A novel idea... reading groups as community outreach

Jenny Townend and Fiona MacLellan describe a University of Northampton project which has set up reading groups in local community groups to raise literacy levels and aspirations, and to nurture a passion for readin

Provision of interpreting support for cross-cultural communication in UK maternity services:A Freedom of Information request

Background: Language, communication and understanding of information are central to safe, ethical and efficient maternity care. The National Health Service (NHS) commissioning board, NHS England, describes how healthcare providers should obtain language support through professionally trained interpreters. Providers of interpreters are commissioned to deliver remote/face to face interpretation across the NHS. Services can be booked in advance or calls can be made in real time. However, women report infrequent use of professionally trained interpreters during their maternity care, often relying on friends and family as interpreters which can compromise confidentiality, disclosure and accuracy.Methods: To determine the demand for, and provision of, professionally trained interpreters in practice, we sent a Freedom of Information (FOI) request to 119 NHS Trusts delivering maternity services in England in November 2022. For the financial years 2020/2021 and 2021/2022, we asked how many women in the maternity service were identified as needing an interpreter, the number and mode of interpreter sessions, and the annual spend on interpreting services. Datawere analysed using descriptive statistics.Results: One hundred maternity Trusts responded by 21st April 2023 (response rate 100/119–84 %). Of these, 56 (56 %) recorded a woman’s need for an interpreter. Nineteen Trusts relied on documentation in paper notes and 37 Trusts recorded the information on a digital system. From the 37 Trusts where this information could be digitally retrieved, women requiring interpretersupport reflected between 1 and 25 % of the annual birth rate of the Trust (average 9 %) and received an average of three interpreter sessions across their pregnancy, birth and postnatal journey. Telephone was the dominant mode used for interpreting sessions, though 11 Trusts favoured face to face interpreting. Financial spend on interpreting services varied across Trusts; some funded their own in-house interpreting services, or worked with local community groups inaddition to their contracted interpreting provider.Conclusion: Information obtained from this FOI request suggests that Documentation of a woman’s interpreting need is not complete or consistent across NHS maternity services. As a result, it is not clear how many women require an interpreter, the mode of provision or how frequently it is provided, and the cost involved. However, the limited information available suggests a failure to provide interpreter support to women at each scheduled care encounter. This raises questions about, the risk of women not understanding the care being offered, and the increased risk of uninformed, unconsented care as women traverse pregnancy and birth

Unpacking complexity: GP perspectives on addressing the contribution of trauma to women’s ill health

Background: There is an intricate relationship between the mind and the body in experiences of health and wellbeing. This can result in complexity of both symptom presentation and experience. Although the contribution of life trauma to illness experience is well described, this is not always fully recognised or addressed in health care encounters. Negotiating effective and acceptable trauma informed conversations can be difficult for clinicians and patients. Aim: To explore the experience of primary care practitioners caring for women through a trauma informed care lens. Design and Setting: Qualitative study in the general practice setting of England, with reflections from representatives of a group with lived experience of trauma. Methods: A secondary thematic analysis of 46 qualitative interviews conducted online/by telephone to explore primary care practitioner’s experiences of supporting women’s health needs in general practice, alongside consultation with representatives of a lived experience group to contextualise the findings. Results: Four themes were constructed: you prioritise physical symptoms because you don’t want to miss something; you don’t want to alienate people by saying the wrong thing; the system needs to support trauma informed care; delivering trauma informed care takes work which can impact on practitioners. Conclusion: Health Care Practitioners are aware of the difficulties in discussing the interface between trauma and illness with patients, and request support and guidance in how to negotiate this supportively. Lack of support for practitioners moves the focus of trauma informed care from a whole systems approach towards individual clinician – patient interactions

eHealth literacy and the use of NHS111 online urgent care service in England: a cross-sectional survey

Background: Many healthcare systems have turned to digital technologies to support care delivery, a trend amplified by the COVID-19 pandemic. ‘Digital first’ may exacerbate health inequalities due to variation in eHealth literacy. Objective: We explored eHealth literacy amongst users and non-users of the NHS 111 online urgent care service. Methods: A cross-sectional sequential convenience sample survey of 2754 adults (October 2020 - July 2021), from primary, urgent/emergency care, third sector organisations and NHS 111 website. The survey included the eHealth Literacy Questionnaire (eHLQ), questions about use and preferences for using 111 online, and sociodemographic characteristics. Results: Across almost all domains of the eHLQ, NHS 111 online users had higher mean digital literacy scores than non-users (P<0.001). Four eHLQ domains were significant predictors of 111 online use, most highly significant for domain eHLQ1 (Using technology to process health information) and eHLQ3 (Ability to actively engage with digital services) with odds ratios (95% CI) of 1.86 (1.46 to 2.38) and 1.51 (1.22 to 1.88) respectively. Respondents reporting a long-term condition (LTC) had lower eHLQ scores and a subset of non-users with a LTC had the lowest eHLQ scores. People under 25 (OR (95% CI) 3.24 (1.87 to 5.62)), and those with formal qualifications (0.74 (0.55 to 0.99) were more likely to use 111 online. Users and non-users expressed willingness to use NHS 111 online for a range of symptoms, including chest pain symptoms (70.4%) or for illness in children (70.0%). Users of NHS 111 online were more likely to have also used other health services, particularly the 111 telephone service (X2=138.57; P <0.001). Conclusions: These differences in eHealth literacy scores amplify perennial concerns about digital exclusion and access to care for those impacted by intersecting forms of disadvantage, including long term illness. Although many appear willing to use NHS 111 online for a range of health scenarios, indicating broad acceptability, not all are able or willing to use this service. Despite a policy ambition for 111 online to substitute for other services, it appears to be used alongside other urgent care access routes, and thus may not reduce demand

Improving fairness in machine learning systems: What do industry practitioners need?

The potential for machine learning (ML) systems to amplify social inequities and unfairness is receiving increasing popular and academic attention. A surge of recent work has focused on the development of algorithmic tools to assess and mitigate such unfairness. If these tools are to have a positive impact on industry practice, however, it is crucial that their design be informed by an understanding of real-world needs. Through 35 semi-structured interviews and an anonymous survey of 267 ML practitioners, we conduct the first systematic investigation of commercial product teams' challenges and needs for support in developing fairer ML systems. We identify areas of alignment and disconnect between the challenges faced by industry practitioners and solutions proposed in the fair ML research literature. Based on these findings, we highlight directions for future ML and HCI research that will better address industry practitioners' needs.Comment: To appear in the 2019 ACM CHI Conference on Human Factors in Computing Systems (CHI 2019

Using peer advocates to improve access to services among hard-to-reach populations with hepatitis C:a qualitative study of client and provider relationships

BACKGROUND: Peer support programmes use individuals with specific experiences to improve engagement and outcomes among new clients. However, the skills and techniques used to achieve this engagement have not been mapped. This potentially restricts the development and replication of successful peer advocate models of care. This study explored how a group of peer advocates with experience of homelessness, alcohol and drug misuse made and sustained relationships with their client group. For the purposes of this project, the client group were located among a hepatitis C-positive cohort of people who have a history of injecting drug use and homelessness. METHODS: Five self-selecting advocates gave a narrative interview lasting 40-90 min. These interviews were double transcribed using both thematic analysis and narrative analysis in order to triangulate the data and provide a robust set of findings about the unique skills of peer advocates in creating and sustaining relationships with clients from hard-to-reach populations. RESULTS: Peer advocates build rapport with clients through disclosing personal details about their lives. While this runs counter to assumptions about the need to maintain distance in client-patient relationships, the therapeutic benefits appear to outweigh the potential costs of this engagement. CONCLUSION: We conclude the therapeutic benefits of self-disclosure between peer advocates and their clients offer a moral grounding for self-disclosure as a means of building relationships with key hard-to-reach populations

Peer Support Workers in Health:A Qualitative Metasynthesis of Their Experiences

Peer support models, where an individual has a specific illness or lifestyle experience and supports others experiencing similar challenges, have frequently been used in different fields of healthcare to successfully engage hard-to-reach groups. Despite recognition of their value, the impact of these roles on the peer has not been systematically assessed. By synthesising the qualitative literature we sought to review such an impact, providing a foundation for designing future clinical peer models.Systematic review and qualitative metasynthesis of studies found in Medline, CINAHL or Scopus documenting peer worker experiences.1,528 papers were found, with 34 meeting the criteria of this study. Findings were synthesised to reveal core constructs of reframing identity through reciprocal relations and the therapeutic use of self, enhancing responsibility.The ability of the Peer Support Worker to actively engage with other marginalised or excluded individuals based on their unique insight into their own experience supports a therapeutic model of care based on appropriately sharing their story. Our findings have key implications for maximising the effectiveness of Peer Support Workers and in contributing their perspective to the development of a therapeutic model of care

Reading groups: establishing partnerships as part of a community outreach strategy at the University of Northampton

The reading groups project at Northampton has been a great success currently running two groups in the local community and one for University staff the project has been nominated for volunteering awards and over the past three years has had an impact upon many of the local communities vulnerable or disadvantaged people. The workshop will be run by Jenny Townend (Learning Support Specialist) and Fiona MacLellan (Academic Librarian) who have used their enthusiasm for reading to inspire others to take up or rediscover the reading habit. The project has come along way from an initial ‘off the cuff’ comment in a departmental meeting, and has expanded over the past three years to include three separate groups and a core team of six group facilitators. The workshop will cover the initial set up of the project, its development over the past three years and the impact of the groups on the people involved, there will also be time for brainstorming ideas for engaging in community outreach in your local community and time for question