Now showing items 41-60 of 837

    • Parental participation in Sure Start Jolly Giraffe The role and effectiveness of the Parents’ Forum

      Mann, Frances; Perry, Catherine (Centre for Public Health Research, University College Chester, 2005-05)
      The aim of the commissioned research project was to examine Sure Start Jolly Giraffe’s model for facilitating parental participation. Commitment to, and evidence of, user involvement is now included as a central theme in the design and delivery of initiatives which impact upon individuals and their communities. An additional and increasingly prominent issue for scrutiny is the effectiveness and significance of the methods selected by service providers for promoting consultation and participation. A key principle of the Sure Start initiative is the transparent involvement of service users in all aspects of programme decision making. A further requirement of local programmes is to provide evidence of parental consultation and participation. Sure Start guidance places significant emphasis on the need for local programmes to provide relevant and appropriate services to match the needs of their communities. In acknowledging Jolly Giraffe’s parents’ group, the Parents’ Forum, as the primary arena for parental feedback in the programme, a need was identified for an in-depth examination of its role, processes and impact.
    • Evaluation of the Paediatric Home-based Palliative Care Service

      Caiels, James; Perry, Catherine (Centre for Public Health Research, University of Chester, 2006-01)
      Palliative care has been recognised as a medical speciality since 1987 (Hynson & Sawyer, 2001). However, it remains relatively underdeveloped in the paediatric setting, and there has been little research carried out in the area. One reason for this may be the nature and challenge of surveying caretakers about a highly emotive and painful subject (Hynson & Sawyer, 2001). However, as Dangel, Fowler-Kerry, Karwacki, and Bereda (2000) suggest, ongoing programme evaluation is a necessary component to improve the quality of service delivery. Research is required in all aspects of palliative care in order to ensure that this relatively new speciality can move forward from an anecdotal basis to one that has a sound evidence base (Twycross & Dunn, 1994). The most distinctive feature of palliative care is its divergence from most other types of medical care: the aims are different to that of curative care and thus create different priorities. Palliative care focuses on relieving pain or the symptoms of a disease or disorder without effecting a cure (World Health Organisation [WHO], 2005). As such palliative care aims to preserve normality as far as possible; for the great majority of children and young people, this means delivering care in the home (Watterson & Hain, 2003). In this setting, parents play a key role in decision making as they are involved in the day-to-day management of their child's symptoms (Dangel et al., 2000).
    • A Strategic Analysis of Halton Children’s Fund

      Artaraz, Kepa; Thurston, Miranda; University of Chester (Centre for Public Health Research, University College Chester, 2005-05)
      The Children’s Fund is a government programme of work with children aged five to 13 years, the objective of which is to put in motion a series of initiatives for the prevention of social exclusion. The programme aims to support the reorganisation of services by breaking down traditional professional boundaries and developing multi-agency collaborative working arrangements. In this way, the Children’s Fund fits with other policy initiatives that offer provision for children and young people as part of a drive towards the seamless provision of services for people up to the age of 19. Halton Children’s Fund (HCF) has been in existence since 2001 with the express commitment to work in favour of the creation and maintenance of a network of services that meet the needs of children, young people and families who are at risk of social exclusion, according to guiding principles developed by Halton’s Children and Young People’s Strategic Partnership (CYPSP). The Halton Children’s Fund Board commissioned the Centre for Public Health Research (CPHR) to carry out an evaluation of its activities at a strategic level.
    • Engaging parents and carers with Sure Start New Steps

      Perry, Catherine; Samuels, Tanya; University of Chester (Centre for Public Health Research, University of Chester, 2006-01)
      Sure Start New Steps is one of five local programmes in Halton. It is a fifth round programme, established in 2002, and is based at Kingsway Learning Centre, Widnes. The staff at Sure Start New Steps have had some concerns about the number of families they are reaching. A recent parent satisfaction survey indicated that although general awareness of Sure Start New Steps was high, 18 respondents (12% of those taking part in the survey) were unaware of the Sure Start programme in their area, although 14 of this group had actually used Sure Start New Steps services. Anecdotal information reported by staff at Sure Start New Steps also suggests that a number of eligible families are not registered with the programme and are unaware of its existence. Concerns have therefore been raised about the strategies used to inform parents and carers about Sure Start New Steps and how systematically and effectively its activities are introduced and promoted by health professionals and others working with the eligible population. The aim of this study was therefore to explore how Sure Start New Steps is promoted and publicised to parents and carers, in order to inform future marketing strategies.
    • Perceptions of volcanic air pollution and exposure reduction practices on the Island of Hawai‘i: Working towards socially relevant risk communication

      Horwell, Claire; Elias, Tamar; Covey, Judith; Bhandari, Ramjee; Truby, Jennifer; Durham University; U.S. Geological Survey Hawaiian Volcano Observatory; University of Chester (Elsevier, 2023-07-17)
      Kīlauea volcano, on the Island of Hawai‘i, is one of the most active volcanoes in the world. Over the past four decades it has released large amounts of volcanic gases and aerosols which form volcanic air pollution known as ‘vog’. Communities downwind of Kīlauea have been chronically or episodically exposed to this potentially harmful air pollution and have raised concerns about the hazards of vog exposure. Public health and civil protection agencies have offered a range of advice, information, and mitigation strategies for living with vog. In this mixed-methods social study, we investigate the translation of official advice into practice in Island of Hawai‘i communities and assess how risk communication could be improved by considering public input, preferences, and community relevance. Given the paucity of information on the long-term effects of chronic vog exposure, assessing the effectiveness of public health and risk communication is vital. In 2015, through questionnaire surveys (n = 143), four focus groups and several stakeholder meetings, we assessed whether, and how, residents accessed intervention advice, if it was relevant and useful, how they acted on it and how they would like to receive advice and urgent exposure warnings in the future. We also investigated local knowledge and self-developed interventions and documented the perceived risks of vog exposure, including symptoms that people attribute to vog. Most participants (83%) perceived that vog caused health symptoms such as exacerbation of asthma, itchy eyes, and blocked nose and 62% thought it was harmful to their long-term health. A third of participants had considered relocating to avoid the vog yet, despite this, most people took no action to reduce vog exposure. Participants reported that the official advice was difficult to follow given their living situation or lifestyle. Some participants viewed the agency advice as inconsistent, irrelevant, or out of date. Participants preferred to receive advice and air quality alerts via a variety of media, depending on factors such as their access to internet, cell phone, and radio reception. The study findings led to a collaboration with federal and state health, land management, educational, science, and civil protection agencies to improve and standardize health advisory messaging, to make it more relevant to Island of Hawai‘i communities and environment. New printable and web-based communication products were developed, which included local knowledge of effective protective actions/symptom reduction strategies. An interagency ‘Vog Dashboard’ was also introduced to consolidate vog knowledge, including sources of air quality data, vog forecasts, and advice on vog environmental, agricultural, and health impacts. This dashboard was recommended as a primary site for advice by international media outlets in 2018 and was heavily used during the 2018 Kīlauea and 2022 Mauna Loa eruption crises.
    • Understanding the contribution of intellectual disabilities nurses: Paper 3 of 4 - evaluation

      Mafuba, Kay; Chapman, Hazel M.; Kiernan, Joann; Kupara, Dorothy; Kudita, Chiedza; Chester, Rebecca; City University, London; University of Chester; Edge Hill University; Berkshire Healthcare NHS Foundation Trust (SAGE Publications, 2023-08-23)
      Abstract The overall objective of this research was to identify intellectual disability nursing interventions and their impact on the health and healthcare of people with intellectual disability. This is part 3 of a 4-part series. In this paper we report the findings from quantitative questions from an online survey of intellectual disability nurses. The objective of this part of the study was to evaluate intellectual disability nurses’ confidence in their understanding of the interventions they undertook. Quanitative data was collected using an online survey questionnaire from a voluntary response and snowball sample of 230 participants from 7 countries. Thematic, descriptive statistical, and inferential statistical analyses were undertaken. The evaluation data suggest and demonstrate a lack of clarity among intellectual disability nurses of the interventions they can effectively undertake. There appears to be correlations between lack of role clarity and the types of employer organisations and countries. Further work needs to be undertaken by nurse leaders to ascertain and address this lack of clarity.
    • Tuberculosis-diabetes screening: how well are we doing? A mixed-methods study from North India

      Majumdar, Anindo; Wilkinson, Ewan; Rinu, P Krishnankutty; Maung, Thae Maung; Bachani, Damodar; Punia, Jaswant Singh; Jain, Shalu; Yadav, Taramani; Jarhyan, Prashant; Mohan, Sailesh; et al. (International Union Against Tuberculosis and Lung Disease, 2019-03-21)
      Setting: Public health care facilities in Sonipat District, Haryana State, India. Objectives: To assess 1) the proportion of tuberculosis (TB) patients screened for diabetes mellitus (DM) and vice versa, 2) factors associated with screening, and 3) the enablers, barriers and solutions related to screening. Design: A mixed-methods study with quantitative (cohort study involving record reviews of patients registered between November 2016 and April 2017) and qualitative (interviews of patients, health care providers [HCPs] and key district-level staff) components. Results: Screening for TB among DM patients was not implemented, despite documents indicating that it had been. Of 562 TB patients, only 137 (24%) were screened for DM. TB patients registered at tertiary and secondary health centres were more likely to be screened than primary health centres. Low patient awareness, poor knowledge of guidelines among HCPs, lack of staff and inadequate training were barriers to screening. Enablers were the positive attitude of HCPs and programme staff. The key solutions suggested were to improve awareness of HCPs and patients regarding the need for screening, training of HCPs and wider availability of DM testing facilities. Conclusion: The implementation of bidirectional screening was poor. Adequate staffing, regular training, continuous laboratory supplies for DM diagnosis and widespread publicity should be ensured.
    • Did school characteristics affect the uptake of meningococcal quadrivalent vaccine in Greater Manchester, United Kingdom?

      Fletcher, Rebecca; Wilkinson, Ewan; Cleary, Paul; Blagden, Sarah; Farmer, Siobhan; Health Education England (North West); University of Chester; Public Health England (Elsevier, 2019-05-10)
      Objectives The objective of this study was to assess if school characteristics were associated with the uptake of the meningococcal ACWY (MenACWY) vaccine in Greater Manchester in 2017/18. Study design This is an ecological cross-sectional study. Methods We analysed data on all 129 schools in seven local authorities in Greater Manchester from the Department for Education and from local child health information systems to determine whether school characteristics, including school type and Ofsted effectiveness score, were associated with vaccine uptake. Schools with no eligible pupils were excluded. We undertook single-variable and multivariable analysis and considered key interactions. Results The overall uptake rate was 80.7%, with a median uptake per school of 80.6% (interquartile range, 69.0%–87.4%). Lower vaccination rates were associated with lower overall effectiveness scores (odds ratio [OR]: 3.54, 95% confidence interval [CI]: 3.00–4.19) and lower numbers of pupils eligible for vaccination (OR: 1.39, 95% CI: 1.28–1.51). Schools with a lower percentage of pupils for whom English is a second language and high deprivation were associated with lower uptake (OR: 1.58, 95% CI: 1.41–1.78). In addition, community schools (the schools with the most local authority oversight) had lower vaccination rates than other categories of schools. Conclusions In this study, uptake rates of the MenACWY vaccine were associated with all five school characteristics considered. Effectiveness scores for schools had the largest association with vaccine uptake, with poorer schools having lower uptake. These characteristics should be used by vaccination providers to prioritise their interventions to increase immunisation rates.
    • Adapting the Structured Operational Research Training Initiative (SORT IT) for high-income countries

      Ghebrehewet, Samuel; Harries, Anthony David; Kliner, Merav; Smith, Kevin; Cleary, Paul; Wilkinson, Ewan; Stewart, Alex; Public Health England; International Union Against Tuberculosis and Lung Disease; London School of Hygiene & Tropical Medicine; University of Chester; University of Exeter (International Union Against Tuberculosis and Lung Disease, 2019-06-21)
      SORT IT (Structured Operational Research Training InitiaTive) is a successful capacity building programme started 10 years ago to develop operational research skills in low- and middle-income countries. Public Health England (PHE) aims to embed a culture of research in front-line staff, and SORT IT has been adapted to train frontline health protection professionals at PHE North West (PHE NW) to collate, analyse and interpret routinely collected data for evidence-informed decision-making. Six participants from the PHE NW Health Protection team were selected to attend a two-module course in Liverpool, UK, in May and in November 2018. Five participants finished the course with completed papers on characteristics and burden of influenza-like illness in elderly care homes (two papers), use of dried blood spots for blood-borne virus screening in prisons, uptake of meningococcal ACWY (groups A, C, W-135 and Y) vaccine in schoolchildren and fires in waste management sites. The SORT IT course led to 1) new evidence being produced to inform health protection practice, and 2) agreement within PHE NW to continue SORT IT with two courses per year, and 3) showed how a research capacity building initiative for low- and middle-income countries that combines ‘learning with doing’ can be adapted and used in a high-income country.
    • Can the “Current View” show that autistic young people referred to mental health services have more comorbidities and complex needs?

      Thompson, Lisa Marie; Wilkinson, Ewan; Nall-Evans, Sharleen; Michelet, Felix; Lewis, Michael Thomas; Pender, Fiona; Jaydeokar, Sujeet; Cheshire and Wirral Partnership NHS Foundation Trust, Chester; University of Chester; University of Warwick (Emerald, 2023-06-07)
      Purpose Autistic young people have health and care needs that may benefit from a multi-agency intervention. The “Current View” tool is routinely used in England to profile the needs of young people referred to mental health services. This study aims to examine associations between comorbidities and complex needs in autistic and non-autistic young people to assess the multifaceted needs of autistic young people. Design/methodology/approach A cohort study was conducted using data from the electronic patient record, comparing autistic and non-autistic young people to see which items in the four “Current View” tool categories were associated with autistic young people. Findings Issues associated with autistic young people were: “community issues”, “attainment issues” and “deemed child in need” (all p < 0.001). Autistic young people scored significantly more items (p < 0.05) in the categories complexity/contextual/educational factors. Comorbidities associated with autistic young people included anxiety, “behavioural difficulties”, “peer relationship difficulties” and “self-care issues” (all p < 0.001). There was an association with increased comorbidities and complexity factors in autistic young people which suggests increased support from agencies may be beneficial. Originality/value Few studies have used data in the “Current View” tool to assess young people referred to services. More use could be made of this data for planning and delivering services.
    • Quality of Electronic TB Register Data Compared with Paper-Based Records in the Kyrgyz Republic

      Shauer, Daniil; Petrosyan, Ofelya; Gemilyan, Manik; Kamau, Edward M.; Thekkur, Pruthu; Goncharova, Olga; Gulmira, Kalmambetova; Kyrbashov, Bolot; Istamov, Kylychbek; Kadyrov, Meder; et al. (MDPI, 2023-08-16)
      This study evaluated the effectiveness of an electronic system for managing individuals with drug-sensitive pulmonary tuberculosis in the Kyrgyz Republic. This cohort study used programmatic data. The study included people registered on the paper-based system in 2019 and 302 people registered on both the electronic and the paper-based systems between June 2021 and May 2022. The data from the 302 individuals were used to assess the completeness of each form of record and the concordance of the electronic record with the paper-based system. This study showed that for most variables, the completeness and concordance were 85.3–93.0% and were lowest for nonmandatory fields such as medication side effects (26.8% vs. 13.6%). No significant difference was observed in the time taken from symptom onset to diagnosis and treatment initiation between the two systems. However, the electronic system had a significantly higher percentage of subjects who initiated treatment on the day of diagnosis (80.3% vs. 57.1%). The proportion with successful outcomes was similar in both groups, but the electronic system had a significantly lower proportion of individuals with outcomes that were not evaluated or recorded (4.8% vs. 14.3%, p < 0.001). This study highlights the potential advantages and gaps associated with implementing an electronic TB register system for improving records.
    • COVID-19: changing fields of social work practice with children and young people

      Dillon, Jo; Evans, Ffion; Wroe, Lauren; University of Chester, Manchester Metropolitan University, Durham University (Bristol University Press, 2021-02-10)
      Drawing on the theoretical work of Wacquant, Bourdieu and Foucault, we interrogate how the COVID-19 pandemic has weaponised child and family social work practices through reinvigorated mechanisms of discipline and surveillance. We explore how social workers are caught in the struggle between enforcement and relational welfare support. We consider how the illusio of social work obscures power dynamics impacting children, young people and families caught in child welfare systems, disproportionately affecting classed and racialised individuals.
    • ‘Wishes and feelings’: Misunderstandings and missed opportunities for participation in child protection proceedings

      Dillon, Jo; University of Chester (Wiley, 2021-06-01)
      The gathering of ‘wishes and feelings’ in UK child protection proceedings (s.53 Children Act 2004) should highlight the child's opinion of social work intervention and services provided. However, with no statutory social work guidance on participation currently in place, children frequently miss opportunities to be involved in their own child protection planning. This paper is drawn from a 3-year study into participation in child protection social work. It includes findings from qualitative interviews, and one focus group, with social workers, parents, children and participation workers, from three local authorities in the United Kingdom. The findings revealed some examples of significant gaps in service provision, particularly from the perspective and understanding of the child. The skewed translation of wishes and feelings legislation, along with its subsequent (and often inadequate) application to practice, prevents children from understanding and responding to social work intervention and can lead to idiosyncratic practice. This paper provides recommendations for a practical response to practitioner dilemmas regarding wishes and feelings and bridges the gap between research and practice.
    • P783 Clinical, Humanistic, and Economic Burden in Patients with PNH Receiving C5 Inhibition Treatment across UK, Germany, and France. Insights from the Commodore Burden of Illness Study

      Terriou, Louis; Piggin, Maria; Burmester, Pascale; Zhang, Fengkui; Finnegan, Alan; Kritikou, Persefoni; Mighiu, Claudia; Buehrer, Christian; Katz, Pablo; Mode, Selma; et al. (Wolters Kluwer, 2023-08-08)
      Paroxysmal nocturnal hemoglobinuria (PNH) is a rare, life-threatening blood disorder. In the UK, Germany, and France, C5 complement inhibitors, such as eculizumab and ravulizumab, both of which are intravenously (IV) infused, are the standard of care for PNH.
    • Suicide after leaving the UK Armed Forces 1996–2018: A cohort study

      Rodway, Cathryn; Ibrahim, Saied; Westhead, Jodie; Bojanić, Lana; Turnbull, Pauline; Appleby, Louis; Bacon, Andy; Dale, Harriet; Harrison, Kate; Kapur, Nav; et al. (Public Library of Science, 2023-08-08)
      There are comparatively few international studies investigating suicide in military veterans and no recent UK–wide studies. This is important because the wider context of being a UK Armed Forces (UKAF) veteran has changed in recent years following a period of intensive operations. We aimed to investigate the rate, timing, and risk factors for suicide in personnel who left the UKAF over a 23–year period. Methods and findings: We carried out a retrospective cohort study of suicide in personnel who left the regular UKAF between 1996 and 2018 linking national databases of discharged personnel and suicide deaths, using survival analysis to examine the risk of suicide in veterans compared to the general population and conditional logistic regression to investigate factors most strongly associated with suicide after discharge. The 458,058 individuals who left the UKAF accumulated over 5,852,100 person years at risk, with a median length of follow–up of 13 years, were mostly male (91%), and had a median age of 26 years at discharge. 1,086 (0.2%) died by suicide. The overall rate of suicide in veterans was slightly lower than the general population (standardised mortality ratio, SMR [95% confidence interval, CI] 94 [88 to 99]). However, suicide risk was 2 to 3 times higher in male and female veterans aged under 25 years than in the same age groups in the general population (age–specific mortality ratios ranging from 160 to 409). Male veterans aged 35 years and older were at reduced risk of suicide (age–specific mortality ratios 47 to 80). Male sex, Army service, discharge between the ages of 16 and 34 years, being untrained on discharge, and length of service under 10 years were associated with higher suicide risk. Factors associated with reduced risk included being married, a higher rank, and deployment on combat operations. The rate of contact with specialist NHS mental health services (273/1,086, 25%) was lowest in the youngest age groups (10% for 16– to 19–year–olds; 23% for 20– to 24–year–olds). Study limitations include the fact that information on veterans was obtained from administrative databases and the role of pre–service vulnerabilities and other factors that may have influenced later suicide risk could not be explored. In addition, information on contact with support services was only available for veterans in contact with specialist NHS mental health services and not for those in contact with other health and social care services. Conclusions: In this study, we found suicide risk in personnel leaving the UKAF was not high but there are important differences according to age, with higher risk in young men and women. We found a number of factors which elevated the risk of suicide but deployment was associated with lower risk. The focus should be on improving and maintaining access to mental health care and social support for young service leavers, as well as implementing general suicide prevention measures for all veterans regardless of age.
    • Study on Pause: how to help student nurses resume their courses

      Ridgway, Victoria; University of Chester (RCN Publishing, 2022-10-21)
      Strategies to support those at risk of leaving their degree courses for good, and how a pastoral lecturer programme can help students get back on track
    • The impact of bleeding event frequency on health-related quality of life and work productivity outcomes in a European cohort of adults with haemophilia A: insights from the CHESS II study

      Young, Lisa; Chen, Yong; Alvir, José; Burke, Tom; Ferri Grazzi, Enrico; Winburn, Ian (BMC, 2023-08-03)
      Background: Haemophilia A carries a substantial healthcare burden, affecting health-related quality of life (HRQoL). The Cost of Haemophilia in Men: a Socioeconomic Survey II (CHESS II), a retrospective real-world study, characterised the burden of haemophilia and its impact on HRQoL and work productivity. The current analysis explored the impact of bleeding events on HRQoL and work productivity in Europe. This analysis focused on data collected from males aged 18 to 64 years with haemophilia A without inhibitors who were receiving replacement factor products or a monoclonal antibody and were not participating in a clinical trial at the time of study recruitment. Descriptive statistics were analysed using scores from EuroQoL’s EQ-5D-5L index and EQ-VAS analogue scale and the Work Productivity and Activity Index Specific Health Problem (WPAI:SHP) percentage scores stratified by the number of annual bleeding events (ABs) 0, 1, 2, 3–4, or ≥ 5. Results: Of 918 males with haemophilia A in CHESS II, 318 met inclusion criteria and had data available for HRQoL measures; mean age (SD) was 33.8 (12.1) years and 96% were White. Mean (SD) ABs of 2.7 (2.9) occurred over the preceding 12 months: 20% had 3 or 4 ABs; 17% had ≥ 5 ABs. Mean EQ-5D-5L index scores for patients with 0, 1, 2, 3–4, or ≥ 5 ABs were 0.92, 0.76, 0.76, 0.71, and 0.56, respectively. Mean (SD) EQ-VAS scores were 86.9 (13.6), with 0 ABs versus 69.5 (19.1) for 3 or 4 ABs and 61.2 (17.2) for ≥ 5 ABs. Mean percentage of overall work productivity loss on the WPAI:SHP questionnaire ranged from 9.70 to 0 ABs to 47.65 for ≥ 5 ABs. Conclusions: In this European sample of adult men with haemophilia A, HRQoL and work productivity scores were lower among those reporting more AB events. Bleeding burden appears to affect HRQoL and productivity; however, this cross-sectional analysis limits the ability to draw firm conclusions on causality.
    • A Hermeneutic Study of a Paraprofessional Mental Health Initiative involving Medical Teams and Male Professional Footballers

      Kingston, Paul; Ellis, Caroline J. (University of Chester, 2023-07)
      The spotlight has only recently focussed on mental health in professional football. High-profile suicides alarmed the football community and players continue to take their own lives. Consequently, mental health disorders in professional football have become a topic of increasing interest in research, due to the serious consequences for quality of life, and the likelihood of the player’s predisposition to inflict serious self-harm. Aims Given the increased interest in and importance of mental health issues, mental health education and guidance for football medical teams is essential. The research aim was to investigate the role of the medical team in managing the mental health issues faced by male professional football players and establish whether a paraprofessional Solution Focussed Brief Therapy (SFBT) initiative could enhance that role. A total of thirty-four participants, working in Premier League and Championship level professional football, took part in this two-phased study. Nineteen were contracted players, thirteen were members of medical teams and two were PFA representatives. A Heideggerian hermeneutic approach was adopted and data was collected through fifteen in-depth interviews and four focus groups. In Phase 1, the problem of mental health disorders and mental healthcare in professional football was explored. In Phase 2, a pilot study investigated the feasibility of a SFBT intervention, delivered through a smartphone APP. Results All of the nineteen players declared mental health issues. De-selection, not injury, was the main reported issue. The majority of players and medics agreed that disclosing mental health problems could lead to de-selection from the team, for some further punishment, due to the value placed on maintaining a ‘mental toughness’. Therefore, if a sports psychologist was present at the club, the player may not seek help as it was dependent on trust in the individual. None of the players made use of the PFA counselling hotline, at any time, for mental health support. The majority of players would speak to a member of the medical team if confidentiality was guaranteed. None of the medical team members had any mental health education, and yet engaged in unofficial paraprofessional mental healthcare. All medical team members thought paraprofessional mental health education would be of benefit. The SFBT APP intervention was unanimously well received as a paraprofessional mental healthcare aid. Conclusions The SFBT intervention indicated it was clearly possible to develop a paraprofessional mental healthcare supporting role for players. Mental health issues of professional footballers could be managed more effectively if the appropriate education and SFBT intervention, from inside the medical team, was in place. This could potentially save lives. Recommendations for future strategies and further research have been detailed.
    • Development and Validation of a Questionnaire to Assess Evidence-Based Practice and Evidence-Informed Practice Knowledge, Attitudes, Understanding and Behaviour  

      Kumah, Elizabeth; Bettany-Saltikov, Josette; Van Schaik, Paul; McSherry, Robert; Boadu, Paul; Liverpool School of Tropical Medicine; Teesside University; University of Chester; London School of Hygiene and Tropical Medicine (Elsevier, 2023-07-22)
      Good-quality questionnaires are needed to assess the effectiveness of educational programs on undergraduate healthcare students’ knowledge, attitudes, understanding and behavior regarding evidence-based practice and evidence-informed practice. However, there is currently no available questionnaires designed to evaluate the outcomes of evidence-based practice and evidence-informed practice education. Based on the methods proposed by Streiner et al., this study developed and validated a questionnaire for assessing evidence-informed practice and evidence-based practice knowledge, attitudes, understanding, self-perceived application and use, and behavior among undergraduate preregistration students in the nursing and allied health disciplines. Seventy-three questionnaire items were developed and administered to varied groups of people, including students and academics. Principal component analysis was conducted to reduce dimensions and establish construct validity and internal consistency of the developed questionnaire. Following pilot-testing and expert review, the final validated questionnaire consists of 53 items (8 demographic items, 25 evidence-based practice items, and 20 evidence-informed practice items). The evidence-based practice and evidence-informed practice questionnaire is a valid and reliable tool to measure the outcomes of evidence-based practice and evidence-informed practice education.
    • Opportunistic optimization of inhaler technique in hospitalized adults with asthma: a two-phase educational study

      Kouranloo, Koushan; Dey, Mrinalini; Hanna, Joseph; Singh, Ananya; Rafferty, Alice; Scott, Stephen; University of Liverpool; Royal Liverpool University NHS Foundation Trust; Queen Elizabeth Hospital, London; Manchester Royal Infirmary; North Manchester General Hospital; Countess of Chester NHS Foundation Trust; University of Chester (Taylor & Francis, 2023-03-21)
      To investigate effectiveness of two different educational methods to improve inhaler techniques in patients with prior diagnosis of asthma, hospitalized with a non-asthma-related diagnosis. Methods We undertook a real-world, opportunistic quality-improvement project. Inhaler technique in hospitalized patients with prior diagnosis of asthma was assessed in two cohorts over two 12-week cycles using a standardized device-specific proforma of seven-step inhaler technique, classed: “good” if 6/7 steps achieved; “fair” if 5/7 compliant; “poor” for others. Baseline data was collected in both cycles. Cycle one involved face-to-face education by a healthcare professional; cycle two involved additional use of an electronic device to show device-specific videos (asthma.org.uk). In both cycles, patients were reassessed within two days for improvements and the two methods compared for effectiveness. Results During cycle one 32/40 patients were reassessed within 48 h; eight lost to follow-up. During cycle two 38/40 patients were reassessed within 48 h; two lost to follow-up During cycle one, two and 12 had good/fair baseline technique respectively, and 26 poor. Most commonly missed steps were no expiry check/not rinsing mouth after steroid use. On reassessment 17% patients improved from poor to fair/good. During cycle two, initial technique assessment identified: 23 poor; 12 fair; five good. Post-videos, 35% of patients improved from poor to fair/good. Proportion of patients improving from poor to fair, or poor/fair to good increased in cycle two vs one (52.5% vs 33%). Conclusion Visual instruction is associated with improved technique compared to verbal feedback. This is a user-friendly and cost-effective approach to patient education.