Embedded or Modular? Preliminary Findings From a Study of Pre-Registration Nursing EBP Teaching Delivery Methods.

Aim: This study explores the impact of teaching delivery method (embedded vs. modular) on undergraduate pre-registration nursing students’ self-reported Evidence-Based Practice (EBP) implementation, attitudes, knowledge and skills. Background: For the past 20 years EBP has been increasingly emphasised as an effective approach and goal in healthcare. Although research has identified a number of barriers to its adoption and implementation, little research has focused on nurses’ pre-registration training; particularly on the impact of teaching delivery-method EBP throughout the learning process. Method: The study represents an on-going educational audit. Two cohorts of undergraduate nursing students were recruited for a longitudinal, cross-sectional survey study: cohort one (N=57, response rate= 90.1%) were being taught EBP modularly, but cohort two (N=88, response rate= 63.8%) had EBP embedded across their modules. Data was collected using the Evidence-Based Practice Questionnaire (EBPQ; Upton & Upton, 2006), administered at six-monthly intervals across the duration of students’ courses. Results: Preliminary analysis of students’ EBP 6-months into their courses identified no statistically significant differences between the cohorts on EBP Practice (U=2,138.00, Z=-0.13, p=.894). However, statistically significant differences between the two cohorts were identified on EBP attitudes (U=1, 852.00, Z=-2.43, p=.015; embedded group Md= 5.67, modular group Md=6.33) and Knowledge/skills (U=2,802.00, Z=3.68, p<.001; embedded group Md= 4.89, modular group Md=4.29). Conclusions: Although the project is still in its infancy, preliminary findings raise important questions about the relationship between EBP attitudes, practice and skill. The embedded cohort’s lower attitude scores may reflect social-desirability effects: modules dedicated to EBP may instil greater importance of displaying positive EBP attitudes. Embedding EBP may provide an effective means of developing students’ practice, knowledge and skills, without requiring dedicated modules (thereby reducing resource demands)

Increasing Primary School Children’s Fruit and Vegetable Consumption: a Review of the Food Dudes Programme.

Purpose: To evaluate the evidence base of the Food Dudes healthy eating programme, specifically the short and long term effectiveness of the intervention for: a) consumption of fruit and vegetables both at school and at home and b) displacement of unhealthy snack consumption. Design/methodology/approach: Articles were identified using Academic Search Complete, PsycARTICLES, Medline and PubMed databases for the period January 1995 to August 2013. Articles were included if they reported an empirical evaluation of the Food Dudes programme aimed at children aged between 4-11 years. Articles were included regardless of geographical location and publication type (i.e. published and ‘grey’ literature). Findings: Six articles were included for review. Findings indicated that the programme was moderately effective in the short-term; however the long-term effectiveness of the programme is unknown. The ability of the programme to generalise to the home setting and to displace unhealthy snack foods also requires further investigation. Originality/value: This is the first independent review of the Food Dudes programme. In light of the extensive roll out of the Food Dudes programme, an appraisal of the evidence surrounding the programme is timely. The review highlights that sustaining fruit and vegetable intake cannot be achieved through behaviour-based interventions alone and the long term maintenance of fruit and vegetable consumption requires more than the implementation of an intervention found to be effective in a controlled research environment

Regional Evaluation of Weight Management Programmes for Children and Adults. Commissioned by the Department of Health West Midlands

In response to the increasing prevalence of obesity in children and adolescents, numerous interventions with the potential to reduce obesity levels or associated risk of chronic diseases in children and youths have been implemented across the UK, including the West Midlands. However, few of these interventions have been systematically evaluated and consequently, there is a need to examine their effectiveness. This report outlines an evaluation of seven child weight management programmes that were in place in the West Midlands region during July 2007-July 2009

Family-based Childhood Obesity Interventions in the UK: a Systematic Review of Published Studies.

Family-based programmes that emphasise lifestyle and behaviour change using psychological principles have been shown to be effective in targeting childhood obesity. While there is some evidence that evaluates UK family-based obesity interventions at a local level, no review to date has addressed this nationally. This review presents the available evidence from UK family-based childhood obesity interventions. Ten articles that met the inclusion criteria were included for review. The majority of programmes reviewed lasted 12 weeks, with only three studies providing follow-up data at 12 months or longer. Change in adiposity may be a short-term benefit of participation in a child weight management programme, but there is insufficient robust evidence to indicate that this benefit is long lasting and many studies were methodologically weak with limited internal validity. There is insufficient evidence to suggest how the inclusion of parents and the wider family may impact on the effectiveness of UK community based weight management programme for children and young people

A Preliminary Investigation of Child, Parent and Programme Leader Reflections on Participation in and Delivery of a Family- Based Weight Intervention Programme.

Childhood obesity is considered to be the greatest public health risk to children today, placing young people at considerable risk for adult obesity and consequent CVD, diabetes, liver dysfunction, and other morbidities (Doro-Altan et al., 2008; Singh et al., 2008). As a result numerous interventions with the potential to reduce obesity levels or associated risk of chronic diseases have been devised (Steinberger et al., 2003; Flynn et al., 2006). Not withstanding the need for further quantitative evaluation of the effect of such interventions, key publications have now called for qualitative evaluations to be undertaken in order to create an evidence base from the views of participants that may highlight why certain interventions may be more, or less successful (National Institute for Health and Clinical Excellence, 2006; Luttikhuis et al., 2009). In response to these very recent calls, this abstract intends to present, from qualitative methods of enquiry, preliminary findings of parent, child and programme leader experiences of, reflections on and future intentions following participation in and delivery of a nationally implemented family-based weight intervention programme in the UK. Data from semi-structured interviews with 6 families who completed the programme in December 2008 and 1 programme leader will be presented. Informal thematic analysis will be utilised to identify emergent themes with data presentation accentuating the qualitative, ‘lived’ experience of the programme and the impact of the various aspects of the intervention on intentions for future behaviours. It is anticipated that the outcomes of this study will help to inform the organisation, content, implementation and nature of future intervention programmes in order to enhance their effectiveness

Phase 1 Evaluation of Lothian’s Nursing, Midwifery and Allied Health Professions (NMAHP) Clinical Academic Research Careers (CARC) Scheme.

The Clinical Academic Research Careers (CARC) Scheme for Nurses, Midwives and Allied Health Professionals (NMAHPs) in Lothian was launched in 2010, as part of the NHS Lothian NMAHP Research Framework. It is funded and managed by a partnership between NHS Lothian, NHS Education for Scotland (NES), University of Edinburgh, Edinburgh Napier University and Queen Margaret University. Aim: To assess the processes involved in setting up and managing the scheme and progress and achievements to date. Method: A mixed method approach was used which included a document review; a questionnaire completed by four post-holders; a questionnaire sent to R&D and NMAHP Directors across NHS Scotland (43% response rate); and semi-structured interviews with key stakeholders. A total of 27 interviews were conducted with post-holders (4); steering group members (8); management group members (6); demonstration site staff (8) and one external stakeholder. Results: Outcome measures Two demonstration sites had been funded to date, with progress being made in terms of conducting research studies, applying for additional research funding, dissemination and training. It was considered to be too early to have achieved any measurable impact on practice. At NMAHPs Director level, there is limited awareness of Clinical Academic Career schemes across NHS Scotland or of the NHS Lothian CARC Scheme. Post holder views Post-holders felt well supported by academic and clinical staff, and they welcomed having dedicated time to conduct research, along with opportunities for research training and personal development. Working under the ‘CARC’ identity was seen to be valuable. However, the degree of integration between the clinical and research roles was sometimes less than expected. Challenges faced included managing time between clinical and academic roles; negotiating the different systems of the partner organisations; securing backfill for their clinical role; and having limited influence on the direction of research. Stakeholder views There was overall support for the CARC scheme, with on-going commitment to the programme from all strategic leads. The Scheme facilitated stronger relationships between partner organisations, supported research focused on practice development, and provided a basis upon which to build clinical academic pathways for NMAHPs and support further research capacity and capability. There was some frustration at the length of time it had taken to get the scheme operational, and aligning the priorities of the academic partners with NHS Lothian in some areas. Selection of post-holders had been a challenge, with a limited pool of suitably qualified NMAHPs within Lothian; it was recognised that more flexible approach to recruitment, along with a rigorous selection process, would attract the best candidates to the CARC posts. However, the Scheme has demonstrated enough flexibility within the model for it to be applied in different settings. Considerations for Future Development: Sustainability was seen to be a significant risk to the scheme, in terms of maintaining activity and building on the achievements made to date. Suggested considerations for future development included: • Agreeing a plan of sustainability including identification of potential new CARC sites; • Wider publicity, and dissemination of achievements and lessons learnt; • More flexibility in recruitment, including wider advertisement of CARC posts within NHS Lothian, and elsewhere; • Greater alignment with other elements of the clinical academic career pathway and integrating with other degree options; • Simplifying administrative processes, for example by facilitating the adoption of the CARC model in other clinical areas. Further evaluation, at the end of the current funding period will be useful to assess achievements against outcome measures