drug behaviours. Mass media campaigns were found to increase knowledge and awareness across several topics, and to influence intentions regarding physical activity and smoking. Tobacco and illicit drug campaigns appeared to be more effective for young people and children but there was no or inconsistent evidence regarding effectiveness by sex, ethnicity or socioeconomic status. There was moderate evidence that tobacco mass media campaigns are cost-effective, but there was weak or limited evidence in other topic areas. Although there was limited evidence on characteristics associated with effectiveness, longer or greater intensity campaigns were found to be more effective, and messages were important, with positive and negative messages and social norms messages affecting smoking behaviour. The evidence suggested that targeting messages to target audiences can be effective. There was little evidence regarding the role that theory or media channels may play in campaign effectiveness, and also limited evidence on new media.Statistical synthesis was not possible owing to considerable heterogeneity across reviews and studies. The focus on review-level evidence limited our ability to examine intervention characteristics in detail.Overall, the evidence is mixed but suggests that (1) campaigns can reduce sedentary behaviour, improve sexual health and contribute to smoking cessation, (2) tobacco control c","PeriodicalId":32306,"journal":{"name":"Public Health Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47507487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A workplace-based intervention to increase levels of daily physical activity: the Travel to Work cluster RCT","authors":"S. Audrey, H. Fisher, A. Cooper, D. Gaunt, C. Metcalfe, K. Garfield, W. Hollingworth, S. Procter, Marie Gabe-Walters, S. Rodgers, F. Gillison, A. Davis, P. Insall","doi":"10.3310/PHR07110","DOIUrl":"https://doi.org/10.3310/PHR07110","url":null,"abstract":"There may be opportunities for working adults to accumulate recommended physical activity levels (≥ 150 minutes of moderate-intensity physical activity in bouts of ≥ 10 minutes throughout the week) during the commute to work. Systematic reviews of interventions to increase active transport indicate that studies are predominantly of poor quality, rely on self-report and lack robust statistical analyses.\u0000 \u0000 \u0000 \u0000 To assess the effectiveness, cost and consequences of a behavioural intervention to increase walking during the commute to work.\u0000 \u0000 \u0000 \u0000 A multicentre, parallel-arm, cluster randomised controlled trial incorporating economic and process evaluations. Physical activity outcomes were measured using accelerometers and GPS (Global Positioning System) receivers at baseline and the 12-month follow-up.\u0000 \u0000 \u0000 \u0000 Workplaces in seven urban areas in south-west England and south Wales.\u0000 \u0000 \u0000 \u0000 Employees (n = 654) in 87 workplaces.\u0000 \u0000 \u0000 \u0000 Workplace-based Walk to Work promoters were trained to implement a 10-week intervention incorporating key behaviour change techniques.\u0000 \u0000 \u0000 \u0000 The primary outcome was the daily number of minutes of moderate to vigorous physical activity (MVPA). Secondary outcomes included MVPA during the commute, overall levels of physical activity and modal shift (from private car to walking). Cost–consequences analysis included employer, employee and health service costs and consequences. Process outcomes included barriers to, and facilitators of, walking during the daily commute.\u0000 \u0000 \u0000 \u0000 There was no evidence of an intervention effect on MVPA at the 12-month follow-up [adjusted difference in means 0.3 minutes, 95% confidence interval (CI) –5.3 to 5.9 minutes]. The intervention cost was on average, £181.97 per workplace and £24.19 per participating employee. In comparison with car users [mean 7.3 minutes, standard deviation (SD) 7.6 minutes], walkers (mean 34.3 minutes, SD 18.6 minutes) and public transport users (mean 25.7 minutes, SD 14.0 minutes) accrued substantially higher levels of daily MVPA during the commute. Participants who walked for ≥ 10 minutes during their commute were more likely to have a shorter commute distance (p < 0.001). No access to a car (p < 0.001) and absence of free workplace car parking (p < 0.01) were independently related to walking to work and using public transport. Higher quality-of-life scores were observed for the intervention group in a repeated-measures analysis (mean 0.018, 95% CI 0.000 to 0.036; scores anchored at 0 indicated ‘no capability’ and scores anchored at 1 indicated ‘full capability’).\u0000 \u0000 \u0000 \u0000 Although this research showed that walking to work and using public transport are important contributors to physical activity levels in a working population, the behavioural intervention was insufficient to change travel behaviour. Broader contextual factors, such as length of journey, commuting options and availability of car parking, may influence the effectiveness of behavioural interventions to change","PeriodicalId":32306,"journal":{"name":"Public Health Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69498526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A school-based intervention (‘Girls Active’) to increase physical activity levels among 11- to 14-year-old girls: cluster RCT","authors":"D. Harrington, M. Davies, D. Bodicoat, J. Charles, Y. Chudasama, T. Gorely, K. Khunti, A. Rowlands, L. Sherar, R. Tudor-Edwards, T. Yates, C. Edwardson","doi":"10.3310/PHR07050","DOIUrl":"https://doi.org/10.3310/PHR07050","url":null,"abstract":"Physical activity (PA) levels among adolescent girls in the UK are low. ‘Girls Active’, developed by the Youth Sport Trust (YST), has been designed to increase girls’ PA levels.To understand the effectiveness and cost-effectiveness of the Girls Active programme.A two-arm cluster randomised controlled trial.State secondary schools in the Midlands, UK.Girls aged between 11 and 14 years.Girls Active involves teachers reviewing PA, sport and physical education provision, culture and practices in their school; attending training; creating action plans; and effectively working with girls as peer leaders to influence decision-making and to promote PA to their peers. Support from a hub school and the YST is offered.The change in objectively measured moderate to vigorous intensity PA (MVPA) levels at 14 months. Secondary outcomes included changes in overall PA level (mean acceleration), light PA levels, sedentary time, body composition and psychosocial outcomes. Cost-effectiveness and process evaluation (qualitative and quantitative) data were collected.Twenty schools and 1752 pupils were recruited; 1211 participants provided complete primary outcome data at 14 months. No difference was found in mean MVPA level between groups at 14 months [1.7 minutes/day, 95% confidence interval (CI) –0.8 to 4.3 minutes/day], but there was a small difference in mean MVPA level at 7 months (2.4 minutes/day, 95% CI 0.1 to 4.7 minutes/day). Significant differences between groups were found at 7 months, but not at 14 months, in some of the objective secondary outcomes: overall PA level represented by average acceleration (1.39 mg, 95% CI 0.1 to 2.2 mg), after-school sedentary time (–4.7 minutes/day, 95% CI –8.9 to –0.6 minutes/day), overall light PA level (5.7 minutes/day, 95% CI 1.0 to 10.5 minutes/day) and light PA level on school days (4.5 minutes/day, 95% CI 0.25 to 8.75 minutes/day). Minor, yet statistically significant, differences in psychosocial measures at 7 months were found in favour of control schools. Significant differences in self-esteem and identified motivation in favour of intervention schools were found at 7 and 14 months, respectively. Subgroup analyses showed a significant effect of the intervention for those schools with higher numbers of pupils at 14 months. Girls Active was well received by teachers, and they reported that implemented strategies and activities were having a positive impact in schools. Barriers to implementation progress included lack of time, competing priorities and the programme flexibility. Implementation costs ranged from £2054 (£23/pupil) to £8545 (£95/pupil) per school. No differences were found between groups for health-related quality-of-life scores or frequencies, or for costs associated with general practitioner, school nurse and school counsellor use.Girls Active may not have had an effect on the random 90 girls per school included in the evaluation. Although we included a diverse sample of schools, the results may not be g","PeriodicalId":32306,"journal":{"name":"Public Health Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49155681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visually Impaired OLder people’s Exercise programme for falls prevenTion (VIOLET): a feasibility study","authors":"N. Adams, D. Skelton, C. Bailey, D. Howel, Dorothy Coe, Rosy Lampitt, J. Wilkinson, T. Fouweather, L. D. de Jong, S. Gawler, V. Deary, J. Gray, H. Waterman, S. Parry","doi":"10.3310/phr07040","DOIUrl":"https://doi.org/10.3310/phr07040","url":null,"abstract":"\u0000 \u0000 The visually impaired have a higher risk of falling and are likely to avoid activity.\u0000 \u0000 \u0000 \u0000 To adapt the existing Falls Management Exercise (FaME) programme, which is delivered in the community, for visually impaired older people (VIOP) and to investigate the feasibility of conducting a definitive randomised controlled trial of this adapted intervention.\u0000 \u0000 \u0000 \u0000 Phase I – consultation with stakeholders to adapt the existing programme. Two focus groups were conducted, each with 10 VIOP across the study sites. Phase II – two-centre randomised pilot trial and economic evaluation of the adapted programme for VIOP versus usual care. Phases III and IV – qualitative interviews with VIOP and Postural Stability Instructors regarding their views and experiences of the research process, undertaking the intervention and its acceptability.\u0000 \u0000 \u0000 \u0000 This was adapted from the group-based FaME programme. A 1-hour exercise programme ran weekly over 12 weeks at the study sites (Newcastle upon Tyne and Glasgow) and was delivered by third-sector organisations. Participants were advised to also exercise at home for 2 hours per week. Those randomised to the usual activities group received no intervention.\u0000 \u0000 \u0000 \u0000 These were completed at baseline, week 12 and week 24. The primary potential outcome measure used was the Short Form Falls Efficacy Scale – International. Secondary outcome assessment measures were activity avoidance, current activity, balance/falls risk, physical activity, loneliness, anxiety and depression, work and social adjustment, quality of life and economic costs. Participants’ compliance was assessed by reviewing attendance records and self-reported compliance with the home exercises. Instructors’ compliance with the course content (fidelity) was assessed by a researcher attending a sample of exercise sessions. Adverse events were collected in a weekly telephone call for all participants in both the intervention and control arm.\u0000 \u0000 \u0000 \u0000 An adapted exercise programme was devised with stakeholders. In the pilot trial, 82 participants drawn from community-living VIOP were screened, 68 met the inclusion criteria and 64 were randomised, with 33 allocated to the intervention and 31 to the usual activities arm. A total of 94% of participants provided data at week 12 and 92% at week 24. Adherence to the study was high. The intervention was found to be both safe and acceptable to participants, with 76% attending nine or more classes. Median time for home exercise was 50 minutes per week. There was little or no evidence that fear of falling, exercise, attitudinal or quality-of-life outcomes differed between trial arms at follow-up. Thematic analysis of the interviews with VIOP participants identified facilitators of and barriers to exercise, including perceived relevance to health, well-being and lifestyle, social interaction, self-perception and practical assistance. Instructors identified issues regarding level of challenge and assistance from a second perso","PeriodicalId":32306,"journal":{"name":"Public Health Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44292283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Contributing to Seoul Citizens’ Perception of Environmental Health Risks and Policy Needs","authors":"Mijung Jang, Jeonghoon Kim, Eun Ju Lee, KyooSang Kim","doi":"10.22900/KPHR.2019.45.3.001","DOIUrl":"https://doi.org/10.22900/KPHR.2019.45.3.001","url":null,"abstract":"","PeriodicalId":32306,"journal":{"name":"Public Health Research","volume":"92 1","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68344657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Empowerment Education on Vietnam Lao-Cai Village Health Worker","authors":"Lee, Kyeong-Soo, Choi, Eunhee, Young Hwan Lee, Hwang Tae Yoon, Youngchul Jeon, L. Ran, S. Kim, Young-suk Lee, Minji Kang","doi":"10.22900/KPHR.2019.45.4.001","DOIUrl":"https://doi.org/10.22900/KPHR.2019.45.4.001","url":null,"abstract":"","PeriodicalId":32306,"journal":{"name":"Public Health Research","volume":"45 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68344761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of a Social Prescribing Program on the Depressive Status of Elderly People in a Rural Area of Gangwon-do","authors":"Geurum Song, Hye-yeon Jo, E. Nam","doi":"10.22900/KPHR.2019.45.4.008","DOIUrl":"https://doi.org/10.22900/KPHR.2019.45.4.008","url":null,"abstract":"","PeriodicalId":32306,"journal":{"name":"Public Health Research","volume":"45 1","pages":"77-87"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68344770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomised controlled trial with economic and process evaluations of domiciliary welfare rights advice for socioeconomically disadvantaged older people recruited via primary health care (the Do-Well study)","authors":"C. Haighton, S. Moffatt, D. Howel, M. Steer, F. Becker, A. Bryant, S. Lawson, E. McColl, L. Vale, E. Milne, T. Aspray, M. White","doi":"10.3310/PHR07030","DOIUrl":"https://doi.org/10.3310/PHR07030","url":null,"abstract":"Welfare rights advice services are effective at maximising previously unclaimed welfare benefits, but their impact on health has not been evaluated.To establish the acceptability, cost-effectiveness and effect on health of a domiciliary welfare rights advice service targeting older people, compared with usual practice.A pragmatic, individually randomised, parallel-group, single-blinded, wait-list controlled trial, with economic and process evaluations. Data were collected by interview at baseline and 24 months, and by self-completion questionnaire at 12 months. Qualitative interviews were undertaken with purposive samples of 50 trial participants and 17 professionals to explore the intervention’s acceptability and its perceived impacts.Participants’ homes in North East England, UK.A total of 755 volunteers aged ≥ 60 years, living in their own homes, fluent in English and not terminally ill, recruited from the registers of 17 general practices with an Index of Multiple Deprivation within the most deprived two-fifths of the distribution for England, and with no previous access to welfare rights advice services.Welfare rights advice, comprising face-to-face consultations, active assistance with benefit claims and follow-up as required until no longer needed, delivered in participants’ own homes by a qualified welfare rights advisor. Control group participants received usual care until the 24-month follow-up, after which they received the intervention.The primary outcome was health-related quality of life (HRQoL), assessed using the CASP-19 (Control, Autonomy, Self-realisation and Pleasure) score. The secondary outcomes included general health status, health behaviours, independence and hours per week of care, mortality and changes in financial status.A total of 755 out of 3912 (19%) general practice patients agreed to participate and were randomised (intervention,n = 381; control,n = 374). In the intervention group, 335 participants (88%) received the intervention. A total of 605 (80%) participants completed the 12-month follow-up and 562 (75%) completed the 24-month follow-up. Only 84 (22%) intervention group participants were awarded additional benefits. There was no significant difference in CASP-19 score between the intervention and control groups at 24 months [adjusted mean difference 0.3, 95% confidence interval (CI) –0.8 to 1.5], but a significant increase in hours of home care per week in the intervention group (adjusted difference 26.3 hours/week, 95% CI 0.8 to 56.1 hours/week). Exploratory analyses found a weak positive correlation between CASP-19 score and the amount of time since receipt of the benefit (0.39, 95% CI 0.16 to 0.58). The qualitative data suggest that the intervention was acceptable and that receipt of additional benefits was perceived by participants and professionals as having had a positive impact on health and quality of life. The mean cost was £44 per participant, the incremental mean health gain was 0.009 quality-adjus","PeriodicalId":32306,"journal":{"name":"Public Health Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45281851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}