RSS 1.0Health and Social Care
The Faculty of Health and Social Care has a long history at University of Chester, being established in the early 1990s as the School of Nursing and Midwifery. A wide variety of programmes are delivered by the Faculty including foundation degrees, undergraduate degrees and postgraduate degrees. All branches (adult, mental health, learning disability and child) of pre-registration nursing can be undertaken, as well as pre-qualification courses in Midwifery and Social Work. Social Work programmes are available at both undergraduate and masters levels. The Faculty also offers a wide ranging and exciting portfolio of post-qualifying programmes with an inter-professional focus. Within the Faculty, research is viewed as integral to the working life of staff, in partnership with local and regional providers of care. The Faculty has a research office which coordinates the activity of the Faculty. The strategic focus is on further development in community/primary care, users and carers support and inter-professional learning. There are opportunities to register for a PhD, with supervision from recognised experts in their field. Individual Professors, Readers and Teaching Fellows lead their own research developments in subjects closely related to practice-based care. These include clinical interventions in eating disorders, supporting individuals with learning disabilities in the penal system, interventions in forensic mental health, supporting carers and users of services, safety factors for single practitioners in the community and pedagogical research.
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Professional doctorates in health and social care: A qualitative exploration of their impact and outcomes by two northern universitiesAim: To explore the experiences, outcomes and impact identified by current and past students of undertaking a professional doctorate (PD) in health and/or social care on themselves, their employing organisations and their professional domain. Background: Professional Doctorates are intended to equip graduates with critical and creative thinking skills, and the ability to understand, question and produce evidence relevant to health and social care policy, practice and education. They are costly in terms of time, effort and resources for student and employer, but there is little empirical evidence to support these claims. Methodology: This modified constructivist grounded theory study used a qualitative methods approach, that included both questionnaires (mainly free text answers with a few demographic and numerical questions) and in-depth semi-structured interviews. Current (n=42), graduate (n=4) and previous (2) professional doctorate students completed the questionnaires. The interviews were conducted online with 12 current students from three different health and/or social care programmes from two universities in England. Descriptive demographic and numerical student experience and outcome data were presented to provide context for the study. The qualitative data from both datasets were analysed using Braun and Clarke’s (2022) thematic analysis. Results/Findings: Ten themes were identified, five relating to individual impact. These included: positive outcomes on personal growth and validation; improved ability to deal with complexity; more mixed effects from both challenges and support in academia; as well as some career development opportunities. Frustrations were found by some in their current role. Employers were seen as gaining employees with enhanced assessment skills, making a stronger contribution to organisational development. Doctoral students also brought esteem to employing organisations by virtue of their academic status. Professional impact could be limited by the expectations, support and culture of their employing organisation and in the way doctorates are viewed by the profession. Policy development was evidenced, but it was often a slow process, needing opportunity, mentorship and time to be fully realised. Conclusions/Recommendations: Participants valued their professional doctorate experience and the way it transformed their world view, professional knowledge and confidence. Some students felt conflict between their developing professional self-concept and the support, recognition and scope for development on the part of their employer, although some evidenced career progression. Employers should engage with staff undertaking professional doctorates in order to provide support and optimise organisation benefits. More research is needed to explore the perspectives of employers and professional organisations. It is also necessary to evaluate longer-term outcomes for the postdoctoral professional.
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Person-centred care in the management of imaging-related anxiety in diagnostic radiography: a scoping review exploring cancer and non-cancer populationsIntroduction: The potential anxiety invoked by diagnostic imaging procedures intensifies in cancer diagnoses, with the term ‘scanxiety’ originating from the additional fear associated with cancer imaging. This emphasises the importance of a person-centred approach to care. This scoping review mapped the literature regarding imaging-related anxiety, ‘scanxiety’, and person-centred care. Methods: Databases used were Cinahl Plus; Proquest; PubMed; Scopus; Web of Science; PsycINFO, and Cochrane. Broad search terms were utilised to maximise results, with specific inclusion and exclusion criteria. Limiters were English language articles within the previous 10 years. Further to systematic filtering and critical appraisal, 60 studies were included. Results: Findings were organised in four themes: ‘Quantification and causes of anxiety’; ‘The nature of imaging procedures’; ‘Perceptions of Person-centredness’; and ‘Service and staffing factors’. MRI and PET/CT cause the highest procedural stress. Fear of results causes greater, and more sustained, anxiety in cancer patients than other groups, creating complex emotional needs. The physiological effects of anxiety can adversely affect image quality and ability to complete scans. Human interaction is central to managing anxiety, but service pressures and staff emotional labour influence care delivery. Most existing person-centred care research in imaging relates to generic populations, with limited focus on how diagnostic radiography staff can support people with cancer. Conclusion: Although the psychosocial needs of those undergoing cancer imaging are greater than in other diagnoses, more research is needed into the benefits of a person-centred approach and the support and education needs of staff working in this field. Implications for practice: Understanding experiences of cancer imaging, from both patient and staff perspectives, including any facilitators and barriers to care, would support development of a model for person-centred care in this specialist area.
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Enhancing equality, equity, diversity and inclusion in rare disease research in the United KingdomBackground: Inclusion of under-represented rare-disease communities in research remains limited, threatening representativeness and equity. Methods: To assess equality, equity, diversity, and inclusion in research and identify barriers to participation faced by the rare disease community, utilising a mixed-methods online survey of a convenience sample of community advocates using Likert scales and free response options. Results: The findings from seventeen stakeholders in the rare disease community showed unanimous agreement that anxiety, fear, safety concerns, and lack of trust hinder participation in research. A total of 82% agreed or strongly agreed that additional financial resources are needed, and 76% agreed or strongly agreed that research grant applications often lack sufficient funds. The free-text responses demonstrate that the rare disease communities are keen to be involved in research but faces barriers to inclusion. Rare disease communities are willing to participate in research, but those responsible for research need to address the challenges related to language, misconceptions and fear. Conclusions: Key legislation in the United Kingdom, specifically the Proposed Patient and Public Involvement Strategy 2020–2025, emphasises the importance of involving patients and the public in health and social care. This survey marks the first step toward gaining valuable insights into the challenges faced by this community in participating in healthcare research, which is crucial for developing a solid evidence base for their treatment and care. Involving stakeholders is essential in health and social care policy and practice, rooted in advocacy and social justice.
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Rural inpatient hospitals and substance use—a 10-year retrospective analysisAims: To determine the burden and nature of substance use presentations within a defined rural region and provide an estimate of the prevalence and subsequent local needs. Method: Anonymised secondary data, based on hospital inpatient enquiry (HiPE) records dated 2010–2021 from three sites, were analysed using descriptive and inferential statistics. Result: Despite similar gender distributions across the three hospitals, approximately 3:1 male to female, substance-related admissions varied significantly across hospitals (p < .001). Hospital C had the highest alcohol-related admissions 3537(98.6%), followed by Hospital A for opiates 369(12.3%) and Hospital B for cannabis 161 (2.2%). Only 1151(8.2%) of patients received substance use treatment. Discharge destinations also differed (p < .001), with Hospital A having higher patient transfer rates 301(10%) and self-discharge/absconding incidents 415(13.8%) compared to Hospitals B 261(3.6%) and 442(6%) and C 175(4.9%) and 200(5.6%) respectively. Alcohol-related disorders were among the top five non-communicable diseases for men across all sites, and for women in two of the three hospitals, indicating a widespread but gender-variable burden of alcohol-related harm. Discussion: The data demonstrates significant disparities in substance-related admissions, discharges, and treatment across the hospitals, highlighting the need for integrated care pathways, personalized services, and targeted professional development to address substance use presentations effectively. The findings underscore that a one-size-fits-all approach is insufficient.
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Correction to: Ethnic and minority group differences in engagement with COVID-19 vaccination programmes – at Pandemic Pace; when vaccine confidence in mass rollout meets local vaccine hesitancyIn the original publication of this article [1] an error was introduced during the publication process in the reference numbering. This caused all citations after 13 to be incorrect. The citations in the original article have now been corrected.
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(In)action on the social and commercial determinants of health: a call to arms to push the agenda forwardIn this article, Noonan contends that boosting public support is vital for increasing pressure on the Government to enact change for the common good. He argues that the public health community can build public support for the required structural changes by challenging misinformation and sharing a new story.
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A third way: Off-team practice educators in social work educationIn Social Work, Practice Educators (PEs) are termed ‘on-site’ or ‘off-site’ depending on whether they work in the same location as the student they are supporting, or are ‘physically located away from the learners practice area’. Here, we trial and examine a third model: ‘off-team’ practice education. An off-team PE works in the same local authority (LA) as the student but in a different team, providing some familiarity and distance. We hypothesized that this model could be more favorable to LAs, providing some advantages of off-site and on-site models. Using focus groups, we explored student and PE experiences of the off-team model and compared them with experiences of the on-site model. We found that off team education offers a viable pathway for supporting students, but there are differences to recognize to maximize advantages and mitigate disadvantages. The significance of our study for practice education lies in its exploration of the potentials and limitations of the off-team model, particularly regarding supervision, assessment, and the development of professional relationships. We conclude by offering reflections on how educators might more effectively operationalize both on-site and off-team models to maximize their respective strengths.
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Impact of Severe Hemophilia on Costs and Quality of Life in South American Men: Findings From the CHESS LATAM StudySevere hemophilia is a rare bleeding disorder, associated with high socioeconomic costs and burden. The "Cost of Hemophilia in Latin America: A Socioeconomic Survey" (CHESS LATAM) study aimed to quantify this burden across 4 Latin American countries; Argentina, Brazil, Chile, and Colombia. Demographic, clinical, and medical data of patients were captured through their hemophilia specialists during the period between September 2020 and May 2021. Direct medical resource use was captured by a physician survey, and direct nonmedical and indirect costs were captured via a patient survey. Health-related quality of life was also captured from a patient perspective. Local country-specific unit costs were applied to resource use to calculate per-patient costs over a 12-month period. Physician data were captured for a total of 830 patients. For a subsample, 153 (18% of the sample) associated patient surveys were completed. Annual cost of severe hemophilia across the 4 countries was estimated at less than US$ 104 000 (International$ 234 237) per patient. Factor replacement therapy accounted for the majority of costs (up to 99%). Indirect costs were driven by patient and caregiver work loss. The results of the CHESS LATAM study highlight the large burden faced by patients with severe hemophilia A and B in Latin America. Despite the dominating treatment costs, the indirect impact of hemophilia on the patients and those who care for them was still substantial and should not be dismissed. [Abstract copyright: Copyright © 2025 The Authors. Published by Elsevier Inc. All rights reserved.]
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Fruit and vegetable intake in minority ethnic groups in the UK: Analysis from ‘Understanding Society’ and UK BiobankObjective: To examine differences in fruit and vegetable intake and food insecurity between Black African and Caribbean and South Asian (Indian, Pakistani and Bangladeshi) ethnic minority groups with a White (British) reference population in the UK. This study was part of the TANGERINE project (nuTritional heAlth aNd aGeing in oldER ethnIc miNoritiEs). Design: Longitudinal analysis using multilevel logistic regression from Understanding Society, and a cross-sectional comparison with UK Biobank. Setting: Understanding Society waves 2 (2010-2012), 5 (2013-2015), 7 (2015-2017), 9 (2017-2019) 11 (2019-2021), and 13 (2021-2023). UK Biobank baseline data (2006-2010). Participants: Understanding Society: adults aged 16 years and above (approximately 44,000 households). UK Biobank: participants aged 37-73 years (n=502,412). Results: At wave 2, African, Caribbean, Pakistani, and Bangladeshi participants in Understanding Society had lower odds of daily vegetable intake than White British/Irish participants, with Pakistanis showing the lowest intake. These disparities persisted after adjusting for socioeconomic position (SEP) at individual and area level, particularly for Caribbean and Pakistani groups. Indians consistently had higher odds of vegetable intake. Ethnic differences in fruit intake were smaller and largely attenuated by SEP adjustment. Food insecurity was more prevalent in all ethnic minority groups (except Indians) and associated with lower vegetable and fruit intake, though SEP explains more of the ethnic difference. Conclusions: Ethnic differences in fruit and vegetable intake are at least partially explained by SEP, with persistent vegetable consumption disparities after adjustment. Culturally tailored interventions addressing affordability, accessibility, and SEP disparities are needed to improve dietary behaviours among minority ethnic groups.
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Exploring the relationship between personalization of care and participation in sport activities among people with severe Hemophilia A across Europe: Post hoc analysis of the CHESS II studyTo describe the demographic and clinical characteristics of patients with hemophilia A receiving different levels of treatment personalization (TP), and to assess the relationship between TP and sport active time (SAT). This post hoc analysis of the CHESS II study used data from physician-completed patient record forms and patient self-completion forms for adult males receiving prophylaxis for severe hemophilia A in Europe between November 2018 and October 2020. SAT was assessed using propensity score matching (PSM) across levels of TP, including pharmacokinetic (PK)-guided and non-PK-guided. Of 54 patients, 32 (59.3%) received TP. Of these, 22 (68.8%) and 10 (31.3%) received non-PK-guided and PK-guided treatment, respectively. Median age varied between the TP and no-TP groups (29.5 and 34.0 years, respectively). Median (IQR) annual bleeding incidence was higher with non-PK-guided vs PK-guided TP (4.0 [3.0-8.0] vs 3.5 [2.0-4.0]). Median (IQR) problem joints were similar with non-PK-guided and PK-guided TP (1.0 [0.0-1.0] and 1.0 [0.0-2.0]). Patients in the TP vs no-TP group had higher median (IQR) SAT per month (3.3 [1.8-6.2] vs 1.8 [0.7-5.0] hours). Median (IQR) SAT per month was higher with PK-guided vs non-PK-guided TP (4.0 [3.0-20.0] vs 3.0 [1.3-5.3] hours). After controlling for confounding in the PSM model, SAT remained higher with TP vs no-TP and with PK-guided vs non-PK-guided TP. In both PSM models, P values were <0.05 for the average treatment effect and <0.01 for the average treatment effect on the treated. Sensitivity analyses confirmed the robustness of the PSM. Patients receiving TP vs no-TP had higher median SAT. Of those with TP, those receiving PK-guided vs non-PK-guided TP experienced lower bleeding rates and higher SAT. PK-guided TP may help patients to be more active, potentially gaining the clinical and psychosocial benefits of exercise. [Abstract copyright: © 2025 The Takeda Pharmaceutical Company Limited (Takeda).]
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Spatial distribution and multilevel analysis of factors associated with long-acting reversible contraceptive use among sexually active women of reproductive age in NigeriaBackground: Long-acting reversible contraceptives (LARCs), including hormonal implants and intrauterine devices, are highly effective pregnancy prevention methods. Aside its advantages over other hormonal methods, LARCs are cost-effective, easy to maintain, and have a low risk of non-compliance-related method failure. Besides, LARCs are also relatively safe for all sexually active women in the postpartum or post-abortion period. However, despite its effectiveness, most sexually active women use other short-term methods, such as condoms and contraceptive pills, which are associated with high discontinuation rates. Thus, this study examines the spatial distribution and multilevel factors associated with LARC use among sexually active reproductive-age women in Nigeria. Methods: This is a cross-sectional analysis of a population-based study from the 2018 Nigeria Demographic Health Survey (NDHS). The NDHS is a nationally representative survey that collects data on socio-demographic characteristics, sexual and reproductive health-related indicators such as contraceptive use and child & maternal health. A sample of 3,978 sexually active reproductive-age women (15–49 years) in Nigeria was used in the analysis. Frequency distribution and spatial analysis of LARC use were displayed with tables and maps, respectively, while multilevel analysis at a 95% confidence interval (CI) and a p-value of less than 0.05 was used to determine factors associated with LARC use among the sample. Results: The spatial distribution of LARC use among sexually active women of reproductive age in Nigeria ranges between 20 and 34.8%. Fifteen of the 36 states (excluding the Federal Capital Territory, FCT) recorded low utilization of LARCs. These states include Adamawa, Lagos, Ogun, Enugu, Anambra, Imo, Abia, Rivers, Kogi, Taraba, Yobe, Gombe, Jigawa, Borno, and Kebbi. Besides, the likelihood of LARC use was lower among participants with a prior history of pregnancy termination [aOR = 0.62; 95%(CI = 0.48–0.80)] compared to their counterparts without pregnancy termination history. Also, participants with no fertility intention had a higher likelihood of using LARCs [aOR = 1.65; 95%(CI = 1.30–2.08)] compared to those with fertility intention. At the community level, women with higher socioeconomic status were less likely to use LARCs [aOR = 0.66; 95%(CI = 0.45–0.97)] compared to women with lower socioeconomic status. Conclusions: This study showed a relatively low utilisation of LARC among sexually active reproductive-age women in Nigeria. Notably, this low utilisation is also common in states that could be described as cosmopolitan, indicating a need for closer investigation to understand context-specific factors associated with LARC use. Population-specific family planning education and counselling for this population are important to address common misconceptions about LARCs in particular and modern contraceptive use in general.
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Physical activity volume and intensity for healthy body mass index and cardiorespiratory fitness: Enhancing the translation of children and adolescent’s accelerometer physical activity reference valuesIntroduction: This secondary data analysis aimed to demonstrate the utility of physical activity (PA) wrist accelerometer outcome reference values by identifying the PA volume (average acceleration) and intensity distribution (intensity gradient) centiles and values associated with body mass index (BMI) status (normal weight, overweight, obese) and cardiorespiratory fitness (CRF, multi-stage shuttle runs test) status (low, moderate high) in children and adolescents. Methods: We assessed the dose-response associations between average acceleration and intensity gradient with BMI and CRF outcomes using restricted cubic spline linear mixed models. To aid translation of the findings we calculated the increases in average acceleration needed to shift exemplar participants to ‘healthy’ weight and CRF status. Results: For boys and girls there was a non-linear inverse association between average acceleration and BMI. In both sexes a positive dose-response was observed between average acceleration and intensity gradient with CRF. The values and centiles of average acceleration and intensity gradient that aligned with BMI and CRF statuses were identified. To move from an average acceleration associated with overweight to healthy weight 10-year-old boys and girls would need to increase daily average acceleration by 23 mg (~30 minutes running) and 16 mg (~18 minutes running) respectively. Conclusions: These findings further demonstrate the importance of PA in relation to BMI and CRF and the utility of PA reference values for the translation of accelerometer outcomes into meaningful information. Additional studies demonstrating how PA reference values can be used to track behaviours and provide insights into health associations could inform practice further.
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Mental health, work productivity, and quality of life in people with severe Haemophilia A receiving prophylaxis: Findings from the CHESS data platformNewer therapeutic options for people with severe haemophilia A (PwSHA), in addition to improved clinical and patient-reported outcomes (PROs), have offered more personalised treatment regimens. This analysis explored mental health, work productivity, and health-related quality of life (HRQoL) among PwSHA in Europe receiving a prophylactic treatment regimen.The Cost of Haemophilia: a Socio-economic Survey (CHESS) study is a retrospective cross-sectional study of adult men with haemophilia in Europe. We analysed data from CHESS participants with severe haemophilia A and no factor VIII (FVIII) inhibitors who received emicizumab or FVIII replacement prophylaxis. Data are from patient questionnaires and their treating health care providers. This analysis focused on PROs, including productivity and activity impairment via the Work Productivity and Activity Impairment, HRQoL via the EQ-5D-5L, and anxiety via the 7-item General Anxiety Disorder questionnaire (GAD-7) and depression via the 8-item Patient Health Questionnaire (PHQ-8). SHA treatment and clinical characteristics were also collected, including bleeding events, joint health, and chronic pain. All findings were analysed descriptively.A total of 350 PwSHA met the inclusion criteria, 94 (27%) of whom provided PROs. Most (68%; n = 64) were receiving emicizumab (FVIII prophylaxis, 32%; n = 30). Clinical characteristics were generally comparable between emicizumab and FVIII prophylaxis groups, including reported chronic pain (63% and 70%) and problem joints (61% and 63%), with on-demand FVIII use for the treatment of breakthrough bleeding events more commonly reported in the FVIII prophylaxis group (34% vs. 56%). Overall, HRQoL showed comparable EQ-5D-5L scores between the treatment groups, with a marginally higher score in the emicizumab group (0.71 vs. 0.69) compared with the FVIII prophylaxis group. Anxiety and depression scores were both numerically lower in the emicizumab group, suggesting a lower burden of disease (anxiety 7-item General Anxiety Disorder questionnaire [GAD-7] mean scores, 6.0 vs. 7.3; depression PHQ-8 mean scores, 6.8 vs. 7.8). Employed PwSHA in the emicizumab group reported a lower impact of SHA on their work impairment (31% vs. 50%), and only 19% (vs. 33%) of the emicizumab group required assistance with daily activities. More PwSHA receiving FVIII prophylaxis reported a negative impact of SHA on their ability to participate in social activities (70% vs. 56%) and on their physical activity (57% vs. 44%).Patients receiving emicizumab prophylaxis appeared to have more favourable mental health, work productivity, and HRQoL-related outcomes than those receiving FVIII prophylaxis. These findings were observed in the context of comparable clinical characteristics between emicizumab and FVIII prophylaxis despite evidence of a more complex treatment history for the emicizumab group. This analysis has limitations, including a lack of adjustment for confounding factors.
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Motivations, perceptions and experiences of cycling for transport: A photovoice studyIntroduction: The aim of this study was to use photovoice methodology to explore perceptions and lived experiences of cycling for transport. It was envisaged that the contextual information gathered from this qualitative study would provide novel insights into the meanings people ascribe towards cycling for transport. Methods: Fifteen adult participants from Liverpool, England each generated three photographs representing what they like and what they dislike about cycling for transport, and what cycling for transport means to them, and completed a subsequent photo-elicitation telephone interview. Data were analysed through an iterative deductive and inductive process, firstly using the ecological model of active living as a thematic framework, and then inductively to enable emergent themes to be further explored. Pen profile figures were constructed to illustrate key emergent themes. Results: The photovoice methodology generated complimentary and interconnected visual and narrative data which confirmed and uncovered new insights into intrapersonal, sociocultural and environmental factors relevant to cycling for transport experiences. Intrapersonal and perceived environmental factors had a stronger influence on cycling for transport than sociocultural factors. Road safety concerns were reported by all participants, and the provision of cycling infrastructure was reported as an enabler and barrier to transport cycling. The motivations and meanings ascribed to cycling for transport principally related to time saving and cost saving, as well as reliability. Conclusions: Convenience was a recurring theme in the present study. Emphasising the relative speed and cost efficiency of cycling for transport, as well as the potential health and environmental benefits, could lead to more cycling for transport uptake.
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Restructuring priorities: Rethinking economic growth for a more active futurePhysical inactivity is among the most formidable public health challenges of our time. The World Health Organization recently revealed that physical inactivity is on the rise and predicted that globally, there will be around 500 million new cases of preventable non-communicable diseases between 2020 and 2030 if physical inactivity levels remain as they are. But why? What’s driving this formidable public health challenge? In this commentary article, I illustrate how the continual pursuit of economic growth is a key driver underpinning physical inactivity at the population level. I contend that if the priority really is to address physical inactivity at the population level, then the metrics we use to define social progress will need recalibrating.
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A qualitative study of how and why gym-based resistance training may benefit women's mental health and wellbeingPurpose: This study used photovoice methodology to explore women's lived experiences of gym-based resistance training, and the potential mechanisms by which resistance training may promote wellbeing. Methods: Ten women aged between 18 and 27 years from various locations across England each generated a total of three photographs illustrating 1) what they like and 2) what they dislike about gym-based resistance training, and 3) what gym-based resistance training means to them, and completed a subsequent photo-elicitation telephone interview via Zoom video conferencing software. Data were analysed through an iterative deductive and inductive process, firstly using Ryff's psychological wellbeing model (Ryff, 1989) as a thematic framework, and then inductively to further explore the data. Results: Five themes linking gym-based resistance training and mental health and wellbeing were identified: (1) self-acceptance, (2) personal growth, (3) flow state, (4) social affiliation and (5) autonomy. Through engaging in resistance training participants exercise self-direction (i.e., autonomy) and have the opportunity to develop positive relations with like-minded others. The activity itself can facilitate the achievement of the “flow state” of mind. The setting, pursuit and achievement of meaningful “intrinsic goals” can result in feelings of personal growth and realisation a more positive self-regard. Conclusion: Gym-based resistance training provides various paths to wellbeing. Greater emphasis of these wellbeing benefits in public health messaging may encourage more women to engage in gym-based resistance training.
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PE teachers’ perceived expertise and professional development requirements in the delivery of muscular fitness activity: PE Teacher EmPOWERment SurveyMuscular fitness (MF) is an important modifiable factor to improve overall health. Schools offer a unique opportunity to deliver MF activity during physical education (PE) and develop competence to engage in various activities across the life course. However, the implementation of school-based MF activity may be impaired by some teachers reporting a lack of expertise and low confidence in the delivery of MF activity. Understanding teachers’ thoughts and perceptions regarding the delivery of MF in schools may help guide future research and policy to support MF delivery in UK schools. Following ethical approval, a survey of secondary school PE teachers across the UK was distributed via Twitter. Survey responses were analysed and reported descriptively and thematically. Completed surveys were returned by 194 teachers (61.9% male) from England, Scotland, Wales, and Northern Ireland. Relative to less experienced teachers, those with at least five years’ service were 2.2 times more likely to have completed continued professional development (CPD) in MF activity (OR = 2.16; ß = 0.77; 95% CI: 1.25-3.74; p < 0.01), and 1.8 times more likely to use assessments of MF to inform PE programme decision-making (OR = 1.83; ß = 0.60; 95% CI: 1.18-2.82; p < 0.01). Despite the promising contribution school-based PE may have to developing MF, we report a poor understanding of MF activity amongst UK-based PE teachers. CPD is warranted to deliver successful MF interventions in a school setting.
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Family income matters! Tracking of habitual car use for school journeys and associations with overweight/obesity in UK youthIntroduction: The aims of this study were to assess associations between car use for school journeys in early childhood and car use for school journeys in later childhood and adolescence, (ii) determine whether an income gradient to habitual car use for school journeys and overweight/obesity exists in the UK, and (iii) assess the extent to which habitual car use for school journeys through childhood and into adolescence is associated with overweight/obesity in adolescence. Methods: Data is from sweep three, four, five and six of the UK Millennium Cohort Study. Subjects consisted of 8494 children (4251 girls). Stature and body mass were assessed at age 5 and 14 years and children were categorised as normal weight or overweight/obesity. Commute mode to and from school was parent/carer reported at age 5, 7, 11 and 14 years and habitual car use for school journeys was determined. Family income at age 5 years was determined using equivalised household income. Adjusted logistic and multinomial logistic regression analyses were conducted. Results: Car use for school journeys at age 5 was positively associated with car use for school journeys at age 7, 11 and 14 years (p < 0.001). Family income at child age 5 was inversely associated with overweight/obese at age 5 and 14 years and positively associated with habitual car use (p < 0.001). Habitual car use for school journeys was not associated with overweight/obesity at age 14 years. Conclusions: Car use for school journeys in early childhood is positively associated with car use for school journeys in later childhood and adolescence. Children living in the highest income households have the lowest rates of overweight/obesity, and there is an income gradient to habitual car use for school journeys. Habitual car use for school journeys through childhood and into adolescence is not positively associated with overweight/obesity in adolescence.
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How can UK public health initiatives support each other to improve the maintenance of physical activity? Evidence from a cross-sectional survey of runners who move from Couch-to-5k to parkrunPhysical activity improves physical and mental well-being and reduces mortality risk. However, only a quarter of adults globally meet recommended physical activity levels for health. Two common initiatives in the UK are Couch-to-5k (an app-assisted 9-week walk/run programme) and parkrun (a free, weekly, timed 5-km walk/run). It is not known how these initiatives are linked, how Couch-to-5k parkrunners compare to parkrunners, and the extent to which this influences their parkrun performance. The aims were to compare the characteristics and motives and to compare physical activity levels, parkrun performance and the impact of parkrun between Couch-to-5k parkrunners and parkrunners. Three thousand two hundred and ninety six Couch-to-5k parkrunners were compared to 55,923 parkrunners to explore age, sex, ethnicity, employment status, neighbourhood deprivation, motives, physical activity levels, parkrun performance and the impact of parkrun. Couch-to-5k parkrunners were slightly older, more likely to be female and work part-time, but similar in ethnicity, and neighbourhood deprivation compared with other parkrunners. Couch-to-5k parkrunners had different motives for participation and reported high levels of physical activity at registration, which remained to the point of survey completion. This group had slower parkrun times but, when registered for a year, completed a similar number of runs (11) per year. Larger proportions of Couch-to-5k parkrunners perceived positive impacts compared with other parkrunners and 65% of Couch-to-5k parkrunners reported improvements to their lifestyle. parkrun appears to be an effective pathway for those on the Couch-to-5k programme, and the promising positive association between the two initiatives may be effective in assisting previously inactive participants to take part in weekly physical activity.
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What are the roots of the nation’s poor health and widening health inequalities? Rethinking economic growth for a fairer and healthier futureHealth inequalities are differences in health between groups in society. Despite them being preventable they persist on a grand scale. At the beginning of 2024, the Institute of Health Equity revealed in their report titled: Health Inequalities, Lives Cut Short, that health inequalities caused 1 million early deaths in England over the past decade. While the number of studies on the prevalence of health inequalities in the UK has burgeoned, limited emphasis has been given to exploring the factors contributing to these (widening) health inequalities. In this commentary article I will describe how the Government's relentless pursuit of economic growth and their failure to implement the necessary regulatory policies to mitigate against the insecurity and health effects neoliberal free market capitalism (referred to as capitalism herein) causes in pursuit of innovation, productivity and growth (economic dynamism) is one key driver underpinning this social injustice. I contend that if the priority really is to tackle health inequalities and ensure health for all then there is an imperative need to move beyond regulation alone to mitigate the worst effects of capitalist production; the goal of the economy has to change to fully restore the balance between economic growth and public health.
