Public health research (Southampton, England)最新文献

{"title":"Learning together for mental health: feasibility of measures to assess a whole-school mental health and wellbeing intervention in secondary schools.","authors":"Oliver Lloyd-Houldey, Joanna Sturgess, Neisha Sundaram, Steven Hope, Semina Michalopoulou, Elizabeth Allen, Lee Hudson, Stephen Scott, Dasha Nicholls, Deborah Christie, Rosa Legood, Chris Bonell, Russell Viner","doi":"10.3310/GFDT2323","DOIUrl":"https://doi.org/10.3310/GFDT2323","url":null,"abstract":"<p><strong>Background: </strong>Population mental health in young people worsened during and since the COVID-19 pandemic. School environments can play a key role in improving young people's mental health. Learning Together for Mental Health is a whole-school intervention aiming to promote mental health and well-being among young people in secondary schools. Before progressing to a Phase III effectiveness evaluation of the intervention, it is critical to assess the feasibility of trial measures at baseline and follow-up.</p><p><strong>Objective: </strong>To evaluate the feasibility of trial measures and procedures within a feasibility study of a whole-school intervention aiming to promote mental health and well-being among young people in secondary schools, including whether we met our progression criterion of survey response rates of 60% or more in two or more schools at baseline and follow-up.</p><p><strong>Design and methods: </strong>We conducted a feasibility study which included assessment of the indicative primary and secondary outcomes measures and procedures to be used in a future Phase III trial.</p><p><strong>Setting and participants: </strong>Setting for our feasibility study included five state, mixed-sex secondary schools in southern England (one of which dropped out after baselines and one of which replaced this). We recruited year-7 students to participate in the baseline survey and year-10 students to participate in the follow-up survey at 12-month follow-up. Baseline and follow-up participants were different groups, as the focus was assessing feasibility of measures for the age groups that would be surveyed at baseline and follow-up in a Phase III randomised controlled trial. Our study was not powered or designed to estimate intervention effects.</p><p><strong>Interventions: </strong>As part of our feasibility study, all schools received the Learning Together for Mental Health intervention for one academic school year.</p><p><strong>Main outcome measures: </strong>The indicative primary outcome measure trialled was the total difficulties score of the Strengths and Difficulties Questionnaire. Indicative secondary outcomes measures trialled were the: Warwick-Edinburgh Mental Well-being Scale; Short Moods and Feelings Questionnaire; Generalised Anxiety Disorder-7 scale; Eating Disorders Examination - Questionnaire Short, self-harm (single item from the Health Behaviour in School-aged Children study); bullying victimisation (Gatehouse Bullying Scale); cyberbullying (two items adapted from the Dose Adjustment for Normal Eating II questionnaire); substance use (National Health Service measure); and Beyond Blue School Climate Questionnaire.</p><p><strong>Results: </strong>Trial measures and procedures were feasible to implement and were acceptable to year-7 and year-10 students, teachers and parents. At baseline, response rates ranged from 58% to 91% between schools. Only two students were opted out by parents, and no students opted out","PeriodicalId":74615,"journal":{"name":"Public health research (Southampton, England)","volume":" ","pages":"1-18"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531546","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":"Feasibility study of Learning Together for Mental Health: fidelity, reach and acceptability of a whole-school intervention aiming to promote health and wellbeing in secondary schools.","authors":"Neisha Sundaram, Oliver Lloyd-Houldey, Joanna Sturgess, Elizabeth Allen, Semina Michalopoulou, Steven Hope, Rosa Legood, Stephen Scott, Lee D Hudson, Dasha Nicholls, Deborah Christie, Russell M Viner, Chris Bonell","doi":"10.3310/RTRT0202","DOIUrl":"10.3310/RTRT0202","url":null,"abstract":"<p><strong>Background: </strong>Despite high rates of adolescent mental health problems, there are few effective school-based interventions to address this. Whole-school interventions offer a feasible and sustainable means of promoting mental health, but to date, few have been evaluated. Previously we trialled the Learning Together intervention comprising local needs assessment, student and staff participation in decision-making, restorative practice, and a social and emotional skills curriculum. This was effective not only in preventing bullying (primary outcome) but also in promoting mental well-being and psychological functioning (secondary outcomes). We adapted Learning Together to develop Learning Together for Mental Health, focused on promoting mental health.</p><p><strong>Objective: </strong>This paper reports on quantitative data on intervention implementation fidelity, reach and acceptability to assess progression to a Phase III trial.</p><p><strong>Design: </strong>We drew on student baseline and follow-up surveys and an integral process evaluation from a non-randomised feasibility study involving four secondary schools.</p><p><strong>Setting: </strong>Southern England.</p><p><strong>Participants: </strong>Students in year 8 (age 12/13) at baseline and year 10 (age 14/15) at follow-up and school staff and students and intervention trainers and facilitators completing process evaluation tools.</p><p><strong>Interventions: </strong>Whole-school intervention featuring student needs assessment, action groups involving staff and students which selected actions from an evidence-based menu, restorative practice to improve relationships and address student behaviour and a social and emotional skills curriculum.</p><p><strong>Results: </strong>Restorative practice training was implemented with fidelity in all schools. Curriculum training was implemented with fidelity in three of four schools. The response rate to the needs survey across the three schools that participated was 79%. Action groups were implemented with fidelity. Action groups at all four schools completed at least one locally decided action and chose at least one action from the menu of evidence-based options. Restorative practice was implemented across all schools. Of lessons that were observed and lessons for which teachers returned logbooks, curriculum delivery was implemented with fidelity. However, two schools delivered 50% or less of the recommended lessons, and not all teachers completed logbooks. All students and staff completing surveys reported finding the Learning Together for Mental Health intervention a good way to promote student mental health. Over a third of students reported definite awareness of actions being undertaken by their schools to improve student mental health. All pre-defined progression criteria to proceed to a Phase III trial were met. The intervention was delivered with good fidelity and had strong acceptability.</p><p><strong>Limitations: </strong>Th","PeriodicalId":74615,"journal":{"name":"Public health research (Southampton, England)","volume":" ","pages":"1-36"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340769","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":"Evaluating the effectiveness of the Drink Less smartphone app for reducing alcohol consumption compared with usual digital care: a comprehensive synopsis from a 6-month follow-up RCT.","authors":"Claire Garnett, Melissa Oldham, Gemma Loebenberg, Larisa Dinu, Emma Beard, Colin Angus, Robyn Burton, Matt Field, Felix Greaves, Matthew Hickman, Eileen Kaner, Susan Michie, Marcus Munafò, Elena Pizzo, Jamie Brown","doi":"10.3310/LNNB8060","DOIUrl":"https://doi.org/10.3310/LNNB8060","url":null,"abstract":"<p><strong>Background: </strong>Digital interventions can be effective for reducing alcohol consumption. However, most digital interventions that have been evaluated are websites and there is little evidence on the effectiveness of smartphone apps, especially in a United Kingdom context. We developed an evidence- and theory-informed app, Drink Less, to help increasing-and-higher-risk drinkers (Alcohol Use Disorders Identification Test score ≥ 8) reduce their alcohol consumption.</p><p><strong>Objective: </strong>To evaluate the effectiveness of Drink Less for reducing alcohol consumption compared with usual digital care in the United Kingdom.</p><p><strong>Design: </strong>Two-arm, double-blind, parallel-group, randomised controlled trial with 1 : 1 group allocation and an embedded process evaluation, with 6-month follow-up.</p><p><strong>Setting: </strong>Remotely conducted among participants living in the United Kingdom, recruited from July 2020 to March 2022.</p><p><strong>Participants: </strong>Five thousand six hundred and two increasing-and-higher-risk drinkers aged 18+ who had access to an iPhone operating system device and wanted to drink less alcohol.</p><p><strong>Interventions: </strong>Participants were recommended to use the intervention (Drink Less) or recommended the comparator (National Health Service alcohol advice web page). Drink Less is an app-based intervention to help increasing-and-higher-risk drinkers reduce their alcohol consumption. It consists of evidence-based modules (e.g. goal setting, self-monitoring) and was systematically and transparently developed and refined. The National Health Service alcohol advice web page was considered usual digital care and provides tips on cutting down.</p><p><strong>Main outcome measures: </strong>The primary outcome was self-reported weekly alcohol consumption at 6-month follow-up (derived from the extended Alcohol Use Disorders Identification Test - Consumption), adjusted for baseline alcohol consumption.</p><p><strong>Results: </strong>The retention rate at 6-month follow-up was 80%. The data were not missing completely at random with differences detected in educational qualifications, occupation and income, indicating that multiple imputation was the most appropriate analytic approach. This found that Drink Less resulted in a 2.00 United Kingdom unit greater weekly reduction (95% confidence interval -3.76 to -0.24) at 6-month follow-up compared with the National Health Service alcohol advice web page. Compared with the National Health Service alcohol advice web page, Drink Less cost an additional £1.28 per user, when including the sunk costs (already incurred and cannot be recovered), but saved £0.04 per user when considering only the annual maintenance costs. Drink Less costs only an extra £0.64 per additional weekly unit of alcohol reduction, and may be cost saving if sufficient people use the app to cover the sunk costs. There was no statistically significant difference in quali","PeriodicalId":74615,"journal":{"name":"Public health research (Southampton, England)","volume":"13 5","pages":"1-26"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303910","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":"Evaluation of parenting interventions for those with additional health and social care needs during pregnancy: THRIVE a multi-arm RCT with embedded economic and process components.","authors":"Marion Henderson, Anja Wittkowski, Katie Buston, Karen Crawford, Alice MacLachlan, Alex McConnachie, Emma McIntosh, Claudia-Martina Messow, Catherine Nixon, Rosaleen O'Brien, Shona Shinwell, Daniel Wight, Yiqiao Xin, Rachel Calam, Ruth Dundas, James Law, Helen Minnis, Lucy Thompson, Philip Wilson","doi":"10.3310/KYMT5407","DOIUrl":"10.3310/KYMT5407","url":null,"abstract":"<p><strong>Background: </strong>Women who have additional social and care needs in pregnancy (e.g. social adversity, maternal depression and anxiety) are likely to produce high levels of stress hormones. This has the potential to affect fetal brain development, increase infant reactivity to stress, and impair sensitive mother-infant bonds from developing. These in turn may have long-term effects on children's health, social and educational outcomes. Parenting interventions show promising improvements to child outcomes; however, there is little evidence of their efficacy in the UK.</p><p><strong>Objective(s): </strong>THRIVE compared the impact of taking part in one of two antenatal parenting support programmes both incorporating cognitive-behavioural therapy (Enhanced Triple P for Baby or Mellow Bumps) with care-as-usual alone on the mental health and maternal attunement of vulnerable mothers-to-be, as well as the socioemotional and behavioural development of their children.</p><p><strong>Design: </strong>THRIVE is a three-arm randomised controlled trial. Pregnant women with additional social and care needs in pregnancies were invited to participate. Participants were randomly allocated to Enhanced Triple P for Baby, Mellow Bumps or care-as-usual.</p><p><strong>Setting: </strong>The study took place in National Health Service Greater Glasgow and Clyde and National Health Service Ayrshire and Arran health board areas. Intervention sessions were predominantly in community settings.</p><p><strong>Participants: </strong>Women identified as having additional social and care needs in pregnancies during pregnancy based on the National Health Service Greater Glasgow and Clyde's Special Needs in Pregnancy criteria were recruited to THRIVE (<i>n</i> = 485), slightly below the target of 500 women. Participants were block-randomised 5 : 5 : 2 to Enhanced Triple P for Baby, Mellow Bumps or care-as-usual. Subsequently their babies and accompanying person of choice were also invited.</p><p><strong>Interventions: </strong>Enhanced Triple P for Baby consists of four weekly group-based antenatal sessions followed by up to three postnatal home visits and one postnatal group session. It aims to provide babies with a healthy start to life by combining parenting skills training with strategies to enhance individual well-being and couple adjustment. Mellow Bumps in comparison, comprises of seven weekly antenatal sessions and one postnatal session. It aims to decrease maternal stress, increase understanding of neonates' capacity for social interaction, and emphasise the importance of early interaction for brain development and attachment. Recruitment to the trial took place between early 2014 and May 2018.</p><p><strong>Main outcome measures: </strong>Our two primary outcomes were the Hospital Anxiety and Depression Scale, plus outwardly directed irritability from the Adult Wellbeing Scale, and CARE Index mother-infant dyadic interaction synchrony.</p><p><strong>Results","PeriodicalId":74615,"journal":{"name":"Public health research (Southampton, England)","volume":"13 4","pages":"1-138"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055746","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":"Well-being package for foster carers and teachers of looked-after children aged 8 to 11 years: the STrAWB feasibility RCT.","authors":"Nikki Luke, Robin Banerjee, Valerie Dunn, Nick Douglas, Áine Kelly, Helen Trivedi, Annette Bauer, Andrew Cook, Nick Midgley, Matt Woolgar","doi":"10.3310/NGXR5244","DOIUrl":"https://doi.org/10.3310/NGXR5244","url":null,"abstract":"<p><strong>Background: </strong>Children in care are at elevated risk of mental health issues and poorer well-being, and social care and health services are under pressure to meet their needs. The Shared Training and Assessment for Well-Being programme is a recent approach to training and assessment designed to bring together foster carers and designated teachers to identify and meet the well-being needs of primary school-aged children in care, across the home and school contexts.</p><p><strong>Objectives: </strong>This feasibility randomised controlled trial addressed key questions concerning the acceptability of the Shared Training and Assessment for Well-Being intervention (including training, assessments, clinical review and feedback) and the feasibility of the research design for a larger randomised controlled trial (including recruitment, randomisation and outcome measures).</p><p><strong>Design: </strong>This was a two-arm randomised controlled trial (Shared Training and Assessment for Well-Being intervention vs. control group), with two points of data collection (baseline and 12-month follow-up) for our primary and secondary outcomes.</p><p><strong>Setting: </strong>The study focused on looked-after children from four local authorities in southern England. In the context of the COVID-19 pandemic, both the research and intervention activities were undertaken online with participants.</p><p><strong>Participants: </strong>Looked-after children aged 8-11 years were recruited from the participating local authorities, along with their foster/kinship carers and designated teachers. Carers for all children in the authorities meeting inclusion criteria were initially invited to participate. The original target sample size was 70 children, with 35 receiving the Shared Training and Assessment for Well-Being intervention and 35 in the control group. However, only 21 looked-after children were successfully recruited and randomised.</p><p><strong>Interventions: </strong>Shared Training and Assessment for Well-Being is an integrated approach that combines training on mental health, well-being and resilience for foster carers and designated teachers; a multi-informant assessment package; review of assessments by mental health experts; and feedback to enable key adults to respond to identified needs and strengths. COVID-19 adaptations enabled all key elements to be delivered remotely.</p><p><strong>Main outcome measures: </strong>Two multi-informant primary outcome measures were included as possible candidates for a larger randomised controlled trial: the Strengths and Difficulties Questionnaire and the Paediatric Quality of Life Scale. A further multi-informant secondary outcome measure was also included: the Behavioural and Emotional Rating Scale.</p><p><strong>Results: </strong>Feasibility was not demonstrated, as recruitment was heavily impacted by the COVID-19 pandemic and further attrition occurred over the extended project duration. For the small n","PeriodicalId":74615,"journal":{"name":"Public health research (Southampton, England)","volume":" ","pages":"1-45"},"PeriodicalIF":0.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744523","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":"Developing research collaborations and building capacity in palliative and end-of-life care in the North West Coast of England: the PalCaRe-NWC partnership.","authors":"Lesley Dunleavy, Ruth Board, Seamus Coyle, Andrew Dickman, John Ellershaw, Amy Gadoud, Jaime Halvorsen, Nick Hulbert-Williams, Liz Lightbody, Stephen Mason, Amara Callistus Nwosu, Andrea Partridge, Sheila Payne, Nancy Preston, Brooke Swash, Vanessa Taylor, Catherine Walshe","doi":"10.3310/AWLT2995","DOIUrl":"https://doi.org/10.3310/AWLT2995","url":null,"abstract":"<p><strong>Background: </strong>The North West Coast area of England (Lancashire, Merseyside, Cheshire and South Cumbria) has high palliative care need (third highest prevalence in England) and historically low recorded National Institute for Health and Care Research research activity (second lowest research recruitment rate in England). To stimulate research activity, a new research partnership was formed to support and encourage palliative care research, funded by the National Institute for Health and Care Research from January 2022 until June 2023.</p><p><strong>Objectives: </strong>To develop a sustainable palliative care research partnership infrastructure across the North West Coast. To work with palliative care providers, patients and the public, and research staff to further understand local barriers and facilitators to palliative and end-of-life care research, and develop and implement solutions to these barriers. To build capacity in palliative and end-of-life care research through the mentorship of emerging research leaders and share expertise across organisations. To facilitate the development of high-quality research grant applications.</p><p><strong>Activities: </strong>Phased activities were planned and actioned throughout the funded period to develop and embed an active palliative care research partnership across the region. These included: a survey and working groups to rapidly identify current local barriers to research and their sustainable solutions; individual and group support activities to build research capabilities and capacity; development and submission of high-quality, clinically relevant research proposals to the National Institute for Health and Care Research and other funders.</p><p><strong>Results: </strong>Survey participants (<i>n</i> = 293) were mainly from clinical settings (71%), with 45% being nurses. While around three-quarters of participants were not research active, most wanted to increase their involvement. Key barriers identified from both the survey and working groups (<i>n</i> = 20 professional participants) included: lack of organisational research culture and capacity (including prioritisation and available time); research knowledge (including skills/expertise and funding opportunities); research infrastructure (including collaborative opportunities across multiple organisations and governance challenges); and patient and public perceptions of research (including vulnerabilities and burdens). Based on these findings, the partnership is working with national stakeholders to develop user-friendly resources to facilitate hospice-based research. Three action learning sets, that met several times (<i>n</i> = 15 staff), and two networking events (<i>n</i> = 78 participants) took place to facilitate collaboration and research capacity building. Eleven research grant applications totalling £5,435,967 were submitted as a direct result of partnership activities between January 2022 and June 2023.</p><p><stron","PeriodicalId":74615,"journal":{"name":"Public health research (Southampton, England)","volume":" ","pages":"1-13"},"PeriodicalIF":0.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671546","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":"Building multi-professional UK partnerships and networks to improve access to palliative care for people experiencing homelessness.","authors":"Briony Hudson, Jodie Crooks, Caroline Shulman, Kate Flemming","doi":"10.3310/JWRG6933","DOIUrl":"https://doi.org/10.3310/JWRG6933","url":null,"abstract":"<p><strong>Background: </strong>People experiencing homelessness have high rates of multi-morbidity and age-related conditions at a young age. Despite having high support needs, they have disparately low access to palliative care services and often die at a young age. To facilitate access to support for this group towards the end of life, a multi-professional approach should be taken. Over recent years, clinical and research activities have begun to address this issue. However, until now, there has been no centralised United Kingdom-based group to facilitate collaboration and shared learning.</p><p><strong>Aim: </strong>To build multi-professional partnerships across the United Kingdom to promote shared learning and a multidisciplinary approach to supporting people experiencing homelessness who may be approaching the end of their lives.</p><p><strong>Method: </strong>This project had three workstreams: (1) development of a Palliative Care and Homelessness Extensions of Community Healthcare Outcomes network; (2) a rapid review around involving people with experience of multiple exclusion in palliative and end-of-life care research; and (3) a qualitative study to identify recommendations for involving people with lived experience of homelessness in future palliative and end-of-life care research.</p><p><strong>Results: workstream 1: </strong>A National Palliative Care and Homelessness Extensions of Community Healthcare Outcomes (ECHO) network was successfully established in the UK, with 10 sessions running over 12 months. A total of 268 people registered to the network, with an average of 52 participants per session. Evaluation of the network illustrated positive experiences and appetite for continuation of the network. The majority of attendees surveyed (78%) agreed that the network had increased their awareness of complexities and challenges faced by people experiencing homelessness and 85% of respondents reported better connections with others who are interested in or are working in this field.</p><p><strong>Workstream 2: </strong>A rapid review was conducted to summarise existing evidence and reflections on co-producing palliative care research with inclusion health groups, including people with lived experience of homelessness. Given the scarcity of existing research within this area, the review provided a starting point from which to explore the successes and challenges of co-research in this field. The review advocates for greater guidance around the involvement of people with lived experience of homelessness in palliative and end-of-life care research.</p><p><strong>Workstream 3: </strong>Professionals with experience of involving people experiencing homelessness in their work were interviewed (<i>n</i> = 16), and focus groups were held with people with lived experience of homelessness (<i>n</i> = 11). Recommendations were co-developed to support researchers to involve people with lived experience of homelessness in their palliative and end","PeriodicalId":74615,"journal":{"name":"Public health research (Southampton, England)","volume":" ","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631111","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":"Using natural experiments to evaluate population health interventions: a framework for producers and users of evidence.","authors":"Peter Craig, Mhairi Campbell, Manuela Deidda, Ruth Dundas, Judith Green, Srinivasa Vittal Katikireddi, Jim Lewsey, David Ogilvie, Frank de Vocht, Martin White","doi":"10.3310/JTYW6582","DOIUrl":"10.3310/JTYW6582","url":null,"abstract":"<p><strong>Background: </strong>There has been a substantial increase in the conduct of natural experimental evaluations in the last 10 years. This has been driven by advances in methodology, greater availability of large routinely collected datasets, and a rise in demand for evidence about the impacts of upstream population health interventions. It is important that researchers, practitioners, commissioners, and users of intervention research are aware of the recent developments. This new framework updates and extends existing Medical Research Council guidance for using natural experiments to evaluate population health interventions.</p><p><strong>Methods: </strong>The framework was developed with input from three international workshops and an online consultation with researchers, journal editors, funding representatives, and individuals with experience of using and commissioning natural experimental evaluations. The project team comprised researchers with expertise in natural experimental evaluations. The project had a funder-assigned oversight group and an advisory group of independent experts.</p><p><strong>Results: </strong>The framework defines key concepts and provides an overview of recent advances in designing and planning evaluations of natural experiments, including the relevance of a systems perspective, mixed methods and stakeholder involvement throughout the process. It provides an overview of the strengths, weaknesses, applicability and limitations of the range of methods now available, identifies issues of infrastructure and data governance, and provides good practice considerations.</p><p><strong>Limitations: </strong>The framework does not provide detailed information for the substantial volume of themes and material covered, rather an overview of key issues to help the conduct and use of natural experimental evaluations.</p><p><strong>Conclusion: </strong>This updated and extended framework provides an integrated guide to the use of natural experimental methods to evaluate population health interventions. The framework provides a range of tools to support its use and detailed, evidence-informed recommendations for researchers, funders, publishers, and users of evidence.</p><p><strong>Study registration: </strong>This methodological project was not registered.</p><p><strong>Funding: </strong>This project was jointly funded by the Medical Research Council (MRC) and National Institute for Health and Care Research (NIHR), with project reference MC_PC_21009. The work is published in full in <i>Public Health Research</i>; Vol. 13, No. 3.</p>","PeriodicalId":74615,"journal":{"name":"Public health research (Southampton, England)","volume":"13 3","pages":"1-59"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756288","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":"Social network intervention for loneliness and social isolation in a community setting: the PALS cluster-RCT.","authors":"Rebecca Band, Karina Kinsella, Jaimie Ellis, Elizabeth James, Sandy Ciccognani, Katie Breheny, Rebecca Kandiyali, Sean Ewings, Anne Rogers","doi":"10.3310/WTJH4379","DOIUrl":"10.3310/WTJH4379","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Loneliness and social isolation are associated with adverse mental and physical health outcomes in adults. However, there is a lack of existing research on effective interventions and the contexts in which these could be implemented.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Primary objective: &lt;/strong&gt;To assess the clinical and cost-effectiveness of a social network intervention compared to usual care among at-risk populations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;A pragmatic, community-based, cluster randomised controlled trial with embedded health economic evaluation, process evaluation and qualitative study. Outcome assessments were conducted at baseline and at 3 and 6 months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;The study was conducted in collaboration with 44 community-based organisations in two regions in England.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;Adults aged ≥ 18 years at risk of loneliness and social isolation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Intervention: &lt;/strong&gt;A facilitated social network tool ('project about loneliness and social networks'; PALS) designed to link people to opportunities for social involvement. First, participants map and reflect on personal social networks. Second, identification of local resources based on individual preferences, available support, and health and wellness needs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcome measures: &lt;/strong&gt;The primary outcome was mental wellness at 6-month follow-up, measured by the Short Form questionnaire-12 items mental health component score (MCS). Secondary outcomes included the Short Form questionnaire-12 items Physical Health subscale, loneliness, social isolation, well-being and collective efficacy. Economic measures assessed the cost-effectiveness of the intervention in terms of costs, quality-adjusted life-years and net monetary benefits.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We recruited 469 adults into the study, with 120 withdrawals (25.6%). The main trial results indicate little to no treatment effect of the intervention on either the primary or secondary outcomes compared to usual care. The within-trial economic evaluation found that PALS was inexpensive to deliver but there was no significant difference in quality-adjusted life-years, measures of well-being capability or costs, and the intervention did not lead to demonstrable cost-effectiveness in terms of net monetary benefits. The process evaluation found PALS to be acceptable to all types of community organisations, but low resource availability and capacity to sustain PALS was found across all community organisational contexts. Qualitative interviews (&lt;i&gt;n&lt;/i&gt; = 20) highlighted that participants wanted to engage with meaningful social activities but barriers to doing so were psychological (i.e. confidence and competence) and practical (i.e. transport or cost).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;The timing of COVID-19 and associated restrictions (approximately splitting trial follow-up into thirds of pre-COVID, during the first lockdown, and following t","PeriodicalId":74615,"journal":{"name":"Public health research (Southampton, England)","volume":"13 1","pages":"1-86"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588432","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":"Establishing a research partnership for delivering palliative and end-of-life care for older people in rural and remote areas: a formative mixed-methods study.","authors":"Caroline Mogan, Nathan Davies, Karen Harrison Dening, Abigail Woodward, Caroline Watkins, Nigel Hartley, Mari Lloyd-Williams","doi":"10.3310/RWSG7439","DOIUrl":"https://doi.org/10.3310/RWSG7439","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Many older people live in rural and remote areas. As the ageing population grows, conditions such as cancer, dementia and stroke will become more prevalent, causing a huge demand for palliative and end-of-life care. However, evidence regarding models of care and interventions in rural and remote areas is limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;A new United Kingdom rural palliative care partnership was funded for 12 months. It aimed to understand the models of palliative and end-of-life care for older people with cancer, dementia and stroke in rural/remote areas across all four nations of the United Kingdom. It also aimed to identify the core priorities for research into rurality and palliative care for older people.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The project consisted of three integrated components, including: (1) a scoping review of relevant literature on rural palliative care for older people with cancer, dementia and stroke; (2) stakeholder engagement workshops using a modified Nominal Groups Technique and (3) qualitative interviews with family carers who supported rural-/remote-dwelling older adults towards the end of life.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Our scoping review was undertaken in 2022. The search identified 1128 unique citations, of which five papers were included. There were no United Kingdom studies on models of palliative and end-of-life care delivered to older people with cancer, dementia or stroke within rural/remote locations. However, international models of care were identified. Models included technological interventions to reach those in remote locations, the role of palliative care nurses and the use of volunteers. Articles highlighted the importance of not replacing face-to-face care with technology for ease of reaching more people and emphasised the importance of effective interdisciplinary working in rural and remote palliative care. Additionally, three online workshops to develop research capacity, identify models of care, understand issues of rurality and determine research priorities were attended by 15-20 stakeholders. Qualitative interviews were also undertaken with 20 family carers who had supported rural-/remote-dwelling older adults at their end of life. Data identified that rural/remote communities face challenges in accessing palliative and end-of-life care due to issues such as transport to and distance from services, poor broadband coverage and problems with workforce recruitment and retention. Synthesising the data from these methods helped to identify some interventions and models of care for palliative and end-of-life care for older people in rural and remote areas. It also helped us to jointly shape and develop research priorities, which included workforce planning and service composition, facilitating preferred place of death and the role of technology. However, there are gaps in our understanding about how to improve the family carer support as well as digital literacy ","PeriodicalId":74615,"journal":{"name":"Public health research (Southampton, England)","volume":" ","pages":"1-20"},"PeriodicalIF":0.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532195","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}