What can a participatory approach to evaluation contribute to the field of integrated care?

© 2017 BMJ Publishing Group. All rights reserved. Better integration of care within the health sector and between health and social care is seen in many countries as an essential way of addressing the enduring problems of dwindling resources, changing demographics and unacceptable variation in quality of care. Current research evidence about the effectiveness of integration efforts supports neither the enthusiasm of those promoting and designing integrated care programmes nor the growing efforts of practitioners attempting to integrate care on the ground. In this paper we present a methodological approach, based on the principles of participatory research, that attempts to address this challenge. Participatory approaches are characterised by a desire to use social science methods to solve practical problems and a commitment on the part of researchers to substantive and sustained collaboration with relevant stakeholders. We describe how we applied an emerging practical model of participatory research, the researcher-in-residence model, to evaluate a large-scale integrated care programme in the UK. We propose that the approach added value to the programme in a number of ways: by engaging stakeholders in using established evidence and with the benefits of rigorously evaluating their work, by providing insights for local stakeholders that they were either not familiar with or had not fully considered in relation to the development and implementation of the programme and by challenging established mindsets and norms. While there is still much to learn about the benefits and challenges of applying participatory approaches in the health sector, we demonstrate how using such approaches have the potential to help practitioners integrate care more effectively in their daily practice and help progress the academic study of integrated care

The Effectiveness of a Primary School Based Badminton Intervention on Children’s Fundamental Movement Skills

This study examined the effects of the Badminton World Federation (BWF) Shuttle Time program on fundamental movement skills (FMS) in English children. A total of 124 children; 66 in key stage 1 (ages 6–7 years) and 58 in key stage 2 (10–11 years) undertook the Shuttle Time program, once weekly for six weeks (n = 63) or acted as controls (n = 61). Pre, post and ten-weeks post, both process and product FMS were determined. Children in the intervention group, aged 6–7 years, had higher total process FMS (via test of gross motor development-2) compared to the control group at post and ten-weeks post intervention (both p = 0.0001, d = 0.6 and 0.7, respectively). There were no significant differences in process FMS scores for children aged 10–11 years. Ten-meter sprint speed decreased pre to post and was maintained at ten-weeks post for the intervention groups aged 6–7 years (p = 0.0001, d = 0.6) and 10–11 years (p = 0.001, d = 0.2) compared to control. Standing long jump distance increased pre to post (p = 0.0001, d = 0.8) and was maintained at ten-weeks post (p = 0.0001, d = 0.5) for the intervention group. Medicine ball throw performance increased pre to post (p = 0.0001, d = 0.3) for the intervention group. The BWF Shuttle Time program is beneficial in developing FMS for key stage 1 children (ages 6–7)

The Effect of flexographic printing on the compression strength of corrugated shipping containers

This study examined the effect of flexographic printing, using both natural rubber and photopolymer printing plates, on the top-to-bottom compression strength of RSC style shipping containers. six sets of factors were studied including, 1) Print location on panels (center, one-inch to edge); 2) Number of panels printed (two majors, all four); 3) Print coverage (15%, 30%); 4) Number of colors of print (one-, two-color); 5) Flute size (B, C); and 6) Shape of print (square, rectangle). Individual sets of printing plates were produced to represent each factor studied. The containers were manufactured during an on-line production run under standard operating conditions. Preconditioning, conditioning, and compression testing was completed based on ASTM standards. The Taguchi Method of statistical design was used to analyze the data. The results showed that some printing factors significantly affected the compression strength of an RSC style container and should be incorporated into the evaluation of container design

The Effects of Combined Movement and Storytelling Intervention on Motor Skills in South Asian and White Children Aged 5–6 Years Living in the United Kingdom

Early motor development has an important role in promoting physical activity (PA) during childhood and across the lifespan. Children from South Asian backgrounds are less active and have poorer motor skills, thus identifying the need for early motor skill instruction. This study examines the effect of a movement and storytelling intervention on South Asian children’s motor skills. Following ethics approval and consent, 39 children (46% South Asian) participated in a 12-week movement and storytelling intervention. Pre and post, seven motor skills (run, jump, throw, catch, stationary dribble, roll, and kick) were assessed using Children’s Activity and Movement in Preschool Study protocol. At baseline, South Asian children had poorer performance of motor skills. Following the intervention, all children improved their motor skills, with a bigger improvement observed for South Asian children. Early intervention provided remedial benefits to delays in motor skills and narrowed the motor skills gap in ethnic groups

Relationships between Motor Competence, Physical Activity, and Obesity in British Preschool Aged Children

Background: This cross-sectional study aimed to examine associations between motor competence, physical activity, and obesity in British children aged three to five years. Method: Motor competence (MC) was assessed using the Test of Gross Motor Development-2. Physical activity (PA) was assessed using triaxial wrist-worn accelerometers. Children were assessed on compliance to current PA recommendations of ≥180 min of total PA (TPA) and ≥60 min of moderate-to-vigorous PA (MVPA) for health benefits. Associations were explored with Pearson’s product moments and weight-status, and sex-differences were explored with independent t-tests and chi-squared analysis. Results: A total of 166 children (55% males; 4.28 ± 0.74 years) completed MC and PA assessments. Associations were found between PA and MC (TPA and overall MC, TPA and object-control MC (OC), MVPA and overall MC, and MVPA and OC). This study suggests that good motor competence is an important correlate of children meeting physical activity guidelines for health

Exploring the Acute Effects of the Daily Mile™ vs. Shuttle Runs on Children’s Cognitive and Affective Responses

Background: This study investigated the acute effects of two physical activity (PA) bouts on children’s cognitive and affective responses. Methods: Twenty-nine participants (16 boys and 13 girls; Mage = 9.34 years, SD = 0.48), using a within-subjects crossover design, performed three 15-min conditions: (a) TDM—The Daily Mile™; (b) 12 repeated 30–45-s shuttle runs at ≥ 85% HRMAX; and (c) a sedentary control condition. Cognitive performance (i.e., Stroop, Digit Span, and Corsi blocks) was measured before PA and 1 and 30 min post-PA. Felt Arousal and Feeling Scale self-report scales were administered before, during, and after PA. Results: The results show no changes following the TDM condition relative to the sedentary control condition in cognitive responses. However, when comparing the shuttle runs condition to the sedentary control condition, participants showed higher arousal, an improved reaction time, and lower self-reported pleasure at 1 min post-PA. Nevertheless, at 30 min post-PA, participants’ pleasure values were higher in the shuttle runs condition than they were before PA. Conclusions: When comparing PA conditions, shuttle runs enhanced reaction time and might thus be seen as an option to implement or modify PA opportunities in school settings