A Scoping Review Exploring Whether a Free “Offer” Devalues or Widens Sport and Physical Activity Participation Amongst Children and Young Adults Aged 0–25?

BackgroundSocio-economic status continues to mediate physical activity engagement, despite a range of interventions aimed at reducing inequalities and widening sport and physical activity participation. As a result there has been increasing interest amongst policy makers, national governing bodies (NGB), county sports partnerships (CPS) and the sport and physical activity sector more broadly, in understanding how best to reduce inequalities and widen participation. The “price point” of offers and whether a “free offer” enables or devalues participation, has been a key area of interest. This scoping review aimed to explore this topic further by investigating whether “a free “offer” devalues or widens sport and physical activity participation amongst children and young adults aged 0-25?”.MethodsThis scoping review searched three electronic bibliographic databases (MEDLINE, PsycINFO, SPORTDiscus) using a structured search strategy to identify articles published between 2017 and January 2022. Studies were included using the PICO criteria of; Population: children and young adults aged 0-25; Intervention: free “offer” relating to physical activity; Context: areas of deprivation in the UK; Outcome: engagement, involvement, participation in sport and physical activity.Results and DiscussionFive studies were eligible after screening 1301 titles and reviewing 14 full-text studies. Features reported included intervention design, outcomes, potential challenges and wider implications / future recommendations. Specifically, a narrative synthesis of the key themes of participation deprivation and cost effectiveness were outlined in more detail. A subsidized cost or free offer can improve participation generally and in attracting those from lower socio-economic backgrounds. However, the impact of such initiatives decrease with increasing deprivation highlighting that groups with the highest levels of deprivation have wider complexities affecting their participation. Competing priorities and potentially unrealistic expectations at stakeholders level was also identified.ConclusionDespite the paucity of current research exploring the impact of a “free offer” in children and young adults, recommendations for future research, practice and policy included the need for longitudinal, more holistic and participant centric approaches. Further research is required to explore the impact of a “free offer” from an individual, societal and policy-level perspective, in widening and increasing participation in sport and physical activity.</jats:sec

A scoping review exploring whether a free ‘offer’ devalues or widens sport and physical activity participation amongst children and young adults aged 0-25?

Background: Socio-economic status continues to mediate physical activity engagement, despite a range of interventions aimed at reducing inequalities and widening sport and physical activity participation. As a result there has been increasing interest amongst policy makers, national governing bodies (NGB), county sports partnerships (CPS) and the sport and physical activity sector more broadly, in understanding how best to reduce inequalities and widen participation. The ‘price point’ of offers and whether a ‘free offer’ enables or devalues participation, has been a key area of interest. This scoping review aimed to explore this topic further by investigating whether “a free ‘offer’ devalues or widens sport and physical activity participation amongst children and young adults aged 0-25?”. Methods: This scoping review searched three electronic bibliographic databases (MEDLINE, PsycINFO, SPORTDiscus) using a structured search strategy to identify articles published between 2017 and January 2022. Studies were included using the PICO criteria of; Population: children and young adults aged 0-25; Intervention: free ‘offer’ relating to physical activity; Context: areas of deprivation in the UK; Outcome: engagement, involvement, participation in sport and physical activity. Results and Discussion: Five studies were eligible after screening 1301 titles and reviewing 14 full-text studies. Features reported included intervention design, outcomes, potential challenges and wider implications / future recommendations. Specifically, a narrative synthesis of the key themes of participation deprivation and cost effectiveness were outlined in more detail. A subsidised cost or free offer can improve participation generally and in attracting those from lower socio-economic backgrounds. However, the impact of such initiatives decrease with increasing deprivation highlighting that groups with the highest levels of deprivation have wider complexities affecting their participation. Competing priorities and potentially unrealistic expectations at stakeholders level was also identified. Conclusion: Despite the paucity of current research exploring the impact of a ‘free offer’ in children and young adults, recommendations for future research, practice and policy included the need for longitudinal, more holistic and participant centric approaches. Further research is required to explore the impact of a ‘free offer’ from an individual, societal and policy-level perspective, in widening and increasing participation in sport and physical activity

An evaluation of a public partnership project between academic institutions and young people with Black African, Asian and Caribbean heritage

BackgroundThis project (named Reinvent) aimed to promote Public Involvement (PI) in health research. Academics worked with a community group, the Eloquent Praise &amp; Empowerment Dance Company, to develop a community partnership with young people from Black African, Asian and Caribbean heritage communities. The goal of this paper is to evaluate the Reinvent project for key learnings on how to engage and build partnerships with young people from Black African, Asian and Caribbean heritage communities.MethodsReinvent developed a steering group which consisted of five young people, one academic, a Race Equality Ambassador and the Director of Eloquent. The steering group co-produced an agenda for two workshops and the evaluation tools used. The content of the workshops included drama exercises, discussions on physical and mental health, nutrition and school-life, short introductions to the concepts of research and PI, and group work to critique and improve a video currently used to promote PI in health research to young people. The evaluation tools included using the ‘Cube’ evaluation framework, video-blogging and collecting anonymous feedback.FindingsThe responses to the ‘Cube’ evaluation framework were positive across all four domains (agenda, voice, contribute change) in both workshops. A few of the young people described having a better understanding of the meaning and practice of PI in a video-blog. The anonymous feedback suggested that the workshops had increased young people’s confidence in sharing their thoughts and opinions about health and PI.ConclusionReinvent has shown that academic institutions and young people from an under-served community can partner to co-design workshops and apply evaluation tools. Working with young people in an environment in which they were comfortable, and by researchers joining in with the activities that the young people enjoyed (such as dance), enabled more informal and open conversations to develop. More work is needed to build upon this project so that young people can feel confident and supported to get involved in PI activities relating to research

Baseline self-report 'central mechanisms' trait predicts persistent knee pain in the Knee Pain in the Community (KPIC) cohort.

OBJECTIVES: We investigated whether baseline scores for a self-report trait linked to central mechanisms predict 1 year pain outcomes in the Knee Pain in the Community cohort. METHOD: 1471 participants reported knee pain at baseline and responded to a 1-year follow-up questionnaire, of whom 204 underwent pressure pain detection thresholds (PPTs) and radiographic assessment at baseline. Logistic and linear regression models estimated the relative risks (RRs) and associations (β) between self-report traits, PPTs and pain outcomes. Discriminative performance for each predictor was compared using receiver-operator characteristics (ROC) curves. RESULTS: Baseline Central Mechanisms trait scores predicted pain persistence (Relative Risk, RR = 2.10, P = 0.001) and persistent pain severity (β = 0.47, P < 0.001), even after adjustment for age, sex, BMI, radiographic scores and symptom duration. Baseline joint-line PPTs also associated with pain persistence (RR range = 0.65 to 0.68, P < 0.02), but only in univariate models. Lower baseline medial joint-line PPT was associated with persistent pain severity (β = -0.29, P = 0.013) in a fully adjusted model. The Central Mechanisms trait model showed good discrimination of pain persistence cases from resolved pain cases (Area Under the Curve, AUC = 0.70). The discrimination power of other predictors (PPTs (AUC range = 0.51 to 0.59), radiographic OA (AUC = 0.62), age, sex and BMI (AUC range = 0.51 to 0.64), improved significantly (P < 0.05) when the central mechanisms trait was included in each logistic regression model (AUC range = 0.69 to 0.74). CONCLUSION: A simple summary self-report Central Mechanisms trait score may indicate a contribution of central mechanisms to poor knee pain prognosis

Experience of implementing and delivering group consultations in UK general practice: a qualitative study

BACKGROUND: Group consultations are a relatively new concept in UK primary care and are a suggested solution to current workload pressures in general practice. Little is known about the experience of implementing and delivering this approach from staff and organisational perspectives. AIM: To explore the experience of implementing and delivering group consultations in general practice. DESIGN AND SETTING: Qualitative telephone interview study. METHOD: Topic guides explored the perspectives and experiences of general practice staff on the implementation and delivery of group consultations. Data analysis adopted principles of the Framework Method underpinned by Normalisation Process Theory. RESULTS: Interviews were conducted with 8 GPs, 8 practice nurses, 1 nurse associate, 1 practice pharmacist, 1 deputy practice manager, and 1 healthcare assistant. Four themes were identified: sense making of group consultations; the work associated with initiating group consultations; the experiences of operationalising group consultations; and sustaining change. Group consultations made sense to participants as a mechanism to reduce burden on primary care, enhance multidisciplinary working, and provide patient-centred care. Implementation required strong leadership from a 'champion', and a facilitator had a pivotal role in operationalising the approach. The associated workload was often underestimated. Barriers to embedding change included achieving whole practice buy-in, competing practice priorities, and system-level flexibility. CONCLUSION: General practice clinicians enjoyed group consultations, yet significant work is required to initiate and sustain the approach. An implementation plan considering leadership, roles and responsibilities, and wider organisational support is required at the outset. Further research or evaluation is needed to measure process outcomes

Barriers and facilitators to the implementation of osteoarthritis management programmes in primary or community care settings: a systematic review and qualitative framework synthesis protocol.

Despite consistent international guidelines for osteoarthritis (OA) management, evidence-based treatments are underutilised. OA management programmes (OAMPs) are being implemented internationally to address this evidence-practice gap. An OAMP is defined as a 'model of evidence-based, non-surgical OA care that has been implemented in a real-world setting'. Our objective is to identify, synthesise and appraise qualitative research identifying anticipated or experienced micro (individual/behavioural), meso (organisational) or macro (context/system) level barriers or facilitators to the implementation of primary or community care-based OAMPs. Five electronic databases will be searched for papers published between 2010 and 2021. Qualitative or mixed-methods studies that include qualitative data on the anticipated or experienced barriers or facilitators to the implementation of primary or community care-based OAMPs, from the perspective of service users or service providers, will be included. The review will be reported using the PRISMA and ENTREQ guidelines. A data extraction form will be used to provide details of the included studies. Data will be analysed and identified barriers and facilitators will be mapped onto an appropriate implementation framework, such as the Theoretical Domains Framework. The appropriate JBI critical appraisal tools will be used to assess methodological quality, while the GRADE-CERQual approach will be used to assess confidence in the findings. Translation of evidence-based guidelines into practice is challenging and reliant on the quality of implementation. By comparing and contrasting anticipated and experienced barriers, this review will determine the extent of congruence between the two, and provide valuable insights into the views and experiences of key stakeholders involved in the implementation of OAMPs. The mapping of identified barriers and facilitators to behaviour change theory will enhance the applicability and construct validity of our findings and will offer significant utility for future development and implementation of OAMPs. Registration: This protocol was registered with PROSPERO (CRD42021255698) on 15/07/21

Surgery is better than nasal sprays for people with severely blocked airways caused by septal deviation

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. The study: Carrie S, O\u27Hara J, Fouweather T, et al. Clinical effectiveness of septoplasty versus medical management for nasal airways obstruction: multicentre, open label, randomised controlled trial. BMJ 2023;383:e075445. To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/surgery-is-better-than-nasal-sprays-for-people-with-severely-blocked-airways/

Embedding group consultations into practice: Perceptions of the general practice workforce

Group consultations are to be ‘championed’ to address growing concerns facing primary care general practice, but what are the barriers, facilitators and key roles required in setting up and delivering this model of care, according to the experiences of healthcare professionals

Implementation of physical activity interventions for people with inflammatory arthritis: an overview and future recommendations

Regular physical activity is important for both physical and mental health. This is particularly important for people with inflammatory arthritis, because of the benefits on both disease-specific and systemic outcomes and the increased risk of comorbidities such as cardiovascular disease. Despite a wealth of evidence supporting physical activity interventions, there remains a significant gap in implementation into routine care. This overview describes what implementation is, examines why it is important to consider implementation approaches to improve uptake of physical activity, highlights factors that influence successful implementation using exemplars from both osteoarthritis and inflammatory arthritis and recommends where future research is needed