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Brierley ML, Chater AM, Edwardson CL, Castle EM, Hunt ER, Biddle SJ, Sisodia R, Bailey DP. The Regulate your Sitting Time (RESIT) intervention for reducing sitting time in individuals with type 2 diabetes: findings from a randomised-controlled feasibility trial. Diabetol Metab Syndr 2024; 16:87. [PMID: 38659052 PMCID: PMC11040907 DOI: 10.1186/s13098-024-01336-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 04/15/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Reducing and breaking up sitting is recommended for optimal management of Type 2 diabetes mellitus (T2DM). Yet, there is limited evidence of interventions targeting these outcomes in individuals with this condition. The primary aim of this study was to assess the feasibility and acceptability of delivering and evaluating a tailored online intervention to reduce and break up sitting in adults with T2DM. METHODS A mixed-methods two-arm randomised controlled feasibility trial was conducted in ambulatory adults with T2DM who were randomised 1:1 to the REgulate your SItting Time (RESIT) intervention or usual care control group. The intervention included online education, self-monitoring and prompt tools (wearable devices, smartphone apps, computer apps) and health coaching. Feasibility outcomes were recruitment, attrition, data completion rates and intervention acceptability. Measurements of device-assessed sitting (intended primary outcome for definitive trial), standing and stepping, and physical function, psychosocial health and wellbeing were taken at baseline, 3 months and 6 months. Individual semi-structured interviews were conducted at six-months (post intervention) to explore acceptability, feasibility and experiences of the trial and intervention using the Framework Method. RESULTS Seventy participants aged 55 ± 11 years were recruited. Recruitment rate (proportion of eligible participants enrolled into the study) was 67% and participant retention rate at 6 months was 93% (n = 5 withdrawals). Data completion rates for daily sitting were 100% at baseline and ranged from 83 to 91% at 3 months and 6 months. Descriptive analysis demonstrated potential for the intervention to reduce device-measured sitting, which was 30.9 ± 87.2 and 22.2 ± 82.5 min/day lower in the intervention group at 3 and 6 months, respectively, compared with baseline. In the control group, sitting was 4.4 ± 99.5 and 23.7 ± 85.2 min/day lower at 3 and 6 months, respectively. Qualitative analysis identified three themes: reasons for participating in the trial, acceptability of study procedures, and the delivery and experience of taking part in the RESIT intervention. Overall, the measurement visits and intervention were acceptable to participants. CONCLUSIONS This study demonstrated the feasibility and acceptability of the RESIT intervention and evaluation methods, supporting a future definitive trial. If RESIT is found to be clinically effective, this could lead to changes in diabetes healthcare with a focus on reducing sitting. TRIAL REGISTRATION The trial was registered with ISRCTN (number ISRCTN14832389).
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Affiliation(s)
- Marsha L Brierley
- Centre for Physical Activity in Health and Disease, College of Health, Medicine and Life Sciences, Brunel University London, Kingston Lane, UB8 3PH, Uxbridge, UK
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Kingston Lane, UB8 3PH, Uxbridge, UK
| | - Angel M Chater
- Institute for Sport and Physical Activity Research, Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Polhill Avenue, MK41 9EA, Bedford, UK
- Centre for Behaviour Change, University College London, 1-19 Torrington Place, WC1E 7HB, London, UK
| | - Charlotte L Edwardson
- Leicester Lifestyle and Health Research Group, Diabetes Research Centre, University of Leicester, Leicester General Hospital, LE5 4PW, Leicester, UK
- NIHR Leicester Biomedical Research Centre, Leicester General Hospital, LE5 4PW, Leicester, UK
| | - Ellen M Castle
- Centre for Physical Activity in Health and Disease, College of Health, Medicine and Life Sciences, Brunel University London, Kingston Lane, UB8 3PH, Uxbridge, UK
- Physiotherapy Division, Department of Health Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Kingston Lane, UB8 4PH, Uxbridge, UK
- Curtin School of Allied Health, School of Health Sciences, Curtin University, Western Australia, 6845, Bentley, Australia
| | - Emily R Hunt
- Centre for Physical Activity in Health and Disease, College of Health, Medicine and Life Sciences, Brunel University London, Kingston Lane, UB8 3PH, Uxbridge, UK
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Kingston Lane, UB8 3PH, Uxbridge, UK
| | - Stuart Jh Biddle
- Centre for Health Research, University of Southern Queensland, Springfield Central, 4300, Springfield, QLD, Australia
- Faculty of Sport & Health Sciences, University of Jyväskylä, FI-40014, Jyväskylä, Finland
| | - Rupa Sisodia
- Centre for Physical Activity in Health and Disease, College of Health, Medicine and Life Sciences, Brunel University London, Kingston Lane, UB8 3PH, Uxbridge, UK
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Kingston Lane, UB8 3PH, Uxbridge, UK
| | - Daniel P Bailey
- Centre for Physical Activity in Health and Disease, College of Health, Medicine and Life Sciences, Brunel University London, Kingston Lane, UB8 3PH, Uxbridge, UK.
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Kingston Lane, UB8 3PH, Uxbridge, UK.
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Ojo SO, Chater AM, Hewson DJ, Bailey DP. Workplace sitting and productivity: findings from a cluster randomised controlled pilot trial of a workplace intervention for reducing sitting time in office workers. J Occup Environ Med 2024:00043764-990000000-00526. [PMID: 38509659 DOI: 10.1097/jom.0000000000003091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
OBJECTIVE To evaluate the feasibility and potential effects of a workplace intervention to reduce and break up sitting. METHODS Office workers were randomised in clusters to intervention (=22) or control (n = 22). The intervention included a height-adjustable workstation, education, computer prompt software and line manager support. Outcomes included device-measured workplace sitting and ecological momentary assessed (EMA) workplace productivity. Recruitment, retention and data completion rates were assessed. RESULTS Recruitment (n = 44), retention (91%) and workplace sitting measurement rates demonstrated study feasibility. At 8 weeks, workplace sitting was 11% lower (95% CI: -20.71, -1.30) in the intervention group compared with control participants. Intervention participants were also more engaged, motivated and productive while sitting (p ≤ 0.016). CONCLUSIONS It was feasible to implement and evaluate this office workplace intervention, with potential benefits on workplace sitting and EMA-measured productivity.
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Affiliation(s)
| | | | - David J Hewson
- Institute for Health Research, University of Bedfordshire, University Square, Luton, United Kingdom
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Porter L, Chater AM, Haycraft E, Farrow C, Holley CE. Role-model, reoffer, reward: A thematic analysis and TDF mapping of influences on families' use of evidence-based vegetable feeding practices. Appetite 2023; 189:106764. [PMID: 37442525 DOI: 10.1016/j.appet.2023.106764] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 06/21/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023]
Abstract
Children's vegetable intake is low, despite benefits for immediate and long-term health. Repeatedly reoffering vegetables, role-modelling consumption, and offering non-food rewards effectively increase children's vegetable acceptance and intake. However, a number of barriers prevent families from reoffering previously-rejected vegetables. This study used the Theoretical Domains Framework (TDF) and the COM-B model of behaviour to explore barriers and enablers to reoffering, role-modelling and offering non-food rewards among parents of 2-4-year-old children. Twenty-five semi-structured interviews were conducted, from which eleven core inductive themes were generated: 'Child factors', 'Eating beliefs', 'Effectiveness beliefs', 'Past experience', 'Current family behaviours', 'Harms', 'Knowledge', 'Need for change', 'Parent effort', 'Parent values' and 'Practical issues'. The codes underpinning these themes were inductively mapped to 11 of the 14 TDF domains, and five of the six COM-B components. Previously-reported influences on families' vegetable feeding practices were confirmed, including concerns about child rejection of foods/meals, cost of vegetables, and food waste. Novel findings included some parents' perceptions that these practices are pressurising, and that certain beliefs/knowledge about children's eating behaviour can provide a "protective mindset" that supports families' perseverance with reoffering over time. Future interventions should be tailored to better reflect the diversity of needs and previous experiences of feeding that families have, with some families likely to find that troubleshooting and further signposting is appropriate for their needs while others might benefit from more persuasive and educational approaches. The mapping of codes to the TDF and COM-B will facilitate the identification of appropriate intervention functions and behaviour change techniques when designing new interventions to support families with increasing their children's vegetable intake.
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Affiliation(s)
- Lucy Porter
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK
| | - Angel M Chater
- Centre for Behaviour Change, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK; Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Polhill Avenue, Bedford, MK41 9EA, UK
| | - Emma Haycraft
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK
| | - Claire Farrow
- School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, B4 7ET, UK
| | - Clare E Holley
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK.
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Amirova A, Taylor L, Volkmer B, Ahmed N, Chater AM, Fteropoulli T. Informing behaviour change intervention design using systematic review with Bayesian meta-analysis: physical activity in heart failure. Health Psychol Rev 2023; 17:456-484. [PMID: 35701235 DOI: 10.1080/17437199.2022.2090411] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 06/02/2022] [Indexed: 12/11/2022]
Abstract
Embracing the Bayesian approach, we aimed to synthesise evidence regarding barriers and enablers to physical activity in adults with heart failure (HF) to inform behaviour change intervention. This approach helps estimate and quantify the uncertainty in the evidence and facilitates the synthesis of qualitative and quantitative studies. Qualitative evidence was annotated using the Theoretical Domains Framework and represented as a prior distribution using an expert elicitation task. The maximum a posteriori probability (MAP) for the probability distribution for the log OR was used to estimate the relationship between physical activity and each determinant according to qualitative, quantitative, and qualitative and quantitative evidence combined. The probability distribution dispersion (SD) was used to evaluate uncertainty in the evidence. Three qualitative and 16 quantitative studies were included (N = 2739). High pro-b-type natriuretic peptide (MAP = -1.16; 95%CrI: [-1.21; -1.11]) and self-reported symptoms (MAP = - 0.48; 95%CrI: [ -0.40; -0.55]) were suggested as barriers to physical activity with low uncertainty (SD = 0.18 and 0.19, respectively). Modifiable barriers were symptom distress (MAP = -0.46; 95%CrI: [-0.68; -0.24], SD = 0.36), and negative attitude (MAP = -0.40; 95%CrI: [-0.49; -0.31], SD = 0.26). Modifiable enablers were social support (MAP = 0.56; 95%CrI: [0.48; 0.63], SD = 0.26), self-efficacy (MAP = 0.43; 95%CrI: [0.32; 0.54], SD = 0.37), positive physical activity attitude (MAP = 0.92; 95%CrI: [0.77; 1.06], SD = 0.36).
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Affiliation(s)
- Aliya Amirova
- Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Lauren Taylor
- Department of Psychology, University of Surrey, Guildford, UK
| | - Brittannia Volkmer
- Psychology department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Nafiso Ahmed
- Mental Health Policy Research Unit, UCL Division of Psychiatry, London, UK
| | - Angel M Chater
- Centre for Behaviour Change, Clinical, Educational & Health Psychology, Division of Psychology & Language Sciences, Faculty of Brain Sciences, UCL, London, UK
- Institute for Sport and Physical Activity Research (ISPAR), Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Bedford, UK
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Chater AM, Brook-Rowland P, Tolani F, Christopher E, Hart J, Byrne-Davis LMT, Moffat A, Shorter GW, Epton T, Kamal A, O’Connor DB, Whittaker E, Lewis LJM, McBride E, Swanson V, Arden MA. Understanding a constellation of eight COVID-19 disease prevention behaviours using the COM-B model and the theoretical domains framework: a qualitative study using the behaviour change wheel. Front Public Health 2023; 11:1130875. [PMID: 37475767 PMCID: PMC10355219 DOI: 10.3389/fpubh.2023.1130875] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 05/30/2023] [Indexed: 07/22/2023] Open
Abstract
Background The use of behavioural science and behaviour change within local authorities and public health has supported healthful change; as evidenced by its importance and contribution to reducing harm during the COVID-19 pandemic. It can provide valuable information to enable the creation of evidence-based intervention strategies, co-created with the people they are aimed at, in an effective and efficient manner. Aim This study aimed to use the COM-B model to understand the Capability, Opportunity and Motivation of performing a constellation of eight COVID-19 disease prevention behaviours related to the slogans of 'Hands, Face, Space, Fresh Air'; 'Find, Isolate, Test, (FIT), and Vaccinate' in those employed in workplaces identified as high risk for transmission of the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) to support intervention development. Methods This qualitative study recruited twenty-three participants (16 female, 7 male), who were interviewed from three environments (schools, care homes, warehouses) across three local authorities. Semi-structured interviews were analysed using thematic analysis. Findings Ten core themes were identified inductively; (1) knowledge and skills, (2) regulating the behaviour, (3) willingness to act, (4) necessity and concerns, (5) emotional impact, (6) conducive environment, (7) societal influence, (8) no longer united against COVID-19, (9) credible leadership, and (10) inconsistent adherence to COVID-19 prevention behaviours. Themes were then deductively mapped to the COM-B model of behaviour change and the theoretical domains framework and a logic model using the behaviour change wheel (BCW) was produced to inform intervention design. Conclusion This study offers a novel approach to analysis that has included eight behaviours within a single thematic analysis and COM-B diagnosis. This will enable local authorities to direct limited resources to overarching priorities. Of key importance, was the need for supportive and credible leadership, alongside developing interventions collaboratively with the target audience. COVID-19 has had an emotional toll on those interviewed, however, promoting the value of disease prevention behaviours, over and above their costs, can facilitate behaviour. Developing knowledge and skills, through education, training, marketing and modelling can further facilitate behaviour. This supports guidance produced by the British Psychological Society COVID-19 behavioural science and disease prevention taskforce.
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Affiliation(s)
- Angel M. Chater
- Centre for Health, Wellbeing and Behaviour Change, Institute for Sport and Physical Activity Research, University of Bedfordshire, Bedford, United Kingdom
- Centre for Behaviour Change, University College London, London, United Kingdom
| | - Phoebe Brook-Rowland
- Centre for Health, Wellbeing and Behaviour Change, Institute for Sport and Physical Activity Research, University of Bedfordshire, Bedford, United Kingdom
| | - Foyeke Tolani
- Bedford Borough, Central Bedfordshire and Milton Keynes Councils’ Shared Public Health Services, Bedford, United Kingdom
| | - Emily Christopher
- Bedford Borough, Central Bedfordshire and Milton Keynes Councils’ Shared Public Health Services, Bedford, United Kingdom
| | - Jo Hart
- School of Medical Sciences, University of Manchester, Manchester, United Kingdom
| | | | - Abby Moffat
- Centre for Health, Wellbeing and Behaviour Change, Institute for Sport and Physical Activity Research, University of Bedfordshire, Bedford, United Kingdom
| | - Gillian W. Shorter
- Drug and Alcohol Research Network, School of Psychology, Queen’s University Belfast, Belfast, United Kingdom
| | - Tracy Epton
- Manchester Centre for Health Psychology, University of Manchester, Manchester, United Kingdom
| | - Atiya Kamal
- School of Social Sciences, Birmingham City University, Birmingham, United Kingdom
| | - Daryl B. O’Connor
- Laboratory for Stress and Health Research, University of Leeds, Leeds, United Kingdom
| | - Eleanor Whittaker
- North Yorkshire County Council, Northallerton, North Yorkshire, United Kingdom
| | - Lesley J. M. Lewis
- Behavioural Science Unit, Public Health, Somerset County Council, Taunton, United Kingdom
| | - Emily McBride
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Vivien Swanson
- Psychology Division, University of Stirling, Stirling, United Kingdom
| | - Madelynne A. Arden
- Centre for Behavioural Science and Applied Psychology, Sheffield Hallam University, Sheffield, United Kingdom
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Bailey DP, Kilbride C, Harper JH, Victor C, Brierley ML, Hewson DJ, Chater AM. The Frail-LESS (LEss Sitting and Sarcopenia in Frail older adults) intervention to improve sarcopenia and maintain independent living via reductions in prolonged sitting: a randomised controlled feasibility trial protocol. Pilot Feasibility Stud 2023; 9:1. [PMID: 36609363 PMCID: PMC9823257 DOI: 10.1186/s40814-022-01225-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 12/01/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Sarcopenia is a progressive and generalised loss of muscle mass and function with advancing age and is a major contributor to frailty. These conditions lead to functional disability, loss of independence, and lower quality of life. Sedentary behaviour is adversely associated with sarcopenia and frailty. Reducing and breaking up sitting should thus be explored as an intervention target for their management. The primary aim of this study, therefore, is to examine the feasibility, safety, and acceptability of conducting a randomised controlled trial (RCT) that evaluates a remotely delivered intervention to improve sarcopenia and independent living via reducing and breaking up sitting in frail older adults. METHODS This mixed-methods randomised controlled feasibility trial will recruit 60 community-dwelling older adults aged ≥ 65 years with very mild or mild frailty. After baseline measures, participants will be randomised to receive the Frail-LESS (LEss Sitting and Sarcopenia in Frail older adults) intervention or serve as controls (usual care) for 6 months. Frail-LESS is a remotely delivered intervention comprising of tailored feedback on sitting, information on the health risks of excess sitting, supported goal setting and action planning, a wearable device that tracks inactive time and provides alerts to move, health coaching, and peer support. Feasibility will be assessed in terms of recruitment, retention and data completion rates. A process evaluation will assess intervention acceptability, safety, and fidelity of the trial. The following measures will be taken at baseline, 3 months, and 6 months: sitting, standing, and stepping using a thigh-worn activPAL4 device, sarcopenia (via hand grip strength, muscle mass, and physical function), mood, wellbeing, and quality of life. DISCUSSION This study will determine the feasibility, safety, and acceptability of evaluating a remote intervention to reduce and break up sitting to support improvements in sarcopenia and independent living in frail older adults. A future definitive RCT to determine intervention effectiveness will be informed by the study findings. TRIAL REGISTRATION ISRCTN, ISRCTN17158017; Registered 6 August 2021, https://www.isrctn.com/ISRCTN17158017.
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Affiliation(s)
- Daniel P. Bailey
- grid.7728.a0000 0001 0724 6933Centre for Physical Activity in Health and Disease, Brunel University London, Kingston Lane, Uxbridge, UB8 3PH UK ,grid.7728.a0000 0001 0724 6933Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge, UB8 3PH UK
| | - Cherry Kilbride
- grid.7728.a0000 0001 0724 6933Centre for Physical Activity in Health and Disease, Brunel University London, Kingston Lane, Uxbridge, UB8 3PH UK ,grid.7728.a0000 0001 0724 6933Division of Physiotherapy and Physician Associates, Department of Health Sciences, Brunel University London, Uxbridge, UB8 3PH UK
| | - Jamie H. Harper
- grid.7728.a0000 0001 0724 6933Centre for Physical Activity in Health and Disease, Brunel University London, Kingston Lane, Uxbridge, UB8 3PH UK ,grid.7728.a0000 0001 0724 6933Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge, UB8 3PH UK
| | - Christina Victor
- grid.7728.a0000 0001 0724 6933Division of Global Public Health, Brunel University London, Uxbridge, UB8 3PH UK
| | - Marsha L. Brierley
- grid.7728.a0000 0001 0724 6933Centre for Physical Activity in Health and Disease, Brunel University London, Kingston Lane, Uxbridge, UB8 3PH UK
| | - David J. Hewson
- grid.15034.330000 0000 9882 7057Institute for Health Research, University of Bedfordshire, Luton, LU1 3JU UK
| | - Angel M. Chater
- grid.15034.330000 0000 9882 7057Institute for Sport and Physical Activity Research, University of Bedfordshire, Polhill Avenue, Bedford, MK41 9EA UK ,grid.83440.3b0000000121901201Centre for Behaviour Change, University College London, London, WC1E 7HB UK
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Chater AM, Schulz J, Jones A, Burke A, Carr S, Kukucska D, Troop N, Trivedi D, Howlett N. Outcome evaluation of Active Herts: A community-based physical activity programme for inactive adults at risk of cardiovascular disease and/or low mental wellbeing. Front Public Health 2022; 10:903109. [PMID: 36159253 PMCID: PMC9500394 DOI: 10.3389/fpubh.2022.903109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 07/25/2022] [Indexed: 01/22/2023] Open
Abstract
Background A high proportion of UK adults are inactive, which can lead to a range of physical and mental health concerns. Active Herts is a community-based physical activity programme for inactive adults at risk of cardiovascular disease and/or low mental wellbeing. This paper provides a pragmatic evaluation of this programme. Method This longitudinal study observed 717 adults (68% female, mean age = 56.9 years) from the "Active Herts" programme. Programme users were provided with a 45-min consultation with a "Get Active Specialist," who talked them through an Active Herts self-help booklet and then signposted them to free or subsidized local exercise sessions. Programme users were followed up with a booster call 2 weeks later. The Get Active Specialist was a registered exercise professional (REPS Level 3), with additional training from the study team in motivational interviewing, health coaching, COM-B behavioral diagnosis and delivery of behavior change techniques (BCTs) in practice. The Active Herts booklet contained theoretically-driven and evidence-based BCTs to translate behavioral science into public health practice. Physical activity (Metabolic Equivalent Time [METs], measured using the International Physical Activity Questionnaire (IPAQ), perceived health (EQ-5D-5L) and mental wellbeing (Warwick-Edinburgh Mental Wellbeing Scale: WEMWBS) were measured at baseline, 3, 6 and 12 months. Results At the end of the 12-month programme, users showed sustained improvements in physical activity (by +1331 METS), exceeding weekly recommendations. Sitting (reducing by over an hour per day), sporting participation, and perceptions of health were also improved, with improvements in mental wellbeing in the first 3 months. Conclusion Designing and delivering a community-based physical activity programme that is theoretically-driven and evidence-based with frequent behavior change training and supervision can yield a significant increase in self-reported physical activity, reduction in sitting behavior and improvements to perceived health and mental wellbeing. Future research should extend this approach, utilizing a real-world, pragmatic evaluation. Trial registration ClinicalTrials.gov, identifier (NCT number): NCT03153098.
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Affiliation(s)
- Angel M. Chater
- Institute for Sport and Physical Activity Research, University of Bedfordshire, Bedford, United Kingdom,Centre for Behaviour Change, University College London, London, United Kingdom,*Correspondence: Angel M. Chater
| | - Joerg Schulz
- Department of Psychology, Sports, and Geography, University of Hertfordshire, Hatfield, United Kingdom
| | - Andy Jones
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Amanda Burke
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Shelby Carr
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Dora Kukucska
- Institute for Sport and Physical Activity Research, University of Bedfordshire, Bedford, United Kingdom
| | - Nick Troop
- Department of Psychology, Sports, and Geography, University of Hertfordshire, Hatfield, United Kingdom,School of Psychology, University of Plymouth, Plymouth, United Kingdom
| | - Daksha Trivedi
- Centre for Research in Public Health and Community Care, University of Hertfordshire, Hatfield, United Kingdom
| | - Neil Howlett
- Department of Psychology, Sports, and Geography, University of Hertfordshire, Hatfield, United Kingdom
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Brierley ML, Smith LR, Chater AM, Bailey DP. A-REST (Activity to Reduce Excessive Sitting Time): A Feasibility Trial to Reduce Prolonged Sitting in Police Staff. IJERPH 2022; 19:ijerph19159186. [PMID: 35954543 PMCID: PMC9368451 DOI: 10.3390/ijerph19159186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/12/2022] [Accepted: 07/23/2022] [Indexed: 11/16/2022]
Abstract
The aim of this study was to evaluate the acceptability and feasibility of a theory-derived sedentary workplace intervention for police office staff. Twenty-four staff participated in an 8-week intervention (single arm, pre-post design) incorporating an education session, team competition with quick response (QR) codes, team trophy, weekly leaderboard newsletters, a self-monitoring phone app, and electronic prompt tools. The intervention supported participants to reduce and break up their sitting time with three minutes of incidental movement every 30 min at work. Feasibility and acceptability were assessed using mixed methods via the RE-AIM QuEST and PRECIS-2 frameworks. The intervention was highly pragmatic in terms of eligibility, organisation, adherence, outcome, and analysis. It was slightly less pragmatic on recruitment and setting. Delivery and follow-up were more explanatory. Reach and adoption indicators demonstrated feasibility among police staff, across a range of departments, who were demographically similar to participants in previous office-based multi-component interventions. The intervention was delivered mostly as planned with minor deviations from protocol (implementation fidelity). Participants perceived the intervention components as highly acceptable. Results showed improvements in workplace sitting and standing, as well as small improvements in weight and positive affect. Evaluation of the intervention in a fully powered randomised controlled trial to assess behaviour and health outcomes is recommended.
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Affiliation(s)
- Marsha L. Brierley
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Polhill Avenue, Bedford MK41 9EA, UK; (M.L.B.); (L.R.S.); (A.M.C.)
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK
- Centre for Physical Activity in Health and Disease, Brunel University London, Kingston Lane, Uxbridge UB8 3PH, UK
| | - Lindsey R. Smith
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Polhill Avenue, Bedford MK41 9EA, UK; (M.L.B.); (L.R.S.); (A.M.C.)
| | - Angel M. Chater
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Polhill Avenue, Bedford MK41 9EA, UK; (M.L.B.); (L.R.S.); (A.M.C.)
- Centre for Behaviour Change, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
| | - Daniel P. Bailey
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Polhill Avenue, Bedford MK41 9EA, UK; (M.L.B.); (L.R.S.); (A.M.C.)
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK
- Centre for Physical Activity in Health and Disease, Brunel University London, Kingston Lane, Uxbridge UB8 3PH, UK
- Correspondence: ; Tel.: +44-(0)1895-266127
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Finlay KA, Hearn JH, Gillett JL, Ratwatte P, Morton-Bye J, Chater AM. Adaptations to mindfulness-based interventions for neurological impairment: The SMALL PROMPTS approach. Rehabil Psychol 2022; 67:391-404. [PMID: 35797151 DOI: 10.1037/rep0000455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
PURPOSE/OBJECTIVE Standardized mindfulness-based interventions (MBIs), used for the management of physical and psychological symptoms associated with neurological impairment/injury (NI), have been problematized as lacking accessibility due to their focus on sensory presence and mindful walking. Research is needed to generate formalized recommendations regarding how MBIs may be best adapted to enhance their suitability for people with NI. RESEARCH METHOD/DESIGN A two-phase qualitative study was completed. First, semistructured interviews were undertaken with eight accredited mindfulness teachers with NI. Interviews reviewed the adaptations participants made in their personal and teaching practice, using thematic analysis, and generated recommendations for adaptations to MBIs specific to people with NI. Second, using the DELPHI method, the adapted practice recommendations were reviewed and revised via three rounds, following cognitive interviews with an expert panel (N = 5 trained mindfulness teachers with NI). RESULTS Ten core areas for adaptation are proposed and validated, acting as SMALL PROMPTS which can be used to adapt mindfulness-based teaching techniques to the specific requirements of people with NI: (a) Skin/bladder/bowel management; (b) mindful Movement; (c) Accessible training; (d) Language Leadership; (e) Permissive pRactice; (f) Optimizing timelines; (g) Management of posture; (h) inclusion of Pacing; (i) Teaching from experience; and (j) body Scanning. CONCLUSION/IMPLICATIONS Mindfulness is a highly applicable approach for people with sensory loss, however significant, specific adaptations are required to improve inclusivity and accessibility. The SMALL PROMPTS adaptations increase the accessibility, applicability, and utility of MBIs for populations living with NI, enhancing effective management of physical and psychological wellbeing, and optimizing MBI delivery. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Ojo SO, Bailey DP, Chater AM, Hewson DJ. Workplace Intervention for Reducing Sitting Time in Sedentary Workers: Protocol for a Pilot Study Using the Behavior Change Wheel. Front Public Health 2022; 10:832374. [PMID: 35493386 PMCID: PMC9039234 DOI: 10.3389/fpubh.2022.832374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/03/2022] [Indexed: 11/13/2022] Open
Abstract
The workplace is a major contributor to excessive sitting in office workers. There are a wide array of adverse effects of high volumes of sitting time, including an increased risk of type 2 diabetes and depression. Active workstations can be used in effective interventions to decrease workplace sitting. However, there are a lack of interventions that have been developed using a systematic process that is informed by participant needs and a framework for identifying the most appropriate content for the intervention. Applying these methods could increase adherence and potential effectiveness of the intervention. Therefore, the purpose of this pilot study is to examine the feasibility, acceptability, and efficacy of a tailored workplace intervention to reduce and break up sitting in office workers that has been developed using the Behavior Change Wheel and the APEASE (Acceptability, Practicability, Effectiveness/cost-effectiveness, Affordability, Safety/side-effects, Equity) criteria. This article reports the protocol for this study that is currently ongoing. Participants will be cluster-randomized (by offices) to control and intervention groups. The evaluation of the intervention includes determining feasibility by assessing participant recruitment, retention and data completion rates. Adherence to the intervention will be assessed based on daily sitting and standing time relative to guidelines provided to participants as part of the intervention. Outcome measures also include productivity measured using Ecological Momentary Assessment, absenteeism, presenteeism, cardiometabolic risk markers, and wellbeing. The findings of this study will inform the effective design and implementation of interventions for reducing and breaking up sitting in office workers.
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Affiliation(s)
- Samson O Ojo
- Institute for Health Research, University of Bedfordshire, Luton, United Kingdom.,Quality Improvement, Northampton General Hospital NHS Trust, Northampton, United Kingdom
| | - Daniel P Bailey
- Institute for Sport and Physical Activity Research, Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Bedford, United Kingdom.,Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge, United Kingdom.,Centre for Physical Activity in Health and Disease, Brunel University London, Uxbridge, United Kingdom
| | - Angel M Chater
- Institute for Sport and Physical Activity Research, Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Bedford, United Kingdom.,Centre for Behaviour Change, University College London, London, United Kingdom
| | - David J Hewson
- Institute for Health Research, University of Bedfordshire, Luton, United Kingdom
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11
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Brierley ML, Smith LR, Bailey DP, Ojo SO, Hewson DJ, Every SA, Staines TA, Chater AM. Evaluating a multi-component intervention to reduce and break up office workers' sitting with sit-stand desks using the APEASE criteria. BMC Public Health 2022; 22:458. [PMID: 35255850 PMCID: PMC8902706 DOI: 10.1186/s12889-022-12794-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 01/24/2022] [Indexed: 12/13/2022] Open
Abstract
Objective Sedentary workplace interventions have had success in reducing excessive sitting time in office workers, but barriers to implementation and uptake remain. This study formally assessed a theory-derived, sit-stand desk intervention using the APEASE (Acceptability, Practicability, Effectiveness, Affordability, Side-effects, Equity) criteria. Methods Thirteen adults (eight female, mean age 38 ± 10 years) from the treatment arm of a sedentary behaviour intervention participated in semi-structured interviews. Thematic codes were inductively assigned to data items followed by deductive charting using the APEASE criteria. Results The intervention was highly acceptable, practicable, safe to deploy, and helped workers reduce workplace sitting time, though individual preferences and workload mediated engagement. Affordability of sit-stand desks and Equity of access were potential barriers to uptake. Conclusions Through the lens of the APEASE criteria, this theory-derived, multi-component sit-stand desk intervention showed acceptability, practicability and effectiveness in reducing and breaking up sedentary time at work with minimal side effects. Using this approach with further tailoring and personalisation may help workers achieve greater reductions in workplace sitting, though affordability and equity should be considered further. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12794-w.
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Affiliation(s)
- Marsha L Brierley
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Polhill Avenue, Bedford, MK41 9EA, UK.,Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge, UB8 3PH, UK.,Centre for Physical Activity in Health and Disease, Brunel University London, Kingston Lane, Uxbridge, UB8 3PH, UK
| | - Lindsey R Smith
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Polhill Avenue, Bedford, MK41 9EA, UK
| | - Daniel P Bailey
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Polhill Avenue, Bedford, MK41 9EA, UK.,Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge, UB8 3PH, UK.,Centre for Physical Activity in Health and Disease, Brunel University London, Kingston Lane, Uxbridge, UB8 3PH, UK
| | - Samson O Ojo
- Institute for Health Research, University of Bedfordshire, University Square, Luton, LU1 3JU, UK.,Quality Improvement, Northampton General Hospital NHS Trust, Cliftonville, Northampton, Northamptonshire, NN1 5BD, UK
| | - David J Hewson
- Institute for Health Research, University of Bedfordshire, University Square, Luton, LU1 3JU, UK
| | - Sofie A Every
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge, UB8 3PH, UK.,Centre for Physical Activity in Health and Disease, Brunel University London, Kingston Lane, Uxbridge, UB8 3PH, UK
| | - Taylor A Staines
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Polhill Avenue, Bedford, MK41 9EA, UK
| | - Angel M Chater
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Polhill Avenue, Bedford, MK41 9EA, UK. .,Centre for Behaviour Change, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
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12
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Brierley ML, Smith LR, Bailey DP, Every SA, Staines TA, Chater AM. Perceived influences on reducing prolonged sitting in police staff: a qualitative investigation using the Theoretical Domains Framework and COM-B model. BMC Public Health 2021; 21:2126. [PMID: 34798842 PMCID: PMC8605563 DOI: 10.1186/s12889-021-12019-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 10/07/2021] [Indexed: 12/27/2022] Open
Abstract
Background Workplace interventions have shown promise for reducing sitting in office workers. Police office staff remain an understudied population group that work within a disciplined organisation with distinctive work tasks around public safety, potentially affecting their capability, opportunity, and motivation to change sitting behaviour. This study aimed to assess the perceived influences on reducing workplace sitting in non-operational, desk-based police staff in order to derive theoretical determinants for behaviour change. Methods Ten police staff from a single police force in Bedfordshire, England [eight female; 39.5 ± 11.5 years] took part in face-to-face semi-structured interviews lasting 46 ± 11 min on average. Thematic analysis identified key themes which were then mapped onto the Theoretical Domains Framework (TDF) and linked to the Capability, Opportunity, Motivation-Behaviour (COM-B) model. Results Seven themes were identified: ‘Work tasks are seated’, ‘Social norm is to sit’, ‘Belief in ability to regulate behaviour’, ‘Knowledge of health risks’, ‘Organisational support’, ‘Impact on productivity’, and ‘Perceived autonomy for sitting reduction’. Conclusions Awareness of behaviour and health impacts (Capability), social and physical support to sit less (Opportunity), and habit formation techniques (Motivation) are recommended considerations in sitting reduction workplace interventions for police staff. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12019-6.
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Affiliation(s)
- Marsha L Brierley
- Centre for Health, Wellbeing and Behaviour Change, Institute for Sport and Physical Activity Research, University of Bedfordshire, Polhill Avenue, Bedford, MK41 9EA, UK.,Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge, UB8 3PH, UK.,Sedentary Behaviour, Health and Disease Research Group, Brunel University London, Kingston Lane, Uxbridge, UB8 3PH, UK
| | - Lindsey R Smith
- Centre for Health, Wellbeing and Behaviour Change, Institute for Sport and Physical Activity Research, University of Bedfordshire, Polhill Avenue, Bedford, MK41 9EA, UK
| | - Daniel P Bailey
- Centre for Health, Wellbeing and Behaviour Change, Institute for Sport and Physical Activity Research, University of Bedfordshire, Polhill Avenue, Bedford, MK41 9EA, UK.,Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge, UB8 3PH, UK.,Sedentary Behaviour, Health and Disease Research Group, Brunel University London, Kingston Lane, Uxbridge, UB8 3PH, UK
| | - Sofie A Every
- Centre for Health, Wellbeing and Behaviour Change, Institute for Sport and Physical Activity Research, University of Bedfordshire, Polhill Avenue, Bedford, MK41 9EA, UK.,Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge, UB8 3PH, UK.,Sedentary Behaviour, Health and Disease Research Group, Brunel University London, Kingston Lane, Uxbridge, UB8 3PH, UK
| | - Taylor A Staines
- Centre for Health, Wellbeing and Behaviour Change, Institute for Sport and Physical Activity Research, University of Bedfordshire, Polhill Avenue, Bedford, MK41 9EA, UK
| | - Angel M Chater
- Centre for Health, Wellbeing and Behaviour Change, Institute for Sport and Physical Activity Research, University of Bedfordshire, Polhill Avenue, Bedford, MK41 9EA, UK. .,Centre for Behavioural Medicine, University College London, Tavistock Square, London, WC1H 9JP, UK.
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13
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Chater AM, Shorter GW, Swanson V, Kamal A, Epton T, Arden MA, Hart J, Byrne-Davis LMT, Drury J, Whittaker E, Lewis LJM, McBride E, Chadwick P, O’Connor DB, Armitage CJ. Template for Rapid Iterative Consensus of Experts (TRICE). Int J Environ Res Public Health 2021; 18:10255. [PMID: 34639553 PMCID: PMC8508030 DOI: 10.3390/ijerph181910255] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 09/02/2021] [Accepted: 09/03/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Public health emergencies require rapid responses from experts. Differing viewpoints are common in science, however, "mixed messaging" of varied perspectives can undermine credibility of experts; reduce trust in guidance; and act as a barrier to changing public health behaviours. Collation of a unified voice for effective knowledge creation and translation can be challenging. This work aimed to create a method for rapid psychologically-informed expert guidance during the COVID-19 response. METHOD TRICE (Template for Rapid Iterative Consensus of Experts) brings structure, peer-review and consensus to the rapid generation of expert advice. It was developed and trialled with 15 core members of the British Psychological Society COVID-19 Behavioural Science and Disease Prevention Taskforce. RESULTS Using TRICE; we have produced 18 peer-reviewed COVID-19 guidance documents; based on rapid systematic reviews; co-created by experts in behavioural science and public health; taking 4-156 days to produce; with approximately 18 experts and a median of 7 drafts per output. We provide worked-examples and key considerations; including a shared ethos and theoretical/methodological framework; in this case; the Behaviour Change Wheel and COM-B. CONCLUSION TRICE extends existing consensus methodologies and has supported public health collaboration; co-creation of guidance and translation of behavioural science to practice through explicit processes in generating expert advice for public health emergencies.
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Affiliation(s)
- Angel M. Chater
- Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Bedford MK41 9EA, UK
- Centre for Behavioural Medicine, University College London, BMA House, Tavistock Square, London WC1H 9JP, UK
| | - Gillian W. Shorter
- Centre for Improving Health Related Quality of Life, School of Psychology, Queen’s University Belfast, Northern Ireland BT7 1NN, UK;
| | - Vivien Swanson
- Psychology Division, University of Stirling, Stirling FK9 4LA, UK;
- NHS Education for Scotland, 2 Central Quay, 89, Hydepark Street, Glasgow G3 8BW, UK
| | - Atiya Kamal
- School of Social Sciences, Department of Psychology, Birmingham City University, Birmingham B4 7BD, UK;
| | - Tracy Epton
- Manchester Centre for Health Psychology, University of Manchester, Oxford Road, Manchester M13 9PT, UK; (T.E.); (C.J.A.)
| | - Madelynne A. Arden
- Centre for Behavioural Science and Applied Psychology, Sheffield Hallam University, Sheffield S10 2BQ, UK;
| | - Jo Hart
- School of Medical Sciences, University of Manchester, Stopford Building, Manchester M13 9PT, UK; (J.H.); (L.M.T.B.-D.)
| | - Lucie M. T. Byrne-Davis
- School of Medical Sciences, University of Manchester, Stopford Building, Manchester M13 9PT, UK; (J.H.); (L.M.T.B.-D.)
| | - John Drury
- School of Psychology, University of Sussex, Falmer BN1 9QN, UK;
| | - Ellie Whittaker
- North Yorkshire County Council, County Hall, Northallerton, North Yorkshire DL7 8DD, UK;
| | - Lesley J. M. Lewis
- Public Health Wales, 2 Capital Quarter, Tyndall Street, Cardiff CF10 4BZ, UK;
| | - Emily McBride
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London WC1E 6BT, UK;
| | - Paul Chadwick
- Centre for Behaviour Change, University College London, 1-19 Torrington Place, London WC1E 7HB, UK;
| | - Daryl B. O’Connor
- Laboratory for Stress and Health Research, University of Leeds, Leeds LS2 9JT, UK;
| | - Christopher J. Armitage
- Manchester Centre for Health Psychology, University of Manchester, Oxford Road, Manchester M13 9PT, UK; (T.E.); (C.J.A.)
- Manchester University NHS Foundation Trust and NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester M13 9PL, UK
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Yates JD, Aldous JWF, Bailey DP, Chater AM, Mitchell ACS, Richards JC. The Prevalence and Predictors of Hypertension and the Metabolic Syndrome in Police Personnel. Int J Environ Res Public Health 2021; 18:ijerph18136728. [PMID: 34206524 PMCID: PMC8297085 DOI: 10.3390/ijerph18136728] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/15/2021] [Accepted: 06/16/2021] [Indexed: 11/29/2022]
Abstract
Hypertension and metabolic syndrome (METSYN) are reportedly high in police forces. This may contribute to health deterioration and absenteeism in police personnel. Police forces comprise of staff in ‘operational’ and ‘non-operational’ job types but it is not known if job type is associated to hypertension and METSYN prevalence. This study aimed to explore the prevalence of hypertension and METSYN, the factors associated with the risk of hypertension and METSYN, and compare physiological, psychological, and behavioural factors between operational and non-operational police personnel. Cross-sectional data was collected from 77 operational and 60 non-operational police workers. Hypertension and METSYN were prevalent in 60.5% and 20% of operational and 60.0% and 13.6% of non-operational police personnel, respectively (p > 0.05). Operational job type, moderate organisational stress (compared with low stress) and lower high-density lipoprotein cholesterol were associated with lower odds of hypertension, whereas increasing body mass index was associated with increased odds of hypertension (p < 0.05). None of the independent variables were significantly associated with the odds of METSYN. Operational police had several increased cardiometabolic risk markers compared with non-operational police. Given the high prevalence of hypertension and METSYN in operational and non-operational personnel, occupational health interventions are needed for the police and could be informed by the findings of this study.
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Affiliation(s)
- James D. Yates
- Institute for Sport and Physical Activity Research, University of Bedfordshire, Bedford MK41 9EA, UK; (J.W.F.A.); (D.P.B.); (A.M.C.); (A.C.S.M.)
- Correspondence: (J.D.Y.); (J.C.R.)
| | - Jeffrey W. F. Aldous
- Institute for Sport and Physical Activity Research, University of Bedfordshire, Bedford MK41 9EA, UK; (J.W.F.A.); (D.P.B.); (A.M.C.); (A.C.S.M.)
| | - Daniel P. Bailey
- Institute for Sport and Physical Activity Research, University of Bedfordshire, Bedford MK41 9EA, UK; (J.W.F.A.); (D.P.B.); (A.M.C.); (A.C.S.M.)
- Sedentary Behaviour, Health and Disease Research Group, Brunel University London, Uxbridge UB8 3PH, UK
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK
| | - Angel M. Chater
- Institute for Sport and Physical Activity Research, University of Bedfordshire, Bedford MK41 9EA, UK; (J.W.F.A.); (D.P.B.); (A.M.C.); (A.C.S.M.)
| | - Andrew C. S. Mitchell
- Institute for Sport and Physical Activity Research, University of Bedfordshire, Bedford MK41 9EA, UK; (J.W.F.A.); (D.P.B.); (A.M.C.); (A.C.S.M.)
| | - Joanna C. Richards
- Institute for Sport and Physical Activity Research, University of Bedfordshire, Bedford MK41 9EA, UK; (J.W.F.A.); (D.P.B.); (A.M.C.); (A.C.S.M.)
- Correspondence: (J.D.Y.); (J.C.R.)
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15
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Williams J, Shorter GW, Howlett N, Zakrzewski-Fruer J, Chater AM. Can Physical Activity Support Grief Outcomes in Individuals Who Have Been Bereaved? A Systematic Review. Sports Med Open 2021; 7:26. [PMID: 33830368 PMCID: PMC8028581 DOI: 10.1186/s40798-021-00311-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 03/04/2021] [Indexed: 11/11/2022]
Abstract
Background In 2018, there were 616,014 registered deaths in the United Kingdom (UK). Grief is a natural consequence. Many mental health concerns, which can be identified as grief outcomes (e.g. anxiety and depression) in those who have experienced a bereavement, can be improved through physical activity. The objective of this review was to identify from the existing literature if physical activity can benefit grief outcomes in individuals who have been bereaved. Methods A systematic review of nine databases was performed. Included studies (qualitative and quantitative) explored physical activity to help individuals (of any age) who had experienced a human bereavement (excluding national loss). Results From 1299 studies screened, 25 met the inclusion criteria, detailing eight types of bereavement (parental (n = 5), spousal (n = 6), patient (n = 4), pre-natal (n = 3), later life (n = 1), caregiver (n = 1), multiple (n = 4) and non-defined (n = 1). Activities including yoga, running, walking and martial arts were noted as beneficial. Physical activity allowed a sense of freedom, to express emotions, provided a distraction and an escape from grief, whilst enhancing social support. Conclusion There is some evidence that physical activity may provide benefit for the physical health and psychological wellbeing of those who have been bereaved, including when the loss has happened at a young age. This review is timely, given the wide-scale national loss of life due to COVID-19 and extends knowledge in this area. More research is needed to explore the benefits of physical activity for those who have been bereaved. In particular, there is a need for well-designed interventions which are tailored to specific activities, populations and grief outcomes.
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Affiliation(s)
- Jane Williams
- Institute for Sport and Physical Activity Research, Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Bedford, MK41 9EA, UK
| | - Gillian W Shorter
- Centre for Improving Health Related Quality of Life, School of Psychology, Queen's University Belfast, Belfast, BT9 7NN, UK
| | - Neil Howlett
- Department of Psychology and Sport Sciences, University of Hertfordshire, Hatfield, AL10 9AB, UK
| | - Julia Zakrzewski-Fruer
- Institute for Sport and Physical Activity Research, Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Bedford, MK41 9EA, UK
| | - Angel M Chater
- Institute for Sport and Physical Activity Research, Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Bedford, MK41 9EA, UK.
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Bailey DP, Edwardson CL, Pappas Y, Dong F, Hewson DJ, Biddle SJH, Brierley ML, Chater AM. A randomised-controlled feasibility study of the REgulate your SItting Time (RESIT) intervention for reducing sitting time in individuals with type 2 diabetes: study protocol. Pilot Feasibility Stud 2021; 7:76. [PMID: 33741077 PMCID: PMC7977248 DOI: 10.1186/s40814-021-00816-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/09/2021] [Indexed: 12/14/2022] Open
Abstract
Background People with type 2 diabetes mellitus (T2DM) generally spend a large amount of time sitting. This increases their risk of cardiovascular disease, premature mortality, diabetes-related complications and mental health problems. There is a paucity of research that has evaluated interventions aimed at reducing and breaking up sitting in people with T2DM. The primary aim of this study is to assess the feasibility of delivering and evaluating a tailored intervention to reduce and break up sitting in ambulatory adults with T2DM. Methods This is a mixed-methods randomised controlled feasibility trial. Participants (n=70) with T2DM aged 18-85 years who sit ≥7 h/day and are able to ambulate independently will be randomly allocated to receive the REgulate your SItting Time (RESIT) intervention or usual care (control group) for 24 weeks. RESIT is a person-focused intervention that delivers a standardised set of behaviour change techniques to the participants, but the mode through which they are delivered can vary depending on the tools selected by each participant. The intervention includes an online education programme, health coach support, and a range of self-selected tools (smartphone apps, computer-prompt software, and wearable devices) that deliver behaviour change techniques such as self-monitoring of sitting and providing prompts to break up sitting. Measures will be taken at baseline, 12 and 24 weeks. Eligibility, recruitment, retention and data completion rates will be used to assess trial feasibility. Sitting, standing and stepping will be measured using a thigh-worn activity monitor. Cardiometabolic health, physical function, psychological well-being, sleep and musculoskeletal symptoms will also be assessed. A process evaluation will be conducted including evaluation of intervention acceptability and fidelity. Discussion This study will identify the feasibility of delivering a tailored intervention to reduce and break up sitting in ambulatory adults with T2DM and evaluating it through a randomised controlled trial (RCT) design. The findings will inform a fully powered RCT to evaluate the effectiveness of the intervention. Trial registration ISRCTN, ISRCTN14832389; Registered 6 August 2020.
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Affiliation(s)
- Daniel P Bailey
- Sedentary Behaviour, Health and Disease Research Group, Brunel University London, Kingston Lane, Uxbridge, UB8 3PH, UK. .,Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Kingston Lane, Uxbridge, UB8 3PH, UK.
| | - Charlotte L Edwardson
- Leicester Lifestyle and Health Research Group, Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, LE5 4PW, UK.,NIHR Leicester Biomedical Research Centre, Leicester General Hospital, Leicester, LE5 4PW, UK
| | - Yannis Pappas
- Institute for Health Research, University of Bedfordshire, Luton, LU1 3JU, UK
| | - Feng Dong
- Department of Computer and Information Sciences, University of Strathclyde, G1 1XH, Glasgow, UK
| | - David J Hewson
- Institute for Health Research, University of Bedfordshire, Luton, LU1 3JU, UK
| | - Stuart J H Biddle
- Centre for Health Research, University of Southern Queensland, Springfield, QLD, 4300, Australia
| | - Marsha L Brierley
- Sedentary Behaviour, Health and Disease Research Group, Brunel University London, Kingston Lane, Uxbridge, UB8 3PH, UK.,Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Kingston Lane, Uxbridge, UB8 3PH, UK
| | - Angel M Chater
- Institute for Sport and Physical Activity Research, Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Polhill Avenue, Bedford, MK41 9EA, UK
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Chater AM, Williams J, Courtenay M. The prescribing needs of community practitioner nurse prescribers: A qualitative investigation using the theoretical domains framework and COM-B. J Adv Nurs 2019; 75:2952-2968. [PMID: 31423627 DOI: 10.1111/jan.14170] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 05/22/2019] [Accepted: 08/05/2019] [Indexed: 11/29/2022]
Abstract
AIM With a number of qualified community practitioner nurse prescribers (CPNPs) not prescribing, this research aimed to understand what influences this behaviour. DESIGN A qualitative research design. METHODS Semi-structured interviews, based on the theoretical domains framework (TDF) were conducted with 20 CPNPs. Data collection took place between March-July 2018 and continued until data saturation was reached. RESULTS Nine themes inductively explained prescribing behaviour: 1) 'Knowledge and experience'; 2) 'Consultation and communication skills'; 3) 'Professional confidence and identity'; 4) 'Wanting the best outcome'; 5) 'NHS versus patient cost'; 6) 'Emotion-led decisions'; 7) 'Time allocation'; 8) 'Formulary access' and 9) 'Supporting environment for patient-centred care'. Themes were then deductively mapped to the TDF and COM-B. CONCLUSION There is an ongoing need to support community practitioner nurse prescribers' 'Capability' to prescribe in terms of knowledge and aquired skills; 'Opportunity' to make prescribing easier, such as access to a wider and up to date nurse formulary alongside effective clinical support; and 'Motivation' to feel confident in prescribing behaviour, highlighting positive patient outcomes while reducing perceived issues such as cost and non-adherence. IMPACT Findings show that Capability, Opportunity and Motivation all influence the decision to prescribe. Those responsible for professional regulation and training should ensure community practitioner nurse prescribers have access to the relevant knowledge, skills and formulary to facilitate their prescribing behaviour. Professional confidence and identity as a prescriber should be encouraged, with acknowledgment of influences such as cost and emotion. An environment that allows for patient-centred care and the best outcome should be supported, this may mean increasing time allocated to consultations.
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Affiliation(s)
- Angel M Chater
- University of Bedfordshire, Centre for Health, Wellbeing and Behaviour Change, Bedford, UK.,University College London School of Pharmacy, London, UK
| | - Jane Williams
- University of Bedfordshire, Centre for Health, Wellbeing and Behaviour Change, Bedford, UK
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Ojo SO, Bailey DP, Brierley ML, Hewson DJ, Chater AM. Breaking barriers: using the behavior change wheel to develop a tailored intervention to overcome workplace inhibitors to breaking up sitting time. BMC Public Health 2019; 19:1126. [PMID: 31420033 PMCID: PMC6697980 DOI: 10.1186/s12889-019-7468-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 08/11/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The workplace is a prominent domain for excessive sitting. The consequences of increased sitting time include adverse health outcomes such as cardiovascular disease and poor mental wellbeing. There is evidence that breaking up sitting could improve health, however, any such intervention in the workplace would need to be informed by a theoretical evidence-based framework. The aim of this study was to use the Behaviour Change Wheel (BCW) to develop a tailored intervention to break up and reduce workplace sitting in desk-based workers. METHODS The BCW guide was followed for this qualitative, pre-intervention development study. Semi-structured interviews were conducted with 25 office workers (26-59 years, mean age 40.9 [SD = 10.8] years; 68% female) who were purposively recruited from local council offices and a university in the East of England region. The interview questions were developed using the Theoretical Domains Framework (TDF). Transcripts were deductively analysed using the COM-B (Capability, Opportunity, Motivation - Behaviour) model of behaviour. The Behaviour Change Technique Taxonomy Version 1 (BCTv1) was thereafter used to identify possible strategies that could be used to facilitate change in sitting behaviour of office workers in a future intervention. RESULTS Qualitative analysis using COM-B identified that participants felt that they had the physical Capability to break up their sitting time, however, some lacked the psychological Capability in relation to the knowledge of both guidelines for sitting time and the consequences of excess sitting. Social and physical Opportunity was identified as important, such as a supportive organisational culture (social) and the need for environmental resources (physical). Motivation was highlighted as a core target for intervention, both reflective Motivation, such as beliefs about capability and intention and automatic in terms of overcoming habit through reinforcement. Seven intervention functions and three policy categories from the BCW were identified as relevant. Finally, 39 behaviour change techniques (BCTs) were identified as potential active components for an intervention to break up sitting time in the workplace. CONCLUSIONS The TDF, COM-B model and BCW can be successfully applied through a systematic process to understand the drivers of behaviour of office workers to develop a co-created intervention that can be used to break up and decrease sitting in the workplace. Intervention designers should consider the identified BCW factors and BCTs when developing interventions to reduce and break up workplace sitting.
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Affiliation(s)
- Samson O. Ojo
- Institute for Health Research, University Square, University of Bedfordshire, Luton, Bedfordshire LU1 3JU UK
| | - Daniel P. Bailey
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Polhill Avenue, Bedford, Bedfordshire MK41 9EA UK
| | - Marsha L. Brierley
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Polhill Avenue, Bedford, Bedfordshire MK41 9EA UK
| | - David J. Hewson
- Institute for Health Research, University Square, University of Bedfordshire, Luton, Bedfordshire LU1 3JU UK
| | - Angel M. Chater
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Polhill Avenue, Bedford, Bedfordshire MK41 9EA UK
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Ojo SO, Bailey DP, Chater AM, Hewson DJ. The Impact of Active Workstations on Workplace Productivity and Performance: A Systematic Review. Int J Environ Res Public Health 2018; 15:E417. [PMID: 29495542 PMCID: PMC5876962 DOI: 10.3390/ijerph15030417] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 02/20/2018] [Accepted: 02/21/2018] [Indexed: 12/13/2022]
Abstract
Active workstations have been recommended for reducing sedentary behavior in the workplace. It is important to understand if the use of these workstations has an impact on worker productivity. The aim of this systematic review was to examine the effect of active workstations on workplace productivity and performance. A total of 3303 articles were initially identified by a systematic search and seven articles met eligibility criteria for inclusion. A quality appraisal was conducted to assess risk of bias, confounding, internal and external validity, and reporting. Most of the studies reported cognitive performance as opposed to productivity. Five studies assessed cognitive performance during use of an active workstation, usually in a single session. Sit-stand desks had no detrimental effect on performance, however, some studies with treadmill and cycling workstations identified potential decreases in performance. Many of the studies lacked the power required to achieve statistical significance. Three studies assessed workplace productivity after prolonged use of an active workstation for between 12 and 52 weeks. These studies reported no significant effect on productivity. Active workstations do not appear to decrease workplace performance.
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Affiliation(s)
- Samson O Ojo
- Institute for Health Research, University of Bedfordshire, Luton LU1 3JU, UK.
| | - Daniel P Bailey
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Bedford MK41 9EA, UK.
| | - Angel M Chater
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Bedford MK41 9EA, UK.
| | - David J Hewson
- Institute for Health Research, University of Bedfordshire, Luton LU1 3JU, UK.
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20
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Cook EJ, Randhawa G, Large S, Guppy A, Chater AM, Pang D. Who uses NHS Direct? Investigating the impact of ethnicity on the uptake of telephone based healthcare. Int J Equity Health 2014; 13:99. [PMID: 25376276 PMCID: PMC4229603 DOI: 10.1186/s12939-014-0099-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Accepted: 10/12/2014] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION NHS Direct, a leading telephone healthcare provider worldwide, provided 24/7 health care advice and information to the public in England and Wales (1998-2014). The fundamental aim of this service was to increase accessibility, however, research has suggested a disparity in the utilisation of this service related to ethnicity. This research presents the first national study to determine how the diverse population in England have engaged with this service. METHODS NHS Direct call data from the combined months of July, 2010 October, 2010, January 2011 and April, 2011 was analysed (N = 1,342, 245) for all 0845 4647 NHS Direct core service calls in England. Expected usage of NHS Direct was determined for each ethnic group of the population by age and gender and compared by actual usage using Chi-square analysis. A one-way analysis of variance (ANOVA) was used to determine variations of uptake by ethnic group and Index for Multiple Deprivation (IMD) 2010 rank. RESULTS Results confirmed that all mixed ethnic groups (White and Black Caribbean, White and Black African, White and Asian) had a higher than expected uptake of NHS Direct which held consistent across all age groups. Lower than expected uptake was found for Black (African/Caribbean) and Asian (Bangladeshi/Indian/Chinese) ethnic group which held consistent by age and gender. For the Pakistani ethnic group usage was higher than expected in adults aged 40 years and older although was lower than expected in younger age groups (0-39). CONCLUSION Findings support previous research suggesting a variation in usage of NHS Direct influenced by ethnicity, which is evidenced on a national level. Further research is now required to examine the underlying barriers that contribute to the ethnic variation in uptake of this service.
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Affiliation(s)
- Erica J Cook
- Department of Psychology, University of Bedfordshire, Park Square, Luton, UK.
| | - Gurch Randhawa
- Institute for Health Research, University of Bedfordshire, Putteridge Bury, Hitchin Road, Luton, UK.
| | | | - Andy Guppy
- Department of Psychology, University of Bedfordshire, Park Square, Luton, UK.
| | - Angel M Chater
- UCL School of Pharmacy, BMA House, Tavistock Square, London, UK.
| | - Dong Pang
- Institute for Health Research, University of Bedfordshire, Putteridge Bury, Hitchin Road, Luton, UK.
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21
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Cook EJ, Randhawa G, Large S, Guppy A, Chater AM, Ali N. Barriers and facilitators to using NHS Direct: a qualitative study of 'users' and 'non-users'. BMC Health Serv Res 2014; 14:487. [PMID: 25344061 PMCID: PMC4220056 DOI: 10.1186/s12913-014-0487-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 10/03/2014] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND NHS Direct, introduced in 1998, has provided 24/7 telephone-based healthcare advice and information to the public in England and Wales. National studies have suggested variation in the uptake of this service amongst the UK's diverse population. This study provides the first exploration of the barriers and facilitators that impact upon the uptake of this service from the perspectives of both 'users' and 'non- users'. METHODS Focus groups were held with NHS Direct 'users' (N = 2) from Bedfordshire alongside 'non-users' from Manchester (N = 3) and Mendip, Somerset (N = 4). Each focus group had between five to eight participants. A total of eighty one people aged between 21 and 94 years old (M: 58.90, SD: 22.70) took part in this research. Each focus group discussion lasted approximately 90 minutes and was audiotape-recorded with participants' permission. The recordings were transcribed verbatim. A framework approach was used to analyse the transcripts. RESULTS The findings from this research uncovered a range of barriers and facilitators that impact upon the uptake of NHS Direct. 'Non-users' were unaware of the range of services that NHS Direct provided. Furthermore, 'non-users' highlighted a preference for face-to face communication, identifying a lack of confidence in discussing healthcare over the telephone. This was particularly evident among older people with cognitive difficulties. The cost to telephone a '0845' number from a mobile was also viewed to be a barrier to access NHS Direct, expressed more often by 'non-users' from deprived communities. NHS Direct 'users' identified that awareness, ease of use and convenience were facilitators which influenced their decision to use the service. CONCLUSIONS An understanding of the barriers and facilitators which impact on the access and uptake of telephone-based healthcare is essential to move patients towards the self-care model. This research has highlighted the need for telephone-based healthcare services to increase public awareness; through the delivery of more targeted advertising to promote the service provision available.
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Affiliation(s)
- Erica J Cook
- />Department of Psychology, University of Bedfordshire, Park Square, Luton, UK
| | - Gurch Randhawa
- />Institute for Health Research, University of Bedfordshire, Putteridge Bury, Hitchin Road, Luton, UK
| | | | - Andy Guppy
- />Department of Psychology, University of Bedfordshire, Park Square, Luton, UK
| | - Angel M Chater
- />UCL School of Pharmacy, BMA House, Tavistock Square, London, UK
| | - Nasreen Ali
- />Institute for Health Research, University of Bedfordshire, Putteridge Bury, Hitchin Road, Luton, UK
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Chater AM, Parham R, Riley S, Hutchison AJ, Horne R. Profiling patient attitudes to phosphate binding medication: a route to personalising treatment and adherence support. Psychol Health 2014; 29:1407-20. [PMID: 25012529 DOI: 10.1080/08870446.2014.942663] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Nonadherence to phosphate binding medication (PBM) compromises the efficacy of treatment for chronic kidney disease, but its causes are poorly understood. This study sought to explore patient attitudes towards PBM and to evaluate the utility of the necessity-concerns framework for understanding adherence to PBM. DESIGN A sample of 221 dialysis patients currently prescribed PBM were surveyed from eight UK renal units. MAIN OUTCOME MEASURES Demographic data and clinical information, alongside the Beliefs about Medicines Questionnaire and the medication adherence report scale were reported. RESULTS Low adherence to PBM was predicted by reduced beliefs in personal need for PBM (OR = .34; 95% CI: .14-.83; p < .05), and increased concerns about PBM (OR = 3.17; 95% CI: 1.87-5.37; p < .001). Patients were categorised into attitudinal groups based on their beliefs about PBM and being 'skeptical' of PBM (low necessity beliefs and high concerns) was most associated with low adherence. CONCLUSION Strategies to improve adherence to PBM should aim to elicit and address patients' beliefs about their personal need for PBM and their concerns about this medication.
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Affiliation(s)
- Angel M Chater
- a UCL School of Pharmacy, Centre for Behavioural Medicine , University College London , London , UK
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Cook EJ, Randhawa G, Large S, Guppy A, Chater AM, Pang D. Young people's use of NHS Direct: a national study of symptoms and outcome of calls for children aged 0-15. BMJ Open 2013; 3:e004106. [PMID: 24327365 PMCID: PMC3863119 DOI: 10.1136/bmjopen-2013-004106] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Revised: 10/31/2013] [Accepted: 11/05/2013] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES National Health Service (NHS) Direct provides 24/7 expert telephone-based healthcare information and advice to the public in England. However, limited research has explored the reasons to why calls are made on behalf of young people, as such this study aimed to examine call rate (CR) patterns in younger people to enable a better understanding of the needs of this population in England. SETTING NHS Direct, England, UK. PARTICIPANTS AND METHODS CRs (expressed as calls/100 persons/annum) were calculated for all calls (N=358 503) made to NHS Direct by, or on behalf of, children aged 0-15 during the combined four '1-month' periods within a year (July 2010, October 2010, January 2011 and April 2011). χ² Analysis was used to determine the differences between symptom, outcome and date/time of call. RESULTS For infants aged <1, highest CRs were found for 'crying' for male (n=14, 440, CR=13.61) and female (n=13 654, CR=13.46) babies, which is used as a universal assessment applied to all babies. High CRs were also found for symptoms relating to 'skin/hair/nails' and 'colds/flu/sickness' for all age groups, whereby NHS Direct was able to support patients to self-manage and provide health information for these symptoms for 59.7% and 51.4% of all cases, respectively. Variations in CRs were found for time and age, with highest peaks found for children aged 4-15 in the 15:00-23:00 period and in children aged <1 in the 7:00-15:00 period. CONCLUSIONS This is the first study to examine the symptoms and outcome of calls made to NHS Direct for and on behalf of young children. The findings revealed how NHS Direct has supported a range of symptoms through the provision of health information and self-care support which provides important information about service planning and support for similar telephone-based services.
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Affiliation(s)
- E J Cook
- Department of Psychology, University of Bedfordshire, Luton, Bedfordshire, UK
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