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Hoffmann C, Avery KNL, Macefield RC, Snelgrove V, Blazeby JM, Hopkins D, Hickey S, Cabral C, Hall J, Gibbison B, Rooshenas L, Williams A, Aning J, Bekker HL, McNair AGK. Real-time monitoring and feedback to improve shared decision-making for surgery (the ALPACA Study): protocol for a mixed-methods study to inform co-development of an inclusive intervention. BMJ Open 2024; 14:e079155. [PMID: 38238045 PMCID: PMC10806516 DOI: 10.1136/bmjopen-2023-079155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 12/07/2023] [Indexed: 01/23/2024] Open
Abstract
INTRODUCTION High-quality shared decision-making (SDM) is a priority of health services, but only achieved in a minority of surgical consultations. Improving SDM for surgical patients may lead to more effective care and moderate the impact of treatment consequences. There is a need to establish effective ways to achieve sustained and large-scale improvements in SDM for all patients whatever their background. The ALPACA Study aims to develop, pilot and evaluate a decision support intervention that uses real-time feedback of patients' experience of SDM to change patients' and healthcare professionals' decision-making processes before adult elective surgery and to improve patient and health service outcomes. METHODS AND ANALYSIS This protocol outlines a mixed-methods study, involving diverse stakeholders (adult patients, healthcare professionals, members of the community) and three National Health Service (NHS) trusts in England. Detailed methods for the assessment of the feasibility, usability and stakeholder views of implementing a novel system to monitor the SDM process for surgery automatically and in real time are described. The study will measure the SDM process using validated instruments (CollaboRATE, SDM-Q-9, SHARED-Q10) and will conduct semi-structured interviews and focus groups to examine (1) the feasibility of automated data collection, (2) the usability of the novel system and (3) the views of diverse stakeholders to inform the use of the system to improve SDM. Future phases of this work will complete the development and evaluation of the intervention. ETHICS AND DISSEMINATION Ethical approval was granted by the NHS Health Research Authority North West-Liverpool Central Research Ethics Committee (reference: 21/PR/0345). Approval was also granted by North Bristol NHS Trust to undertake quality improvement work (reference: Q80008) overseen by the Consent and SDM Programme Board and reporting to an Executive Assurance Committee. TRIAL REGISTRATION NUMBER ISRCTN17951423; Pre-results.
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Affiliation(s)
- Christin Hoffmann
- National Institute for Health and Care Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK
| | - Kerry N L Avery
- National Institute for Health and Care Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK
| | - Rhiannon C Macefield
- National Institute for Health and Care Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK
| | | | - Jane M Blazeby
- National Institute for Health and Care Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK
| | | | - Shireen Hickey
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Christie Cabral
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jennifer Hall
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Ben Gibbison
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Leila Rooshenas
- National Institute for Health and Care Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK
| | | | - Jonathan Aning
- Bristol Urological Institute, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Hilary L Bekker
- Leeds Unit of Complex Intervention Development (LUCID), Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, UK
- The Research Centre for Patient Involvement (ResCenPI), Department of Public Health, Aarhus Universitet, Central Denmark Region, Denmark
| | - Angus G K McNair
- National Institute for Health and Care Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK
- North Bristol NHS Trust, Bristol, UK
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Dickerson J, Bridges S, Willan K, Kelly B, Moss RH, Lister J, Netkitsing C, Atkinson AL, Bird PK, Uphoff EP, Mason D, Newsham A, Waiblinger D, Razaq R, Ahern S, Bryant M, Blower SL, Pickett KE, McEachan RM, Wright J. Born in Bradford's Better Start (BiBBS) interventional birth cohort study: Interim cohort profile. Wellcome Open Res 2023; 7:244. [PMID: 37830108 PMCID: PMC10565418 DOI: 10.12688/wellcomeopenres.18394.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 10/14/2023] Open
Abstract
Background: The Born in Bradford's Better Start (BiBBS) interventional birth cohort study was designed as an innovative cohort platform for efficient evaluation of early life interventions delivered through the Better Start Bradford programme. There are a growing number of interventional cohorts being implemented internationally. This paper provides an interim analysis of BiBBS in order to share learning about the feasibility and value of this method. Methods: Recruitment began in January 2016 and will complete in December 2023 with a target sample of 5,000 pregnancies. An interim analysis was completed for all pregnancies recruited between January 2016 and November 2019 with an expected due date between 1 st April 2016 and 8 th March 2020. Descriptive statistics were completed on the data. Results: Of 4,823 eligible pregnancies, 2,626 (54%) pregnancies were recruited, resulting in 2,392 mothers and 2,501 children. The sample are representative of the pregnant population (61% Pakistani heritage; 12% White British; 8% other South Asian and 6% Central and Eastern European ethnicity). The majority of participants (84%) live in the lowest decile of the Index of Multiple Deprivation, and many live in vulnerable circumstances. A high proportion (85%) of BiBBS families have engaged in one or more of the Better Start Bradford interventions. Levels of participation varied by the characteristics of the interventions, such as the requirement for active participation and the length of commitment to a programme. Conclusions: We have demonstrated the feasibility of recruiting an interventional cohort that includes seldom heard families from ethnic minority and deprived backgrounds. The high level of uptake of interventions is encouraging for the goal of evaluating the process and outcomes of multiple early life interventions using the innovative interventional cohort approach. BiBBS covers a period before, during and after the coronavirus disease 2019 (COVID-19) pandemic which adds scientific value to the cohort.
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Affiliation(s)
- Josie Dickerson
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Sally Bridges
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Kathryn Willan
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Brian Kelly
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Rachael H. Moss
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Jennie Lister
- Health Sciences, University of York, York, YO10 5DD, UK
| | - Chandani Netkitsing
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
- Health Sciences, University of York, York, YO10 5DD, UK
| | - Amy L. Atkinson
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Philippa K. Bird
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | | | - Dan Mason
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Alex Newsham
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Dagmar Waiblinger
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Rifat Razaq
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Sara Ahern
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Maria Bryant
- Health Sciences, University of York, York, YO10 5DD, UK
- Hull York Medical School, University of York, York, YO10 5DD, UK
| | | | | | - Rosemary M. McEachan
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - John Wright
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
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3
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Dickerson J, Bridges S, Willan K, Kelly B, Moss RH, Lister J, Netkitsing C, Atkinson AL, Bird PK, Uphoff EP, Mason D, Newsham A, Waiblinger D, Razaq R, Ahern S, Bryant M, Blower SL, Pickett KE, McEachan RM, Wright J. Born in Bradford's Better Start (BiBBS) interventional birth cohort study: Interim cohort profile. Wellcome Open Res 2023; 7:244. [PMID: 37830108 PMCID: PMC10565418 DOI: 10.12688/wellcomeopenres.18394.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 06/08/2024] Open
Abstract
Background: The Born in Bradford's Better Start (BiBBS) interventional birth cohort study was designed as an innovative cohort platform for efficient evaluation of early life interventions delivered through the Better Start Bradford programme. There are a growing number of interventional cohorts being implemented internationally. This paper provides an interim analysis of BiBBS in order to share learning about the feasibility and value of this method. Methods: Recruitment began in January 2016 and will complete in December 2023 with a target sample of 5,000 pregnancies. An interim analysis was completed for all pregnancies recruited between January 2016 and November 2019 with an expected due date between 1 st April 2016 and 8 th March 2020. Descriptive statistics were completed on the data. Results: Of 4,823 eligible pregnancies, 2,626 (54%) pregnancies were recruited, resulting in 2,392 mothers and 2,501 children. The sample are representative of the pregnant population (61% Pakistani heritage; 12% White British; 8% other South Asian and 6% Central and Eastern European ethnicity). The majority of participants (84%) live in the lowest decile of the Index of Multiple Deprivation, and many live in vulnerable circumstances. A high proportion (85%) of BiBBS families have engaged in one or more of the Better Start Bradford interventions. Levels of participation varied by the characteristics of the interventions, such as the requirement for active participation and the length of commitment to a programme. Conclusions: We have demonstrated the feasibility of recruiting an interventional cohort that includes seldom heard families from ethnic minority and deprived backgrounds. The high level of uptake of interventions is encouraging for the goal of evaluating the process and outcomes of multiple early life interventions using the innovative interventional cohort approach. BiBBS covers a period before, during and after the coronavirus disease 2019 (COVID-19) pandemic which adds scientific value to the cohort.
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Affiliation(s)
- Josie Dickerson
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Sally Bridges
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Kathryn Willan
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Brian Kelly
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Rachael H. Moss
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Jennie Lister
- Health Sciences, University of York, York, YO10 5DD, UK
| | - Chandani Netkitsing
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
- Health Sciences, University of York, York, YO10 5DD, UK
| | - Amy L. Atkinson
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Philippa K. Bird
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | | | - Dan Mason
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Alex Newsham
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Dagmar Waiblinger
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Rifat Razaq
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Sara Ahern
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - Maria Bryant
- Health Sciences, University of York, York, YO10 5DD, UK
- Hull York Medical School, University of York, York, YO10 5DD, UK
| | | | | | - Rosemary M. McEachan
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
| | - John Wright
- Born in Bradford, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, BD9 6RJ, UK
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Nielsen D, d'Apice K, Cheung RW, Bryant M, Heald R, Storr C, Tracey L, Rashid R, Dickerson J, Bowyer-Crane C. A randomised controlled feasibility trial of an early years language development intervention: results of the 'outcomes of Talking Together evaluation and results' (oTTer) project. Pilot Feasibility Stud 2023; 9:107. [PMID: 37386614 DOI: 10.1186/s40814-023-01333-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 06/07/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Early language difficulties are associated with poor school readiness and can impact lifelong attainment. The quality of the early home language environment is linked to language outcomes. However, few home-based language interventions have sufficient evidence of effectiveness in improving preschool children's language abilities. This study reports the first stage in the evaluation of a theory-based programme, Talking Together (developed and delivered by BHT Early Education and Training) given over 6 weeks to families in the home setting. We aimed to test the feasibility and acceptability of delivering Talking Together in the Better Start Bradford community prior to a definitive trial, using a two-armed randomised controlled feasibility study. METHODS Families from a single site within the Better Start Bradford reach area were randomly allocated (1:1) to the Talking Together intervention or a wait list control group. Child language and parent-level outcome measures were administered before randomisation (baseline), pre-intervention (pre-test), 2 months post-intervention start (post-test), and 6 months post-intervention start (follow-up). Routine monitoring data from families and practitioners were also collected for eligibility, consent, protocol adherence, and attrition rates. Descriptive statistics on the feasibility and reliability of potential outcome measures were analysed alongside qualitative feedback on trial design acceptability. Pre-defined progression-to-trial criteria using a traffic light system were assessed using routine monitoring data. RESULTS Two-hundred and twenty-two families were assessed for eligibility; of these, 164 were eligible. A total of 102 families consented and were randomised (intervention: 52, waitlist control: 50); 68% of families completed outcome measures at 6-month follow-up. Recruitment (eligibility and consent) reached 'green' progression criteria; however, adherence reached 'amber' and attrition reached 'red' criteria. Child- and parent-level data were successfully measured, and the Oxford-CDI was identified as a suitable primary outcome measure for a definitive trial. Qualitative data not only indicated that the procedures were largely acceptable to practitioners and families but also identified areas for improvement in adherence and attrition rates. CONCLUSIONS Referral rates indicate that Talking Together is a much-needed service and was positively received by the community. A full trial is feasible with adaptations to improve adherence and reduce attrition. TRIAL REGISTRATION ISRCTN registry ISRCTN13251954. Retrospectively registered 21 February 2019.
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Affiliation(s)
- Dea Nielsen
- Department of Health Sciences, University of York, York, UK.
| | - Katrina d'Apice
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Maria Bryant
- Department of Health Sciences/Hull York Medical School, University of York, York, UK
| | | | - Chloe Storr
- BHT Early Education and Training, Bradford, UK
| | - Louise Tracey
- Department of Health Sciences, University of York, York, UK
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Hoosain M, Mayet-Hoosain N, Plastow NA. Workplace-Based Interventions for Mental Health in Africa: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105863. [PMID: 37239589 DOI: 10.3390/ijerph20105863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/12/2023] [Accepted: 04/17/2023] [Indexed: 05/28/2023]
Abstract
Mental health problems are one of the leading contributors to the global burden of disease. Workplaces provide a valuable and accessible setting for interventions to improve worker health. However, little is known about mental health interventions on the African continent, particularly those based in the workplace. This review aimed to identify and report on the literature about workplace-based interventions for mental health in Africa. This review followed the JBI and PRISMA ScR guidelines for scoping reviews. We searched 11 databases for qualitative, quantitative and mixed-methods studies. The grey literature was included, and no language or date limits were applied. Title and abstract screening and full text review, were completed independently by two reviewers. A total of 15 514 titles were identified, of which, 26 titles were included. The most common study designs were qualitative studies (n = 7) and pre-experimental, single-group, pre-test, post-test studies (n = 6). Workers with depression, bipolar mood disorder, schizophrenia, intellectual disability, alcohol and substance abuse, stress and burnout were included in the studies. The participants were mostly skilled and professional workers. A wide variety of interventions were offered, of which, most were multi-modal. There is a need to develop multi-modal interventions in partnership with stakeholders, particularly for semi-skilled and unskilled workers.
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Affiliation(s)
- Munira Hoosain
- Division of Occupational Therapy, Department of Health & Rehabilitation Sciences, Faculty of Medicine & Health Sciences, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa
| | - Naafi'ah Mayet-Hoosain
- Division of Occupational Therapy, Department of Health & Rehabilitation Sciences, Faculty of Medicine & Health Sciences, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa
| | - Nicola Ann Plastow
- Division of Occupational Therapy, Department of Health & Rehabilitation Sciences, Faculty of Medicine & Health Sciences, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa
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Cavallaro FL, Cannings-John R, Lugg-Widger F, Gilbert R, Kennedy E, Kendall S, Robling M, Harron KL. Lessons learned from using linked administrative data to evaluate the Family Nurse Partnership in England and Scotland. Int J Popul Data Sci 2023; 8:2113. [PMID: 37670953 PMCID: PMC10476150 DOI: 10.23889/ijpds.v8i1.2113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023] Open
Abstract
Introduction "Big data" - including linked administrative data - can be exploited to evaluate interventions for maternal and child health, providing time- and cost-effective alternatives to randomised controlled trials. However, using these data to evaluate population-level interventions can be challenging. Objectives We aimed to inform future evaluations of complex interventions by describing sources of bias, lessons learned, and suggestions for improvements, based on two observational studies using linked administrative data from health, education and social care sectors to evaluate the Family Nurse Partnership (FNP) in England and Scotland. Methods We first considered how different sources of potential bias within the administrative data could affect results of the evaluations. We explored how each study design addressed these sources of bias using maternal confounders captured in the data. We then determined what additional information could be captured at each step of the complex intervention to enable analysts to minimise bias and maximise comparability between intervention and usual care groups, so that any observed differences can be attributed to the intervention. Results Lessons learned include the need for i) detailed data on intervention activity (dates/geography) and usual care; ii) improved information on data linkage quality to accurately characterise control groups; iii) more efficient provision of linked data to ensure timeliness of results; iv) better measurement of confounding characteristics affecting who is eligible, approached and enrolled. Conclusions Linked administrative data are a valuable resource for evaluations of the FNP national programme and other complex population-level interventions. However, information on local programme delivery and usual care are required to account for biases that characterise those who receive the intervention, and to inform understanding of mechanisms of effect. National, ongoing, robust evaluations of complex public health evaluations would be more achievable if programme implementation was integrated with improved national and local data collection, and robust quasi-experimental designs.
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Affiliation(s)
- Francesca L. Cavallaro
- UCL Great Ormond Street Institute of Child Health, London, UK
- The Health Foundation, 8 Salisbury Square, London, UK
| | - Rebecca Cannings-John
- Centre for Trials Research, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Fiona Lugg-Widger
- Centre for Trials Research, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Ruth Gilbert
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Eilis Kennedy
- Children, Young Adults and Families Directorate, Tavistock and Portman NHS Foundation Trust, London, UK
| | - Sally Kendall
- Centre for Health Services Studies, University of Kent, Canterbury, UK
| | - Michael Robling
- Centre for Trials Research, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Katie L. Harron
- UCL Great Ormond Street Institute of Child Health, London, UK
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Mooney KE, Bywater T, Dickerson J, Richardson G, Hou B, Wright J, Blower S. Protocol for the effectiveness evaluation of an antenatal, universally offered, and remotely delivered parenting programme 'Baby Steps' on maternal outcomes: a Born in Bradford's Better Start (BiBBS) study. BMC Public Health 2023; 23:190. [PMID: 36709270 PMCID: PMC9884130 DOI: 10.1186/s12889-023-15111-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 01/20/2023] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Poor perinatal mental health and maternal sensitivity towards a child in the early years can carry a long-term cost to individuals and to society, and result in negative child outcomes such as poor mental health and social emotional issues. Despite the recognition of early intervention and prevention, there is mixed evidence regarding antenatal parenting interventions that aim to enhance perinatal mental health and maternal sensitivity to prevent negative child outcomes. 'Baby Steps' is a relationship-based antenatal and postnatal parenting programme. The service evaluated in this study is delivered in a low-income and ethnically diverse community via Better Start Bradford. This study aims to assess whether the universally, and remotely delivered Baby Steps programme is effective in improving postnatal maternal sensitivity (primary outcome) and postnatal maternal mental health (secondary outcome) when compared to services as usual 6-10 weeks post-birth. It will also assess differences in birth outcomes, and differences in the prevalence of poor perinatal mental ill health through routine data. The feasibility of collecting cost and health related resource use data for a future economic evaluation will be explored. METHODS The study is a quasi-experimental evaluation in a single centre. All participants are drawn from Born in Bradford's Better Start (BiBBS) interventional family cohort study. Intervention participants will be matched to a demographically comparable control group using propensity score matching. The required minimum sample is n = 130 (ratio 1:1) to detect a medium effect (± 2.35, d = .50) on the primary outcome-maternal-child sensitivity, using the Mothers Object Relations Scale Short Form (MORS-SF). Secondary outcomes include the Patient Health Questionnaire (PHQ-8), Generalised Anxiety Disorder assessment 7 (GAD-7), identification of poor perinatal mental health through routine data, and birth outcomes (delivery method, gestation period, low birth weight). Service delivery costs and health resource use will be gathered from routine data. DISCUSSION This study will evaluate the effectiveness of Baby Steps for enhancing maternal-child sensitivity and maternal mental health when delivered universally and remotely. The findings regarding programme effectiveness, process, and costs will be relevant for researchers, service commissioners, and service staff. TRIAL REGISTRATION This study was prospectively registered with ISRCTN (22/04/2022, ISRCTN12196131).
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Affiliation(s)
- Kate E. Mooney
- grid.5685.e0000 0004 1936 9668Department of Health Sciences, University of York, York, UK ,grid.418449.40000 0004 0379 5398Bradford Institute for Health Research, Bradford, UK
| | - Tracey Bywater
- grid.5685.e0000 0004 1936 9668Department of Health Sciences, University of York, York, UK
| | - Josie Dickerson
- grid.418449.40000 0004 0379 5398Bradford Institute for Health Research, Bradford, UK
| | - Gerry Richardson
- grid.5685.e0000 0004 1936 9668Centre for Health Economics, University of York, York, UK
| | - Bo Hou
- grid.418449.40000 0004 0379 5398Bradford Institute for Health Research, Bradford, UK
| | - John Wright
- grid.418449.40000 0004 0379 5398Bradford Institute for Health Research, Bradford, UK
| | - Sarah Blower
- grid.5685.e0000 0004 1936 9668Department of Health Sciences, University of York, York, UK
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Straw C, Sanchez-Antelo V, Kohler R, Paolino M, Viswanath K, Arrossi S. Implementation and scaling-up of an effective mHealth intervention to increase adherence to triage of HPV-positive women (ATICA study): perceptions of health decision-makers and health-care providers. BMC Health Serv Res 2023; 23:47. [PMID: 36653775 PMCID: PMC9847147 DOI: 10.1186/s12913-023-09022-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 01/02/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The ATICA study was a Hybrid I type randomized effectiveness-implementation trial that demonstrated effectiveness of a multicomponent mHealth intervention (Up to four SMS messages sent to HPV-positive women, and one SMS message to CHWs to prompt a visit of women with no triage Pap 60 days after a positive-test), to increase adherence to triage of HPV positive women (ATICA Study). We report data on perceptions of health decision-makers and health-care providers regarding the intervention implementation and scaling-up. METHODS A qualitative study was carried out based on individual, semi-structured interviews with health decision-makers (n = 10) and health-care providers (n = 10). The themes explored were selected and analyzed using domains and constructs of the Consolidated Framework for Implementation Research (CFIR) and the maintenance dimension of the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework. RESULTS Both health-care providers and decision-makers had a positive assessment of the intervention through most included constructs: knowledge of the intervention, intervention source, design quality, adaptability, compatibility, access to knowledge and information, relative advantage, women's needs, and relative priority. However, some potential barriers were also identified including: complexity, leadership engagement, external policies, economic cost, women needs and maintenance. Stakeholders conditioned the strategy's sustainability to the political commitment of national and provincial health authorities to prioritize cervical cancer prevention, and to the establishment of the ATICA strategy as a programmatic line of work by health authorities. They also highlighted the need to ensure, above all, that there was staff to take Pap tests and carry out the HPV-lab work, and to guarantee a constant provision of HPV-tests. CONCLUSION Health decision-makers and health-care providers had a positive perception regarding implementation of the multicomponent mHealth intervention designed to increase adherence to triage among women with HPV self-collected tests. This increases the potential for a successful scaling-up of the intervention, with great implications not only for Argentina but also for middle and low-income countries considering using mHealth interventions to enhance the cervical screening/follow-up/treatment process.
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Affiliation(s)
- Cecilia Straw
- grid.7345.50000 0001 0056 1981Faculty of Social Sciences, University of Buenos Aires, Buenos Aires, Argentina ,Centre for the Study of State and Society, Buenos Aires, Argentina
| | - Victoria Sanchez-Antelo
- grid.423606.50000 0001 1945 2152Centre for the Study of State and Society, National Council for Scientific and Technical Research, Buenos Aires, Argentina
| | - Racquel Kohler
- grid.516084.e0000 0004 0405 0718Cancer Health Equity, Cancer Institute of New Jersey, Rutgers - the State University of New Jersey, New Brunswick, USA
| | - Melisa Paolino
- grid.423606.50000 0001 1945 2152Centre for the Study of State and Society, National Council for Scientific and Technical Research, Buenos Aires, Argentina
| | - Kasisomayajula Viswanath
- grid.38142.3c000000041936754XDepartment of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, USA
| | - Silvina Arrossi
- grid.423606.50000 0001 1945 2152Centre for the Study of State and Society, National Council for Scientific and Technical Research, Buenos Aires, Argentina
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Boelens M, Raat H, Jonkman H, Hosman CMH, Wiering D, Jansen W. Effectiveness of the Promising Neighbourhoods community program in 0-to 12-year-olds : A difference-in-difference analysis. SSM Popul Health 2022; 19:101166. [PMID: 35859931 PMCID: PMC9289725 DOI: 10.1016/j.ssmph.2022.101166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 07/04/2022] [Accepted: 07/04/2022] [Indexed: 11/30/2022] Open
Abstract
Objective The purpose of this study was to evaluate a collaborative community-based program that aims to a) increase the health, safety and talent development of youth, and b) contribute to the reduction of socioeconomic inequalities. Methods A difference-in difference design with two separate cross-sectional samples in 2018 (n = 984) and 2021 (n = 413) among 0- to 12-year-olds with an intervention and comparator condition was used. The program, called Promising Neighbourhoods, consists of collaboration with community stakeholders, data-based priority setting, knowledge-and theory-based policies, and evidence-based interventions. The program was implemented in three neighbourhoods which were compared with three similar comparator neighbourhoods in which the program was not implemented. Logistic difference-in-difference regression was used to test effectiveness of the intervention on informal parenting support, outdoor-play, sport club membership, general health and risk of emotional and behavioural difficulties and to examine differences in intervention effects between children with a lower or higher socioeconomic status. Results A significant intervention effect of the Promising Neighbourhoods program after two-years was found for outdoor-play (OR 0.61; 95%CI 0.37, 0.99). No other significant intervention effects were found for other outcomes. No different interventions effects were found for children with a lower or higher socioeconomic status on outcomes. Conclusion The findings of this study indicate a positive intervention effect for one of the outcomes in 0- to 12-year-olds. Further mixed-methods evaluation research and using longer follow-up periods are needed to examine the value of these type of programs. Further development of Promising Neighbourhoods seems warranted. Trial registration This study was prospectively registered in the Netherlands National Trial Register (Number: NL7279) on 26 September 2018. A collaborative neighbourhood program involving stakeholders was evaluated. The program included joint priority setting to promote child health/well-being. A positive intervention effect was found for one outcome in 0- to 12-year-olds. No reduction in socioeconomic inequalities was found in 0- to 12-year-olds.
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Affiliation(s)
- Mirte Boelens
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | | | - Clemens M H Hosman
- Department of Health Promotion, Maastricht University, Maastricht, the Netherlands.,Department of Clinical Psychology, Radboud University, Nijmegen, the Netherlands.,Hosman Prevention and Innovation Consultancy, Berg en Dal, the Netherlands
| | - Denis Wiering
- Department of Social Development, Municipality of Rotterdam, Rotterdam, the Netherlands
| | - Wilma Jansen
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Social Development, Municipality of Rotterdam, Rotterdam, the Netherlands
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Rahman A, Nawaz S, Khan E, Islam S. Nothing about us, without us: is for us. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:39. [PMID: 35927767 PMCID: PMC9351243 DOI: 10.1186/s40900-022-00372-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 07/12/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Public Participation Involvement Engagement (PPIE) is now strongly encouraged across health policy and research. Coproduction, although linked to PPIE is a way of working that can be applied to work collaboratively with participants in health. However, a lack of definition which leads to interchangeable terminology, limited guidance and examples of good practice on how to facilitate the process impedes progress. The Born in Bradford (BiB) research programme consists of a family of observational and longitudinal birth cohort studies (Raynor et al. in BMC Public Health 8:1-13, 2008; Dickerson et al. in BMC Public Health 16(1):1-14, 2016) which include participants from multi-ethnic and socially diverse backgrounds (Uphoff et al. in Int J Equity Health 12:1-12, 2013). METHODS This paper aims to highlight our approach to PPIE and coproduction methodologies, to provide an outline of the methods we have utilised to work collaboratively with our cohort populations from diverse communities and how we have managed to overcome challenges to achieve successful PPIE.A secondary aim of this paper is to demonstrate the value of PPIE and coproduction and how it can enhance research. Some examples from recent years are provided to demonstrate how useful the approach has been for BiB community engagement and community participation. In addition, we discuss the methods we have used and how this methodology has now been embedded into protocol and practice in our research. RESULTS Successful and productive PPIE and coproduction occur where stakeholders are taken on board and realise the impact that their involvement can have in terms of policy design and delivery. CONCLUSIONS The involvement of participants and the community in research about them becomes more credible when equal partnerships are formed and they are involved in the whole process leading to community ownership of research. Hence, nothing about us, without us-is for us.
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Affiliation(s)
- Aamnah Rahman
- Born in Bradford - Bradford Institute for Health Research, Bradford, UK.
| | - Salma Nawaz
- Born in Bradford - Bradford Institute for Health Research, Bradford, UK
| | - Eisha Khan
- Born in Bradford - Bradford Institute for Health Research, Bradford, UK
| | - Shahid Islam
- Born in Bradford - Bradford Institute for Health Research, Bradford, UK
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11
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The Situation-Specific Theory of Heart Failure Self-care: An Update on the Problem, Person, and Environmental Factors Influencing Heart Failure Self-care. J Cardiovasc Nurs 2022; 37:515-529. [PMID: 35482335 PMCID: PMC9561231 DOI: 10.1097/jcn.0000000000000919] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Many studies of heart failure (HF) self-care have been conducted since the last update of the situation-specific theory of HF self-care.
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12
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Healthy Habits, Happy Homes Scotland (4HS) feasibility study: Translation of a home-based early childhood obesity prevention intervention evaluated using RE-AIM framework. PUBLIC HEALTH IN PRACTICE 2020; 1:100026. [PMID: 36101681 PMCID: PMC9461167 DOI: 10.1016/j.puhip.2020.100026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/21/2020] [Accepted: 06/23/2020] [Indexed: 11/21/2022] Open
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Bowyer-Crane C, Nielsen D, Bryant M, Dharni N, Heald R, Storr C, Dickerson J. A randomised controlled feasibility trial and qualitative evaluation of an early years language development intervention: study protocol of the 'outcomes of Talking Together evaluation and results' (oTTer) project. Pilot Feasibility Stud 2019; 5:119. [PMID: 31687175 PMCID: PMC6819528 DOI: 10.1186/s40814-019-0498-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 09/06/2019] [Indexed: 12/30/2022] Open
Abstract
Background Problems with oral language skills in childhood have been linked with poor educational, employment, and mental health outcomes. In the UK, there is increasing concern about the oral language skills of children, particularly children from areas of social disadvantage. Research emphasises the importance of the home language environment as a fundamental bedrock for the development of oral language skills. It is vital, therefore, that support is available to help families in need to provide the optimal language environment for their child. Talking Together is a 6-week home visiting programme recently commissioned by Better Start Bradford to develop parents’ knowledge of the importance of a good language environment and help to improve parent-child interactions. This study represents the initial steps in developing a definitive trial of the Talking Together programme. Method This study is a two-arm randomised controlled feasibility study in which families referred into the Talking Together programme and consent to participate in the trial will be randomly allocated to either an intervention group or a waiting control group. We will assess the recruitment and retention rates, the representativeness of our sample, the appropriateness of our measures, and the sample size needed for a definitive trial. We will also carry out a qualitative evaluation to explore the acceptability of trial procedures for families and service providers, fidelity of delivery, time and resources for training, and barriers and facilitators to engagement with the programme. Clear progression criteria will be used to assess suitability for a definitive trial. Conclusion This feasibility study will inform the development of a definitive trial of this home-based visiting programme, which will add to the sparse evidence base on which practitioners can draw when supporting families in need. The lessons learnt from this feasibility study will also inform the wider evaluation work of the Better Start Bradford Innovation Hub. Trial registration The trial is registered with the ISRCTN registry: study ID ISRCTN13251954. Date of registration: 21 February 2019 (the trial was retrospectively registered).
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Affiliation(s)
| | - Dea Nielsen
- 2University of York, Heslington, York, YO10 5DD UK
| | - Maria Bryant
- 3Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT UK
| | - Nimarta Dharni
- 4Better Start Bradford Innovation Hub, Born in Bradford, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, BD9 6RJ UK
| | - Rebecca Heald
- BHT Early Education and Training, 16 Teasdale Street, Bradford, BD4 7QJ UK
| | - Chloe Storr
- BHT Early Education and Training, 16 Teasdale Street, Bradford, BD4 7QJ UK
| | - Josie Dickerson
- 4Better Start Bradford Innovation Hub, Born in Bradford, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, BD9 6RJ UK
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Riegel B, Dunbar SB, Fitzsimons D, Freedland KE, Lee CS, Middleton S, Stromberg A, Vellone E, Webber DE, Jaarsma T. Self-care research: Where are we now? Where are we going? Int J Nurs Stud 2019; 116:103402. [PMID: 31630807 DOI: 10.1016/j.ijnurstu.2019.103402] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 08/04/2019] [Accepted: 08/10/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND OBJECTIVE The beneficial effects of self-care include improved well-being and lower morbidity, mortality, and healthcare costs. In this article we address the current state of self-care research and propose an agenda for future research based on the inaugural conference of the International Center for Self-Care Research held in Rome, Italy in June 2019. The vision of this Center is a world where self-care is prioritized by individuals, families, and communities and is the first line of approach in every health care encounter. The mission of the Center is to lead the self-care research endeavor, improving conceptual clarity and promoting interdisciplinary work informed by a shared vision addressing knowledge gaps. A focused research agenda can deepen our theoretical understanding of self-care and the mechanisms underlying self-care, which can contribute to the development of effective interventions that improve outcomes. METHODS During conference discussions, we identified seven major reasons why self-care is challenging, which can be grouped into the general categories of behavior change and illness related factors. We identified six specific knowledge gaps that, if addressed, may help to address these challenges: the influence of habit formation on behavior change, resilience in the face of stressful life events that interfere with self-care, the influence of culture on self-care behavioral choices, the difficulty performing self-care with multiple chronic conditions, self-care in persons with severe mental illness, and the influence of others (care partners, family, peer supporters, and healthcare professionals) on self-care. PLANS TO ACHIEVE RESULTS To achieve the vision and mission of the Center, we will lead a collaborative program of research that addresses self-care knowledge gaps and improves outcomes, create a supportive international network for knowledge transfer and support of innovations in self-care research, and support and train others in self-care research. Beyond these specific short-term goals, important policy implications of this work are discussed.
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Affiliation(s)
- Barbara Riegel
- School of Nursing, University of Pennsylvania, 418 Curie Boulevard, Philadelphia, PA 19104-4217, USA; Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.
| | | | | | | | | | - Sandy Middleton
- Nursing Research Institute, St Vincent's Health Australia & Australian Catholic University, Australia.
| | - Anna Stromberg
- Department of Medical and Health Sciences and Department of Cardiology, Linkoping University, Sweden.
| | | | | | - Tiny Jaarsma
- Julius Center, University Medical Center Utrecht, the Netherlands; Faculty of Medical and Health Sciences, Linkoping University, Sweden.
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Dharni N, Dickerson J, Willan K, Ahern S, Dunn A, Nielsen D, Uphoff E, McEachan RRC, Bryant M. Implementation evaluation of multiple complex early years interventions: an evaluation framework and study protocol. BMJ Paediatr Open 2019; 3:e000479. [PMID: 31321321 PMCID: PMC6598556 DOI: 10.1136/bmjpo-2019-000479] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 05/28/2019] [Accepted: 05/30/2019] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Implementation evaluations are integral to understanding whether, how and why interventions work. However, unpicking the mechanisms of complex interventions is often challenging in usual service settings where multiple services are delivered concurrently. Furthermore, many locally developed and/or adapted interventions have not undergone any evaluation, thus limiting the evidence base available. Born in Bradford's Better Start cohort is evaluating the impact of multiple early life interventions being delivered as part of the Big Lottery Fund's 'A Better Start' programme to improve the health and well-being of children living in one of the most socially and ethnically diverse areas of the UK. In this paper, we outline our evaluation framework and protocol for embedding pragmatic implementation evaluation across multiple early years interventions and services. METHODS AND ANALYSIS The evaluation framework is based on a modified version of The Conceptual Framework for Implementation Fidelity. Using qualitative and quantitative methods, our evaluation framework incorporates semistructured interviews, focus groups, routinely collected data and questionnaires. We will explore factors related to content, delivery and reach of interventions at both individual and wider community levels. Potential moderating factors impacting intervention success such as participants' satisfaction, strategies to facilitate implementation, quality of delivery and context will also be examined. Interview and focus guides will be based on the Theoretical Domains Framework to further explore the barriers and facilitators of implementation. Descriptive statistics will be employed to analyse the routinely collected quantitative data and thematic analysis will be used to analyse qualitative data. ETHICS AND DISSEMINATION The Health Research Authority (HRA) has confirmed our implementation evaluations do not require review by an NHS Research Ethics Committee (HRA decision 60/88/81). Findings will be shared widely to aid commissioning decisions and will also be disseminated through peer-reviewed journals, summary reports, conferences and community newsletters.
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Affiliation(s)
- Nimarta Dharni
- Born in Bradford, Bradford Institute for Health Research, Bradford, UK
| | - Josie Dickerson
- Born in Bradford, Bradford Institute for Health Research, Bradford, UK
| | - Kathryn Willan
- Born in Bradford, Bradford Institute for Health Research, Bradford, UK
| | - Sara Ahern
- Born in Bradford, Bradford Institute for Health Research, Bradford, UK
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