Service use of older people who participate in primary care health promotion: a latent class analysis

Background: Recruiting patients to health promotion programmes who will benefit is crucial to success. A key policy driver for health promotion in older people is to reduce health and social care use. Our aim was to describe service use among older people taking part in the Multi-dimensional Risk Appraisal for Older people primary care health promotion programme. Methods: A random sample of 1 in 3 older people (≥65 years old) was invited to participate in the Multi-dimensional Risk Appraisal for Older people project across five general practices in London and Hertfordshire. Data collected included socio-demographic characteristics, well-being and functional ability, lifestyle factors and service use. Latent class analysis (LCA) was used to identify groups based on use of the following: secondary health care, primary health care, community health care, paid care, unpaid care, leisure and local authority resources. Differences in group characteristics were assessed using univariate logistic regression, weighted by probability of class assignation and clustered by GP practice. Results: Response rate was 34% (526/1550) with 447 participants presenting sufficient data for analysis. LCA using three groups gave the most meaningful interpretation and best model fit. About a third (active well) were fit and active with low service use. Just under a third (high NHS users) had high impairments with high primary, secondary and community health care contact, but low non-health services use. Just over a third (community service users) with high impairments used community health and other services without much hospital use. Conclusion: Older people taking part in the Multi-dimensional Risk Appraisal for Older people primary care health promotion can be described as three groups: active well, high NHS users, and community service users

Children’s wellbeing and reading affect: exploring the impact of reading to dogs

INTRODUCTION: The aim of this thesis was to explore the impact of Reading to Dogs (RTD) on children’s wellbeing and reading affect. RTD inventions in schools are growing in popularity yet several concerns exist, such as uncertainty about benefits due to methodological weaknesses in studies to date, and risk to the welfare of participants, including children, school staff and the dogs themselves. Furthermore, teacher perspectives of RTD are rarely included, and current practice generally lacks a curricular and pedagogical basis. This research aimed to address these concerns. METHODOLOGY: After a review of the literature, a mixed method research design incorporating three linked studies was developed. Firstly 253 teachers’ perspectives of RTD were sought through an online survey. Perceived benefits and challenges, and teachers’ experience of RTD interventions, were explored through quantitative and qualitative data. The second study involved the development of a four-week collaborative co-design framework and the subsequent RTD intervention co-design which drew on research (researcher) and practice (three primary school teachers). The final study involved evaluating the new intervention, Paws and Learn (PAL), delivered online over four weeks, in a controlled feasibility study involving three Scottish schools and N=106 Primary 5 pupils (aged nine years) of mixed ability, gathering quantitative and qualitative data through questionnaires and interviews. FINDINGS: The Study 1 survey showed that teachers were largely positive about the potential of RTD to support wellbeing and reading. Valuable insights about challenges associated with RTD were also provided, although these were not generally seen as insurmountable. The Study 2 co- design framework was deemed effective in facilitating the intervention co-design, and as a valuable professional learning opportunity for both the researcher and teachers. Study 3 findings were mixed, with quantitative results showing little significant effect, but qualitative analysis suggesting improvements in both wellbeing and reading affect. PAL components were highly rated, and the intervention was deemed feasible particularly if technical issues can be addressed. LIMITATIONS: Limitations include effects of the Covid-19 pandemic such as additional pressures on participants, the extent to which teacher views in Study 1 were representative of all teachers, the small scale of Study 2, and the short-term nature of Study 3. CONTRIBUTION: This thesis makes a significant contribution to RTD research, practice and theory in a number of ways. These include: 1) exploring teachers’ perspectives of RTD, 2) incorporating teachers’ practical experience and expertise in a new RTD intervention, 3) trialling the new RTD intervention (the first known online RTD study) in a controlled feasibility study which addressed weaknesses in research to date, 4) proposing a new theoretical model for understanding how RTD may support wellbeing and reading affect, which could be applied and tested in future research

READING TO DOGS IN SCHOOLS: A CONTROLLED FEASIBILITY STUDY OF AN ONLINE READING TO DOGS INTERVENTION

TThis study evaluated an online multi-component Reading to Dogs (RTD) intervention named Paws and Learn (PAL). Designed as a controlled feasibility study (i.e., comparing an intervention and a control group, as well as evaluating the intervention’s practicality for the classroom), this research examined the intervention’s impact on children’s wellbeing, reading affect and frequency (RAF), children and teachers’ perceptions and experiences of PAL, and implementation considerations for the classroom. PAL consists of five components, one of which is RTD, complemented by four additional components designed to increase connection to the dog (whom they only meet virtually) and increase and consolidate benefits. RTD in schools is growing in international popularity and prevalence yet concerns about the practice exist. Online PAL was informed by a survey of teachers’ perspectives of RTD, and a co-design process combining research and practice. A pre-post-test control group design, with a mixed method evaluation was adopted. In total, 106 pupils (aged 9) and their teachers from 3 schools participated in the 4-week study. Measures included wellbeing and RAF questionnaires, and interviews with intervention class teachers (n=3) and a sub-sample of children (n=33). In general, no statistically significant differences were found in wellbeing, reading affect or frequency, however qualitative insights revealed positive perceptions and experiences of online PAL, specifically in relation to wellbeing and reading affect. Online PAL was deemed feasible for classroom use, particularly if technological challeng

Dispositional and Trait Perceptions and Beliefs: A Snapshot of Three Stakeholders

The assessment of student dispositions is an important part of teacher preparation programs in the United States. To explore the beliefs and perceptions of in-service educators and teacher education students, we used a researcher-designed survey to examine responses of three groups: a) in-service music educators, b) collegiate music education majors, and c) collegiate education majors (not music) in a Midwestern state in the United States. The survey included questions that asked participants to describe dispositions, rank and rate the importance of the dispositional traits, and to rank their opinion on the importance of dispositions in comparison to content knowledge and pedagogical skills. Members of each group indicated they did not know the term ‘disposition’ and could not define it. Ratings of dispositions by the three groups in this study all showed a high perceived importance of two dispositional traits: ‘respectful’ and ‘reliable.’ The in-service music educators and collegiate music education majors ranked professional dispositions as most important while non-music collegiate education majors ranked pedagogical knowledge as the most important. Results from this study are not generalizable due to the homogeneous sample

Online physical activity interventions for mental disorders: A systematic review

Background: Accumulating evidence indicates that face-to-face physical activity interventions improve the physical and mental health of people with mental disorders. However, it is unclear whether internet-delivered physical activity interventions are also efficacious. Objective: Our aim was to determine the effect of online physical activity interventions on the severity of symptoms of mental illness among people experiencing mental disorders. Methods: A systematic review of major electronic databases was conducted from inception to January 2015. Randomised controlled trials of internet-delivered interventions to increase physical activity participation in adults (>18 years) with a DSM, ICD, clinician-confirmed diagnosis, and/or those receiving specialist mental health treatment were eligible for inclusion. Outcome data for symptom severity (depression) and physical activity participation was extracted. Results: Two trials (N = 95 participants) met the inclusion criteria, which investigated online clinician-guided interventions of 9–10 week duration. Results were discrepant across studies. One study found a moderate between-groups effect size compared to wait-list control on depression outcomes (d = .67) but no differences in physical activity participation. In the other study, there were no significant differences between an online physical activity intervention versus treatment-as-usual in a university counselling service. Conclusion: The preliminary findings suggest that online physical activity interventions may have positive effects on depression symptoms, but the size of the effects and mechanism of change remain unclear. Further research is critically needed to explore the efficacy and acceptability of online physical interventions for people with mental disorders

Physical activity in the treatment of post-traumatic stress disorder: A systematic review and meta-analysis

People with PTSD experience high levels of cardiovascular disease and comorbid mental health problems. Physical activity (PA) is an effective intervention in the general population. We conducted the first systematic review and meta-analysis to determine the effect of PA on PTSD. We searched major electronic databases from inception till 03/2015 for RCTs of PA interventions among people with PTSD. A random effects meta-analysis calculating hedges g was conducted. From a potential of 812 hits, four unique RCTs met the inclusion criteria (n=200, mean age of participants 34-52 years). The methodological quality of included trials was satisfactory, and no major adverse events were reported. PA was significantly more effective compared to control conditions at decreasing PTSD and depressive symptoms among people with PTSD. There was insufficient data to investigate the effect on anthropometric or cardiometabolic outcomes. Results suggest that PA may be a useful adjunct to usual care to improve the health of people with PTSD. Although there is a relative paucity of data, there is reason to be optimistic for including PA as an intervention for people with PTSD, particularly given the overwhelming evidence of the benefits of PA in the general population. Robust effectiveness and implementation studies are required.publisher: Elsevier articletitle: Physical activity in the treatment of Post-traumatic stress disorder: A systematic review and meta-analysis journaltitle: Psychiatry Research articlelink: http://dx.doi.org/10.1016/j.psychres.2015.10.017 content_type: article copyright: Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.status: publishe