Richard Purves, Andrea Mohan, Rachel O'Donnell, Matt Egan, Nason Maani, Niamh Fitzgerald
<p><strong>Background: </strong>Evidence suggests that controls on the physical and temporal availability of alcohol can reduce alcohol-related harms. Public health teams in England and Scotland have in recent years been given a statutory role in licensing systems through which premises are granted permits to sell alcohol. The Exploring the Impact of alcohol premises Licensing in England and Scotland study examined public health team efforts to engage in alcohol licensing from 2012 to 2019.</p><p><strong>Objective: </strong>We aimed to describe the range of public health team practice in engaging with alcohol licensing across England and Scotland, with a particular focus on unusual or innovative practices.</p><p><strong>Methods: </strong>Two sets of interviews were conducted with 20 public health teams in England and Scotland who were actively engaged in alcohol premises licensing. Firstly, representatives of each public health team with experience of licensing activity took part in structured face-to-face or telephone interviews (<i>n</i> = 41) and provided documentation to identify how and when their team engaged with alcohol premises licensing. Secondly, members of public health teams took part in in-depth one-to-one interviews (<i>n</i> = 28) which focused on individual roles and responsibilities. Relevant public health team activity was analysed quantitatively within 19 activities in 6 categories using the 'Public Health engagement In Alcohol Licensing' measure, as well as qualitatively using NVivo (QSR International, Melbourne, Australia). Innovative practices were identified using the highest Public Health engagement In Alcohol Licensing scores for specific activity types across single or multiple 6-month periods.</p><p><strong>Findings: </strong>Within each of the six activity categories, a range of practices were observed. More unusual practices included having a dedicated post to work full-time on alcohol licensing; developing a standardised reviewer tool allowing the team to respond to applications and provide the most relevant evidence in a consistent and systematic way; committing to additional scrutiny of occasional licences or temporary event notices; maintaining a detailed database recording applications made, whether the public health team decided to object and the outcome of the licensing board's decision; engaging with applicants prior to them submitting an application; visiting proposed/current licensed premises to gather bespoke data; leading the writing of local licensing policy; and working closely with licensing standards officers.</p><p><strong>Conclusions: </strong>Across six categories of public health team activity relating to the local alcohol premises licensing system, public health team practices varied, and some public health teams stood out as engaging in more innovative or intensive activities. The identified examples will be of value in informing public health team practice in what remains a relatively new area
{"title":"Innovation and diversity in public health team engagement in local alcohol premises licensing: qualitative interview findings from the ExILEnS study.","authors":"Richard Purves, Andrea Mohan, Rachel O'Donnell, Matt Egan, Nason Maani, Niamh Fitzgerald","doi":"10.3310/RNVD1542","DOIUrl":"https://doi.org/10.3310/RNVD1542","url":null,"abstract":"<p><strong>Background: </strong>Evidence suggests that controls on the physical and temporal availability of alcohol can reduce alcohol-related harms. Public health teams in England and Scotland have in recent years been given a statutory role in licensing systems through which premises are granted permits to sell alcohol. The Exploring the Impact of alcohol premises Licensing in England and Scotland study examined public health team efforts to engage in alcohol licensing from 2012 to 2019.</p><p><strong>Objective: </strong>We aimed to describe the range of public health team practice in engaging with alcohol licensing across England and Scotland, with a particular focus on unusual or innovative practices.</p><p><strong>Methods: </strong>Two sets of interviews were conducted with 20 public health teams in England and Scotland who were actively engaged in alcohol premises licensing. Firstly, representatives of each public health team with experience of licensing activity took part in structured face-to-face or telephone interviews (<i>n</i> = 41) and provided documentation to identify how and when their team engaged with alcohol premises licensing. Secondly, members of public health teams took part in in-depth one-to-one interviews (<i>n</i> = 28) which focused on individual roles and responsibilities. Relevant public health team activity was analysed quantitatively within 19 activities in 6 categories using the 'Public Health engagement In Alcohol Licensing' measure, as well as qualitatively using NVivo (QSR International, Melbourne, Australia). Innovative practices were identified using the highest Public Health engagement In Alcohol Licensing scores for specific activity types across single or multiple 6-month periods.</p><p><strong>Findings: </strong>Within each of the six activity categories, a range of practices were observed. More unusual practices included having a dedicated post to work full-time on alcohol licensing; developing a standardised reviewer tool allowing the team to respond to applications and provide the most relevant evidence in a consistent and systematic way; committing to additional scrutiny of occasional licences or temporary event notices; maintaining a detailed database recording applications made, whether the public health team decided to object and the outcome of the licensing board's decision; engaging with applicants prior to them submitting an application; visiting proposed/current licensed premises to gather bespoke data; leading the writing of local licensing policy; and working closely with licensing standards officers.</p><p><strong>Conclusions: </strong>Across six categories of public health team activity relating to the local alcohol premises licensing system, public health team practices varied, and some public health teams stood out as engaging in more innovative or intensive activities. The identified examples will be of value in informing public health team practice in what remains a relatively new area ","PeriodicalId":74615,"journal":{"name":"Public health research (Southampton, England)","volume":" ","pages":"1-19"},"PeriodicalIF":0.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chris Bonell, Steven Hope, Neisha Sundaram, Oliver Lloyd-Houldey, Semina Michalopoulou, Stephen Scott, Dasha Nicholls, Russell Viner
<p><strong>Background: </strong>Despite high rates of adolescent mental health problems, there are few effective school-based interventions to address this. Whole-school interventions offer a feasible and sustainable means of promoting mental health, but few have to date been evaluated. Previously we trialled the Learning Together intervention comprising local needs assessment, student and staff participation in decision-making, restorative practice, and a social and emotional skills curriculum. This was effective not only in preventing bullying (primary outcome), but also in promoting mental well-being and psychological functioning (secondary outcomes).</p><p><strong>Objective: </strong>We aimed to adapt Learning Together to develop Learning Together for Mental Health, focused on promoting mental health. This paper reports on how we refined and elaborated intervention materials to produce the Learning Together for Mental Health intervention including through patient and public involvement and engagement.</p><p><strong>Design: </strong>We reviewed evidence to inform choice of the curriculum component and the contents of our needs assessment survey. We conducted patient and public involvement and engagement with school staff and students, and children and young people from the National Children's Bureau to adapt the intervention. We also conducted a systematic review of reviews to inform a menu of evidence-based actions, but this is reported separately.</p><p><strong>Setting: </strong>Southern England.</p><p><strong>Participants: </strong>Patient and public involvement and engagement was conducted with four staff and five students from one secondary school, and a group of two school senior leadership team members from different schools, and about eight children and young people who were members of the Young National Children's Bureau.</p><p><strong>Interventions: </strong>None.</p><p><strong>Results: </strong>We refined and elaborated our initial plans for Learning Together for Mental Health to generate an intervention supported by full materials, training and external facilitation. We focused needs assessment on mental health, added a menu of evidence-based whole-school mental health actions, and switched to a different social and emotional skills curriculum. We retained restorative practice and staff/student involvement in decisions. No further refinements were made to the intervention theory of change or overall approach. Patient and public involvement and engagement was useful, but not all suggestions were acted on either because some participants suggested dropping pre-determined elements (e.g. needs survey) or because suggestions (e.g. to include aromatherapy) lacked evidence of effectiveness.</p><p><strong>Limitations: </strong>Not all of our engagements with patient and public involvement and engagement stakeholders were sustained over time. Our patient and public involvement and engagement work was affected by its having occurred within t
{"title":"Public engagement to refine a whole-school intervention to promote adolescent mental health.","authors":"Chris Bonell, Steven Hope, Neisha Sundaram, Oliver Lloyd-Houldey, Semina Michalopoulou, Stephen Scott, Dasha Nicholls, Russell Viner","doi":"10.3310/JWGT4863","DOIUrl":"https://doi.org/10.3310/JWGT4863","url":null,"abstract":"<p><strong>Background: </strong>Despite high rates of adolescent mental health problems, there are few effective school-based interventions to address this. Whole-school interventions offer a feasible and sustainable means of promoting mental health, but few have to date been evaluated. Previously we trialled the Learning Together intervention comprising local needs assessment, student and staff participation in decision-making, restorative practice, and a social and emotional skills curriculum. This was effective not only in preventing bullying (primary outcome), but also in promoting mental well-being and psychological functioning (secondary outcomes).</p><p><strong>Objective: </strong>We aimed to adapt Learning Together to develop Learning Together for Mental Health, focused on promoting mental health. This paper reports on how we refined and elaborated intervention materials to produce the Learning Together for Mental Health intervention including through patient and public involvement and engagement.</p><p><strong>Design: </strong>We reviewed evidence to inform choice of the curriculum component and the contents of our needs assessment survey. We conducted patient and public involvement and engagement with school staff and students, and children and young people from the National Children's Bureau to adapt the intervention. We also conducted a systematic review of reviews to inform a menu of evidence-based actions, but this is reported separately.</p><p><strong>Setting: </strong>Southern England.</p><p><strong>Participants: </strong>Patient and public involvement and engagement was conducted with four staff and five students from one secondary school, and a group of two school senior leadership team members from different schools, and about eight children and young people who were members of the Young National Children's Bureau.</p><p><strong>Interventions: </strong>None.</p><p><strong>Results: </strong>We refined and elaborated our initial plans for Learning Together for Mental Health to generate an intervention supported by full materials, training and external facilitation. We focused needs assessment on mental health, added a menu of evidence-based whole-school mental health actions, and switched to a different social and emotional skills curriculum. We retained restorative practice and staff/student involvement in decisions. No further refinements were made to the intervention theory of change or overall approach. Patient and public involvement and engagement was useful, but not all suggestions were acted on either because some participants suggested dropping pre-determined elements (e.g. needs survey) or because suggestions (e.g. to include aromatherapy) lacked evidence of effectiveness.</p><p><strong>Limitations: </strong>Not all of our engagements with patient and public involvement and engagement stakeholders were sustained over time. Our patient and public involvement and engagement work was affected by its having occurred within t","PeriodicalId":74615,"journal":{"name":"Public health research (Southampton, England)","volume":" ","pages":"1-22"},"PeriodicalIF":0.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rhiannon Evans, Sarah MacDonald, Robert Trubey, Jane Noyes, Michael Robling, Simone Willis, Soo Vinnicombe, Maria Boffey, Charlotte Wooders, Asmaa El-Banna, G J Melendez-Torres
<p><strong>Background: </strong>Children and young people with experience of being in care (e.g. foster care, kinship care, residential care or at home with a supervision requirement order) are at higher risk of adverse mental health and well-being outcomes compared to the general population. Despite a range of policy recommendations and interventions, it is not clear what approaches are effective in the United Kingdom, or how context factors give rise to facilitators and inhibitors of implementation and acceptability.</p><p><strong>Objectives: </strong>The CHIMES review is a complex-systems-informed mixed-method systematic review that aimed to synthesise the international evidence base for interventions addressing the mental health and well-being of care-experienced children and young people (age ≤ 25 years) and to assess the potential transportability of this evidence base to the United Kingdom context.</p><p><strong>Data sources: </strong>We searched 16 electronic bibliographic databases and 22 websites from 1990 to May 2022. We conducted citation tracking, screened relevant systematic reviews and contacted international experts.</p><p><strong>Method: </strong>We used a convergent synthesis design. We first constructed an evidence map to confirm review scope before undertaking method-level syntheses for outcome evaluations, process evaluations and economic evaluations. These elements were integrated into a review-level synthesis to identify potential evidence-based interventions that may progress to further development, adaptation and evaluation in the United Kingdom. We conducted stakeholder consultations to prioritise intervention theories, types and outcomes.</p><p><strong>Results: </strong>We identified 64 interventions from 124 study reports. Interventions were primarily evaluated in the United States and targeted young people's competencies or carers' parenting practices. Meta-analysis reported limited evidence that interventions effectively improved mental health in the shorter term (0-6 months): total social, emotional and behavioural problems (<i>d</i> <i>= -</i>0.15, 95% confidence interval -0.28 to -0.02); internalising problem behaviours (<i>d</i> = -0.35, 95% confidence interval -0.61 to -0.08); externalising problem behaviours (<i>d</i> = -0.30, 95% confidence interval -0.53 to -0.08); depression and anxiety (<i>d</i> = -0.26, 95% confidence interval -0.40 to -0.13) and social-emotional functioning difficulties (<i>d</i> = -0.18, 95% confidence interval -0.31 to -0.05), but these impacts were not observed in the longer term (> 6 months). Five key context factors potentially explain challenges to implementation and acceptability: lack of system resources; the time, cognitive and emotional burden of delivery or participation; interprofessional tensions; the devaluing of young people, meaning that they felt unable to express dissatisfaction with interventions; and the devaluating of carers' expertise and needs. From the evidence, st
{"title":"Interventions to improve mental health and well-being in care-experienced children and young people aged less than 25: the CHIMES systematic review.","authors":"Rhiannon Evans, Sarah MacDonald, Robert Trubey, Jane Noyes, Michael Robling, Simone Willis, Soo Vinnicombe, Maria Boffey, Charlotte Wooders, Asmaa El-Banna, G J Melendez-Torres","doi":"10.3310/MKYP6299","DOIUrl":"https://doi.org/10.3310/MKYP6299","url":null,"abstract":"<p><strong>Background: </strong>Children and young people with experience of being in care (e.g. foster care, kinship care, residential care or at home with a supervision requirement order) are at higher risk of adverse mental health and well-being outcomes compared to the general population. Despite a range of policy recommendations and interventions, it is not clear what approaches are effective in the United Kingdom, or how context factors give rise to facilitators and inhibitors of implementation and acceptability.</p><p><strong>Objectives: </strong>The CHIMES review is a complex-systems-informed mixed-method systematic review that aimed to synthesise the international evidence base for interventions addressing the mental health and well-being of care-experienced children and young people (age ≤ 25 years) and to assess the potential transportability of this evidence base to the United Kingdom context.</p><p><strong>Data sources: </strong>We searched 16 electronic bibliographic databases and 22 websites from 1990 to May 2022. We conducted citation tracking, screened relevant systematic reviews and contacted international experts.</p><p><strong>Method: </strong>We used a convergent synthesis design. We first constructed an evidence map to confirm review scope before undertaking method-level syntheses for outcome evaluations, process evaluations and economic evaluations. These elements were integrated into a review-level synthesis to identify potential evidence-based interventions that may progress to further development, adaptation and evaluation in the United Kingdom. We conducted stakeholder consultations to prioritise intervention theories, types and outcomes.</p><p><strong>Results: </strong>We identified 64 interventions from 124 study reports. Interventions were primarily evaluated in the United States and targeted young people's competencies or carers' parenting practices. Meta-analysis reported limited evidence that interventions effectively improved mental health in the shorter term (0-6 months): total social, emotional and behavioural problems (<i>d</i> <i>= -</i>0.15, 95% confidence interval -0.28 to -0.02); internalising problem behaviours (<i>d</i> = -0.35, 95% confidence interval -0.61 to -0.08); externalising problem behaviours (<i>d</i> = -0.30, 95% confidence interval -0.53 to -0.08); depression and anxiety (<i>d</i> = -0.26, 95% confidence interval -0.40 to -0.13) and social-emotional functioning difficulties (<i>d</i> = -0.18, 95% confidence interval -0.31 to -0.05), but these impacts were not observed in the longer term (> 6 months). Five key context factors potentially explain challenges to implementation and acceptability: lack of system resources; the time, cognitive and emotional burden of delivery or participation; interprofessional tensions; the devaluing of young people, meaning that they felt unable to express dissatisfaction with interventions; and the devaluating of carers' expertise and needs. From the evidence, st","PeriodicalId":74615,"journal":{"name":"Public health research (Southampton, England)","volume":"12 14","pages":"1-124"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lucy Thompson, Jessica Tanner, Matthew Breckons, Naomi Young, Laura Ternent, Thenmalar Vadiveloo, Philip Wilson, Danny Wight, Louise Marryat, Iain McGowan, Graeme MacLennan, Angus MacBeth, James McTaggart, Tim Allison, John Norrie
<p><strong>Background: </strong>Problems in children's early social and emotional development are likely to have major long-term consequences for the individual and society: maternal emotional well-being is associated with better outcomes. Interventions designed to improve both maternal mental health and the mother-child relationship are thus likely to benefit both maternal health and child development.</p><p><strong>Objectives: </strong>To establish the clinical and cost-effectiveness of the Mellow Babies parenting intervention for women experiencing psychosocial stress and their 6- to 18-month-old babies. Secondary aims included understanding the process of recruitment, retention and engagement in both the trial and the intervention.</p><p><strong>Design: </strong>This was a single-centre randomised controlled trial, employing 1 : 1 randomisation with participants allocated to receive Mellow Babies plus usual care, or usual care only.</p><p><strong>Setting: </strong>Community settings in the Highland Council region of Scotland.</p><p><strong>Participants: </strong>We aimed to recruit 212 mothers to provide evaluable data for 170 participants (90% power to detect an effect size of 0.5 for the primary outcome). Eligible mothers lived within the Highland Council region; were aged ≥ 16 years; had primary caregiving responsibility of a baby aged 6-18 months and scored above threshold for anxiety (≥ 11) and/or depression (≥ 7) on the Hospital Anxiety and Depression Scale.</p><p><strong>Intervention: </strong>Mellow Babies is a 14-week group-based parenting programme specifically designed for mothers with psychosocial difficulties. Sessions run for 5 hours each and include 4-10 participants.</p><p><strong>Main outcome measures: </strong>Maternal Hospital Anxiety and Depression Scale scores at 8 months post randomisation and when the child reaches 30 months. Health economic (service use and quality of life) and child development (language development and mental well-being) outcomes were also examined.</p><p><strong>Results: </strong>Due to the COVID-19 pandemic, the trial did not recruit to target: 106 women were recruited (53 per arm). It was not possible to explore the clinical and cost-effectiveness of Mellow Babies. Baseline, follow-up and process evaluation data were analysed to allow optimal learning from the study. Direct communication (letter) combined with health visitor referral was a better means of recruitment. Despite relatively low sociodemographic disadvantage, there was a high prevalence of mental ill health. Retention to follow-up and within the intervention was good (75% to study end point), and data were well-completed. Quality-of-life ratings increased at 8 months post randomisation, then decreased somewhat at 30 months of age, but remained above baseline. Qualitative interviews highlighted barriers and facilitators of engagement with the intervention groups. There was no observed difference in baseline characteristics or outcomes b
{"title":"Clinical and cost-effectiveness of parenting intervention for mothers experiencing psychosocial stress: insights from the early closure of the Mellow Babies RCT.","authors":"Lucy Thompson, Jessica Tanner, Matthew Breckons, Naomi Young, Laura Ternent, Thenmalar Vadiveloo, Philip Wilson, Danny Wight, Louise Marryat, Iain McGowan, Graeme MacLennan, Angus MacBeth, James McTaggart, Tim Allison, John Norrie","doi":"10.3310/KCVL7125","DOIUrl":"10.3310/KCVL7125","url":null,"abstract":"<p><strong>Background: </strong>Problems in children's early social and emotional development are likely to have major long-term consequences for the individual and society: maternal emotional well-being is associated with better outcomes. Interventions designed to improve both maternal mental health and the mother-child relationship are thus likely to benefit both maternal health and child development.</p><p><strong>Objectives: </strong>To establish the clinical and cost-effectiveness of the Mellow Babies parenting intervention for women experiencing psychosocial stress and their 6- to 18-month-old babies. Secondary aims included understanding the process of recruitment, retention and engagement in both the trial and the intervention.</p><p><strong>Design: </strong>This was a single-centre randomised controlled trial, employing 1 : 1 randomisation with participants allocated to receive Mellow Babies plus usual care, or usual care only.</p><p><strong>Setting: </strong>Community settings in the Highland Council region of Scotland.</p><p><strong>Participants: </strong>We aimed to recruit 212 mothers to provide evaluable data for 170 participants (90% power to detect an effect size of 0.5 for the primary outcome). Eligible mothers lived within the Highland Council region; were aged ≥ 16 years; had primary caregiving responsibility of a baby aged 6-18 months and scored above threshold for anxiety (≥ 11) and/or depression (≥ 7) on the Hospital Anxiety and Depression Scale.</p><p><strong>Intervention: </strong>Mellow Babies is a 14-week group-based parenting programme specifically designed for mothers with psychosocial difficulties. Sessions run for 5 hours each and include 4-10 participants.</p><p><strong>Main outcome measures: </strong>Maternal Hospital Anxiety and Depression Scale scores at 8 months post randomisation and when the child reaches 30 months. Health economic (service use and quality of life) and child development (language development and mental well-being) outcomes were also examined.</p><p><strong>Results: </strong>Due to the COVID-19 pandemic, the trial did not recruit to target: 106 women were recruited (53 per arm). It was not possible to explore the clinical and cost-effectiveness of Mellow Babies. Baseline, follow-up and process evaluation data were analysed to allow optimal learning from the study. Direct communication (letter) combined with health visitor referral was a better means of recruitment. Despite relatively low sociodemographic disadvantage, there was a high prevalence of mental ill health. Retention to follow-up and within the intervention was good (75% to study end point), and data were well-completed. Quality-of-life ratings increased at 8 months post randomisation, then decreased somewhat at 30 months of age, but remained above baseline. Qualitative interviews highlighted barriers and facilitators of engagement with the intervention groups. There was no observed difference in baseline characteristics or outcomes b","PeriodicalId":74615,"journal":{"name":"Public health research (Southampton, England)","volume":"12 17","pages":"1-115"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xiangpu Gong, Nicole Itzkowitz, Calvin Jephcote, Kathryn Adams, Glory O Atilola, John Gulliver, Marta Blangiardo, Anna Hansell
<p><strong>Background: </strong>Long-term exposure to aircraft noise has been associated with small increases in cardiovascular disease risk, but there are almost no short-term exposure studies.</p><p><strong>Objectives: </strong>Research questions were: Is there an association between short-term changes in exposure to aircraft noise and cardiovascular morbidity and mortality? What are the key effect modifiers? Is there variability in risk estimates between areas with consistent versus changing patterns of noise exposure? Do risk estimates differ when using different noise metrics?</p><p><strong>Design: </strong>Descriptive analyses of noise levels and variability at different times of day, analyses of inequalities in noise exposure and case-crossover analyses of cardiovascular events in relation to aircraft noise exposure.</p><p><strong>Setting: </strong>Area surrounding London Heathrow airport.</p><p><strong>Time period: </strong>2014-18.</p><p><strong>Participants: </strong>Whole population in study area.</p><p><strong>Main outcome measures: </strong>Cardiovascular disease hospitalisations and mortality.</p><p><strong>Data sources: </strong>Aircraft noise levels modelled using a standard noise model for: (1) daily equivalent continuous sound levels at different times of day; (2) daily number of events above defined noise thresholds (2018 only). National Health Service digital hospital admission records and Office for National Statistics mortality records for 2014-18 for cardiovascular outcomes, plus individual-level confounders available from healthcare records. Confounder data including road traffic noise (Leicester modelled), rail noise and air pollution (Department for Environment, Food and Rural Affairs), area level deprivation and ethnicity (UK Census).</p><p><strong>Results: </strong>The morning shoulder period (06.00-07.00 hours) was the noisiest of all eight bands (mean: 50.92 dB). The morning shoulder period also had the third highest number of noisy events (flights) > 60 dB per day, with three events across postcodes on average. However, the highest number of noisy events occurred in daytime (highest between 07.00 and 15.00 hours, second highest 15.00 and 19.00 hours). To identify areas with high variability in aircraft noise exposure (due to changes in flight paths because of wind direction and airport operations), we used coefficients of variation (CoV). The period 24.00-04.30 hours had the highest mean CoV (67.33-74.16), followed by 04.30-06.00 hours and 23.00-24.00 hours. Postcodes in the least deprived quintiles of Carstairs index or avoidable death rate had the lowest noise levels. In case-crossover analyses, we observed increased risk for cardiovascular disease hospital admissions for evening noise 19.00-23.00 hours (odds ratio 1.005, 95% confidence interval 1.000 to 1.010 per 5 dB), but not for other periods or mortality. Further analyses suggested that increased risks were occurring in postcodes with low CoV for noise. We fo
背景：长期暴露于飞机噪音与心血管疾病风险的小幅增加有关，但几乎没有短期暴露的研究。目的：研究问题是：暴露于飞机噪音的短期变化与心血管发病率和死亡率之间是否存在关联？什么是关键的效果修饰符？在噪音暴露模式不变与变化的地区之间，风险评估是否存在差异？当使用不同的噪音指标时，风险评估是否不同？设计：对一天中不同时间的噪音水平和变异性进行描述性分析，分析噪音暴露的不平等，并对与飞机噪音暴露相关的心血管事件进行病例交叉分析。环境：伦敦希思罗机场周边地区。时间：2014-18年。参与者：研究区域的全体人口。主要结局指标：心血管疾病住院和死亡率。数据来源：使用标准噪音模型模拟飞机噪音水平：(1)每天不同时间的每日等效连续声级；(2)超过定义噪声阈值的每日事件数（仅2018年）。英国国家卫生局（National Health Service）的数字住院记录和英国国家统计局（Office for National Statistics） 2014-18年心血管疾病死亡率记录，以及医疗记录中可获得的个人水平混杂因素。混杂数据包括道路交通噪音（莱斯特建模），铁路噪音和空气污染（环境，食品和农村事务部），地区贫困和种族（英国人口普查）。结果：早晨肩期（06.00 ~ 07.00）是8个波段中噪声最大的时段，平均为50.92 dB。早上的肩部时段也有第三高的噪音事件（航班），每天bb60 dB，平均每个邮政编码有三个事件。然而，噪声事件发生在白天的次数最多（在07.00 - 15.00时段最多，其次是15.00 - 19.00时段）。为了确定飞机噪声暴露的高变异性区域（由于风向和机场运行导致飞行路径的变化），我们使用了变异系数（CoV）。平均冠状病毒感染率最高的时段为24.00 ~ 04.30 h(67.33 ~ 74.16)，其次为04.30 ~ 06.00和23.00 ~ 24.00；Carstairs指数或可避免死亡率最低的五分之一的邮政编码的噪音水平最低。在病例交叉分析中，我们观察到夜间噪音19.00-23.00小时导致心血管疾病住院的风险增加（优势比1.005,95%置信区间1.000 - 1.010 / 5 dB），但其他时段或死亡率没有增加。进一步的分析表明，在低冠状病毒感染的邮政编码地区，风险增加。我们发现，年龄、性别、种族、剥夺和季节会改变效果。限制：使用的行业标准噪音模型，即航空环境设计工具，没有考虑到风向，这可能导致一些暴露错误分类。结论：我们建立了一个全面的飞机噪声日变化数据集。我们发现心血管住院（但不是死亡）与夜间飞机噪音水平之间存在很小的关联，特别是在噪音变异性较低的地区。未来的工作：需要更多的研究来了解噪音变化和喘息/缓解对心血管疾病的影响。资助：该奖项由国家卫生与保健研究所（NIHR）公共卫生研究方案（NIHR奖号：15/192/13）资助，全文发表在《公共卫生研究》上；第十二卷，第13号有关进一步的奖励信息，请参阅美国国立卫生研究院资助和奖励网站。
{"title":"Impact of short-term aircraft noise on cardiovascular disease risk in the area surrounding London Heathrow airport: the RISTANCO epidemiological study.","authors":"Xiangpu Gong, Nicole Itzkowitz, Calvin Jephcote, Kathryn Adams, Glory O Atilola, John Gulliver, Marta Blangiardo, Anna Hansell","doi":"10.3310/UTCE9104","DOIUrl":"https://doi.org/10.3310/UTCE9104","url":null,"abstract":"<p><strong>Background: </strong>Long-term exposure to aircraft noise has been associated with small increases in cardiovascular disease risk, but there are almost no short-term exposure studies.</p><p><strong>Objectives: </strong>Research questions were: Is there an association between short-term changes in exposure to aircraft noise and cardiovascular morbidity and mortality? What are the key effect modifiers? Is there variability in risk estimates between areas with consistent versus changing patterns of noise exposure? Do risk estimates differ when using different noise metrics?</p><p><strong>Design: </strong>Descriptive analyses of noise levels and variability at different times of day, analyses of inequalities in noise exposure and case-crossover analyses of cardiovascular events in relation to aircraft noise exposure.</p><p><strong>Setting: </strong>Area surrounding London Heathrow airport.</p><p><strong>Time period: </strong>2014-18.</p><p><strong>Participants: </strong>Whole population in study area.</p><p><strong>Main outcome measures: </strong>Cardiovascular disease hospitalisations and mortality.</p><p><strong>Data sources: </strong>Aircraft noise levels modelled using a standard noise model for: (1) daily equivalent continuous sound levels at different times of day; (2) daily number of events above defined noise thresholds (2018 only). National Health Service digital hospital admission records and Office for National Statistics mortality records for 2014-18 for cardiovascular outcomes, plus individual-level confounders available from healthcare records. Confounder data including road traffic noise (Leicester modelled), rail noise and air pollution (Department for Environment, Food and Rural Affairs), area level deprivation and ethnicity (UK Census).</p><p><strong>Results: </strong>The morning shoulder period (06.00-07.00 hours) was the noisiest of all eight bands (mean: 50.92 dB). The morning shoulder period also had the third highest number of noisy events (flights) > 60 dB per day, with three events across postcodes on average. However, the highest number of noisy events occurred in daytime (highest between 07.00 and 15.00 hours, second highest 15.00 and 19.00 hours). To identify areas with high variability in aircraft noise exposure (due to changes in flight paths because of wind direction and airport operations), we used coefficients of variation (CoV). The period 24.00-04.30 hours had the highest mean CoV (67.33-74.16), followed by 04.30-06.00 hours and 23.00-24.00 hours. Postcodes in the least deprived quintiles of Carstairs index or avoidable death rate had the lowest noise levels. In case-crossover analyses, we observed increased risk for cardiovascular disease hospital admissions for evening noise 19.00-23.00 hours (odds ratio 1.005, 95% confidence interval 1.000 to 1.010 per 5 dB), but not for other periods or mortality. Further analyses suggested that increased risks were occurring in postcodes with low CoV for noise. We fo","PeriodicalId":74615,"journal":{"name":"Public health research (Southampton, England)","volume":"12 13","pages":"1-58"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Biza Stenfert Kroese, Gemma Unwin, Richard Hastings, Andrew Jahoda, Rachel McNamara, David Gillespie, Jeremy Segrott, Kate Ingarfield, Myrsini Gianatsi, Elizabeth Randell, Zoe Mather, Barbara Barrett, Poushali Ganguli, John Rose, Mariam Sahle, Emily Warren, Nathan Da Cruz
<p><strong>Background: </strong>Children with a learning disability experience a range of inequalities and adverse life events that put them at greater risk of mental health problems. The construct of emotional literacy has been shown to be a moderating factor of how life stress affects mental health. Teaching emotional literacy in schools may therefore be an effective way to promote positive mental health. There is an identified need for adapted emotional literacy programmes in special schools.</p><p><strong>Objectives: </strong>To evaluate whether it is feasible to conduct a large-scale randomised controlled trial of the effectiveness and cost-effectiveness of an emotional literacy programme (Zippy's Friends special educational needs and disabilities) for children with a learning disability in special schools. The key aims were to assess the acceptability and feasibility of participating in the trial, data collection and the Zippy's Friends special educational needs and disabilities intervention through quantitative and qualitative data collection.</p><p><strong>Design: </strong>A feasibility, cluster randomised controlled trial that aimed to recruit and randomise 12 special schools to either deliver the intervention over 1 academic year or continue with practice as usual and to collect data from 96 pupils at baseline (pre randomisation) and 12 months post randomisation.</p><p><strong>Setting: </strong>Special schools in England and Scotland.</p><p><strong>Participants: </strong>Pupils with a learning disability, aged 9-11 years, attending special schools in England. Follow-up interviews were conducted with 8 pupils, 4 parents/carers and 11 school staff members.</p><p><strong>Intervention: </strong>Zippy's Friends for Special Educational Needs and Disabilities is a manual-based, classroom-based emotional literacy programme focused on a problem-solving approach to develop and improve children's emotional literacy. The mainstream programme has been adapted for children with a learning disability by simplifying the activities, shortening the sessions and introducing more repetition.</p><p><strong>Main outcome measures: </strong>Feasibility and acceptability of: (1) participation in the research trial; (2) the collection of the outcome measure data and (3) the Zippy's Friends for Special Educational Needs and Disabilities intervention.</p><p><strong>Results: </strong>A total of 8 schools and 53 pupils were recruited. Retention of schools after randomisation (100%) and retention of pupils (100%) met the prespecified progression criteria. For recruitment of schools (20.5% of those approached), pupil engagement with the intervention (50%) and collection of outcome and service use data (62.3%) the criteria were partially met. Fidelity of the intervention delivery (48%) fell just below the progression criteria. Thus, the feasibility and acceptability outcome progression criteria were largely met, suggesting that progression to a full trial is warranted
{"title":"Emotional literacy programme in special schools for children with a learning disability in England: the ZF-SEND feasibility RCT.","authors":"Biza Stenfert Kroese, Gemma Unwin, Richard Hastings, Andrew Jahoda, Rachel McNamara, David Gillespie, Jeremy Segrott, Kate Ingarfield, Myrsini Gianatsi, Elizabeth Randell, Zoe Mather, Barbara Barrett, Poushali Ganguli, John Rose, Mariam Sahle, Emily Warren, Nathan Da Cruz","doi":"10.3310/JTJY8001","DOIUrl":"10.3310/JTJY8001","url":null,"abstract":"<p><strong>Background: </strong>Children with a learning disability experience a range of inequalities and adverse life events that put them at greater risk of mental health problems. The construct of emotional literacy has been shown to be a moderating factor of how life stress affects mental health. Teaching emotional literacy in schools may therefore be an effective way to promote positive mental health. There is an identified need for adapted emotional literacy programmes in special schools.</p><p><strong>Objectives: </strong>To evaluate whether it is feasible to conduct a large-scale randomised controlled trial of the effectiveness and cost-effectiveness of an emotional literacy programme (Zippy's Friends special educational needs and disabilities) for children with a learning disability in special schools. The key aims were to assess the acceptability and feasibility of participating in the trial, data collection and the Zippy's Friends special educational needs and disabilities intervention through quantitative and qualitative data collection.</p><p><strong>Design: </strong>A feasibility, cluster randomised controlled trial that aimed to recruit and randomise 12 special schools to either deliver the intervention over 1 academic year or continue with practice as usual and to collect data from 96 pupils at baseline (pre randomisation) and 12 months post randomisation.</p><p><strong>Setting: </strong>Special schools in England and Scotland.</p><p><strong>Participants: </strong>Pupils with a learning disability, aged 9-11 years, attending special schools in England. Follow-up interviews were conducted with 8 pupils, 4 parents/carers and 11 school staff members.</p><p><strong>Intervention: </strong>Zippy's Friends for Special Educational Needs and Disabilities is a manual-based, classroom-based emotional literacy programme focused on a problem-solving approach to develop and improve children's emotional literacy. The mainstream programme has been adapted for children with a learning disability by simplifying the activities, shortening the sessions and introducing more repetition.</p><p><strong>Main outcome measures: </strong>Feasibility and acceptability of: (1) participation in the research trial; (2) the collection of the outcome measure data and (3) the Zippy's Friends for Special Educational Needs and Disabilities intervention.</p><p><strong>Results: </strong>A total of 8 schools and 53 pupils were recruited. Retention of schools after randomisation (100%) and retention of pupils (100%) met the prespecified progression criteria. For recruitment of schools (20.5% of those approached), pupil engagement with the intervention (50%) and collection of outcome and service use data (62.3%) the criteria were partially met. Fidelity of the intervention delivery (48%) fell just below the progression criteria. Thus, the feasibility and acceptability outcome progression criteria were largely met, suggesting that progression to a full trial is warranted ","PeriodicalId":74615,"journal":{"name":"Public health research (Southampton, England)","volume":"12 15","pages":"1-105"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emily Tweed, Kristina Cimova, Peter Craig, Mirjam Allik, Denise Brown, Mhairi Campbell, David Henderson, Charlie Mayor, Petra Meier, Nick Watson
<p><strong>Background: </strong>Secondary data from different policy sectors can provide unique insights into the social, environmental, economic and political determinants of health. This is especially pertinent in the context of whole-systems approaches to healthy public policy, which typically combine cross-sectoral collaboration with the application of theoretical insights from systems science. However, the sharing and linkage of data between different sectors are still relatively rare. Previous research has documented the perspectives of researchers and members of the public on data sharing, especially healthcare data, but has not engaged with relevant policy and practice decision-makers.</p><p><strong>Aim: </strong>We sought to work collaboratively with decision-makers relevant to healthy public policy and practice in Scotland to identify practical ways that cross-sectoral data sharing and linkage could be used to best effect to improve health and reduce health inequalities.</p><p><strong>Methods: </strong>We facilitated three sequential stakeholder workshops with 20 participants from local and central government, public health teams, Health and Social Care Partnerships, the third sector, organisations which support data-intensive research and public representatives from across Scotland. Workshops were informed by two scoping reviews (carried out in June 2021) and three case studies of existing cross-sectoral linkage projects. Workshop activities included brainstorming of factors that would help participants make better decisions in their current role; reflective questions on lessons learnt from the case studies; and identifying and prioritising recommendations for change. Findings were synthesised using thematic analysis.</p><p><strong>Setting and scope: </strong>Scotland; public and third sector data.</p><p><strong>Results: </strong>Based on the workshops, and supported by the reviews and case studies, we created a visual representation of the use of evidence, and secondary data in particular, in decision-making for healthy public policy and practice. This covered three key overarching themes: differing understandings of evidence; diverse functions of evidence; and factors affecting use (such as technical, political and institutional, workforce and governance). Building on this, workshop participants identified six guiding principles for cross-sectoral data sharing and linkage: it should be pragmatic; participatory; ambitious; fair; iterative; with holistic and proportionate governance. Participants proposed 21 practical actions to this end, including: a strategic approach to identifying and sharing key data sets; streamlining governance processes (e.g. through standardised data sharing agreements; central data repositories; and a focus on reusable data resources) and building workforce capacity. To make these possible, participants identified a need for strong political and organisational leadership as well as a transparent and inclusive
{"title":"Unlocking data: Decision-maker perspectives on cross-sectoral data sharing and linkage as part of a whole-systems approach to public health policy and practice.","authors":"Emily Tweed, Kristina Cimova, Peter Craig, Mirjam Allik, Denise Brown, Mhairi Campbell, David Henderson, Charlie Mayor, Petra Meier, Nick Watson","doi":"10.3310/KYTW2173","DOIUrl":"10.3310/KYTW2173","url":null,"abstract":"<p><strong>Background: </strong>Secondary data from different policy sectors can provide unique insights into the social, environmental, economic and political determinants of health. This is especially pertinent in the context of whole-systems approaches to healthy public policy, which typically combine cross-sectoral collaboration with the application of theoretical insights from systems science. However, the sharing and linkage of data between different sectors are still relatively rare. Previous research has documented the perspectives of researchers and members of the public on data sharing, especially healthcare data, but has not engaged with relevant policy and practice decision-makers.</p><p><strong>Aim: </strong>We sought to work collaboratively with decision-makers relevant to healthy public policy and practice in Scotland to identify practical ways that cross-sectoral data sharing and linkage could be used to best effect to improve health and reduce health inequalities.</p><p><strong>Methods: </strong>We facilitated three sequential stakeholder workshops with 20 participants from local and central government, public health teams, Health and Social Care Partnerships, the third sector, organisations which support data-intensive research and public representatives from across Scotland. Workshops were informed by two scoping reviews (carried out in June 2021) and three case studies of existing cross-sectoral linkage projects. Workshop activities included brainstorming of factors that would help participants make better decisions in their current role; reflective questions on lessons learnt from the case studies; and identifying and prioritising recommendations for change. Findings were synthesised using thematic analysis.</p><p><strong>Setting and scope: </strong>Scotland; public and third sector data.</p><p><strong>Results: </strong>Based on the workshops, and supported by the reviews and case studies, we created a visual representation of the use of evidence, and secondary data in particular, in decision-making for healthy public policy and practice. This covered three key overarching themes: differing understandings of evidence; diverse functions of evidence; and factors affecting use (such as technical, political and institutional, workforce and governance). Building on this, workshop participants identified six guiding principles for cross-sectoral data sharing and linkage: it should be pragmatic; participatory; ambitious; fair; iterative; with holistic and proportionate governance. Participants proposed 21 practical actions to this end, including: a strategic approach to identifying and sharing key data sets; streamlining governance processes (e.g. through standardised data sharing agreements; central data repositories; and a focus on reusable data resources) and building workforce capacity. To make these possible, participants identified a need for strong political and organisational leadership as well as a transparent and inclusive","PeriodicalId":74615,"journal":{"name":"Public health research (Southampton, England)","volume":" ","pages":"1-30"},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142712062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Miranda Pallan, Marie Murphy, Breanna Morrison, Irina Pokhilenko, Alice Sitch, Emma Frew, Clare Rawdin, Rachel Adams, Ashley Adamson, Suzanne Bartington, Alexandra Dobell, Rhona Duff, Tania Griffin, Kiya Hurley, Emma Lancashire, Louise McLeman, Sandra Passmore, Vahid Ravaghi, Suzanne Spence, Peymane Adab
<p><strong>Background: </strong>School food standards are a legal requirement for state-funded schools in England and are designed to promote healthy eating in pupils. However, state-funded academies/free schools established between 2010 and 2014 are exempt from this legislation. To complement the school food standards, the government launched the School Food Plan in 2013, which outlines voluntary actions that schools can take to support healthy eating and increase school meal uptake. There has been little evaluation of the school food standards and School Food Plan in secondary schools.</p><p><strong>Objectives: </strong>To compare implementation and costs of the school food standards and School Food Plan, and pupil dietary and dental outcomes in two groups of secondary schools: those mandated and those not mandated to comply with the school food standards legislation.</p><p><strong>Methods: </strong>An observational, multiple-methods study. We sampled state-funded secondary school academies/free schools, pupils aged 11-15 years, and school staff/governors with a role in food provision/education from the Midlands. We collected qualitative data in four schools. The primary outcome was pupil free sugar intake at lunch; across the school day; and during 24-hours. Secondary outcomes were additional nutritional outcomes and dental caries measures. We assessed school food standards/School Food Plan implementation and costs using researcher observation, document analysis, and surveys with staff/governors, schools and pupils. Dietary intake and dental outcomes were measured online using 24-hour dietary recall and surveys, respectively. In the qualitative study we conducted staff/governor interviews and pupil focus groups in a subsample of schools. We used multilevel analyses to explore variation in pupil outcomes across the school food standards-mandated and school food standards-non-mandated school groups. Data were analysed using the Framework approach.</p><p><strong>Results: </strong>Thirty-six schools (13 school food standards-mandated, 23 school food standards-non-mandated), 2453 pupils and 151 staff/governors participated. On average, schools were compliant with 64% of school food standards and implemented 41% of School Food Plan actions, with no differences across school food standards-mandated/non-mandated schools. There was a wide variation in annual costs of the school food standards and School Food Plan reported by schools (mean of £195 per pupil). Pupils in school food standards-mandated schools had lower lunch intakes of free sugar than those in school food standards-non-mandated schools (adjusted mean difference = -2.78 g, 95% confidence interval -4.66 to -0.90 g). After further adjustment for total energy intake, there was no significant difference in free sugar intake, but the school food standards-mandated group had lower fruit and vegetable intake at all time points, and higher consumption of confectionery during the school day and sug
{"title":"School food policy in secondary schools in England and its impact on adolescents' diets and dental health: the FUEL multiple-methods study.","authors":"Miranda Pallan, Marie Murphy, Breanna Morrison, Irina Pokhilenko, Alice Sitch, Emma Frew, Clare Rawdin, Rachel Adams, Ashley Adamson, Suzanne Bartington, Alexandra Dobell, Rhona Duff, Tania Griffin, Kiya Hurley, Emma Lancashire, Louise McLeman, Sandra Passmore, Vahid Ravaghi, Suzanne Spence, Peymane Adab","doi":"10.3310/TTPL8570","DOIUrl":"10.3310/TTPL8570","url":null,"abstract":"<p><strong>Background: </strong>School food standards are a legal requirement for state-funded schools in England and are designed to promote healthy eating in pupils. However, state-funded academies/free schools established between 2010 and 2014 are exempt from this legislation. To complement the school food standards, the government launched the School Food Plan in 2013, which outlines voluntary actions that schools can take to support healthy eating and increase school meal uptake. There has been little evaluation of the school food standards and School Food Plan in secondary schools.</p><p><strong>Objectives: </strong>To compare implementation and costs of the school food standards and School Food Plan, and pupil dietary and dental outcomes in two groups of secondary schools: those mandated and those not mandated to comply with the school food standards legislation.</p><p><strong>Methods: </strong>An observational, multiple-methods study. We sampled state-funded secondary school academies/free schools, pupils aged 11-15 years, and school staff/governors with a role in food provision/education from the Midlands. We collected qualitative data in four schools. The primary outcome was pupil free sugar intake at lunch; across the school day; and during 24-hours. Secondary outcomes were additional nutritional outcomes and dental caries measures. We assessed school food standards/School Food Plan implementation and costs using researcher observation, document analysis, and surveys with staff/governors, schools and pupils. Dietary intake and dental outcomes were measured online using 24-hour dietary recall and surveys, respectively. In the qualitative study we conducted staff/governor interviews and pupil focus groups in a subsample of schools. We used multilevel analyses to explore variation in pupil outcomes across the school food standards-mandated and school food standards-non-mandated school groups. Data were analysed using the Framework approach.</p><p><strong>Results: </strong>Thirty-six schools (13 school food standards-mandated, 23 school food standards-non-mandated), 2453 pupils and 151 staff/governors participated. On average, schools were compliant with 64% of school food standards and implemented 41% of School Food Plan actions, with no differences across school food standards-mandated/non-mandated schools. There was a wide variation in annual costs of the school food standards and School Food Plan reported by schools (mean of £195 per pupil). Pupils in school food standards-mandated schools had lower lunch intakes of free sugar than those in school food standards-non-mandated schools (adjusted mean difference = -2.78 g, 95% confidence interval -4.66 to -0.90 g). After further adjustment for total energy intake, there was no significant difference in free sugar intake, but the school food standards-mandated group had lower fruit and vegetable intake at all time points, and higher consumption of confectionery during the school day and sug","PeriodicalId":74615,"journal":{"name":"Public health research (Southampton, England)","volume":"12 12","pages":"1-167"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aisha Holloway, Gillian Waller, Jennifer Ferguson, Victoria Guthrie, Jamie Brian Smith, Joanne Boyd, Sharon Mercado, Jessica Rees, Richard Anthony Parker, Andrew Stoddart, Jeremy W Bray, Simon Coulton, Kate Hunt, Gertraud Stadler, Arun Sondhi, Pam Smith, Rosie Stenhouse, Philip Conaglen, Aziz Sheikh, Dorothy Newbury-Birch
<p><strong>Background: </strong>As many as 70% of remand prisoners have admitted to being under the influence of alcohol when committing the crime leading to their imprisonment. Providing support and advice regarding alcohol consumption can be effective in some groups of people. There is little evidence regarding this for men on remand in prison.</p><p><strong>Objective: </strong>To pilot the study measures and evaluation methods to assess the feasibility of conducting a future definitive multicentre, pragmatic, parallel group, randomised controlled trial.</p><p><strong>Design: </strong>A two-arm, parallel group, individually randomised pilot study of a self-efficacy-enhancing psychosocial alcohol intervention to reduce levels of alcohol consumption for males on remand in prison and on liberation.</p><p><strong>Setting: </strong>Two purposively selected prisons in Scotland and England.</p><p><strong>Participants: </strong>Adult men on remand in prison with an Alcohol Use Disorders Identification Test score of ≥ 8.</p><p><strong>Intervention: </strong>The APPRAISE intervention delivery comprised four steps: Step 1: 1 × 40-minute face-to-face session, delivered by a trained practitioner from Change Grow Live in prison. Steps 2, 3 and 4: 20-minute sessions conducted by phone, on or as close as possible to days 3, 7 and 21 post liberation. Control: assessment, screening and referral onto further alcohol support options.</p><p><strong>Main outcome measures: </strong>Recruitment and retention rates, completion of follow-ups, outcome measures at 12 months and interventions delivered. The primary outcome for the pilot study was alcohol consumed in the 28 days prior to Time Point 2, assessed using the extended Alcohol Use Disorders Identification Test-C.</p><p><strong>Results: </strong>Of 182 men on remand approached across two study sites, 132 were randomised (90 in England; 42 in Scotland) with 46 randomised to intervention and 44 to care as usual in England and 22 randomised to intervention and 20 to care as usual in Scotland. A total of 53 in-prison interventions were delivered. One day-3 post-liberation intervention was delivered, no day-7 and one day-21. At 12 months, of 132 randomised, 18 (13%) were followed up, 53 (40%) were not liberated; 47 (36%) were uncontactable and 14 (11%) had been released but could not be located. Data completeness was 96% at baseline and 8% at 12 months. The process evaluation reported good acceptability of the intervention with investment in time, capacity and space to support implementation identified. The economic study produced guidance on how to assess costs associated with implementing the APPRAISE intervention which could be applied more broadly.</p><p><strong>Harms: </strong>No adverse events or side effects were noted.</p><p><strong>Conclusions: </strong>A future definitive trial would be possible, but only if follow-up mechanisms can be addressed as well as full access to recidivism and health data. Collaborati
{"title":"A self-efficacy enhancement alcohol reduction intervention for men on-remand in prison: the APPRAISE feasibility pilot RCT.","authors":"Aisha Holloway, Gillian Waller, Jennifer Ferguson, Victoria Guthrie, Jamie Brian Smith, Joanne Boyd, Sharon Mercado, Jessica Rees, Richard Anthony Parker, Andrew Stoddart, Jeremy W Bray, Simon Coulton, Kate Hunt, Gertraud Stadler, Arun Sondhi, Pam Smith, Rosie Stenhouse, Philip Conaglen, Aziz Sheikh, Dorothy Newbury-Birch","doi":"10.3310/KNWT4781","DOIUrl":"10.3310/KNWT4781","url":null,"abstract":"<p><strong>Background: </strong>As many as 70% of remand prisoners have admitted to being under the influence of alcohol when committing the crime leading to their imprisonment. Providing support and advice regarding alcohol consumption can be effective in some groups of people. There is little evidence regarding this for men on remand in prison.</p><p><strong>Objective: </strong>To pilot the study measures and evaluation methods to assess the feasibility of conducting a future definitive multicentre, pragmatic, parallel group, randomised controlled trial.</p><p><strong>Design: </strong>A two-arm, parallel group, individually randomised pilot study of a self-efficacy-enhancing psychosocial alcohol intervention to reduce levels of alcohol consumption for males on remand in prison and on liberation.</p><p><strong>Setting: </strong>Two purposively selected prisons in Scotland and England.</p><p><strong>Participants: </strong>Adult men on remand in prison with an Alcohol Use Disorders Identification Test score of ≥ 8.</p><p><strong>Intervention: </strong>The APPRAISE intervention delivery comprised four steps: Step 1: 1 × 40-minute face-to-face session, delivered by a trained practitioner from Change Grow Live in prison. Steps 2, 3 and 4: 20-minute sessions conducted by phone, on or as close as possible to days 3, 7 and 21 post liberation. Control: assessment, screening and referral onto further alcohol support options.</p><p><strong>Main outcome measures: </strong>Recruitment and retention rates, completion of follow-ups, outcome measures at 12 months and interventions delivered. The primary outcome for the pilot study was alcohol consumed in the 28 days prior to Time Point 2, assessed using the extended Alcohol Use Disorders Identification Test-C.</p><p><strong>Results: </strong>Of 182 men on remand approached across two study sites, 132 were randomised (90 in England; 42 in Scotland) with 46 randomised to intervention and 44 to care as usual in England and 22 randomised to intervention and 20 to care as usual in Scotland. A total of 53 in-prison interventions were delivered. One day-3 post-liberation intervention was delivered, no day-7 and one day-21. At 12 months, of 132 randomised, 18 (13%) were followed up, 53 (40%) were not liberated; 47 (36%) were uncontactable and 14 (11%) had been released but could not be located. Data completeness was 96% at baseline and 8% at 12 months. The process evaluation reported good acceptability of the intervention with investment in time, capacity and space to support implementation identified. The economic study produced guidance on how to assess costs associated with implementing the APPRAISE intervention which could be applied more broadly.</p><p><strong>Harms: </strong>No adverse events or side effects were noted.</p><p><strong>Conclusions: </strong>A future definitive trial would be possible, but only if follow-up mechanisms can be addressed as well as full access to recidivism and health data. Collaborati","PeriodicalId":74615,"journal":{"name":"Public health research (Southampton, England)","volume":"12 11","pages":"1-186"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sarah Combes, Rowan H Harwood, Louise Bramley, Nadia Brookes, Adam L Gordon, Diane Laverty, Julie MacInnes, Emily McKean, Shannon Milne, Heather Richardson, Joy Ross, Emily Sills, Caroline J Nicholson
<p><strong>Background: </strong>Frailty affects around 10% of people aged over 65 years, increasing to 65% of those over 90 years. This number is increasing. Older people with frailty are projected to become the largest future users of care services as they near end of life. Living with frailty increases vulnerability to sudden deterioration, fluctuating capacity and mortality risk. This leads to complex needs, requiring integrated care, and an approach orientated towards living with, as well as dying from, advancing frailty. However, accessing care in a timely manner can be difficult.</p><p><strong>Aims: </strong>To develop a sustainable, cross-sectoral partnership to: identify priorities to improve integrated care delivery, and care transitions, for older people with advancing frailty develop organisations in which to conduct research submit study proposal(s) for funding.</p><p><strong>Objectives: </strong>To establish Partnership infrastructure and identify key contacts across palliative and end-of-life care. To understand the strengths, weaknesses, barriers and enablers of research readiness and clinical services for people with advancing frailty. To support provider services to become research ready. To establish Partnership-wide research questions and develop research proposals.</p><p><strong>Activities: </strong>The Partnership brought together experts, by profession or experience (<i>n</i> = 244), across specialist palliative and geriatric care and local government, to improve the delivery of integrated care for older people with advancing frailty as they near end of life. Members included older people with frailty, unpaid carers, health, social and voluntary care professionals and academics, across the East Midlands, South East England and South West London. A survey of key contacts (<i>n</i> = 76) mapped and scoped the Partnership's strengths, weaknesses, barriers and enablers of services for people with advancing frailty, and service providers' research readiness. Forty-six key contacts responded. Most worked in the East Midlands (59%), in health care (70%) and in the community (58%). Survey findings were used to develop a service framework and to create a short list of potential research questions. Questions were refined and prioritised through coproduction with frail older people (<i>n</i> = 21), unpaid carer representatives (<i>n</i> = 7), health, social and voluntary care professionals (<i>n</i> = 11) and care home representatives (<i>n</i> = 3). The question chosen for bid development focused on ensuring what matters most to older people with frailty informs service development. This bid is currently being written. Partnership members were also supported to develop research readiness and enhance meaningful patient and public involvement by the development and curation of multiple resources.</p><p><strong>Reflections: </strong>This work was challenging. The Partnership enabled the collaboration of diverse stakeholders and fostered
{"title":"Building research capacity and capability to enhance the quality of living and dying addressing advancing frailty through integrated care: the ALLIANCE partnership.","authors":"Sarah Combes, Rowan H Harwood, Louise Bramley, Nadia Brookes, Adam L Gordon, Diane Laverty, Julie MacInnes, Emily McKean, Shannon Milne, Heather Richardson, Joy Ross, Emily Sills, Caroline J Nicholson","doi":"10.3310/ACMW2401","DOIUrl":"https://doi.org/10.3310/ACMW2401","url":null,"abstract":"<p><strong>Background: </strong>Frailty affects around 10% of people aged over 65 years, increasing to 65% of those over 90 years. This number is increasing. Older people with frailty are projected to become the largest future users of care services as they near end of life. Living with frailty increases vulnerability to sudden deterioration, fluctuating capacity and mortality risk. This leads to complex needs, requiring integrated care, and an approach orientated towards living with, as well as dying from, advancing frailty. However, accessing care in a timely manner can be difficult.</p><p><strong>Aims: </strong>To develop a sustainable, cross-sectoral partnership to: identify priorities to improve integrated care delivery, and care transitions, for older people with advancing frailty develop organisations in which to conduct research submit study proposal(s) for funding.</p><p><strong>Objectives: </strong>To establish Partnership infrastructure and identify key contacts across palliative and end-of-life care. To understand the strengths, weaknesses, barriers and enablers of research readiness and clinical services for people with advancing frailty. To support provider services to become research ready. To establish Partnership-wide research questions and develop research proposals.</p><p><strong>Activities: </strong>The Partnership brought together experts, by profession or experience (<i>n</i> = 244), across specialist palliative and geriatric care and local government, to improve the delivery of integrated care for older people with advancing frailty as they near end of life. Members included older people with frailty, unpaid carers, health, social and voluntary care professionals and academics, across the East Midlands, South East England and South West London. A survey of key contacts (<i>n</i> = 76) mapped and scoped the Partnership's strengths, weaknesses, barriers and enablers of services for people with advancing frailty, and service providers' research readiness. Forty-six key contacts responded. Most worked in the East Midlands (59%), in health care (70%) and in the community (58%). Survey findings were used to develop a service framework and to create a short list of potential research questions. Questions were refined and prioritised through coproduction with frail older people (<i>n</i> = 21), unpaid carer representatives (<i>n</i> = 7), health, social and voluntary care professionals (<i>n</i> = 11) and care home representatives (<i>n</i> = 3). The question chosen for bid development focused on ensuring what matters most to older people with frailty informs service development. This bid is currently being written. Partnership members were also supported to develop research readiness and enhance meaningful patient and public involvement by the development and curation of multiple resources.</p><p><strong>Reflections: </strong>This work was challenging. The Partnership enabled the collaboration of diverse stakeholders and fostered ","PeriodicalId":74615,"journal":{"name":"Public health research (Southampton, England)","volume":" ","pages":"1-31"},"PeriodicalIF":0.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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