Co-designing of an intervention to support health visitors’ implementation of practices recommended for prevention of excess weight gain in 0-2 year old children

Ph. D. Thesis.Background: Early rapid weight gain is a risk factor for later obesity. UK health visitors (HVs) are well-positioned to address excessive weight-gain trends in early childhood. However, HVs face unique barriers when caring for children under age two with excessive rates of weight gain. Interventions that strengthen HVs’ role by addressing key barriers and facilitators of implementation of recommended guidelines into routine practice are needed. Aim: This research engaged with HVs to systematically design an intervention to support their implementation of practice behaviours. Methods: A mixed-methods evidence synthesis and series of interactive workshops with HVs were conducted. HVs who are the recipients of the intervention provided their views of what is important, relevant, and feasible in the local context. The findings of the workshops were combined in an iterative process to inform the sequential steps of the Behaviour Change Wheel framework and guide the process of designing the intervention. Results: Theoretical analysis of the workshops revealed HVs’ capabilities, opportunities, and motivations related to addressing early-childhood obesity prevention. Intervention strategies deemed most likely to support implementation (enablement, education, training, modelling, persuasion) were combined to design a face-to-face interactive training intervention. Outcome measures to test feasibility, acceptability, and fidelity of delivery of the proposed intervention were identified. Discussion: An interactive training intervention has been designed, informed by behaviour change theory, evidence, expert knowledge, and experiences of health visitors, in an area of health promotion that is currently evolving. Future research should be directed to evaluate the acceptability and feasibility of the intervention in a pilot trial. The use of a systematic approach to the development process, identification of intervention contents and their hypothesised mechanisms of action using standard terminology provides an opportunity for this research to contribute to the body of literature on designing of implementation interventions using a collaborative approach.Durham County Council, Newcastle University, and Fuse, the Centre for Translational Research in Public Healt

Supporting Nursing Leadership by the Implementation of an increased Supervisory Role

Clinical nurse leadership is essential for the provision of high quality patient care. Recent research has highlighted the need for all Senior Charge Nurses (SCNs) to be equipped to deliver effective ward management, staff development and ultimately a positive patient experience. The provision of ‘supervisory hours’ is a vital component of an SCN role, enabling the effective leadership of their teams. This paper describes the increased supervisory role implemented by the Leading Better Care program within one Health Board area of Scotland. Mixed methods research (online survey n=52 and in-depth qualitative interviews n=12) explored the experiences of SCNs using their increased supervisory time and its perceived impact on clinical practice. Findings demonstrate that increased supervisory time positively impacted several key areas of clinical practice. Although the increased supervisory role empowered SCNs and promoted their professional development, they require greater role clarity, managerial support and leadership development to reduce role stress and promote future career aspirations

Falsification of home rapid antigen lateral flow tests during the COVID-19 pandemic

During the COVID-19 pandemic, lateral flow tests (LFTs) were used to regulate access to work, education, social activities, and travel. However, falsification of home LFT results was a concern. Falsification of test results during an ongoing pandemic is a sensitive issue. Consequently, respondents may not answer truthfully to questions about LFT falsification behaviours (FBs) when asked directly. Indirect questioning techniques such as the Extended Crosswise model (ECWM) can provide more reliable prevalence estimates of sensitive behaviors than direct questioning. Here we report the prevalence of LFT FBs in a representative sample in England (n = 1577) using direct questioning (DQ) and the ECWM. We examine the role of demographic and psychological variables as predictors of LFT FBs. We show that the prevalence estimates of the FBs in the DQ condition were significantly lower than the ECWM estimates, e.g., reporting a negative result without conducting a test: 5.7% DQ vs 18.4% ECWM. Moral norms, subjective norms, anticipated regret, perception of risk to self, and trust in government predicted some of the FBs. Indirect questioning techniques can help provide more realistic and higher quality data about compliance with behavioural regulations to government and public health agencies

Facilitators and barriers to the increased supervisory role of senior charge nurses:a qualitative study

Aims: To explore the experiences of senior charge nurses provided with ‘increased supervisory hours’. Background: Designated supervisory time is essential for senior charge nurses to provide effective clinical leadership. It is important to explore the impact arises of such an increase. Methods: An online questionnaire collected exploratory data from senior charge nurses (n = 60). Semi-structured interviews gathered in-depth qualitative data (n = 12). Findings were analysed for common themes associated with implementation of the increased senior charge nurse supervisory role. Results: The majority of senior charge nurses were unable to use their full allocation of supervisory time. They struggled to accomplish leadership goals because of managing staffing levels, increased workload, time constraints and limited support. Factors that facilitated the role included preparation and support, adequate staff capacity, effective leadership skills and availability of supervisory time. The senior charge nurses took pride in providing clinical leadership, promoting staff development and delivering patient care. Support, in terms of preparation, capacity building and ongoing mentoring, was a key factor for achieving senior charge nurse goals. Conclusion: Senior charge nurses should be supported to maximise supervisory time through the provision of an induction programme, formal coaching and ongoing training and development. Implications for nursing management: Preparation and support is essential for senior charge nurses to deliver enhanced clinical leadership through increased supervisory time

Supporting nursing leadership by the implementation of an increased supervisory role

Clinical nurse leadership is essential for the provision of high quality patient care. Recent research has highlighted the need for all Senior Charge Nurses (SCNs) to be equipped to deliver effective ward management, staff development and ultimately a positive patient experience. The provision of ‘supervisory hours’ is a vital component of an SCN role, enabling the effective leadership of their teams. This paper describes the increased supervisory role implemented by the Leading Better Care program within one Health Board area of Scotland. Mixed methods research (online survey n=52 and in-depth qualitative interviews n=12) explored the experiences of SCNs using their increased supervisory time and its perceived impact on clinical practice. Findings demonstrate that increased supervisory time positively impacted several key areas of clinical practice. Although the increased supervisory role empowered SCNs and promoted their professional development, they require greater role clarity, managerial support and leadership development to reduce role stress and promote future career aspirations

Falsification of home rapid antigen lateral flow tests during the COVID-19 pandemic.

During the COVID-19 pandemic, lateral flow tests (LFTs) were used to regulate access to work, education, social activities, and travel. However, falsification of home LFT results was a concern. Falsification of test results during an ongoing pandemic is a sensitive issue. Consequently, respondents may not answer truthfully to questions about LFT falsification behaviours (FBs) when asked directly. Indirect questioning techniques such as the Extended Crosswise model (ECWM) can provide more reliable prevalence estimates of sensitive behaviors than direct questioning. Here we report the prevalence of LFT FBs in a representative sample in England (n = 1577) using direct questioning (DQ) and the ECWM. We examine the role of demographic and psychological variables as predictors of LFT FBs. We show that the prevalence estimates of the FBs in the DQ condition were significantly lower than the ECWM estimates, e.g., reporting a negative result without conducting a test: 5.7% DQ vs 18.4% ECWM. Moral norms, subjective norms, anticipated regret, perception of risk to self, and trust in government predicted some of the FBs. Indirect questioning techniques can help provide more realistic and higher quality data about compliance with behavioural regulations to government and public health agencies

COVID-19 lateral flow test falsification behaviour in England

We conducted this research to try to understand how people reported their test results using at-home COVID-19 rapid antigen lateral flow device kits

Study One

An online national cross-sectional surve