8 research outputs found
'Seeing' the Difference: The Importance of Visibility and Action as a Mark of 'Authenticity' in Co-production ; Comment on âCollaboration and Co-production of Knowledge in Healthcare: Opportunities and Challengesâ
The Rycroft-Malone paper states that co-production relies on âauthenticâ collaboration as a context for action. Our
commentary supports and extends this assertion. We suggest that âauthenticâ co-production involves processes where
participants can âseeâ the difference that they have made within the project and beyond. We provide examples including:
the use of design in health projects which seek to address power issues and make contributions visible through iteration
and prototyping; and the development of âactionable outputsâ from research that are the physical embodiment of coproduction.
Finally, we highlight the elements of the Collaboration for Leadership in Applied Health Research and Care
(CLAHRC) architecture that enables the inclusion of such collaborative techniques that demonstrate visible co-production.
We reinforce the notion that maintaining collaboration requires time, flexible resources, blurring of knowledge produceruser
boundaries, and leaders who promote epistemological tolerance and methodological exploration
Keywords: Co-production, Knowledge Mobilisation, Design Approaches in Healthcare, Research Impact, Actionable
Tool
Incorporation of a health economic modelling tool into public health commissioning: evidence use in a politicised context
This paper explores how commissioners working in an English local government authority (LA) viewed a health economic decision tool for planning services in relation to diabetes. We conducted 15 interviews and 2 focus groups between July 2015 and February 2016, with commissioners (including public health managers, data analysts and council members). Two overlapping themes were identified explaining the obstacles and enablers of using such a tool in commissioning: a) evidence cultures, and b) system interdependency. The former highlighted the diverse evidence cultures present in the LA with politicians influenced by the 'soft' social care agendas affecting their local population and treating local opinion as evidence, whilst public health managers prioritised the scientific view of evidence informed by research. System interdependency further complicated the decision making process by recognising interlinking with departments and other disease groups. To achieve legitimacy within the commissioning arena health economic modelling needs to function effectively in a highly politicised environment where decisions are made not only on the basis of research evidence, but on grounds of 'soft' data, personal opinion and intelligence. In this context decisions become politicised, with multiple opinions seeking a voice. The way that such decisions are negotiated and which ones establish authority is of importance. We analyse the data using Larson's (1990) discursive field concept to show how the tool becomes an object of research push and pull likely to be used instrumentally by stakeholders to advance specific agendas, not a means of informing complex decisions. In conclusion, LA decision making is underpinned by a transactional business ethic which is a further potential 'pull' mechanism for the incorporation of health economic modelling in local commissioning
Talking about weight in pregnancy : an exploration of practitioners' and women's perceptions
Prevalence of maternal obesity is increasing, with health risks for mother and infant. Effective health promotion depends on sufficient knowledge and appropriate communication skills. We aimed to explore women's, midwives' and health visitors' perceptions of current practice in helping women manage their weight and supporting healthy behaviour change during pregnancy, and their perceived training needs. A modified grounded theory methodology was adopted, based upon critical realist assumptions. Following consultation events with fifty six practitioners to inform data collection tools, twenty (different) practitioners and nine women participated in focus groups. Comparative analysis generated four themes: A core theme, âDiscouraging discoursesâ, described health professionalsâ negative beliefs and reactive approach to communicating about weight. âStaff resourcesâ identified limitations in and requirements for practitioner knowledge, skills and tools for effective communication. âContextual influencesâ were social factors, which hindered practitionersâ efforts to achieve healthy behaviour change. âCommunicating as a Teamâ identified the importance of and challenges to a team approach. Findings have implications for weight management in pregnancy, practitioner resources, teamwork, and national health promotion campaigns
Understanding the value of a doctorate for allied health professionals in practice in the UK: a survey
Background
The need to transform the United Kingdomâs (UK) delivery of health and care services to better meet population needs and expectations is well-established, as is the critical importance of research and innovation to drive those transformations. Allied health professionals (AHPs) represent a significant proportion of the healthcare workforce. Developing and expanding their skills and capabilities is fundamental to delivering new ways of working. However, career opportunities combining research and practice remain limited. This study explored the perceived utility and value of a doctorate to post-doctoral AHPs and how they experience bringing their research-related capabilities into practice environments.
Methods
With a broadly interpretivist design, a qualitatively oriented cross-sectional survey, with closed and open questions, was developed to enable frequency reporting while focusing on the significance and meaning participants attributed to the topic. Participants were recruited via professional networks and communities of practice. Descriptive statistics were used to analyse closed question responses, while combined framework and thematic analysis was applied to open question responses.
Results
Responses were received from 71 post-doctoral AHPs located across all four UK nations. Findings are discussed under four primary themes of utilisation of the doctorate; value of the doctorate; impact on career, and impact on self and support. Reference is also made at appropriate points to descriptive statistics summarising closed question responses.
Conclusion
The findings clearly articulate variability of experiences amongst post-doctoral AHPs. Some were able to influence team and organisational research cultures, support the development of others and drive service improvement. The challenges, barriers and obstacles encountered by others reflect those that have been acknowledged for many years. Acknowledging them is important, but the conversation must move forward and generate positive action to ensure greater consistency in harnessing the benefits and value-added these practitioners bring. If system-wide transformation is the aim, it is inefficient to leave navigating challenges to individual creativity and tenacity or forward-thinking leaders and organisations. There is an urgent need for system-wide responses to more effectively, consistently and equitably enable career pathways combining research and practice for what is a substantial proportion of the UK healthcare workforce
A whole systems approach to integrating physical activity to aid mental health recovery â Translating theory into practice
Improving health outcomes for people with severe mental illness (SMI) through increased physical activity (PA) on a large scale remains an elusive goal. There is promising evidence that increasing levels of PA in people with SMI can improve psychological and physical health outcomes. However, SMI is associated with reduced levels of physical activity and more sedentary behaviour than is usual in people without SMI.
Increasing PA and reducing sedentary behaviour among people with SMI is a complex process, as there are drivers of these behaviours at the individual, household, community and policy levels. Examples of these include the symptoms associated with SMI, poverty, unemployment, social isolation and stigma. Such drivers affect opportunities to take part in PA and individualsâ abilities to do so, creating negative reinforcing loops of behaviours and health outcomes.
Most previous approaches to PA for this population have focused largely on individual behaviour change, with limited success. To increase levels of PA effectively for people with SMI at scale also requires consideration of the wider determinants and complex dynamic drivers of PA behaviour in this population.
This position paper sets out a rationale and recommendations for the utilisation of whole systems approaches to PA in people with SMI and the improvement of physical and psychological outcomes. Such approaches should be delivered in conjunction with bespoke, individual-level interventions which address the unique needs of those with SMI
Understanding the value of a PhD for post-doctoral registered UK nurses : a survey
Aims
This study investigated: âWhat is the perceived value of a PhD to doctoral and postdoctoral nurses in the UK?â
Background
Little is known about what happens to the careers of nurses who undertake a doctorate, and whether they use these skills in the next career steps.
Methods
Nurses (n= 47) with doctorates were recruited via professional networks and twitter (@NMAHP_DoctorateStudy). Qualitative responses from the nurses were analysed using thematic analysis.
Results
Three themes emerged from qualitative analysis; impact on career, utilisation and value, impact on self.
Conclusions
This study provides one of the few insights into how doctoral trained nurses understand and experience the value and utility of their studies to themselves and others.
Implications for nurse management
Nurse managers can play a crucial role in generating a research led culture within their clinical setting. This would include promoting an understanding of research as something directly related to patient benefit rather than an abstract, intellectual activity