People in Public Health. Research Summary

Members of the public are becoming increasingly important in the delivery of public health programmes. The work they do varies. They might give out information about a health issue or tell people about a local service. They might help someone who is going to a health improvement activity for the first time or organise a group that encourages healthy living. Some are paid, others are volunteers. The People in Public Health research study wanted to find out more about these lay health workers. It wanted to discover what type of things they do in public health programmes, how they are recruited, trained and supported and what is needed to make these approaches work well

Promoting Asset Based Approaches for Health and Wellbeing: Exploring a Theory of Change and Challenges in Evaluation

This project sought to explore two key areas that are critical for moving to a more systematised approach to asset based action for health. These two areas are: 1. The need to develop further a Theory of Change for asset based approaches aligned to an asset model for health 2. The requirement to understand how to measure and illustrate impact and benefit from asset based approaches. Following work to develop an understanding of practice, through site visits, interviews and a think piece event, a new Theory of Change for asset-based working is presented. A rapid review of published and grey literature was also conducted to map and categorise evaluation approaches and measures used in asset-based programmes. The map of literature (33 studies) showed that a variety of methodologies and evaluation strategies are used in asset-based practice. Seven clusters were identified: Asset Based Community Development; Asset Mapping; Community-based evaluation; Conceptual frameworks for measurement; Resilience; Salutogenesis; Other

Hamara Healthy Living Centre - an evaluation

Hamara is a Healthy Living Centre which aims to improve health and well-being through providing a range of culturally appropriate activities and services. Hamara has a vision of 'bringing communities together' and since it was established in 2004, the Centre has provided a valuable community resource in South Leeds. Partnership work between Hamara and Leeds Met goes back to 2002. In 2007, the Centre for Health Promotion Research carried out an evaluation of Hamara in partnership with Hamara staff and Leeds Met Community Partnerships and Volunteering. This was followed by a highly successful community cohesion conference 'One Community' which was held at Hamara on 10th October 2008, and was supported through a Leeds Met public engagement grant. The event attracted over a hundred people from diverse communities and organisations across Leeds. A packed audience heard Hilary Benn, local MP and Patron of Hamara, talk about the importance of working in collaboration around community cohesion. Jane South, Centre for Health Promotion Research, presented the main evaluation results and set out the some challenges for the future. The proceedings concluded with the presentation of awards to a number of for local community champions who work to bring people together and make a real difference in the city of Leeds

Researching Bradford: A review of social research on Bradford District

A synthesis of findings from social research on the District of Bradford. This report synthesises the findings from a wide range of social research undertaken on the District of Bradford, primarily between 1995 and 2005. The researchers reviewed almost 200 pieces of work. The key results are summarised under thematic headings: - The social, economic and institutional context - Community cohesion - Housing, neighbourhoods and regeneration - Business and enterprise - Health, disability and social care - Children and young people - Education, skills and the labour market - Crime and community safety It also identifies a future research agenda. The main purpose of the review was to provide the Joseph Rowntree Foundation and local organisations in Bradford with a firm basis upon which to build future work in the District

Improving health and well-being through community health champions: a thematic evaluation of a programme in Yorkshire and Humber.

AIMS: The contribution that lay people can make to the public health agenda is being increasingly recognised in research and policy literature. This paper examines the role of lay workers (referred to as 'community health champions') involved in community projects delivered by Altogether Better across Yorkshire and Humber. The aim of the paper is to describe key features of the community health champion approach and to examine the evidence that this type of intervention can have an impact on health. METHODS: A qualitative approach was taken to the evaluation, with two strands to gathering evidence: interviews conducted with different stakeholder groups including project leads, key partners from community and statutory sectors and community workers, plus two participatory workshops to gather the views of community health champions. Seven projects (from a possible 12) were identified to be involved in the evaluation. Those projects that allowed the evaluation team to explore fully the champion role (training, infrastructure, etc.) and how that works in practice as a mechanism for empowerment were selected. In total, 29 semi-structured interviews were conducted with project staff and partners, and 30 champions, varying in terms of age, gender, ethnicity and disability, took part in the workshops. RESULTS: Becoming a community health champion has health benefits such as increased self-esteem and confidence and improved well-being. For some champions, this was the start of a journey to other opportunities such as education or paid employment. There were many examples of the influence of champions extending to the wider community of family, friends and neighbours, including helping to support people to take part in community life. Champions recognised the value of connecting people through social networks, group activities, and linking people into services and the impact that that had on health and well-being. Project staff and partners also recognised that champions were promoting social cohesiveness and helping to integrate people into their community. CONCLUSIONS: The recent public health White Paper suggested that the Altogether Better programme is improving individual and community health as well as increasing social capital, voluntary activity and wider civic participation. This evaluation supports this statement and suggests that the community health champion role can be a catalyst for change for both individuals and communities

Perfect design or practical study? A workshop on navigating the challenges of community based prevention research

Subject: There is a shared interest among public health researchers in tackling methodological issues surrounding community based research, and on moving beyond a focus on individual level change. As part of a project on community empowerment funded by the People’s Health Trust, we have conducted a feasibility study on quantitative and economic evaluation of complex community-based interventions. To understand different quantitative methods that can be used to evaluate community empowerment interventions, we have undertaken a methodological literature review that identified the following sets of challenges: Defining population of interest – interventions taking place at a community level are not specifically targeted at a well-defined group of individuals. Therefore it is challenging to even find those who are affected by an intervention. Diverse and un-prescribed effects – the effect of community empowerment interventions are likely broad, suggesting we need to measure multiple outcomes in order to detect change. This increases the likelihood of detecting spurious change and can require a lot of resource. Furthermore, in many cases these outcomes are not pre-defined by a programme (i.e. communities choose their own foci)

WHO guidelines on fluid resuscitation in children: missing the FEAST data.

The World Health Organization recommendations on management of common childhood illnesses affect the lives of millions of children admitted to hospital worldwide. Its latest guidelines,1 released in May 2013, continue to recommend rapid fluid resuscitation for septic shock, even though the only large controlled trial of this treatment (Fluid Expansion as a Supportive Treatment (FEAST) found that it increased the risk of death in African children.2 A subsequent systematic review of bolus resuscitation in children with shock resulting from severe infection also did not support its use.3 Failure to take this evidence into account is not consistent with WHO’s commitment to systematically and transparently assess evidence using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) process when producing guidelines and could endanger the lives of children