"Thinking About Drinking”: Exploring Children’s Perceptions of Alcohol Using the Draw and Write Tool);

Purpose: This qualitative study aimed to explore perceptions of alcohol held by schoolchildren using the ‘Draw and Write’ tool, to inform the planning of alcohol education in the classroom setting. Design: A specifically designed ‘Draw and Write’ booklet was used with 169 children aged 9-10 years (Year 5) across 7 primary schools in a small Local Authority in North West England. Written responses were thematically coded. Findings: Results demonstrated that the children had a good basic understanding of alcohol, including who drinks, where it can be purchased and the range of products available. Participants were aware that alcohol could be harmful and held mainly negative views. Findings suggest that alcohol education at this age is both appropriate and necessary to help children explore, understand and clarify their perceptions and misconceptions in a safe classroom environment. Practical Implications: The range and depth of responses from the children demonstrated that Draw and Write can be used successfully to explore children’s perceptions of alcohol. The tool can be used as a baseline assessment to inform classroom based alcohol education for primary school teachers and those supporting delivery at local level, in line with national policy recommendations. Originality/Value: This paper adds to the existing literature on the use of ‘Draw and Write’ in personal, social and health education, demonstrating that it can be used specifically to investigate children’s knowledge and attitudes about alcohol

An exploration of the role of alcohol in relation to living situation and significant life events for the homeless population in Merseyside, UK.

Approximately 10% of the population in the UK are estimated to have been homeless ot some point in their lifetime (Crisis 2014) and there were 2,744 rough sleepers identified in England in 2014 (Department for Communities and Local Government 2015). Alcohol misuse is both a cause and effect of homelessness (Shelter 2007) and is considered to be a major health risks amongst the homeless (Crisis 2002). This research used life history interviews and calendars to explore changes in the research participants’ alcohol consumption in relation to their living situation and significant life events. Additionally, PhotoVoice activities were used to further explore their everyday lived experiences. Recovery capital, which is derived from the concept of ‘social capital’ (Bourdieu and Wacquant 1992; Teachman et al 1997), refers to the quality and quantity of resources that a person can access in order to initiate and sustain recovery from addiction (Granfield and Cloud 2001). In the context of this research, recovery capital has also been applied to the resources needed in order to overcome homelessness as well as addiction to alcohol. The findings from this research highlight the importance of social capital during significant life events. It was often a lack of social capital that led to homelessness and increased alcohol consumption. Subsequently, in order to overcome alcohol addiction and homelessness, participants need to develop recovery capital. The sample that was recruited for this project was small, and is therefore not representative of the experiences of the homeless population in general. However, the findings from this research do demonstrate how further research is needed in order to further explore the relationships between alcohol consumption, living situation and significant life events

Using discursive approaches to examine the utility and functions of language in public health and health promotion: highlighting social constructions of e-cigarettes

This article uses discursive approaches to examine the utility and functions of language in public health, focusing on social constructions of e-cigarettes. Due to the ambiguity surrounding the use of e-cigarettes, understanding may be negotiated collaboratively through co-construction in talk. Ten participants, three men and seven women aged 26–47 years, took part in two focus groups in Manchester, UK, where they discussed e-cigarettes. Data were analysed using blended discourse analysis, with a view to identifying dominant repertoires used by speakers. Participants drew from two discursive frameworks to communicate perceptions of e-cigarettes: (1) uncertainty and risk and (2) the social acceptability and stigma spectrum. The ambiguity surrounding e-cigarettes was reflected in the linguistic devices used in talk. This article demonstrates the value of drawing on discourse analysis to better understand the impact of health-related communication by providing insight into how existing messages are interpreted, co-constructed, and assigned meaning through shared interactions

Process evaluation of a sport-for-health intervention to prevent smoking amongst primary school children: SmokeFree Sports

Background: SmokeFree Sports (SFS) was a multi-component sport-for-health intervention aiming at preventing smoking among nine to ten year old primary school children from North West England. The purpose of this study was to evaluate the process and implementation of SFS, examining intervention reach, dose, fidelity, acceptability and sustainability, in order to understand the feasibility and challenges of delivering such interventions and inform interpretations of intervention effectiveness.  Methods: Process measures included: booking logs, 18 focus groups with children (n=95), semi-structured interviews with teachers (n=20) and SFS coaches (n=7), intervention evaluation questionnaires (completed by children, n=1097; teachers, n=50), as well direct observations (by researchers, n=50 observations) and self-evaluations (completed by teachers, n=125) of intervention delivery (e.g. length of sessions, implementation of activities as intended, children's engagement and barriers). Descriptive statistics and thematic analysis were applied to quantitative and qualitative data, respectively.  Results: Overall, SFS reached 30.8% of eligible schools, with 1073 children participating in the intervention (across 32 schools). Thirty-one schools completed the intervention in full. Thirty-three teachers (55% female) and 11 SFS coaches (82% male) attended a bespoke SFS training workshop. Disparities in intervention duration (range=126 to 201 days), uptake (only 25% of classes received optional intervention components in full), and the extent to which core (mean fidelity score of coaching sessions=58%) and optional components (no adaptions made=51% of sessions) were delivered as intended, were apparent. Barriers to intervention delivery included the school setting and children's behaviour and knowledge. SFS was viewed positively (85% and 82% of children and teachers, respectively, rated SFS five out of five) and recommendations to increase school engagement were provided.  Conclusion: SFS was considered acceptable to children, teachers and coaches. Nevertheless, efforts to enhance intervention reach (at the school level), teachers' engagement and sustainability must be considered. Variations in dose and fidelity likely reflect challenges associated with complex intervention delivery within school settings and thus a flexible design may be necessary. This study adds to the limited scientific evidence base surrounding sport-for-health interventions and their implementation, and suggests that such interventions offer a promising tool for engaging children in activities which promote their health

A systematic scoping review of health-promoting interventions for contact centre employees examined through a behaviour change wheel lens

Purpose: Social determinants of health and poor working conditions contribute to excessive sickness absence and attrition in contact centre advisors. With no recent review conducted, the current scoping review is needed to investigate the volume, effectiveness, acceptability, and feasibility of health-promoting interventions for contact centre advisors. This will inform the adoption and implementation of evidence-based practice, and future research. Methods: Searches conducted across four databases (MEDLINE, PsycInfo, CINAHL, Web of Science) and reference checking in February 2023 identified health-promoting interventions for contact centre advisors. Extracted and coded data from eligible interventions were systematically synthesised using the nine intervention functions of the Behaviour Change Wheel and behaviour change technique taxonomy. Results: This scoping review identified a low number of high quality and peer-reviewed health-promoting intervention studies for contact centre advisors (28 studies since 2002). Most interventions were conducted in high-income countries with office-based advisors, predominantly using environmental restructuring and training strategies to improve health. Most interventions reported positive effectiveness results for the primary intended outcome, which were broadly organised into: i) health behaviours (sedentary behaviour, physical activity, smoking); ii) physical health outcomes (musculoskeletal health, visual health, vocal health, sick building syndrome); iii) mental health outcomes (stress, job control, job satisfaction, wellbeing). Few interventions evaluated acceptability and feasibility. Conclusion: There is little evidence on the effectiveness, acceptability, and feasibility of health-promoting interventions for contact centre advisors. Evidence is especially needed in low-to-middle income countries, and remote/hybrid, nightshift and older advisors, and advisors living with disability

Impact of the government's restrictions and guidance in relation to “social distancing” on the lives of ethnic minority populations:A mixed methods study

Background and Aims: The impacts of the COVID-19 pandemic have not been equal, with a disproportionate impact among ethnic minority communities. Structural inequalities in social determinants of health such as housing and employment have contributed to COVID-19's impact on deprived communities, including many ethnic minority communities. To compare (1) how the UK government's “social distancing” restrictions and guidance were perceived and implemented by ethnic minority populations compared to white populations, (2) the impact of restrictions and guidance upon these groups. Methods: An explanatory sequential mixed methods study incorporated a quantitative survey and qualitative semi-structured interviews to explore individual perceptions and experiences of COVID-19 and the national restrictions. Survey participants (n = 1587) were recruited from North West England; 60 (4%) participants were from ethnic minority communities. Forty-nine interviews were conducted; 19 (39%) participants were from ethnic minority communities. Interviews were transcribed verbatim and analysed using a thematic approach. Data collection was between April and August 2020. Results: Significant differences in demographics and household overcrowding were observed between white vs ethnic minority survey respondents, who were also significantly less confident in their knowledge of COVID-19, less likely to be high-risk drinkers, and marginally more likely to have experienced job loss and/or reduced household income. There were no group differences in wellbeing, perceptions, or nonfinancial impacts. Two inter-related themes included: (1) government guidance, incorporating people's knowledge and understanding of the guidance and their confusion/frustration over messaging; (2) the impacts of restrictions on keyworkers, home-schooling, working from home and changes in lifestyle/wellbeing. Conclusions: Further research is needed on the long-term impacts of COVID-19 on ethnic minority communities. If policy responses to COVID-19 are to benefit ethnic minority communities, there is a need for future studies to consider fundamental societal issues, such as the role of housing and economic disadvantage.</p

Influence of family and friend smoking on intentions to smoke and smoking-related attitudes and refusal self-efficacy among 9-10 year old children from deprived neighbourhoods: a cross-sectional study.

BACKGROUND: Smoking often starts in early adolescence and addiction can occur rapidly. For effective smoking prevention there is a need to identify at risk groups of preadolescent children and whether gender-specific intervention components are necessary. This study aimed to examine associations between mother, father, sibling and friend smoking and cognitive vulnerability to smoking among preadolescent children living in deprived neighbourhoods. METHODS: Cross-sectional data was collected from 9-10 year old children (n =1143; 50.7% girls; 85.6% White British) from 43 primary schools in Merseyside, England. Children completed a questionnaire that assessed their smoking-related behaviour, intentions, attitudes, and refusal self-efficacy, as well as parent, sibling and friend smoking. Data for boys and girls were analysed separately using multilevel linear and logistic regression models, adjusting for individual cognitions and school and deprivation level. RESULTS: Compared to girls, boys had lower non-smoking intentions (P = 0.02), refusal self-efficacy (P = 0.04) and were less likely to agree that smoking is 'definitely' bad for health (P < 0.01). Friend smoking was negatively associated with non-smoking intentions in girls (P < 0.01) and boys (P < 0.01), and with refusal self-efficacy in girls (P < 0.01). Sibling smoking was negatively associated with non-smoking intentions in girls (P < 0.01) but a positive association was found in boys (P = 0.02). Boys who had a smoking friend were less likely to 'definitely' believe that the smoke from other people's cigarettes is harmful (OR 0.57, 95% CI: 0.35 to 0.91, P = 0.02). Further, boys with a smoking friend (OR 0.38, 95% CI: 0.21 to 0.69, P < 0.01) or a smoking sibling (OR 0.45, 95% CI: 0.21 to 0.98) were less likely to 'definitely' believe that smoking is bad for health. CONCLUSION: This study indicates that sibling and friend smoking may represent important influences on 9-10 year old children's cognitive vulnerability toward smoking. Whilst some differential findings by gender were observed, these may not be sufficient to warrant separate prevention interventions. However, further research is needed

Multiple stakeholder views of pre-school child weight management practices: A mixed methods study

Objective: With the increasing prevalence of unhealthy weight status in pre-school children, this study sought to understand current pre-school child weight management practices in Blackburn with Darwen, UK, with a view to informing appropriate intervention strategies. Design: Mixed-methods study (semi-structured interviews, quantitative survey) Setting: Urban-rural borough with high ethnic diversity in the North-West of England. Methods: Phase 1 involved 15 semi-structured interviews with public health/service managers, health professionals and children’s centre staff to explore current pre-school weight management practices, challenges and perceived training needs. Phase 2 involved a quantitative survey of multidisciplinary health professionals (n=30) who work with pre-school children. Data were analysed thematically and perceived challenges organised into individual, interpersonal and organisational levels of the socio-ecological model. Results: Current pre-school child weight management practices appeared to be inconsistent, and staff were unable to locate clear protocols or referral pathways. Challenges most commonly related to individual family factors (e.g. families not perceiving child’s weight status to be a problem) and organisational factors (e.g. lack of time). Perceived training needs differed between professions and included Body Mass Index calculation and interpretation, weight-related communication and pre-school nutrition/physical activity guidelines. Conclusion: Inconsistencies in practice and a lack of clear pathways limited pre-school child weight management practices in Blackburn with Darwen. Although many challenges were attributed as external to the individual, potential steps to help practitioners cope with these demands are outlined

Exploring practices and perceptions of alcohol use during pregnancy in England and Sweden through a cross-cultural lens.

Background: Qualitative studies have aimed to understand why some women continue to drink during pregnancy; however, there is a lack of comparative cross-cultural research. We aimed to explore perceptions and practices of alcohol use during pregnancy in England and Sweden. Methods: Semi-structured interviews were conducted with 21 parents in Merseyside, England and 22 parents in Örebro County, Sweden. Interviews were audio recorded, transcribed verbatim and translated. Data were analyzed using thematic analysis. Results: The majority of women in both countries abstained from alcohol when they found out they were pregnant, despite alcohol being part of many social contexts before pregnancy. Nine of the seventeen English women drank at some point during pregnancy, typically on special occasions. Most parents felt women should modify their alcohol intake when they become mothers, though several English parents argued that responsible motherhood did not necessarily equate to abstinence. Swedish parents held strong opinions against drinking during pregnancy and argued that any amount of alcohol could harm the foetus. English parents' opinions were divided; some were skeptical of whether low to moderate drinking was associated with risks. Conclusions: Practices and attitudes towards alcohol use during pregnancy and views on foetal rights and responsibilities of pregnant women differed in England and Sweden. Shared social norms around drinking may be shaped within the policy context of pregnancy drinking guidelines, determining whether women consume alcohol or not