Exploring the impact on the health and well-being of young adults’ participation in ‘the club’

This study explores the impact of creative arts on the health and well-being of six selected young adults who participated in productions at a performance and entertainment venture (‘The Club’). The qualitative design incorporates in-depth interviews with performers and producers to uncover their stories and experiences, from which key themes are drawn. The study uncovers a number of physical, mental and psychosocial benefits, including empowerment, the learning of new skills, creating and maintaining positive relationships, enhanced confidence and resilience, opportunities for self-expression, and engagement in meaningful activities. Challenges to well-being are also elicited regarding the sometimes negative impact of creative roles on health and well-being. The findings align with evidence from previous studies about the benefits of creative arts in terms of health and well-being promotion. Suggestions for community-based interventions incorporating creative arts are made, including the need for further research in this area

Understanding factors behind the late testing and diagnoses of HIV: a review of the international literature

Late diagnosis of HIV results in increased morbidity and mortality and raises the potential for onward transmission to others. It also increases costs to health service providers and impacts on national health budgets. This paper reports results from a literature review conducted to inform the conduct of an international study investigating barriers to early HIV testing from the perspectives of both patients and healthcare professionals. The literature suggests that reasons for late presentation include demographic factors such as age, sex and ethnicity; fear and stigma associated with an HIV diagnosis; and individual risk appraisal, as well as structural and organisational barriers within the healthcare system. Other key issues highlighted by the literature review include the fact that: the number of people living with HIV is increasing year on year, the proportion of people presenting with a late HIV diagnosis is increasing not only in MSMs but also in other less recognised groups such as heterosexual women and in particular, older heterosexual men and women. Reasons for late presentation and diagnosis are multifactorial, but further research into the issue of late presentation and diagnosis of HIV is required, including the exploration of reasons why people continue to present late. The review indicated that further work to raise public awareness of the benefits of early testing, together with improved education and training for healthcare professionals is vital to improve the uptake and timeliness of HIV testing

Further evidence that singing fosters mental health and wellbeing: The West Kent and Medway project

Purpose: Clift and Morrison (2011) report that weekly singing over eight months for people with enduring mental health issues led to clinically important reductions in mental distress. The present study tested the robustness of the earlier findings. Design: Four community singing groups for people with mental health issues ran weekly from November 2014 to the end of 2015. Evaluation place over a six-month period using two validated questionnaires: the short Clinical Outcomes in Routine Evaluation questionnaire (CORE-10), and the Warwick Edinburgh Mental Wellbeing Scale (WEMWBS). Findings: Twenty-six participants completed baseline and follow-up questionnaires. CORE-10 scores were significantly reduced, and WEMWBS scores significantly increased. Comparisons with the earlier study found a similar pattern of improvements on CORE items that are part of the 'problems' sub-scale in the full CORE questionnaire. There was also evidence from both studies of participants showing clinically important improvements in CORE-10 scores. Research limitations: The main limitations of the study are a small sample size, and the lack of a randomised control group. Originality: No attempts have been made previously to directly test the transferability of a singing for health model to a new geographical area and evaluate outcomes using the same validated measure

Barriers preventing early testing and diagnosis of HIV: results of a five-year retrospective review of clinical data for those diagnosed HIV positive in two European regions

Background: Late diagnosis of HIV is detrimental to patients, resulting in increased morbidity, mortality, and increased potential for onward transmission. The prevalence of HIV in both the UK and France continues to rise, particularly in ‘non-traditional’ groups such a heterosexuals and older people, yet at least 20% of those infected with HIV do not know their status and are capable of transmitting the virus to others according to European Center for Disease Control/WHO data. Methods: A five-year retrospective review of demographic and clinical data was conducted for every patient diagnosed with HIV (n=406) in two European regions, Kent and Medway in the UK, and Amiens and Creil in France to identify common barriers preventing people from seeking an early HIV test. Results: Findings showed similarities between the two countries in relation to those most likely to present late. Heterosexuals formed the largest group of patients and were more likely to present late, as were migrants or other minority ethnic community members. Gay and bisexual men were likely to seek testing more frequently and had higher rates of early diagnosis than other groups. The two French regions performed better than the UK in respect of early diagnosis in all groups, though still not matching the performance of other French regions. Conclusions: In spite of recent improvements in HIV treatment, it is necessary to educate more white and minority ethnic heterosexuals about the benefits of early HIV testing so that the number of late diagnoses and complications associated with these can be reduced. The study suggests that there is a need to develop specific health promotion and education interventions targeted at these groups, as well as healthcare professionals who continue to attribute signs and symptoms of HIV infection to non-HIV causes

Arts and creative activities for mental wellbeing during Covid-19 lockdown: report of a survey of university staff

Purpose: There is evidence that the recent Covid-19 pandemic has led to an increase in stress in the UK workforce. Research also suggests that engaging in arts and creative activities may alleviate stress. The purpose was to explore how this might relate to staff at Canterbury Christ Church University, and specifically: 1) to identify the overall extent of uptake and popularity of different arts activities; 2) to assess how this compares with pre-Covid levels of engagement and; 3) to identify how engagement with activities may serve to mitigate any adverse effects of the pandemic and beyond. Design: The two-stage design comprised an online questionnaire, followed by in-depth interviews with a sub-sample of respondents. Findings: 178 individuals responded to the questionnaire, and 12 individuals were interviewed. Receptive arts engagement featured more frequently than participatory arts. 46.6% respondents reported more engagement during lockdown than before. The most frequently reported benefits related to the ability to disengage from the negative concerns of lockdown. Interview data identified four themes: creativity for wellbeing; connecting and contributing; pandemic as opportunity; and reflecting the times. Originality: Little previous research has been conducted on the impacts of the arts specifically on university staff during Covid, particularly research including non-academic staff

Training Needs and Development of Online AT Training for Healthcare Professionals in UK and France

Background: Assistive Technology (AT) solutions for people with disabilities has become part of mainstream care provision. Despite advantages of AT on offer, abandonment and non-compliance are challenges for healthcare professionals (HCPs), introducing this technology to clients. Studies of abandonment reveal that 1/3 of all devices provided to service users end up stored unused. Key need is training to make informed decisions about AT tailored to individual needs and circumstances. In an online survey undertaken by the ADAPT project, HPCs identified AT training needs and barriers. Currently, a programme is being developed aimed at introducing AT concepts and enhancing practices to a wide range of HCPs. Method: Survey questions explored gaps, availability, qualifications and barriers to AT training in England and France. A series of consultation meetings with ADAPT partners took place. An advisory group consisting of longstanding AT users and their formal/informal carers and HCPs (occupational therapist, speech and language therapist, psychologist and biomedical engineer) contributed to the discussions on survey findings, development and evaluation of AT training for HCPs, key content areas and means of delivery. Key results: HCPs had no AT specific qualifications (UK 94.6%; FR 81.3%) nor in-service AT training (UK 65.1%; FR 66.4%). They either did not know of AT courses (UK 63.3%) or knew that none existed (FR 72.5%). Barriers to AT training were mainly local training (UK 62.7%, FR 50%) and funding (UK 62.7%, FR 55.7%). Some training priorities were clearer for French HCPs – overall knowledge of AT devices (82.1%, UK 45.8%), customization of AT (65.3%, UK 30.1%), assessing patient holistically (53.4%, UK 25.3%), educating patient/carers (56.5%, UK 28.3%) (p < 0.001). Variances may be due to differing country-specific HCP education approach. A third of both groups highlighted also abandonment, client follow-up, powered wheelchair training and prescribing AT. To bridge gaps in knowledge and identified training needs of HCPs, the online interactive training programme starts by introducing foundations of AT, including definitions, types/uses of AT, legislation/policies and AT in practice. More specialist units build and expand on specific areas, e.g. AT for mobility, communication, assessment and evidence-based practice. The biopsychosocial model of Health and World Health Organisation’s (WHO) International Classification of Functioning, Disability and Health (ICF) framework underpin development of content. ICF shifts focus from disability to health and functioning, in line with a social model of rehabilitation. E-learning comprises existing videos, AT textbook material and bespoke animated presentations. Selfassessment and evaluation of training are embedded and learners receive certificate of completion. Training was piloted to a group of HCPs trainees and postregistration HCPs who commented on relevance of AT content, clarity, accessibility of presentation, and usefulness. Users found training very useful, especially legislation/policies and AT literature. Conclusion: Overall, survey results suggest that both UK and French HCPs’ training on AT solutions is limited and highly variable. There is need for crosschannel AT professional competencies, availability of work-based training and funding support. Development of online, interactive training aims to increase professional confidence and competence in this area as well as the evidence base for AT

A Literature Review of the Challenges Encountered in the Adoption of Assistive Technology (AT) and Training of Healthcare Professionals

Background: Long-term disabilities often result in loss of autonomy and social interaction. Accordingly, there is a demand for Assistive Technology (AT) devices to enable individuals to live independently for as long as possible. However, many people experience difficulties in obtaining and using AT. This paper presents findings from a narrative literature review undertaken as part of the development of AT training for healthcare professionals, one of the work areas of the ADAPT project (Assistive Devices for Empowering Disabled People through Robotic Technologies), funded by EU INTERREG France (Channel) England. The results of the review informed the design of a survey of healthcare professionals regarding their views and experiences of AT and the development of AT training. Method: The review sought to understand challenges encountered in the adoption and use of AT as well as how training of healthcare professionals in AT takes place. A narrative approach was adopted as the most appropriate way to synthesise published literature on this topic and describe its current state-of-art. Narrative reviews are considered an important educational tool in continuing professional development. An initial search was conducted via databases in the UK and France, including CINAHL, Academic Search Index, Social Sciences Citation Index, BDSP (Base de données en Santé Publique), Documentation EHESP/MSSH (Ecole des Hautes Etudes en Santé Publique/Maison des Sciences Sociales et Handicap), Cairn, Google Scholar and Pubmed. Inclusion criteria for the review included: covering issues relating to AT provision and training, English or French language, and published from 1990 onwards. Application of these criteria elicited 79 sources, including journal papers (48), reports (11), online sources (11), books (6) and conference papers (3). Sources were thematically analysed to draw out key themes. Key results: The majority of papers were from USA and Canada (27), then UK (20) and France (19). Others were from Europe (7), Australia (3), country unknown (2), and one joint UK/France publication. The main source of literature was journal papers (48), of which the most common types were practice reports (18), evaluation surveys (10) and qualitative studies (9). The review uncovered a number of key challenges related to the adoption of devices, including: difficulty defining AT across disciplines, lack of knowledge of healthcare professionals and users, obtrusiveness and stigmatisation AT users can experience when using devices, and shortfalls in communication amongst professional groups and between professionals and users. These issues can lead to abandonment of AT devices. Furthermore, substantial barriers to healthcare professionals exist, including inconsistent provision and quality of training, lack of evaluation of training, lack of resources and funding, shortage of qualified professionals to teach, and the increasingly rapid development of the technologies. Conclusion: Support, training and education for prescribers, distributors, users, and their carers is vital in the adoption and use of AT. Evidence indicates a need for comprehensive education in the AT field, as well as ongoing assessment, updates and evaluation which is embedded in programmes

A Survey of Assistive Technology (AT) Knowledge and Experiences of Healthcare Professionals in the UK and France: Challenges and Opportunities for Workforce Development

Background: Assistive Technologies (AT) in healthcare can increase independence and quality of life for users. Concurrently, new AT devices offer opportunities for individualised care solutions. Nonetheless, AT remains under-utilised and is poorly integrated in practice by healthcare professionals (HCPs). Although occupational therapists (OTs), physiotherapists and speech and language therapists (SLTs) consider that AT solutions can offer problem-solving approaches to personalised care, they have a lesser understanding of application of AT in their practice. In this paper, we report findings of a survey on AT knowledge and experiences of HCPs in UK and France. Training needs also explored in the survey are presented in a separate paper on development of online training for the ADAPT project. Method: A survey of 37 closed/open questions was developed in English and French by a team of healthcare researchers. Content was informed by published surveys and studies. Email invitations were circulated to contacts in Health Trusts in UK and France ADAPT regions and the survey was hosted on an online platform. Knowledge questions addressed AT understanding and views of impact on user’s lives. Experience questions focussed on current practices, prescription, follow-up, abandonment and practice standards. 429 HCPs completed the survey (UK = 167; FR = 262) between June and November 2018. Key results: Participants were mainly female (UK 89.2%; FR 82.8%) and qualified 10+ years (UK 66.5%; FR 62.2%). A key group in both countries were OTs (UK 34.1%; FR 46.6%), with more physiotherapists and SLTs in UK (16.8%, 16.8%; vs. FR 6.5%, 2.3%), and more nurses in France (22.1% Vs. UK 10.8%). More HCPs were qualified to degree level in France (75.2%; UK 48.5%, p < 0.001). In terms of knowledge, all HCPs agreed that AT helps people complete otherwise difficult or impossible tasks (UK 86.2%; FR 94.3%) and that successful AT adoption always depends on support from carers, family and professionals (UK 52.7%; FR 66.2%). There were some notable differences between countries that require further exploration. For example, more French HCPs thought that AT is provided by trial and error (84.7%, UK 45.5%, p < 0.001), while more UK HCPs believed that AT promotes autonomous living (93.4%; FR 42.8%, p < 0.001). Also, more French HCPs considered that AT refers exclusively to technologically advanced electronic devices (71.8%, UK 28.8%, p <0.001). In both countries, top AT prescribers were OTs, physiotherapists and SLTs. Respondents had little/no knowledge in comparing/choosing AT (UK 86.8%; FR 76.7%) and stated they would benefit from interdisciplinary clinical standards (UK 80.8%; FR 77.1%). A third of HCPs did not know if AT users had access to adequate resources/support (UK 34.1%; FR 27.5%) and rated themselves as capable to monitor continued effective use of AT (UK 38.9%; FR 34.8%). Conclusion: Knowledge and application of AT was varied between the two countries due to differences in health care provision and support mechanisms. Survey findings suggest that HCPs recognised the value of AT for users’ improved care, but had low confidence in their ability to choose appropriate AT solutions and monitor continued use, and would welcome AT interdisciplinary clinical standards

A qualitative evaluation of psychosocial outcomes of the Creative Communications pilot project for people with dementia

This evaluation was designed in order to explore the impact of the Creative Communications pilot programme (a six week programme of person-centred dance, movement and visual arts) on participants at a care home. Timed observations of the sessions were conducted as well as semi-structured interviews with care home staff and the project facilitators. Through the use of observation scales, a number of outcomes were assessed including commitment, creative expression, embodiment, verbal and non-verbal communication, wellbeing and satisfaction. The interviews assisted in exploring from the professionals’ and facilitators’ perspective the impact of the project in these domains as well as exploring further key themes regarding the experiences of those involved in the programme in terms of quality of life and other related factors.The evaluation demonstrated that Creative Communications sessions provided physical, psychological and social benefits to the participants, including the opportunity to participate in meaningful activities; behavioural improvements; increased mobility, social interaction, confidence, self-esteem, mood and concentration; increased skills; and higher levels of wellbeing. These findings confirm evidence from previous studies about the benefits of non-pharmacological methods in the care of people with dementia.Recommendations include ensuring further collaborative work between artists and care homes takes place; the involvement of care home staff and relatives of residents in future sessions; consultation with participants prior to and throughout the intervention; and encouragement of commissioners to consider supporting arts for health projects involving older people, which incorporate comprehensive evaluations

Evaluation of the totally touchable arts intervention project for sight impaired adults

This evaluation was designed in order to explore the impact of a person-centred intervention project of tactile art for sight impaired adults on their health and wellbeing. ‘Totally Touchable’ was instigated and delivered by an artist facilitator with specialist experience in working with blind and sight impaired participants, and overseen by a project coordinator. The project incorporated 14 artist-led sessions which took place over an eight week period in September and October 2015 and a final exhibition of the work produced followed the project delivery.Questionnaires incorporating a wellbeing scale (‘WEMWBS’) were administered to participants at three time points during the project – beginning, mid-point and end. Total scores were collated and statistically analysed. Additionally, interviews were conducted with participants, facilitators and volunteers involved in the Totally Touchable project to elicit key themes regarding their experiences of the programme in terms of its impact on their health and wellbeing.Findings from the evaluation indicate that WEMWBS (wellbeing) scores of participants increased during the life of the programme, and that clear psychological and social benefits were experienced, including social bonding, broadening horizons, enhanced mental health, increased empowerment and confidence and raised awareness of individuals with sight impairments.Recommendations include the development and dissemination of a toolkit to assist those introduction similar interventions and exhibitions to ensure accessibility for sight impaired people and how to attract and inspire people to take part in arts activities; ensuring the venues for such projects are fit for purpose and that sessions are of an appropriate length; ensuring that the level of staffing/resources is adequate, to include support for the artist facilitator including practical assistance and potentially a mental health practitioner to support both the group members and facilitator. In addition, further research and evaluation is required in the area of the impact on the facilitator as well as on participants, and encouragement of commissioners is required to consider supporting arts for health projects for people who are sight impaired, and these projects should be longer-term, delivered to a wider population and incorporate comprehensive evaluations