Reintroducing face-to-face support alongside remote support to form a hybrid stop smoking service in England: a formative mixed methods evaluation
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SUBMITTER: Woodrow N
PROVIDER: S-EPMC10916048 | biostudies-literature | 2024 Jan
REPOSITORIES: biostudies-literature
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Project description:BackgroundMany teenagers in the United States experience challenges with symptoms of depression, and they lack adequate resources for accessing in-person mental health care. Involving teens and clinicians in designing technologies that use evidence-based practices that reduce barriers to accessing mental health care is crucial. Interventions based on behavioral activation (BA) help teens understand the relationship between mood and activity, help them practice goal-directed behaviors to improve mood, and may be particularly well-suited to delivery via internet-based platforms.ObjectiveThis study aims to understand the needs and challenges that teens and mental health clinicians face in depression management and involve them in the design process of a remote intervention that uses asynchronous remote communities. Our goal is to understand the benefits and challenges of adapting BA to an internet-based platform that supports the asynchronous remote community approach as a delivery tool for teen depression management.MethodsWe enrolled mental health clinicians (n=10) and teens (n=8) in separate, private, internet-based groups on Slack (Slack Technologies Inc). They participated in 20-minute design activities for 10 weeks and were then invited to interviews about their experiences in the study.ResultsBoth teen and clinician participants wanted internet-based support for BA as a supplement to in-person therapy. Although participants perceived the asynchronous format as conducive to supporting accessible care, teens and clinicians raised concerns about safety, privacy, and the moderating of the internet-based group. Design decisions that address these concerns need to be balanced with the potential benefits of learning coping skills, increasing access to mental health care, and promoting asynchronous human connection to support teens.ConclusionsWe discuss considerations for balancing tensions in privacy and safety while designing and selecting internet-based platforms to support remote care and integrating evidence-based support when designing digital technologies for the treatment of teens with depression.
| S-EPMC8317030 | biostudies-literature
Project description:IntroductionIn England, eligible adults aged 40-74 years are invited to attend a face-to-face (F2F) NHS Health Check appointment every 5 years. A digital version of the Health Check was introduced by a local authority as an alternative for those hesitant or less able to attend an F2F appointment.ObjectivesThis qualitative study aimed to understand service users' (SUs) and healthcare professionals' (HCPs) experiences and opinions of F2F Health Checks and digital Health Checks (DHC), identify barriers and facilitators of the F2F Health Check and DHC pathways, and recommend potential improvements.DesignThis is a qualitative study, involving interviews with a purposive sample of participants.Participants and settingA purposive sample of 30 SUs and 8 HCPs were recruited by an external market service company in the London Borough of Southwark.MethodsSemistructured interviews were conducted, which included questions on understanding why SUs chose a type of Health Check, their experiences of the service and suggestions for improvement. HCP interviews covered HCP experiences of providing both services, including any impact on workload. The Framework method of thematic analysis was used to analyse the data.ResultsSUs identified benefits of the DHC service including its convenience, ease of use and access. Both SUs and HCPs acknowledged the limitations of the DHC, including self-reporting physical measures (eg, blood pressure and cholesterol levels) or difficulties going elsewhere to measure them, and the lack of opportunity to discuss health with a professional. SUs and HCPs both noted the lack of available appointments and time constraints as barriers associated with the F2F service.ConclusionsBoth HCPs and SUs perceive that in its current form, the DHC has benefits and barriers to its use. If these are adequately addressed, the DHC may help address the demand and pressure within General Practitioner (GP) clinics.Trial registration numberThis study was registered on the Open Science Framework: https://osf.io/y87zt/.
| S-EPMC11907040 | biostudies-literature
Project description:The Commentary contests the increasingly outdated and narrow use of the terminology 'face-to-face' (often abbreviated as F2F) to connote clinical interactions in which both the client and the practitioner are physically present in the same room or space. An expanded definition is necessary because when delivered synchronously via videoconferencing, telehealth also provides face-to-face services (i.e., the practitioner and the client view each other's faces). Terminology that uses face-to-face to connote only in-person care is limiting and perpetuates language that is out of line with progressive US regulatory language and broad interpretation within existing regulatory language. It is this author's hope that this commentary will raise awareness of the important policy implications associated with this seemingly minor distinction in terminology and impact the lingering misapplication of the term, face-to-face.
| S-EPMC5546564 | biostudies-other
Project description:Smoking cessation services have rapidly transformed during the COVID-19 pandemic. Changes include pivoting from face-to-face to telephone and video call support, remote provision of stop smoking aids and more flexible appointments. This study reports an evaluation of a charity-led smoking cessation service rapidly conceived and launched in this context. The pilot service accepted self-referrals in Yorkshire, England from 20 May 2020 to 5 June 2020. A dedicated smoking cessation practitioner provided 12 weeks of weekly behavioural support over telephone or video call. NRT and/or medication and/or e-cigarettes were posted to the participant bi-weekly for up to 12 weeks. Written and telephone evaluation questionnaires were administered post-programme. Of 79 participants, 57 (72.2%) self-reported a 4-week quit and 51 (64.6%) self-reported a 12-week quit. Those concurrently using e-cigarettes and NRT had an 84.1% 12-week quit rate. The majority of participants chose to use e-cigarettes and NRT in combination (55.7%). 39 participants completed an evaluation form, with at least 90% recording they were "very satisfied" with each service component. 27 participants completed a telephone interview, reporting a relationship with practitioners, as well as convenience, and organisational reputation as service strengths. Virtual services can be set up quickly and effectively in response to demand. Quit rates were highest for those concurrently using e-cigarettes and NRT. Service users value flexibility and convenience of remote support and posting of quit aids.
| S-EPMC9266272 | biostudies-literature
Project description: Not available
| S-EPMC8407490 | biostudies-literature
Project description:BackgroundThe COVID-19 pandemic has led to an ongoing increase in the use of remote consultations in general practice in England. Although the evidence is limited, there are concerns that the increase in remote consultations could lead to more antibiotic prescribing.MethodsIn this cohort study, we used patient-level primary care data from the Clinical Practice Research Datalink to estimate the association between consultation mode (remote versus face-to-face) and antibiotic prescribing in England for acute respiratory infections (ARI) between April 2021 and March 2022. Eligibility criteria were applied at both practice-level and patient-level. 400 practices in England were sampled at random and then 600,000 patients were randomly sampled from the eligible patients (whose sex was recorded). Consultations for acute respiratory infections were identified. All antibiotic prescriptions were included, with the exception of antituberculosis drugs and antileprotic drugs, as identified through chapter 5.1 of the British National Formulary. The CPRD Aurum data was linked to the COVID-19 ONS infection survey by region. All analyses were done at the individual level. Repeated consultations from the same patient within 7 days were grouped together. We used targeted maximum likelihood estimation, a causal machine learning method with adjustment for infection type and patient-level, clinician-level and practice-level factors.FindingsThere were 45,997 ARI consultations (34,555 unique patients) within the study period, of which 28,127 were remote and 17,870 were face-to-face. For children, 48% of consultations were remote and, for adults, 66% were remote. For children, 42% of remote and 43% of face-to-face consultations led to an antibiotic prescription; the equivalent values for adults were 52% and 42%, respectively. After adjustment with TMLE, adults with a remote consultation had 23% (odds ratio [OR] 1.23, 95% CI: 1.18-1.29) higher chance of being prescribed antibiotics than if they had been seen face-to-face. We found no significant association between consultation mode and antibiotic prescribing in children (OR 1.04 95% CI: 0.98-1.11).InterpretationThe higher rates of antibiotic prescribing in remote consultations for adults are cause for concern. We see no significant difference in antibiotic prescribing between consultation mode for children. These findings should inform antimicrobial stewardship activities for health-care professionals and policy makers. Future research should examine differences in guideline-compliance between remote and face-to-face consultations to understand the factors driving antibiotic prescribing in different consultation modes.FundingNone.
| S-EPMC10568332 | biostudies-literature
Project description:Reducing smoking rates in pregnancy continues to be a public health priority. Given a recent UK government policy change resulting in The National Health Service (NHS) making a significant new contribution to cessation support in pregnancy in England, in addition to that of Local Authorities (LA), an up-to-date assessment of national support offered to pregnant women is needed. LA Stop Smoking Service (SSS) managers and representatives from maternity services in NHS Trusts were invited to participate in an online survey in autumn 2020. Topics included service configuration, staffing, practitioner consultations and treatments offered. The survey response rate was 66% (99/151) of LAs and 68% (95/140) of Trusts. Most LAs provided smoking support for pregnant smokers (78%), whereas under half (43%) of NHS Trusts did. Combination nicotine replacement therapy, i.e., a combination of a patch and short-acting product, was offered by LAs (92%) and Trusts (95%) and most commonly for 12 weeks duration, at 53% and 50%, respectively. Similar national online training was undertaken by those supporting women, with the majority undertaking the specialist pregnancy-specific module: LAs 60% and Trusts 79%. However, clinicians were reported to deliver specialist stop smoking support in over 50% of Trusts, whereas this was reported in only 16% of LAs. In England, both LA and NHS Trusts are currently delivering similar stop smoking support to pregnant women. Having nationally recognised treatment programmes and training allows for the delivery of consistent, evidence-based smoking cessation to pregnant women in different healthcare settings.
| S-EPMC8835166 | biostudies-literature
Project description:BackgroundSince the outbreak of the COVID-19 pandemic and its social restriction measures, online therapy is a life-saving possibility for patients with acute stress. Wiring Affect with ReAttach (W.A.R.A.) is a brief psychological intervention aiming to decrease negative affect, that can be offered online.MethodsWe assessed the effect of remote W.A.R.A. on negative affect in 37 patients. Consequently, we compared the effect of remote W.A.R.A. versus face-to-face W.A.R.A on negative affect in a cross-sectional design.ResultsW.A.R.A. remote therapy provoked a significant reduction of negative affect with a large effect size (d = 3.08, p < 0.001). However, the reduction on negative affect was smaller than with W.A.R.A. face-to-face. We found a substantial difference between W.A.R.A. remote therapy and W.A.R.A. face-to-face in decrease of negative affect (d = 1.36, p < 0.001).LimitationsThe major limitation of the pilot-study is the sample size of 37 patients. Besides, we designed a numeric rating scale for evaluating negative affect. We investigated the impact on negative affect by assessing "unpleasant feelings." This conceptualization of negative affect might still be a point of discussion.ConclusionThe study's findings indicated that W.A.R.A. remote therapy significantly reduced negative affect, but to a lesser extent than W.A.R.A. face-to-face. Nevertheless, W.A.R.A. remote therapy might offer a fast relief, especially when personal contact is difficult.
| S-EPMC7844207 | biostudies-literature
Project description:IntroductionIn England, in cases of child maltreatment or neglect, the state can intervene through the family court to remove children from their family home and place them in out-of-home care. The Children and Family Court Advisory and Support Service (Cafcass) collects and maintains administrative records of all public family law cases in England. While these national records are primarily used to monitor and manage the workflow of Cafcass teams across England, researchers have re-purposed this data for analysis to understand the drivers and outcomes of public family law intervention.Data contentsThe administrative dataset is a reflection of the cases Cafcass is involved with and the extent of that involvement. The dataset contains information about the local authority that makes an application to initiate public family law proceedings, the children and families involved, and the duration and details of the case. Between 1 April 2007 and 31 March 2019, Cafcass captured information on approximately 172,100 public family law cases, involving 282,300 children, and 349,600 adults (of which 289,300 are recorded as biological parents). Amongst the information recorded are the relations between adults and children, making it possible for researchers to identify family groups. Additionally, recording practices at Cafcass have improved over time, this has increased the availability of demographic information of all those involved, as well as child's final legal outcome.Data accessResearchers can apply to the Secure Anonymised Information Linkage databank (SAIL) for access to the Cafcass pseudonymised administrative data extract, where it is refreshed bi-annually.Keywordschildren, out of home care, family relations, family law.
| S-EPMC7482375 | biostudies-literature
Project description:BackgroundPhysical activity (PA) levels are lower among some UK Black and minority ethnic (BME) groups than the majority White British population and a variety of tailored interventions have emerged. This study documents the characteristics and logic of local adaptations, a vital first step in evaluating such innovations.MethodsAn English PA data set was examined to identify and characterize PA programmes focussed on BME populations. Three case studies were conducted, employing documentary analysis and qualitative interviews. Netto et al.'s principles of adapting health promotion interventions for BME populations guided the analysis.ResultsOut of 861 PA interventions, 57 focussed on BME populations. These were typically aimed to engage the most inactive groups, improve both health and social outcomes and were largely publically/charitably funded. Tailored approaches matched Netto et al.'s five principles: using community resources for publicity, identifying and addressing barriers, developing sensitive communication strategies, working with values and accommodating cultural identification. Another common principle was identified: building community capacity for sustainability.ConclusionsPA interventions tailored to the needs of BME groups reflect their largely disadvantaged position in society and focus on inactivity. The six principles could be used as a framework for developing, designing and evaluating tailored interventions for BME populations.
| S-EPMC6372170 | biostudies-literature