Black and minority ethnic trainees’ experiences of physical education initial teacher training

The official published version can be accessed at the link below.This report draws together the findings of research that aimed to explore black and minority ethnic (BME) trainees’ experiences of Physical Education (PE) initial teacher training (ITT). Although the numbers of BME trainees opting to enter teaching have improved considerably over the last few years, PE remains one of three specific subject areas where they remain significantly under-represented. Current figures suggest that PE attracts approximately 3% of trainees from BME backgrounds, compared with 11% for new entrants into teaching overall. The relative lack of success in attracting BME trainees into PE teaching compared to other subject areas suggests that the subculture of the subject may be a compounding factor. Over the last decade or so, a number of studies have explored the impact of ethnicity on teachers’ professional socialisation and their experiences as teachers in school, but none have focused on experiences within specific subject cultures. The centrality of the body in PE, and the link between this and the perceived low status of the subject, are influencing factors highlighted in the broader literature, including sports studies. For example, research exploring racism and the under-representation of BME participants in sport has highlighted the prevalence of stereotypical attitudes about their physicality and abilities held by coaches, administrators and spectators. Other research has suggested that some minority ethnic groups favour higher status, better paid, careers in areas such as law or medicine rather than teaching. As yet, there has been little attention to ‘race’ and ethnicity within PEITT, although studies have shown the impact of gender on trainees’ developing professional identities, and how teachers’ gendered bodies are important ‘tools’ of their work. In addition, there has been little research that has acknowledged trainees’ multiple identities, or the complex ways in which ‘race’, ethnicity, class and gender and other identity markers intersect to impact on the professional socialisation process. The research on which this report is based sought to fill some of these gaps in our understandings of BME trainees’ experiences of PEITT, and to identify strategies that might help in their recruitment and retention in the longer term. The research was funded through a small Recruitment and Retention Challenge Grant from the Teacher Development Agency (TDA). These grants form part of the TDA’s wider policy agenda to widen the diversity of new intakes opting into teaching. Higher education institutions have been encouraged, through targets and financial support and incentives, to develop specific strategies aimed at widening the diversity of their cohorts. Examples of such strategies include the provision of specialist admission help for BME prospective trainees; opportunities to gain experience in schools; open days and ‘taster’ events; advertising in the ethnic minority media, and the development of good practice guides and staff training to help ITT providers address issues of ‘race’ and ethnicity. 5 The impetus for this research resulted, in part, from presentations and discussions at a one day PEITT Network1 staff seminar on diversity held in October, 2007. The quantitative research conducted by the Association for Physical Education (AfPE) and the Ethnic Minority Foundation (EMF) presented here, showed the extent of the national under-representation of BME students in PEITT. Although the day focused on addressing reasons for BME under representation and strategies that might be used for improving recruitment, we felt it was also important to learn about the qualitative experiences of trainees that have been attracted into PEITT. Understanding the experiences of our current BME trainees might offer useful insights into how we might recruit and retain future such trainees. Our choice of qualitative research was supported by a national study published shortly after the network day, investigating the links between gender, ethnicity and degree attainment (Higher Education Academy, HEA, 2008), which specifically calls for further qualitative studies of students’ experiences of different subject areas.Funding from the Training and Development Agency (TDA

A mixed-methods pilot study of the acceptability and effectiveness of a brief meditation and mindfulness intervention for people with diabetes and coronary heart disease.

PublishedClinical TrialJournal ArticleResearch Support, Non-U.S. Gov'tMindfulness-based interventions can successfully target negative perseverative cognitions such as worry and thought suppression, but their acceptability and effectiveness in people with long-term conditions is uncertain. We therefore pilot tested a six-week meditation and mindfulness intervention in people (n = 40) with diabetes mellitus and coronary heart disease. We used a sequential mixed-methods approach that measured change in worry and thought suppression and qualitatively explored acceptability, feasibility, and user experience with a focus group (n = 11) and in-depth interviews (n = 16). The intervention was highly acceptable, with 90% completing ≥5 sessions. Meditation and mindfulness skills led to improved sleep, greater relaxation, and more-accepting approaches to illness and illness experience. At the end of the six-week meditation course, worry, and thought suppression were significantly reduced. Positive impacts of mindfulness-based interventions on psychological health may relate to acquisition and development of meta-cognitive skills but this needs experimental confirmation.NIHR Collaboration for Leadership in Applied Health Research and Care forGreater Manchester

What maximizes the effectiveness and implementation of technology-based interventions to support healthcare professional practice? A systematic literature review

Background Technological support may be crucial in optimizing healthcare professional practice and improving patient outcomes. A focus on electronic health records has left other technological supports relatively neglected. Additionally, there has been no comparison between different types of technology-based interventions, and the importance of delivery setting on the implementation of technology-based interventions to change professional practice. Consequently, there is a need to synthesise and examine intervention characteristics using a methodology suited to identifying important features of effective interventions, and the barriers and facilitators to implementation. Three aims were addressed: to identify interventions with a technological component that are successful at changing professional practice, to determine if and how such interventions are theory-based, and to examine barriers and facilitators to successful implementation. Methods A literature review informed by realist review methods was conducted involving a systematic search of studies reporting either: (1) behavior change interventions that included technology to support professional practice change; or (2) barriers and facilitators to implementation of technological interventions. Extracted data was quantitative and qualitative, and included setting, target professionals, and use of Behaviour Change Techniques (BCTs). The primary outcome was a change in professional practice. A thematic analysis was conducted on studies reporting barriers and facilitators of implementation. Results Sixty-nine studies met the inclusion criteria; 48 (27 randomized controlled trials) reported behavior change interventions and 21 reported practicalities of implementation. The most successful technological intervention was decision support providing healthcare professionals with knowledge and/or person-specific information to assist with patient management. Successful technologies were more likely to operationalise BCTs, particularly “instruction on how to perform the behavior”. Facilitators of implementation included aligning studies with organisational initiatives, ensuring senior peer endorsement, and integration into clinical workload. Barriers included organisational challenges, and design, content and technical issues of technology-based interventions. Conclusions Technological interventions must focus on providing decision support for clinical practice using recognized behavior change techniques. Interventions must consider organizational context, clinical workload, and have clearly defined benefits for improving practice and patient outcomes

A Technological Innovation to Reduce Prescribing Errors Based on Implementation Intentions: The Acceptability and Feasibility of MyPrescribe

Background: Although prescribing of medication in hospitals is rarely an error-free process, prescribers receive little feedback on their mistakes and ways to change future practices. Audit and feedback interventions may be an effective approach to modifying the clinical practice of health professionals, but these may pose logistical challenges when used in hospitals. Moreover, such interventions are often labor intensive. Consequently, there is a need to develop effective and innovative interventions to overcome these challenges and to improve the delivery of feedback on prescribing. Implementation intentions, which have been shown to be effective in changing behavior, link critical situations with an appropriate response; however, these have rarely been used in the context of improving prescribing practices. Objective: Semistructured qualitative interviews were conducted to evaluate the acceptability and feasibility of providing feedback on prescribing errors via MyPrescribe, a mobile-compatible website informed by implementation intentions. Methods: Data relating to 200 prescribing errors made by 52 junior doctors were collected by 11 hospital pharmacists. These errors were populated into MyPrescribe, where prescribers were able to construct their own personalized action plans. Qualitative interviews with a subsample of 15 junior doctors were used to explore issues regarding feasibility and acceptability of MyPrescribe and their experiences of using implementation intentions to construct prescribing action plans. Framework analysis was used to identify prominent themes, with findings mapped to the behavioral components of the COM-B model (capability, opportunity, motivation, and behavior) to inform the development of future interventions. Results: MyPrescribe was perceived to be effective in providing opportunities for critical reflection on prescribing errors and to complement existing training (such as junior doctors’ e-portfolio). The participants were able to provide examples of how they would use “If-Then” plans for patient management. Technology, as opposed to other methods of learning (eg, traditional “paper based” learning), was seen as a positive advancement for continued learning. Conclusions: MyPrescribe was perceived as an acceptable and feasible learning tool for changing prescribing practices, with participants suggesting that it would make an important addition to medical prescribers’ training in reflective practice. MyPrescribe is a novel theory-based technological innovation that provides the platform for doctors to create personalized implementation intentions. Applying the COM-B model allows for a more detailed understanding of the perceived mechanisms behind prescribing practices and the ways in which interventions aimed at changing professional practice can be implemented

What are the environmental factors that affect implementation of the Manchester Healthy Schools programme? A qualitative exploration of staff perspectives

Objectives: Primary/elementary schools are crucial settings for early weight management interventions but effects on children’s weight are small. This may be because the environments in which these schools are situated support unhealthy behaviours that lead to weight gain (obesogenic environments). Staff working in schools have a unique insight into the environmental factors that might affect their efforts to support child health and weight management interventions. The aim of this study is to explore the views of staff in relation to the perceived effects of the environmental context in which they deliver a child health promotion intervention. Methods: Staff from five schools involved in delivering the Manchester Healthy Schools programme were interviewed (N=19). These interviews were transcribed verbatim and analysed thematically. Results: Three themes were produced: opportunities to be healthy; importance of funding, resources and governance; and resources available to households and neighbourhoods. Conclusion: The views of school staff were consistent with themes identified in other relevant literature. Although there were serendipitous opportunities to capitalise on local resources, such as using nearby land and leisure facilities for outdoor physical activities, many barriers relating to local environmental and resource features were reported. Joined up, multi-agency solutions such as place-based approaches might be able to offer schools some resource-based support; however, more research is needed to establish the best way to achieve the best outcomes for children

Does message framing affect changes in behavioural intentions in people with psoriasis? A randomized exploratory study examining health risk communication

Message framing is important in health communication research to encourage behaviour change. Psoriasis, a long-term inflammatory skin condition, has additional comorbidities including high levels of anxiety and cardiovascular disease (CVD), making message framing particularly important. This experimental study aimed to: (1) identify whether health messages about psoriasis presented as either gain- or loss-framed were more effective for prompting changes in behavioural intentions (BI), (2) examine whether BI were driven by a desire to improve psoriasis or reduce CVD risk; (3) examine emotional reactions to message frame; and (4) examine predictors of BI. A two by two experiment examined the effects on BI of message frame (loss vs. gain) and message focus (psoriasis symptom reduction vs. CVD risk reduction). Participants with psoriasis (n = 217) were randomly allocated to one of four evidence-based health messages related to either smoking, alcohol, diet or physical activity, using an online questionnaire. BI was the primary outcome. Analysis of variance tests and hierarchical multiple regression analyses were conducted. A significant frame by focus interaction was found for BI to reduce alcohol intake (p = .023); loss-framed messages were more effective for CVD risk reduction information, whilst gain-framed messages were more effective for psoriasis symptom reduction information. Message framing effects were not found for BI for increased physical activity and improving diet. High CVD risk was a significant predictor of increased BI for both alcohol reduction (β = .290, p < .01) and increased physical activity (β = −.231, p < .001). Message framing may be an important factor to consider depending on the health benefit emphasised (disease symptom reduction or CVD risk reduction) and patient-stated priorities. Condition-specific health messages in psoriasis populations may increase the likelihood of message effectiveness for alcohol reduction