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A Stop Smoking in Schools Trial: A process evaluation of the implementation of ASSIST in Scotland

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In 2014 the Institute for Social Marketing and a team of collaborators were appointed to conduct a process evaluation of ASSIST (A Stop Smoking in Schools Trial). ASSIST is a peer-led, school-based smoking prevention programme that encourages the dissemination of non-smoking norms by training students aged 12-14 to work as peer supporters. ASSIST was previously evaluated via a large cluster randomised trial of 59 schools in South Wales and Avon, England. Results from this trial showed that ASSIST was effective and cost effective at reducing smoking prevalence in young people (Campbell et al 2008), (Hollingworth et al 2012). This led to the wider roll out of ASSIST in parts of England and Wales and more recently in Scotland.

The overall aim of the study was to evaluate the process of implementing ASSIST in Scotland.

Three different delivery models were piloted in three NHS boards. This did not impact on fidelity or acceptability which was rated highly. Partnership working, from the onset, was viewed as being key to successful delivery and securing school participation. Feedback was overwhelmingly positive regarding the wider benefits of taking part in ASSIST for peer supporters (i.e. personal and communication skills) but also for the school and communities. There was less certainty regarding the extent of message diffusion and the impact this may have an adolescence smoking prevalence. Student survey results showed no significant change in self-reported smoking prevalence between baseline (1.6%) and follow-up (1.8%) and conversation recall with a peer supporter was low at 9%.

However, it is important that the current context (where regular smoking prevalence is 2% overall in 13 year olds in Scotland (SALSUS, 2015 http://www.gov.scot/Resource/0050/00508401.pdf) is taken into account. Opportunities to have informal conversations about smoking with peers may now be limited due to the ongoing decline in adolescent smoking since ASSIST was first developed. In addition, the data collection mode was a self-complete survey, so there is a possibility that by follow-up (12 weeks after baseline) young people may simply not remember conversation(s) with a peer supporter or may not have known that they had spoken with a peer supporter.

Overall, this study has demonstrated that it is feasible and acceptable to deliver the ASSIST programme in Scottish schools, although questions remain about the extent of message diffusion. Further consideration is required to assess whether delivery of ASSIST still offers a suitable return on investment and what role it may play in schools in areas of deprivation where smoking rates are higher. Now may be the time to consider whether, 13 years on from the original Randomised Control Trial, an implementation trial of ASSIST is warranted to determine if it is still effective and cost effective.

For more information see:  http://www.gov.scot/Publications/2017/03/6523 or contact fiona.dobbie@stir.ac.uk

Fiona Dobbie
24 March 2017

Photo Copyright: tum2282 / 123RF Stock Photo

Mythbusting guide to Down’s syndrome and dementia

Dr Karen Watchman has blogged for the Alzheimer Society:

“People with Down’s syndrome are at an increased risk of dementia. Dr Karen Watchman is a researcher, based at the University of Stirling, who specialises in understanding how to help people with learning disabilities to manage their dementia. For World Down’s Syndrome Day (March 21), Dr Watchman discusses myths around Down’s syndrome and how research can help people with both Down’s Syndrome and dementia.”

Read the full article here.

21 March 2017

Is my PhD my midlife crisis? Fiona Dobbie writes in THE

FionaDobbie_afCZNbo6_400x400Fiona Dobbie, Research Fellow in the Institute of Social Marketing has blogged in the Times Higher Education:

“I turned 40 this year, and rather than indulge in the clichéd symptoms of a mid-life crisis (getting a tattoo, having an affair, Botox) I am in my second year of a part-time PhD.

“It’s not that my life isn’t fulfilling or challenging enough. I am typical of my age: happily married with an energetic 6-year-old, fortunate to have friends and family and a full-time job as a university research fellow. So why am I doing a part-time PhD?”

Click here for the full article, published 12 March 2017.

 

How Stirling research is fighting cancer | World Cancer Day

Saturday 4th February 2017 is World Cancer Day – a day where the world comes together in unity in the fight against cancer. Here’s how Stirling research is helping to accelerate progress in the fight against cancer. Investigating carcinogens in astro football pitches In 2016, Professor Andrew Watterson identified cancer-causing chemicals in rubber crumb samples from 3G astro football…

via How Stirling research is fighting cancer | World Cancer Day — University of Stirling

Maintaining the functional ability and quality of life of patients leaving hospital

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Carrie Milligan

Carrie Milligan graduated from the University of Stirling in November 2016 with a Masters in Advanced Practice. Her dissertation was a Quality Improvement Project and focused within her work place.

She was awarded a Research-Based Learning Prize for her dissertation titled: Maintaining the functional ability and quality of life of patients leaving hospital: improving information sharing with care home staff on discharge from an organic assessment ward.

 We found out about Carrie and her work:

Tell us about your project:

I am a Specialist Occupational Therapist working in older peoples’ mental health. The project was focused in the organic assessment ward that I work within. It looked at the communication process from the inpatient setting to the care home. Our patient group is complex, and admission lengths at the commencement of the project were, on average, 98 days. There is some evidence that patients’ quality of life and functional ability decreases on discharge from hospital.  I wondered if improved information sharing could also lead to improved outcomes for patients.

The discharge communication process is reliant on one nurse disseminating the assessments, interventions and treatments of the multi-disciplinary team on discharge.  This means that important information from other clinical disciplines, such as occupational therapy, were not being shared with care homes when patients were discharged from hospital. Consistent and timely information sharing between the multidisciplinary teams hospital and care home staff sounds simple, but is not as straightforward as it seems.

What was the aim of your project?

I aimed to develop and implement a new information care procedure to make sure care homes were receiving all appropriate information about a patient when they were discharged.  We were interested to find out if this process would also lead to improvements in patients’ quality of life, functional ability and Body Mass Index (BMI) on transfer.

 How did you carry it out?

 I used various methods recommended by the Improvement Science approach. A new discharge form was created through consultation with members of the multi-disciplinary team and community staff, including social work. Staff engagement was vital. Continuous education about the new project was required to inform and engage with new ward staff.

The impact of the project was measured using questionnaires with staff in the ward, care homes, and the liaison mental health team. Patient outcomes were measured using quality of life and functional ability scales, and body mass index (BMI) before and four weeks after discharge. Audits of the new discharge form measured how regularly and correctly staff were using the form.

 What was the impact of your project?

Twenty patients were discharged from the ward over 6 months using the new discharge form: 13 were discharged to a care home and 7 returned to their own home. The 13 patients’ discharged to care home were evaluated pre-discharge and post-discharge at 4 weeks by telephone to the care home. One patient died during this time.

Over the six months of the project 98% of professions engaged in the form’s completion. The 12 patients demonstrated an increase in their BMI, 42% improved or maintained their functional ability and 75% improved or maintained their quality of life. All care homes reported a benefit to the increased information to their care of the patient.

This impact of improved sharing of information from hospital to care home appeared to improve patients’ quality of life, function and BMI on their transfer to a care home setting.

 What were your conclusions?

The use of the new multi-disciplinary discharge form increased the level and consistency of information disseminated to a care home on discharge. The information aided care homes to shape their care for the patient.

There appears to be a positive impact of improving communication between the ward and care homes on patient outcomes as demonstrated through their BMI, Quality of Life and Functional Ability on discharge. However, this improvement was only measured over a short time frame with a limited number of patients, and without any control group.

What next for the project?

This project has shown that improved information sharing systems can increase the range of important clinical information that is shared and may benefit patient outcomes. I hope to continue to improve the discharge information sharing processes on the ward.

27 January 2017

Can good fat boost your fitness level? Angus Hunter in The Conversation

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Dr Angus Hunter

Dr Mariasole Da Boit (University of Derby), Dr Angus Hunter (University of Stirling) and Dr Stuart Gray (University of Glasgow) have written in The Conversation:

“Fish oil supplements may seem like a relatively recent health fad but they have actually been produced in the UK on a large scale since 1935 by the company Seven Seas Ltd. Since then, the fish oil supplement market has continued to grow, with many beneficial effects claimed for health……….”

See the full article here.
24 January 2017

How bucket lists help the terminally ill – and those around them

edward-duncanDr Edward Duncan has written in The Conversation UK:

“Buckets lists – inventories of things to do before you die – are often developed by people who know they have little time left. It seems like a good idea. But are they really beneficial, or can they cause harm? And is it really useful to generate lists that may – either due to expense or illness – be perceived as unrealistic?”

Please click here for the full article.

15 December 2016