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South J, Woodall J, Stansfield J, Mapplethorpe T, Passey A, Bagnall AM. A qualitative synthesis of practice-based learning from case studies on COVID community champion programmes in England, UK. BMC Public Health 2024; 24:7. [PMID: 38166766 PMCID: PMC10759547 DOI: 10.1186/s12889-023-17470-1] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Community-based volunteering supports outbreak management by extending reach into at-risk communities. This paper examines the application of a 'community champions' model in England, UK, during the COVID-19 pandemic. Evidence pre-pandemic shows that community champion interventions tap into social networks to strengthen connections with disadvantaged communities. During the pandemic, the UK government set up a COVID community champions funding award scheme for local authorities to develop local programmes that addressed emerging inequalities. The study aim was to identify transferable learning on community engagement in the pandemic by undertaking a secondary qualitative synthesis of practice-based case studies of local COVID community champion programmes. METHODS A systematic staged approach for synthesis of practice-based case studies was used. In total, 16 COVID community champion case studies, which were written by practitioners involved in local programme implementation and published by the Local Government Association, were included. Case studies covered aims, programme development and delivery, examples of activities and a discussion of learning. Framework qualitative analysis methods were used to code and organise data prior to cross case analysis. The final stage produced an overarching thematic framework that best represented descriptive and interpretive themes. RESULTS The results provide an overview of common features of COVID community champion programmes and emergent learning. All local programmes aimed to reduce health inequalities by involving at-risk communities in local prevention efforts, adapting the approach to local priorities. Two levels of community engagement were volunteer mobilisation and subsequent community-based outreach activities. Elements of capacity building, such as training and creation of networks, were common. The synthesis of practice-based learning found that stronger relationships with communities were regarded as a key mechanism to support more equitable prevention strategies. Other learning themes related to champion roles, community engagement strategies and programme implementation. CONCLUSIONS By focusing on how community champion approaches were applied by local authorities in England during the COVID-19 pandemic, this study contributes to knowledge on volunteer mobilisation as a mechanism to improve public health communication and outreach. Notwithstanding the limitations of experiential evidence, the synthesis of practice-based learning highlights potentially transferable community engagement strategies for health protection and health improvement.
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Affiliation(s)
- Jane South
- School of Health, Centre for Health Promotion Research, Leeds Beckett University, Calverley Building, Portland Place, Leeds, LS1 3HE, UK.
| | - James Woodall
- School of Health, Centre for Health Promotion Research, Leeds Beckett University, Calverley Building, Portland Place, Leeds, LS1 3HE, UK
| | - Jude Stansfield
- School of Health, Centre for Health Promotion Research, Leeds Beckett University, Calverley Building, Portland Place, Leeds, LS1 3HE, UK
| | - Tom Mapplethorpe
- Corporate Strategy, Commissioning and Public Health, Kirklees Council, Huddersfield, HD1 9EL, UK
| | - Andrew Passey
- School of Health, Centre for Health Promotion Research, Leeds Beckett University, Calverley Building, Portland Place, Leeds, LS1 3HE, UK
| | - Anne-Marie Bagnall
- School of Health, Centre for Health Promotion Research, Leeds Beckett University, Calverley Building, Portland Place, Leeds, LS1 3HE, UK
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Hall CE, Wehling H, Stansfield J, South J, Brooks SK, Greenberg N, Amlôt R, Weston D. Examining the role of community resilience and social capital on mental health in public health emergency and disaster response: a scoping review. BMC Public Health 2023; 23:2482. [PMID: 38082247 PMCID: PMC10714503 DOI: 10.1186/s12889-023-17242-x] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 11/16/2023] [Indexed: 12/18/2023] Open
Abstract
The ability of the public to remain psychologically resilient in the face of public health emergencies and disasters (such as the COVID-19 pandemic) is a key factor in the effectiveness of a national response to such events. Community resilience and social capital are often perceived as beneficial and ensuring that a community is socially and psychologically resilient may aid emergency response and recovery. This review presents a synthesis of literature which answers the following research questions: How are community resilience and social capital quantified in research?; What is the impact of community resilience on mental wellbeing?; What is the impact of infectious disease outbreaks, disasters and emergencies on community resilience and social capital?; and, What types of interventions enhance community resilience and social capital?A scoping review procedure was followed. Searches were run across Medline, PsycInfo, and EMBASE, with search terms covering both community resilience and social capital, public health emergencies, and mental health. 26 papers met the inclusion criteria.The majority of retained papers originated in the USA, used a survey methodology to collect data, and involved a natural disaster. There was no common method for measuring community resilience or social capital. The association between community resilience and social capital with mental health was regarded as positive in most cases. However, we found that community resilience, and social capital, were initially negatively impacted by public health emergencies and enhanced by social group activities.Several key recommendations are proposed based on the outcomes from the review, which include: the need for a standardised and validated approach to measuring both community resilience and social capital; that there should be enhanced effort to improve preparedness to public health emergencies in communities by gauging current levels of community resilience and social capital; that community resilience and social capital should be bolstered if areas are at risk of disasters or public health emergencies; the need to ensure that suitable short-term support is provided to communities with high resilience in the immediate aftermath of a public health emergency or disaster; the importance of conducting robust evaluation of community resilience initiatives deployed during the COVID-19 pandemic.
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Grants
- NIHR20008900 National Institute for Health Research Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between Public Health England, King's College London and the University of East Anglia
- NIHR20008900 National Institute for Health Research Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between Public Health England, King's College London and the University of East Anglia
- NIHR20008900 National Institute for Health Research Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between Public Health England, King's College London and the University of East Anglia
- NIHR20008900 National Institute for Health Research Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between Public Health England, King's College London and the University of East Anglia
- NIHR20008900 National Institute for Health Research Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between Public Health England, King's College London and the University of East Anglia
- NIHR20008900 National Institute for Health Research Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between Public Health England, King's College London and the University of East Anglia
- National Institute for Health Research Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between Public Health England, King’s College London and the University of East Anglia
- Office for Health Improvement and Disparities, Department of Health and Social Care, as part of a Collaborative Agreement with Leeds Beckett University.
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Affiliation(s)
- C E Hall
- Behavioural Science and Insights Unit, Evaluation & Translation Directorate, Science Group, UK Health Security Agency, Porton Down, Salisbury, SP4 0JG, UK
- Health Protection Research Unit, Institute of Psychology, Psychiatry and Neuroscience, King's College London, 10 Cutcombe Road, London, SE5 9RJ, UK
| | - H Wehling
- Behavioural Science and Insights Unit, Evaluation & Translation Directorate, Science Group, UK Health Security Agency, Porton Down, Salisbury, SP4 0JG, UK
| | - J Stansfield
- School of Health and Community Studies, Leeds Beckett University, Portland Building, PD519, Portland Place, Leeds, LS1 3HE, UK
| | - J South
- School of Health and Community Studies, Leeds Beckett University, Portland Building, PD519, Portland Place, Leeds, LS1 3HE, UK
| | - S K Brooks
- Health Protection Research Unit, Institute of Psychology, Psychiatry and Neuroscience, King's College London, 10 Cutcombe Road, London, SE5 9RJ, UK
| | - N Greenberg
- Health Protection Research Unit, Institute of Psychology, Psychiatry and Neuroscience, King's College London, 10 Cutcombe Road, London, SE5 9RJ, UK
- King's Centre for Military Health Research, Institute of Psychology, Psychiatry and Neuroscience, King's College London, 10 Cutcombe Road, London, SE5 9RJ, UK
| | - R Amlôt
- Behavioural Science and Insights Unit, Evaluation & Translation Directorate, Science Group, UK Health Security Agency, Porton Down, Salisbury, SP4 0JG, UK
| | - D Weston
- Behavioural Science and Insights Unit, Evaluation & Translation Directorate, Science Group, UK Health Security Agency, Porton Down, Salisbury, SP4 0JG, UK.
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South J, Mapplethorpe T, Gledhill R, Marsh W, Stansfield J, Evans S, Mancini M, Outhwaite H. Learning from public health practice: the development of a library of community-centered practice examples. J Public Health (Oxf) 2022:6623459. [PMID: 35774035 DOI: 10.1093/pubmed/fdac065] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 04/28/2022] [Accepted: 05/17/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Valuable learning derived from public health practice can be captured through practice-based case studies, also known as practice examples. Practice examples of participatory interventions supplement the evidence base by providing information on the complexities of implementation in communities. This paper reports on a Public Health England project to build a bank of community-centered practice examples based on robust processes of collection and curation. METHODS The multidisciplinary project had three phases: (i) development and piloting a process to collect practice examples, (ii) refining review processes and gathering further examples via national and regional teams (iii) maintenance of an accessible collection on the library platform. RESULTS The project resulted in a searchable collection of 55 practice examples illustrating participatory approaches in public health practice. The collection shows diversity in terms of settings, population, focus and type of approach used to work with communities. A secondary outcome was the development of generic guidance and templates for further collections on public health topics. CONCLUSIONS This project illustrates how information on the implementation of community-centered approaches in real-life contexts can be gathered and disseminated through a transferable process. Having collections of practice examples supports knowledge exchange in public health as learning is shared.
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Affiliation(s)
- Jane South
- School of Health, Leeds Beckett University, Leeds LS1 3HE, UK.,Office for Health Improvement and Disparities, Department of Health and Social Care, London SW1H 0EU, UK
| | - Tom Mapplethorpe
- Office for Health Improvement and Disparities, Department of Health and Social Care, London SW1H 0EU, UK
| | - Rachel Gledhill
- UK Health Security Agency Knowledge and Library Services, UK Health Security Agency, London SW1H 0EU, UK
| | - Wendy Marsh
- UK Health Security Agency Knowledge and Library Services, UK Health Security Agency, London SW1H 0EU, UK
| | - Jude Stansfield
- School of Health, Leeds Beckett University, Leeds LS1 3HE, UK.,Office for Health Improvement and Disparities, Department of Health and Social Care, London SW1H 0EU, UK
| | - Sian Evans
- Local Knowledge and Intelligence Service (LKIS) East, Office for Health Improvement and Disparities, Department of Health and Social Care, Cambridge CB21 5XA, UK
| | - Michelle Mancini
- Office for Health Improvement and Disparities, North East and Yorkshire, Department of Health and Social Care, Newcastle NE15 8NY, UK
| | - Helen Outhwaite
- Improvement Directorate, NHS England and NHS Improvement, Leeds LS2 7UE, UK
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Shah N, Walker IF, Naik Y, Rajan S, O'Hagan K, Black M, Cartwright C, Tillmann T, Pearce-Smith N, Stansfield J. National or population level interventions addressing the social determinants of mental health - an umbrella review. BMC Public Health 2021; 21:2118. [PMID: 34794401 PMCID: PMC8599417 DOI: 10.1186/s12889-021-12145-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 04/22/2021] [Accepted: 09/15/2021] [Indexed: 01/08/2023] Open
Abstract
Background Social circumstances in which people live and work impact the population’s mental health. We aimed to synthesise evidence identifying effective interventions and policies that influence the social determinants of mental health at national or scaled population level. We searched five databases (Cochrane Library, Global Health, MEDLINE, EMBASE and PsycINFO) between Jan 1st 2000 and July 23rd 2019 to identify systematic reviews of population-level interventions or policies addressing a recognised social determinant of mental health and collected mental health outcomes. There were no restrictions on country, sub-population or age. A narrative overview of results is provided. Quality assessment was conducted using Assessment of Multiple Systematic Reviews (AMSTAR 2). This study was registered on PROSPERO (CRD42019140198). Results We identified 20 reviews for inclusion. Most reviews were of low or critically low quality. Primary studies were mostly observational and from higher income settings. Higher quality evidence indicates more generous welfare benefits may reduce socioeconomic inequalities in mental health outcomes. Lower quality evidence suggests unemployment insurance, warm housing interventions, neighbourhood renewal, paid parental leave, gender equality policies, community-based parenting programmes, and less restrictive migration policies are associated with improved mental health outcomes. Low quality evidence suggests restriction of access to lethal means and multi-component suicide prevention programmes are associated with reduced suicide risk. Conclusion This umbrella review has identified a small and overall low-quality evidence base for population level interventions addressing the social determinants of mental health. There are significant gaps in the evidence base for key policy areas, which limit ability of national policymakers to understand how to effectively improve population mental health. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12145-1.
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Affiliation(s)
- Neha Shah
- City University London, Northampton Square, EC1V 0HB, London, UK.
| | - Ian F Walker
- Hull York Medical School, University of York, Heslington, York, YO10 5DD, England
| | - Yannish Naik
- Leeds Teaching Hospitals NHS Trust, Great St George Street, Leeds, LS1 3EX, England
| | - Selina Rajan
- Department of Health Services Research and Policy, The London School of Hygiene and Tropical Medicine, London, WC1E 7H, UK
| | - Kate O'Hagan
- Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK
| | - Michelle Black
- School of Health and Related Research, The University of Sheffield, Regent Court, 30 Regent, Sheffield, S1 4DA, England
| | - Christopher Cartwright
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, BD9 6RJ, England
| | - Taavi Tillmann
- Centre for Global Non-Communicable Disease, Institute for Global Health, UCL, 30 Guilford, London, WC1N 1EH, UK
| | - Nicola Pearce-Smith
- Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK
| | - Jude Stansfield
- School of Health and Community Studies, Leeds Beckett University, Portland Building, PD519, Portland Place, Leeds, LS1 3HE, UK
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Stansfield J, Cavill N, Marshall L, Robson C, Rutter H. Using complex systems mapping to build a strategic public health response to mental health in England. JPMH 2021. [DOI: 10.1108/jpmh-10-2020-0140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThis paper aims to use systems mapping as a tool to develop an organisation-wide approach to public mental health to inform strategic direction within a national public health agency.
Design/methodology/approachTwo workshops were facilitated with internal staff from a wide range of public health policy teams working in small groups to produce paper-based maps. These were collated and refined by the project team and digitised.
FindingsThe approach engaged a range of teams in forming a shared understanding and producing a complex system map of the influences on population mental health and well-being, where current policy initiatives were addressing them and what the gaps and priorities were. Participants valued the approach which led to further study and organisational commitment to the whole system working as part of national public mental health strategy.
Research limitations/implicationsThe approach was limited to internal stakeholders and wider engagement with other sectors and community members would help further the application of complex system approaches to public mental health.
Originality/valueIt was a valuable process for developing a whole-organisation approach and stimulating thinking and practice in complex system approaches. The paper provides a practical example of how to apply systems mapping and its benefits for organising public mental health practice.
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Qureshi M, Lokanathan S, Adapa A, Stansfield J, Jain N, Bhutta A. 952 In-Patient Trauma Surgery in COVID-19 Positive Patients Carries A Significantly Higher Mortality Risk When Compared to In-Patient Covid-19 Negative Patients and Day Case Trauma Patients. Br J Surg 2021. [PMCID: PMC8135882 DOI: 10.1093/bjs/znab134.101] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Introduction Covid-19 caused many service changes, yet Trauma surgery continued throughout. We compare mortality rates from In-Patient (IP) and Day Case (DC) trauma patients and compare the mortality rates of patients who tested positive or negative for Covid-19. Method We reviewed all trauma admissions that underwent surgical intervention in both our IP and DC services during 31 days from March 23rd 2020. We recorded their sex, age, operation, Covid-19 symptoms, Covid-19 test results and mortality. The findings were compared between the groups. Results In total 127 patients underwent surgery (66 IP; 61 DC). There were 6 deaths (9.1%) within the IP group and 0 deaths in the DC group (p = 0.006). In the IP group 8 patients (12.1%) tested positive for Covid-19 of which 4 died (50%) compared to the remaining 58 patients (87.9%) of which 2 (3.4%) died (p < 0.001). A higher mortality rate was observed in patients with symptoms but a negative Covid-19 test (6.7%) than patients in whom a test was never indicated (2.3%). Conclusion Covid-19 positive patients requiring in-patient admission for trauma surgery have a significantly higher mortality rate than both in-patient admissions that were Covid-19 negative or asymptomatic and patients that were treated with Day Case Trauma surgery.
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Affiliation(s)
- M Qureshi
- Northern Care Alliance, Manchester, United Kingdom
| | - S Lokanathan
- Northern Care Alliance, Manchester, United Kingdom
| | - A Adapa
- Northern Care Alliance, Manchester, United Kingdom
| | - J Stansfield
- Northern Care Alliance, Manchester, United Kingdom
| | - N Jain
- Northern Care Alliance, Manchester, United Kingdom
| | - A Bhutta
- Northern Care Alliance, Manchester, United Kingdom
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Waugh C, Jain N, Bhutta A, Havenhand T, Qureshi M, Stansfield J, Lokanathan S. 890 Predictive Factors for Mortality Following Trauma & Orthopaedic Surgery in The Covid-19 Pandemic. The Manchester Equation. Br J Surg 2021. [PMCID: PMC8135896 DOI: 10.1093/bjs/znab134.094] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Covid-19 caused many service changes including limitations on operations due to potential increased mortality risk to patients. We report our findings from Trauma & Orthopaedic (T&O) surgical mortality through this period and the effectiveness of using a scoring system (The Manchester Equation) to predict likelihood of mortality. Method We reviewed all T&O admissions that underwent surgical intervention during the height of the pandemic. We recorded numerous factors for each patient including mortality and Covid status. From this we created a scoring system which is the product of Covid status, Anaesthetic type, Medical co-morbidities and other medical factors and ASA Score. We then analysed the findings to determine whether the score could be predictive of mortality rate. Results Of 123 patients undergoing surgery 6 deaths were observed (mean score of 51.3) compared to 117 patients surviving (mean score 31.9), p = 0.001. A score of less than 32 carried a 0% chance of death whereas a score of 32 or more resulted in a 14.6% mortality rate (p = 0.01). Conclusion The Manchester Equation can be used to help predict the mortality rate of T&O surgery in the presence of Covid-19 and may be useful for clinical decision making and consent purposes.
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Affiliation(s)
- C Waugh
- Pennine Acute NHS Trust, Manchester, United Kingdom
| | - N Jain
- Pennine Acute NHS Trust, Manchester, United Kingdom
| | - A Bhutta
- Pennine Acute NHS Trust, Manchester, United Kingdom
| | - T Havenhand
- Pennine Acute NHS Trust, Manchester, United Kingdom
| | - M Qureshi
- Pennine Acute NHS Trust, Manchester, United Kingdom
| | - J Stansfield
- Pennine Acute NHS Trust, Manchester, United Kingdom
| | - S Lokanathan
- Pennine Acute NHS Trust, Manchester, United Kingdom
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Stansfield J, South J, Mapplethorpe T. What are the elements of a whole system approach to community-centred public health? A qualitative study with public health leaders in England's local authority areas. BMJ Open 2020; 10:e036044. [PMID: 32847905 PMCID: PMC7451485 DOI: 10.1136/bmjopen-2019-036044] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES The aim of the study was to identify key elements of whole system approaches to building healthy communities and putting communities at the heart of public health with a focus on public health practice to reduce health inequalities. DESIGN A mixed-method qualitative study was undertaken. The primary method was semi-structured interviews with 17 public health leaders from 12 local areas. This was supplemented by a rapid review of literature, a survey of 342 members of the public via Public Health England's (PHE) People's Panel and a round-table discussion with 23 stakeholders. SETTING Local government in England. RESULTS Eleven elements of community-centred public health practice that constitute taking a whole system approach were identified. These were grouped into the headings of involving, strengthening, scaling and sustaining. The elements were underpinned by a set of values and principles. CONCLUSION Local public health leaders are in a strong position to develop a whole system approach to reducing health inequalities that puts communities at its heart. The elements, values and principles summarise what a supportive infrastructure looks like and this could be further tested with other localities and communities as a framework for scaling community-centred public health.
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Affiliation(s)
- Jude Stansfield
- Health Improvement Division, Public Health England, London, UK
- School of Health and Community Studies, Leeds Beckett University, Leeds, West Yorkshire, UK
| | - Jane South
- Health Improvement Division, Public Health England, London, UK
- School of Health and Community Studies, Leeds Beckett University, Leeds, West Yorkshire, UK
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South J, Stansfield J, Amlôt R, Weston D. Sustaining and strengthening community resilience throughout the COVID-19 pandemic and beyond. Perspect Public Health 2020; 140:305-308. [PMID: 32820710 PMCID: PMC7683884 DOI: 10.1177/1757913920949582] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- J South
- Health Improvement Directorate, Public Health England, UK
| | - J Stansfield
- Health Improvement Directorate, Public Health England, UK; School of Health & Community Studies, Leeds Beckett University, UK
| | - R Amlôt
- Behavioural Science Team, Emergency Response Department, Health Protection, Public Health England, UK
| | - D Weston
- Behavioural Science Team, Emergency Response Department, Health Protection, Public Health England, UK
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Duncan FH, McGrath M, Baskin C, Osborn D, Dykxhoorn J, Kaner EFS, Gnani S, LaFortune L, Lee C, Walters KR, Kirkbride J, Fischer L, Jones O, Pinfold V, Stansfield J, Oliver EJ. Delivery of community-centred public mental health interventions in diverse areas in England: a mapping study protocol. BMJ Open 2020; 10:e037631. [PMID: 32665349 PMCID: PMC7359052 DOI: 10.1136/bmjopen-2020-037631] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Public mental health (PMH) is a global challenge and a UK priority area for action. However, to progress, practitioners require a stronger evidence base regarding the effectiveness of approaches, particularly regarding promotion and prevention through community-centred interventions. In addition, policy-makers need to understand what is being delivered, particularly in areas of high need, to identify promising practices or gaps in PMH provision. Finally, and importantly, the public need better information regarding what approaches and services are available to them. We report a protocol designed to (1) identify the types of community-centred interventions used in purposively selected diverse geographical areas of England to improve PMH outcomes and (2) describe the type, target population, content and outcome measures of each intervention. METHODS AND ANALYSIS Five local authority areas of England were selected based on either high social deprivation or differing ethnic population statistics and geographical locations. Community-centred interventions in each area will be identified through: (1) desk-based data capture from standardised searches of publicly-available information (eg, policy, strategy and intervention advertising), (2) established professional networks and service contacts, (3) chain-referral sampling of individuals involved in local mental health promotion and prevention and (4) peer researchers, who will use their personal experience and local knowledge to help identify potentially relevant organisations. Data on the key features of the interventions will be extracted from individuals either by structured interviews or by electronic questionnaires with information regarding the intervention(s) of which they have knowledge. Initial data analysis will involve tabulating descriptive information and grouping interventions according to intervention type, target population, risk/protective factor and intended primary outcome. A descriptive comparison will be made between selected geographical areas. ETHICS AND DISSEMINATION Ethical approval was obtained from Durham University's Department of Sport and Exercise Sciences Research Ethics Committee. We plan to disseminate our findings at relevant conferences, meetings and through peer-reviewed journals. We also plan to disseminate to the public and intervention providers through social media and/or newsletters.
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Affiliation(s)
- Fiona H Duncan
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
| | - Mike McGrath
- Division of Psychiatry, UCL, London, UK
- Department of Primary Care and Population Health, UCL, London, UK
| | - Cleo Baskin
- Department of Primary Care and Public Health, Imperial College, London, UK
| | | | - Jen Dykxhoorn
- Division of Psychiatry, UCL, London, UK
- Department of Primary Care and Population Health, UCL, London, UK
| | - Eileen F S Kaner
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Shamini Gnani
- Department of Primary Care and Public Health, Imperial College, London, UK
| | - Louise LaFortune
- Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Caroline Lee
- Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Kate R Walters
- Department of Primary Care and Population Health, UCL, London, UK
| | | | | | | | | | - Jude Stansfield
- Health Improvement Directorate, Public Health England, London, UK
| | - Emily J Oliver
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
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Walker IF, Stansfield J, Makurah L, Garnham H, Robson C, Lugton C, Hey N, Henderson G. Delivering national public mental health – experience from England. JPMH 2019. [DOI: 10.1108/jpmh-06-2018-0032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Mental health is an emerging health policy priority globally. The emphasis on closing the treatment gap in psychiatric services is now being complemented by an increasing focus on prevention and health promotion. The purpose of this paper is to describe the programmes and delivery of public mental health in England led by Public Health England (PHE), an arms-length body of the Department of Health and Social Care.
Design/methodology/approach
This technical paper outlines the general approach PHE has taken in delivering national work in public mental health and describes several key areas of work: children and young people, suicide prevention, workplace and workforce, strategic engagement with stakeholders, data and information and evidence synthesis.
Findings
A description of the various programmes and guidance documents that PHE have produced are described and referenced, which form a substantial body of work in public mental health.
Practical implications
The outputs from PHE may assist in informing the approach to public mental health that other government agencies could consider adopting. The resources described and signposted within this technical paper are publicly available for readers.
Originality/value
England is one of a small group of countries that have a track record in delivering public mental health at a national level. This paper gives a unique and detailed insight into this work.
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Abstract
BACKGROUND Mental health can help explain how social inequalities impact on health. Many current public health challenges are shaped by social, economic and environmental conditions that take a mental toll on society. PURPOSE This article describes a conceptual framework illustrating the psychosocial pathways that link the wider conditions to health behaviours and outcomes. It draws out implications of this framework for mental health practice that aim to support policy and decision-making on future action to reduce health inequalities and presents practical examples of what can be done. METHODS This article expands on a report commissioned by Public Health England. A narrative review and synthesis of relevant evidence built on existing research by the Institute of Health Equity. A conceptual framework was developed and a consultation exercise with stakeholders helped to revise and illustrate it with practice examples. CONCLUSIONS The field of mental health has much to contribute to prevention, not just of mental illness but also of physical health conditions and reduction of inequalities in life expectancy and healthy life expectancy, especially through collaborative public health action.
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Affiliation(s)
- Jude Stansfield
- 1 Health Improvement Directorate, Public Health England, London, UK.,2 School of Health and Community Studies, Leeds Beckett University, Leeds, UK
| | - Ruth Bell
- 3 Institute of Health Equity, Department of Epidemiology & Public Health, University College London, London, UK
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Affiliation(s)
- J Stansfield
- Health Improvement Directorate, Public Health England, London, UK
- School of Health and Community Studies, Leeds Beckett University, Leeds, UK
| | - J South
- Health Improvement Directorate, Public Health England, London, UK
- School of Health and Community Studies, Leeds Beckett University, Leeds, UK
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Outhwaite H, Evans S, Bell D, Manchini M, Stansfield J, Marsh W, South J. A pilot project to develop community-centred public health practice examples, England, UK. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | | | - D Bell
- Public Health England, Leeds, UK
| | | | | | - W Marsh
- Public Health England, Cambridge, UK
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Stansfield J. Confidence, competence and commitment: Public Health England
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s leadership and workforce development framework for public mental health. Journal of Public Mental Health 2015. [DOI: 10.1108/jpmh-07-2015-0033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– The purpose of this paper is to describe a national framework for leadership and workforce development in public mental health, published by Public Health England in 2015.
Design/methodology/approach
– It has been developed with national partners and the local public health workforce, responding to local need and national policy. It aims to build the capacity and capability of leaders and a workforce that is confident, competent and committed to: promoting good mental health across the population, preventing mental illness and suicide, and improving the quality and length of life of people living with mental illness.
Findings
– The framework outlines six ambitions for change and suggests the core principles and competencies needed in the workforce, and in leaders, to make that change happen, alongside practical actions.
Practical implications
– A call to action approach is used to gain commitment from strategic partners and key organisations. Planners and practitioners are encouraged to use the framework to inform the commissioning and delivery of workforce development.
Originality/value
– This is the first time a national framework for workforce development in public mental health has been published and as such it sets direction for national and local bodies and provides a practical approach to inform and influence action.
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Bellis MA, Lowey H, Hughes K, Deacon L, Stansfield J, Perkins C. Variations in risk and protective factors for life satisfaction and mental wellbeing with deprivation: a cross-sectional study. BMC Public Health 2012; 12:492. [PMID: 22747738 PMCID: PMC3432633 DOI: 10.1186/1471-2458-12-492] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2012] [Accepted: 07/02/2012] [Indexed: 11/10/2022] Open
Abstract
Background Improving life satisfaction (LS) and mental wellbeing (MWB) is important for better public health. Like other health issues, LS and MWB are closely related to deprivation (i.e. lack of resources). Developing public health measures that reduce inequalities in wellbeing requires an understanding of how factors associated with high and low LS and MWB vary with deprivation. Here, we examine such variations and explore which public health measures are likely to improve wellbeing while reducing related inequalities. Methods A self-administered questionnaire measuring LS and MWB was used with a cross-sectional sample of adults from the North West of England (n = 15,228). Within deprivation tertiles, analyses examined how demographics, health status, employment, relationships and behaviours (alcohol, tobacco, physical exercise) were associated with LS and MWB. Results Deprivation was strongly related to low LS and MWB with, for instance, 17.1 % of the most deprived tertile having low LS compared to 8.9 % in the most affluent. After controlling for confounders, across all deprivation tertiles, better self-assessed health status and being in a relationship were protective against low LS and MWB. Unemployment increased risks of low LS across all tertiles but only risks of low MWB in the deprived tertile. For this tertile, South Asian ethnicity and higher levels of exercise were protective against low MWB. In the middle tertile retired individuals had a reduced risk of low MWB and an increased chance of high LS even in comparison to those in employment. Alcohol’s impact on LS was limited to the most deprived tertile where heavy drinkers were at most risk of poor outcomes. Conclusions In this study, positive outcomes for LS and MWB were strongly associated with lower deprivation and good health status. Public health measures already developed to promote these issues are likely to improve LS and MWB. Efforts to increase engagement in exercise are also likely to have positive impacts, particularly in deprived communities. The development of future initiatives that address LS and MWB must take account of variations in their risk and protective factors at different levels of deprivation.
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Affiliation(s)
- Mark A Bellis
- Centre for Public Health, Liverpool John Moores University, 15-21 Webster Street, Liverpool L3 2ET, UK.
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Abstract
The European Commission green paper Improving the Mental Health of the Population, published in October 2005, is essentially a public mental health strategy for the European Union. In this short article Jude Stansfield outlines the main elements of the strategy and discusses its relevance and implications both for the European Union as a whole and for policy and practice in England and the other individual member states. While the green paper is in many ways welcome in that it will raise the profile of public mental health at national and international government level, it has a number of flaws ‐ not least its primary focus on mental illness and mental illness services.
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Abstract
This study investigates how prioritisation in health services have influenced speech and language therapy (SLT) services in Scotland in prioritising their caseload. Additionally, it evaluates how current prioritisation systems may contribute towards the development of the SLT service in Malaysia. Health, education and social agencies in Malaysia were contacted and a literature review was conducted. Information on prioritisation systems used in Malaysia was unavailable. Prioritisation systems from seven SLT departments within Scotland were investigated, of which three SLT managers took part in semi-structured interviews. The findings show that prioritisation is influenced by a combination of factors and that the principles could only be applied to the Malaysian SLT service if consideration is given to the political, economical, social, geographical and cultural factors.
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Affiliation(s)
- C Santiago
- Department of Speech and Language Sciences, Queen Margaret College, Edinburgh
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Johnston F, Stansfield J. Expressive pragmatic skills in pre-school children with and without Down's syndrome: parental perceptions. J Intellect Disabil Res 1997; 41 ( Pt 1):19-29. [PMID: 9089456 DOI: 10.1111/j.1365-2788.1997.tb00673.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Parental perceptions of the pragmatic skills of six pre-school children with Down's syndrome were compared to those of six children without cognitive impairment. Children were matched for language comprehension age on the Reynell Developmental Language Scale and parents were interviewed using the Pragmatics Profile of Early Communication Skills. Data from the parental interviews was analysed taking a qualitative approach, using the technique of content analysis. The results showed that the children with and without Down's syndrome had many similarities in reported behaviours and responses In addition, five out of the six children with Down's syndrome had some skills which were more advanced than their matched pairs. Possible reasons for these findings are discussed. The evidence suggests that children with Down's syndrome have a normal range of pragmatic skills and communicative intentions compared with children of similar levels of comprehension functioning at an early pre-school level.
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Affiliation(s)
- F Johnston
- Department of Speech and Language Sciences, Queen Margaret College, Edinburgh, Scotland
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Armstrong L, Stansfield J. A content analysis of the professional journal of the British Society of Speech Therapists. I: The first 10 years. Spotlight on 'Speech' 1935-1945. Eur J Disord Commun 1996; 31:91-105. [PMID: 8776433 DOI: 10.3109/13682829609042214] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The 24 editions of the professional journal 'Speech' published between 1935-1945 were examined by use of content analysis. The use of this approach enabled an in-depth survey of the professional, clinical and political issues of the period which saw the beginning of speech and language therapy as a profession. Two main areas were focused upon: the development of the professional body and the authored papers which appeared in the journal. 'Speech' at that time can be viewed as a blend of today's 'European Journal of Disorders of Communication' with today's 'Bulletin'.
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Affiliation(s)
- L Armstrong
- Department of Speech and Language Sciences, Queen Margaret College, Edinburgh, Scotland
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Scott PJ, Stansfield J, Williams BO. Prescribing habits and potential adverse drug interactions in a geriatric medical service. Health Bull (Edinb) 1982; 40:5-9. [PMID: 7061232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Stansfield J. Case of Ununited Fracture of the Os Humeri, treated successfully by the Seton. Med Chir Trans 1816; 7:103-106. [PMID: 20895269 PMCID: PMC2129081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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