National Institute of Mental Health Five-Year Strategic Plan for Reducing Health Disparities

The NIMH has a long history of concern and action related to health disparities and ethnic minority groups as well as other underrepresented groups (i.e. women, children, and disabled persons). In 1980, NIMH established the position of Associate Director for Special Populations and subsequently established an Office for Special Populations (OSP) to oversee NIMH activities concerning underrepresented groups, including ethnic minorities. Recently, NIMH in collaboration with consultants and public comment has developed a five-year Strategic Plan to address mental health outcome disparities through research that aims to describe, understand, and remedy the disproportionate impact on minority populations of mental disorders and behaviorally influenced physical health conditions such as HIV/AIDS. The research takes into consideration relevant contextual frameworks, including interpersonal, socio-cultural, and organizational factors

NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES HEALTH DISPARITIES STRATEGIC PLAN

Health disparities exist between citizens of lower socioeconomic status (including minorities and other medically underserved citizens) and those more economically advantaged. Examples where health disparities exist include: shorter life expectancy, higher cancer rates, more birth defects, greater infant mortality, and higher incidence of asthma, diabetes, and cardiovascular disease. These health discrepancies involve increased morbidity and mortality rates associated with increased incidences of disease. The ways in which poverty and other factors create these health disparities are still poorly understood. There is increasing evidence that these groups are burdened with a disproportionate share of residential and occupational exposure to hazardous substances such as lead, PCBs, wood dusts, and air pollutants. Thus, both social and physical environmental exposures represent an important area of investigation for understanding and ameliorating the health disparities suffered by the disadvantaged of this nation

Preparing young people with complex needs and their families for transition to adult services

© RCN Publishing Company Limited 2018Improving survival rates for children and young people with complex health needs requires a robust system for transition to adult services. Effective planning is essential to ensure a smooth transition process that is in the best interests of the young person and their family. This article discusses the needs and requirements for planned and purposeful transition processes to support young people with complex healthcare needs and their families. It considers the preparation of adult services, the team, the young person and their parents in line with an integrated approach and the nurse’s role. Recommendations for practice include the necessity for an integrated approach to ensure optimum outcomes and ascertaining the potential value of a nurse-led service in delivering the transition process. A carefully tailored planning strategy should be developed to prepare and support young people with complex health needs through transition

When does NICE recommend the use of health technologies within a programme of evidence development?

This article is made available through the Brunel Open Access Publishing Fund. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.This article has been made available through the Brunel Open Access Publishing Fund.Background: There is growing interest internationally in linking reimbursement decisions with recommendations for further research. In the UK, the National Institute for Health and Clinical Excellence (NICE) can issue guidance to approve the routine use of a health intervention, reject routine use or recommend use within a research programme. These latter recommendations have restricted use to ‘only in research’ (OIR) or have recommended further research alongside routine use (‘approval with research’ or AWR). However, it is not currently clear when such recommendations are likely to be made. Objectives: This study aims to identify NICE technology appraisals where OIR or AWR recommendations were made and to examine the key considerations that led to those decisions. Methods: Draft and final guidance including OIR/AWR recommendations were identified. The documents were reviewed to establish the characteristics of the technology appraisal, the cost effectiveness of the technologies, the key considerations that led to the recommendations and the types of research required. Results: In total, 29 final and 31 draft guidance documents included OIR/AWR recommendations up to January 2010. Overall, 86 % of final guidance included OIR recommendations. Of these, the majority were for technologies considered to be cost ineffective (83 %) and the majority of final guidance (66 %) specified the need for further evidence on relative effectiveness. The use of OIR/AWR recommendations is decreasing over time and they have rarely been used in appraisals conducted through the single technology appraisal process. Conclusion: NICE has used its ability to recommend technologies within research programmes, although predominantly within the multiple technology appraisal process. OIR recommendations have been most frequently issued for technologies considered cost ineffective and the most frequently cited consideration is uncertainty related to relative effectiveness. Key considerations cited for most AWR recommendations and some OIR recommendations included a need for further evidence on long-term outcomes and adverse effects of treatment.Medical Research Counci

Engagement and observation: a review of local policies in England and Wales

© 2020, Emerald Publishing Limited. Purpose: The purpose of this paper is to report on the content of local policies on engagement and observation written by National Health Service (NHS) organisations in England and Wales. Design/methodology/approach: Engagement and observation policies were obtained from all (n = 61) NHS mental health trusts in England and health boards in Wales via a Freedom of Information Act 2000 request. Data were analysed using content analysis. Findings: All organisations had a specific policy referring to either “observation and engagement” or “observation”. The policies varied considerably in quality, length, breadth and depth of the information provided. Significant variations existed in the terminology used to describe the different types of enhanced observation. Inconsistencies were also noted between organisations regarding: which members of the clinical team could initiate, increase, decrease and terminate observation; who could undertake the intervention (for example students); and the reasons for using it. Finally, despite rhetoric to the contrary, the emphasis of policies was on observation and not engagement. Research limitations/implications: This research has demonstrated the value of examining local policies for identifying inconsistencies in guidance given to practitioners on the implementation of engagement and observation. Further research should be undertaken to explore the impact of local policies on practice. Practical implications: Local policies remain variable in content and quality and do not reflect contemporary research. There is a need to produce evidence-based national standards that organisations are required to comply with. Originality/value: To the best of the author’s knowledge, this is the first research in 20 years examining the local policy framework for the implementation of engagement and observation

Improving the psychological evaluation of exercise referral: psychometric properties of the Exercise Referral Quality of Life Scale

There is a growing need to assess the psychological outcomes of exercise referral and the National Institute of Health and Care Excellence has called for the routine assessment of life-quality. However, a quality of life scale specific to the requirements of exercise referral is currently unavailable. Therefore, the aim of this study was to produce a quality of life measure for this purpose. The Exercise Referral Quality of Life Scale is a 22-item measure comprising three domains: mental and physical health, injury pain and illness and physical activity facilitators. Exploratory factor analysis determined the initial factor structure and was subsequently confirmed by confirmatory factor analysis. Additional scale properties were also assessed. The scale contributes to the global need for improved consistent psychological outcome assessment of exercise referral

NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT Comprehensive Strategic Plan for Health Disparities Research

To identify the most appropriate scientific areas to address in this plan, the Institute drew from its existing research portfolio aimed at eliminating health disparities. Reflecting the Institute’s mission, the unifying concept of the plan is development, starting before conception and continuing throughout the lifespan and across generations. The Institute’s long experience investigating the complex biological and environmental interactions that drive developmental processes is invaluable when clarifying the causes of racial, ethnic, and even community-based disparities. By focusing and coordinating research on gestation and the early years of life, including the transitions into and out of adolescence and young adulthood, the NICHD can address not only the development of health disparities, but the critical timing of preventive and therapeutic strategies