Expert Reference Group Research Articles

Research agenda for ending preventable maternal deaths from postpartum haemorrhage: a WHO research prioritisation exercise

IntroductionPostpartum haemorrhage (PPH) remains the leading cause of maternal death. Yet there is a lack of clarity around what research is needed to determine what works and how best to...

The process of co‐design for a new anxiety intervention for autistic children

AbstractBackgroundMental health difficulties are common for autistic people; however, almost no interventions have been co‐designed with the autistic community. Co‐design has the potential to add important insights from lived experience into intervention design, but there are currently limited examples of how rigorously to undertake this practice. This paper details a worked model of co‐design and its process, focussed on adapting an evidenced parent‐led intervention for non‐autistic child anxiety (HYC), to meet the needs of young autistic children. The aim is to provide an example of co‐design, integrating autistic, parental, academic, clinical, experience and expertise.MethodsUsing prior literature and theory, including Experience‐Based Co‐Design, we developed an iterative and collaborative process between the research team and an expert reference group (ERG). The research team comprised autistic and non‐autistic members. The ERG included parents (autistic and non‐autistic) of autistic children with anxiety problems, autistic adults with experience of anxiety problems, and clinicians with experience supporting autistic children with anxiety problems. The ERG and research team reviewed information from qualitative research interviews with autistic children with anxiety problems and their parents along with information from clinical experience and the academic literature to reach consensus on the adapted intervention design.ResultsThe creation of a truly co‐designed intervention that includes a neurodiversity‐affirmative perspective, alongside CBT techniques. With anxiety problems experienced by autistic children being framed by combining the impacts of being neurodivergent in a neurotypical world, developmental science and well known cognitive behavioural models of child‐anxiety.ConclusionCo‐design can help to integrate multiple perspectives and result in the creation of interventions that are potentially relevant and acceptable to autistic people, their family members, and clinicians.

Developing a coordinated response to chemsex across health, justice and social care settings: expert consensus statement.

Chemsex occurs primarily among gay, bisexual and other men who have sex with men (GBMSM), and there is evidence of a subgroup of users who carry out chemsex-related criminal offences and experience harm. Challenges with chemsex can present to various settings; there are concerns that harm is increasing, including at interfaces between health, social care and criminal justice systems. The UK response to date has lacked a coordinated approach. An expert reference group was convened to share chemsex knowledge, articulate priorities for research and pathway development, and foster collaborative working between agencies. It made three key recommendations: develop and increase training and awareness across all services; implement a coordinated research programme with the development of a common data-set and assessment tool to fully characterise population-level needs; develop a professional network to share information, provide professional support and act as a knowledge hub. There was support for a unified multi-agency strategy incorporating the priorities identified as overarching principles.

Co-design and mixed methods evaluation of an interdisciplinary digital resource for undergraduate health profession students to improve the prevention, recognition, and management of delirium in Ireland: a study protocol.

Delirium is a common symptom of acute illness which is potentially avoidable with early recognition and intervention. Despite being a growing concern globally, delirium remains underdiagnosed and poorly reported, with limited understanding of effective delirium education for undergraduate health profession students. Digital resources could be an effective approach to improving professional knowledge of delirium, but studies utilising these with more than one profession are limited, and no evidence-based, interdisciplinary, digital delirium education resources are reported. This study aims to co-design and evaluate a digital resource for undergraduate health profession students across the island of Ireland to improve their ability to prevent, recognise, and manage delirium alongside interdisciplinary colleagues. Utilising a logic model, three workstreams have been identified. Workstream 1 will comprise three phases: (1) a systematic review identifying the format, methods, and content of existing digital delirium education interventions for health profession students, and their effect on knowledge, self-efficacy, and behavioural change; (2) focus groups with health profession students to determine awareness and experiences of delirium care; and (3) a Delphi survey informed by findings from the systematic review, focus groups, and input from the research team and expert reference group to identify resource priorities. Workstream 2 will involve the co-design of the digital resource through workshops (n = 4) with key stakeholders, including health profession students, professionals, and individuals with lived experience of delirium. Lastly, Workstream 3 will involve a mixed methods evaluation of the digital resource. Outcomes include changes to delirium knowledge and self-efficacy towards delirium care, and health profession students experience of using the resource. Given the dearth of interdisciplinary educational resources on delirium for health profession students, a co-designed, interprofessional, digital education resource will be well-positioned to shape undergraduate delirium education. This research may enhance delirium education and the self-efficacy of future health professionals in providing delirium care, thereby improving practice and patients' experiences and outcomes. Not applicable.

Hearing and vision support in people with dementia living at home: Outcomes from the intervention development programme for the European SENSE-Cog Trial

Background Hearing and vision loss are among the most common and disabling comorbidities in dementia and may worsen the trajectory of decline. Improving sensory function may be an accessible and cost-effective means of improving quality of life (QoL) and other outcomes for people with dementia (PwD). Here we describe the outcome of a multi-step intervention development programme for the components and implementation of a cross-national intervention to support hearing and vision in PwD in community settings. Methods We used the process of ‘intervention mapping’ and a set of mixed method sub-studies to develop the intervention for PwD with hearing and/or vision loss. This involved scoping the gaps in understanding, awareness, and service provision, modelling a prototype intervention, refining the prototype into a draft intervention, and finally field trialling the draft intervention for feasibility, acceptability, and tolerability. Input from the ‘patient and public voice’ (PPV) was interlinked with each step of the development programme (Miah et al., 2017). This paper synthesises the results of sub-studies leading to a description and logic model of the intervention which was then evaluated in a fully powered definitive trial. The sub-studies of the programme took place in participants’ own homes and in university or clinic settings in four EU countries: Cyprus, France, Greece, and the UK. The Expert Reference Group took place in Athens, Greece. We used quantitative and qualitative approaches to analyse the data from the different sub-studies. Results A multi-component psychosocial home-based ‘sensory intervention’ designed to optimise hearing and vision in PwD to improve QoL and other dementia-related and care partner-related outcomes. Conclusion This intervention represents the output of the iterative development of a complex intervention to fulfil an unmet need for PwD and sensory loss.

Challenges of Chemsex in Health, Justice, and Social Care Settings: Developing a Coordinated Response

AimsChemsex refers to the use of specific drugs before or during sex to sustain, enhance, disinhibit, or facilitate the sexual experience, primarily amongst gay, bisexual and other men who have sex with men. The main drugs associated with Chemsex are crystal methamphetamine, gamma-hydroxybutyrate/gamma-butyrolactone, mephedrone and ketamine. There are complex biological, psychological, and social factors that influence why someone may choose to engage in Chemsex that are yet to be fully elucidated. However, there are global concerns that such harm is increasing both in prevalence and complexity, including interfaces between the health, social care and criminal justice systems. Chemsex has been identified as a priority for the UK Home Office Drug Strategy since 2017; however, the response to date has lacked a coordinated approach between the multiple services and agencies where Chemsex can present.MethodsWest London NHS Trust hosted a day-long meeting of the Chemsex Expert Reference Group (ERG) on 27th July 2022 at the London School of Hygiene and Tropical Medicine. This comprised of a group of clinicians and academics across the NHS, criminal justice system and third sector, with the meeting focused on three main clinical questions: what do we need to know about working with this complex and vulnerable group of people?; What is the research needed to improve this?; What are the aspiration clinical pathways that should be developed?ResultsThe ERG identified several gaps in our knowledge including a paucity of epidemiological data, the importance of cultural competency around the health needs of LGBTQ+ people, inconsistencies in the knowledge of healthcare professionals on how to manage emergency presentations such as methamphetamine-induced psychosis, GHB withdrawal and GHB overdose and risk assessment and risk management for those who may also be a victim and/or a perpetrator of a criminal offence in the Chemsex context. The group's core values for service and pathway development were identified as to be authentic, competent, non-judgemental and that lived experience should be at the centre of service development, as well as being evidence-based and supported by national clinical guidelines.ConclusionWhat was apparent was the ambition and interest from across so many clinical specialities, and some incredibly positive work that is already ongoing. It is hoped that the outcomes of this ERG can help progress this to a more cohesive set of responses, and the development of an evidence-based, multi-agency approach to assessment and treatment for this complex group.

Synthesis of the Evidence on What Works for Whom in Telemental Health: Rapid Realist Review.

BackgroundTelemental health (delivering mental health care via video calls, telephone calls, or SMS text messages) is becoming increasingly widespread. Telemental health appears to be useful and effective in providing care to some service users in some settings, especially during an emergency restricting face-to-face contact, such as the COVID-19 pandemic. However, important limitations have been reported, and telemental health implementation risks the reinforcement of pre-existing inequalities in service provision. If it is to be widely incorporated into routine care, a clear understanding is needed of when and for whom it is an acceptable and effective approach and when face-to-face care is needed.ObjectiveThis rapid realist review aims to develop a theory about which telemental health approaches work (or do not work), for whom, in which contexts, and through what mechanisms.MethodsRapid realist reviewing involves synthesizing relevant evidence and stakeholder expertise to allow timely development of context-mechanism-outcome (CMO) configurations in areas where evidence is urgently needed to inform policy and practice. The CMO configurations encapsulate theories about what works for whom and by what mechanisms. Sources included eligible papers from 2 previous systematic reviews conducted by our team on telemental health; an updated search using the strategy from these reviews; a call for relevant evidence, including “gray literature,” to the public and key experts; and website searches of relevant voluntary and statutory organizations. CMO configurations formulated from these sources were iteratively refined, including through discussions with an expert reference group, including researchers with relevant lived experience and frontline clinicians, and consultation with experts focused on three priority groups: children and young people, users of inpatient and crisis care services, and digitally excluded groups.ResultsA total of 108 scientific and gray literature sources were included. From our initial CMO configurations, we derived 30 overarching CMO configurations within four domains: connecting effectively; flexibility and personalization; safety, privacy, and confidentiality; and therapeutic quality and relationship. Reports and stakeholder input emphasized the importance of personal choice, privacy and safety, and therapeutic relationships in telemental health care. The review also identified particular service users likely to be disadvantaged by telemental health implementation and a need to ensure that face-to-face care of equivalent timeliness remains available. Mechanisms underlying the successful and unsuccessful application of telemental health are discussed.ConclusionsService user choice, privacy and safety, the ability to connect effectively, and fostering strong therapeutic relationships need to be prioritized in delivering telemental health care. Guidelines and strategies coproduced with service users and frontline staff are needed to optimize telemental health implementation in real-world settings.Trial RegistrationInternational Prospective Register of Systematic Reviews (PROSPERO); CRD42021260910; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021260910

Curriculum Development: A National Curriculum for Physician Associates in Mental Health

AimsPhysician associates (PAs) are becoming more commonplace in psychiatric services in the UK to help address long term workforce difficulties. The 2019 NHS Long Term Plan detailed a commitment to transforming mental health care in England recognising that services were not meeting current or future increase in demand. Health Education England's (HEE) report, Stepping Forward to 2020/21: The Mental Health Workforce Plan for England, described a longer-term strategy to expand the mental health workforce, including recruiting 5,000 people into ‘new roles’ including physician associates. The NHS Mental Health Implementation Plan 2019/20–2023/243 stated an aim of recruiting 140 PAs to the workforce over five years in addition to the requirements specified in the HEE report. A curriculum for PAs working in mental health would set out the competencies required to work in mental health services.MethodsThe curriculum was developed by the National Collaborating Centre for Mental Health (NCCMH). The work was overseen by an expert reference group, comprising experts in training PAs in mental health, PAs, researchers and experts by experience, all selected for their expertise in research, training and service delivery.ResultsThe overarching aims and objectives of the curriculum was to convey a practical understanding of the attitudes, knowledge and skills that underpin the role, thus enabling PAs to offer effective and value-driven support to patients.The completed curriculum has been arranged into seven modules: Knowledge, Professional/Legal Issues, Engagement and Communication, Diagnostic Assessment and Treatment Planning, Interventions, Managing the Interface of Mental and Physical Health and Team Working. This reflects the expected roles and responsibilities of PAs working in mental health.ConclusionHEE and the Royal College of Psychiatrist have recommended all mental health organisations implement an educational programme for new PAs. The curriculum will inform the training requirements for PAs and standardise the training they receive from mental health organisations. It should support the work of PA supervisors and peer coordinators, and those delivering education and training to them. The curriculum will be a dynamic document and work will be needed to adapt it as the role changes, for example with incoming regulation and potential prescribing rights that follow.

Physician Associates in the Frame: Developing a National Competence Framework for Physician Associates Working in Mental Health

AimsPhysician associates (PAs) are becoming more commonplace in psychiatric services in the UK to help address long term workforce difficulties. The 2019 NHS Long Term Plan detailed a commitment to transforming mental health care in England recognising that services were not meeting current or future increase in demand. Health Education England's (HEE) report, Stepping Forward to 2020/21: The Mental Health Workforce Plan for England, described a longer-term strategy to expand the mental health workforce, including recruiting 5,000 people into ‘new roles’ including physician associates. The NHS Mental Health Implementation Plan 2019/20–2023/24 stated an aim of recruiting 140 PAs to the workforce over five years in addition to the requirements specified in the HEE report. Competence frameworks make the link between evidence and practice and can be a valuable basis for training, an agenda for supervision and a guide for self-monitoring and personal development for people working in the role.MethodsThe competence framework was developed by the National Collaborating Centre for Mental Health (NCCMH). The work was overseen by an expert reference group, comprising experts in training PAs in mental health, PAs, researchers and experts by experience, all selected for their expertise in research, training and service delivery. The completed framework was then sent to relevant stakeholders including the Faculty of Physician Associates and patient groups for comment and adapted accordingly.ResultsThe completed framework has been arranged into seven domains: Knowledge of Mental Health, Professional/Legal Issues, Engagement and Communication, Diagnostic Assessment and Treatment Planning, Interventions, Team Working and Metacompetences. This reflects the expected roles and responsibilities of PAs working in mental health.ConclusionThe Competence Framework for PAs will help those involved in mental health care services who wish to deepen their understanding of the PA role, and will be useful to team members working with PAs, to their managers and to commissioners. It will support the work of PA supervisors and peer coordinators, and those delivering education and training to them. It also brings a level of standardisation of the role. More work will be needed to adapt the Competence Framework for PAs for specialist contexts, such as in dementia care or children and young people's services.

Determining Priorities in the Aboriginal and Islander Mental Health Initiative for Youth App Second Phase Participatory Design Project: Qualitative Study and Narrative Literature Review.

BackgroundDigital mental health tools can promote access to culturally safe early intervention mental health services for Aboriginal and Torres Strait Islander young people. Participatory design methodology facilitates user engagement in the co-design of digital resources. However, several challenges have been identified that limit the methodological rigor of this approach.ObjectiveThis paper aims to present an in-depth account of the second phase of participatory design in the development of the Aboriginal and Islander Mental Health Initiative for Youth (AIMhi-Y) app.MethodsA first idea storyboard, generated from a formative phase of the AIMhi-Y project, was refined through a series of youth co-design workshops and meetings. A narrative review of the literature, 6 service provider interviews, and engagement with an expert reference group also informed the design process. Generative design activities, storyboarding, discussions, and voting strategies were used.ResultsThe participatory design process identified the app features preferred by young people and service providers and assessed their alignment with current recommendations from the scientific literature. Findings from the co-design process are presented across 9 app characteristic domains. Integration of findings into app design proved complex. Although most preferred features identified by young people were included to some degree, other inclusions were restricted by budget, time, and the need to integrate best practice recommendations. A process of prioritization was required.ConclusionsParticipatory design is often cited in the development of digital mental health resources; however, methods are diverse and often lack detailed descriptions. This study reports the outcomes and strategies used to determine priorities in the second phase of the development of the AIMhi-Y app. We provide an example and the key learnings to inform others seeking to use participatory design with a similar cohort.

Engaging Stakeholders in Realist Programme Theory Building: Insights from the Prospective Phase of a Primary Care Dementia Support Study

‘Dementia - Personalised Care Team’ (D-PACT) is a five-year NIHR funded programme, using realist methods to develop and evaluate a complex, person-centred intervention for people with dementia and their carers. During the early project stages, we engaged with multiple stakeholders, including people with dementia and their carers, to develop an initial programme theory (IPT) – into an elaborated programme theory (EPT), by helping to uncover intervention mechanisms leading to outcomes in specific contexts. Realist research methods for developing programme theories are under-reported. In addition, there is a paucity of practical guidance on how to engage underserved and vulnerable populations in complex interventions programme theory development. We attend to these gaps, providing a worked example of how we meaningfully engaged people living with dementia and carers, alongside field experts, as stakeholders in this process. Our IPT theory building included multi-stakeholder primary research exercises and meetings with PPI contributors and an Expert Reference Group. We adapted interview schedules, and used visual resources and scenario-based activities, to support stakeholders to think in a ‘realist’ way. Using realist and thematic analyses led to hypothesis-building of causal mechanisms. Sharing findings with stakeholders led to further refinement of the intervention design, ready for testing in a subsequent feasibility study. We found that, despite the cognitive challenges associated with dementia, innovative methods of engagement can enable this stakeholder group to understand the realist approach and provide a platform through which to share their experiences. Taking a highly flexible and unhurried approach, led to novel insights into the complexities of person-centred dementia support. We argue for more detailed methodological guidance, based on realist principles, on how to collaborate with underrepresented populations to rigorously gain insights as to what is likely to make a difference and refine initial programme theory.

Co-Design of an Evidenced Informed Service Model of Integrated Palliative Care for Persons Living with Severe Mental Illness: A Qualitative Exploratory Study.

Background: Globally, close to one billion people are living with a mental health disorder, and it is one of the most neglected areas in Public Health. People with severe mental illness have greater mortality risk than the general population, experience health care inequalities throughout life and represent a vulnerable, under-served and under-treated population, who have been overlooked in health inequality research to date. There is currently a dearth of evidence in relation to understanding the palliative care needs of people with severe mental illness and how future care delivery can be designed to both recognise and respond to those needs. This study aims to co-design an evidenced informed service model of integrated palliative care for persons living with a severe mental illness. Methods: This qualitative sequential study underpinned by interpretivism will have six phases. An expert reference group will be established in Phase 1, to inform all stages of this study. Phase 2 will include a systematic literature review to synthesise current evidence in relation to palliative care service provision for people with severe mental illness. In Phase 3, qualitative interviews will be undertaken with both, patients who have a severe mental illness and in receipt of palliative care (n = 13), and bereaved caregivers of people who have died 6–18 months previously with a diagnosis of severe mental illness (n = 13), across two recruitment sties in the United Kingdom. Focus groups (n = 4) with both mental health and palliative care multidisciplinary staff will be undertaken across the two recruitment sites in Phase 4. Phase 5 will involve the co-design of a service model of integrated palliative care for persons living with severe mental illness. Phase 6 will develop practice recommendations for this client cohort. Discussion: Palliative care needs to be available at all levels of care systems; it is estimated that, globally, only 14% of patients who need palliative care receive it. Reducing inequalities experienced by people with severe mental illness is embedded in the National Health Service Long Term Plan. Internationally, the gap between those with a mental illness needing care and those with access to care remains considerable. Future policy and practice will benefit from a better understanding of the needs of this client cohort and the development of a co-designed integrated care pathway to facilitate timely access to palliative care for people with a severe mental illness.

Adaptation and Validation of the Program Sustainability Assessment Tool (PSAT) for Use in the Elementary School Setting.

There is a lack of valid and reliable measures of determinants of sustainability specific to public health interventions in the elementary school setting. This study aimed to adapt and evaluate the Program Sustainability Assessment Tool (PSAT) for use in this setting. An expert reference group adapted the PSAT to ensure face validity. Elementary school teachers participating in a multi-component implementation intervention to increase their scheduling of physical activity completed the adapted PSAT. Structural validity was assessed via confirmatory factor analysis. Convergent validity was assessed using linear mixed regression evaluating the associations between scheduling of physical activity and adapted PSAT scores. Cronbach’s alpha was used to evaluate internal consistency and intracluster correlation coefficients for interrater reliability. Floor and ceiling effects were also evaluated. Following adaptation and psychometric evaluation, the final measure contained 26 items. Domain Cronbach’s alpha ranged from 0.77 to 0.92. Only one domain illustrated acceptable interrater reliability. Evidence for structural validity was mixed and was lacking for convergent validity. There were no floor and ceiling effects. Efforts to adapt and validate the PSAT for the elementary school setting were mixed. Future work to develop and improve measures specific to public health program sustainment that are relevant and psychometrically robust for elementary school settings are needed.

Towards the transformation of cities: A built environment process map to identify the role of key sectors and actors in producing the built environment across life stages

Cities must transform in order to address the challenge of climate change and to achieve societal ambitions such as the sustainable development goals. However, a key impediment to achieving transformation is underdeveloped understandings of how key actors and sectors within the built environment work together to achieve goals. This paper addresses these gaps by developing and visually presenting a process map to describe: the key processes involved in producing the built environment across its life stages; key sectors of the built environment, their key actors, and the activities coordinated between them. The process map was peer reviewed by an expert reference group of built environment professionals active in Australia and the UK. The motivation for developing this process map is to facilitate future research to identify and expedite opportunities for coordinated action to address significant societal challenges such as climate change action, and the sustainable development goals – which require transformative action in cities.

Developing and evaluating online COVID-centric advance care planning training and information resources for nursing staff and family members in nursing homes: the necessary discussions study protocol

BackgroundNursing home residents are typically older adults with high levels of chronic illness and impairment. As such, they are particularly susceptible to severe complications and mortality from COVID-19. Since all nursing home residents are at increased risk, nursing home care staff need to know what residents would want to happen should they become infected with COVID-19. This study aims to develop and evaluate advance care planning (ACP) COVID-centric online training and information resources for nursing home staff and family members of residents, to improve care at the end of life during a COVID-19 outbreak. Based on the findings we will develop implementation guidelines for nursing homes to ensure wider impact and application during the pandemic and beyond.MethodsThe content of the training and information resources will be based on a rapid review of literature and guidance on ACP in the context of COVID-19 and consultation with the study expert reference group. An integrated communications company will then work alongside the research team to design the online training and information resources. To evaluate the resources, we will employ a multiple case study design where a nursing home (defined as an institutional setting in which nursing care is provided to older adults on-site 24 h a day) will be the unit of analysis or ‘case’. The RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework will guide the evaluation of implementation of the training and information resources. We will recruit and interview staff and family members from between 6 and 9 nursing homes across Northern Ireland, England and Scotland and gather quantitative data from a feedback survey included in the training and information resources.DiscussionThe Necessary Discussions study is very timely given the challenging experiences of nursing homes, their staff, residents and their family members during the COVID-19 pandemic. It meets a key need and addresses an important gap in research and practice. The training and information resources will be ‘COVID-centric’, but they will also have a longstanding relevance for future ACP practice in UK care homes.Trial registrationISRCTN registry (ID 18003630) on 19.05.21

A qualitative evaluation of the implementation of a cultural competence project in rural Victoria

ObjectiveTo explore the complex factors influencing the implementation of cultural competency frameworks for Aboriginal and Torres Strait Islander peoples within rural, Victorian, mainstream health and community service organisations. MethodsSemi‐structured telephone interviews were conducted with key individuals from 20 public health and community services in rural Victoria who had participated in the Koolin Balit Aboriginal Health Cultural Competence Project (KB‐AHCC project). Interviews were recorded and transcribed verbatim and a content analysis was undertaken. The findings informed the selection of six case study sites for more in‐depth analysis. Following this, an expert reference group provided feedback on the findings. Findings from the different data were triangulated to identify eight factors. ResultsKey factors acting as barriers and/or enablers to implementing cultural competence frameworks were: comprehensive, structured tools; project workers; communication; organisational responsibility for implementation; prioritising organisational cultural competence resourcing; resistance to focussing on one group of people; and accountability. ConclusionsEmbedding cultural competence frameworks within rural, mainstream health and community services requires sustained government resourcing, prioritisation and formal accountability structures. Implications for public healthFindings will inform and guide the future development, implementation and evaluation of organisational cultural competence projects for rural public health and community services.

Education in youth-friendly genetic counseling.

Genetic counselors have long recognized the challenges of working with adolescents and young adults (AYA) and their families. In 2010, a framework of Youth-friendly Genetic Counseling was developed by an expert reference group with the aim to improve both care for AYAs and the experience of health professionals delivering that care. Subsequently, an education workshop was developed aimed to upskill genetic health professionals in youth-friendly genetic counseling. The workshop was piloted with genetic counselors in Australia and New Zealand. A purpose designed, pre- and post-workshop survey and post-workshop focus group was utilized for evaluation. Mean confidence scores increased pre- and post-workshop. Participants also demonstrated increases in knowledge regarding: adolescent development; developmental theory; social factors impacting on health; the needs of young people; practice challenges; youth-friendly engagement, communication, consent and confidentiality; practice approaches; principles of adolescent healthcare; ethical issues; and available services and resources. Focus group data revealed several themes relating to practice challenges, learning gains, barriers, and enablers to clinical translation and workshop feedback. Results demonstrate utility of the workshop in up-skilling genetic health professionals in the provision of youth-friendly genetic counseling. Consideration of adaptation and sustainability, by embedding this theoretical and skills-based workshop as a module within genetic counseling education, is required to ensure practice competence and the best health outcomes for young people and their families.

Qualitative analysis of challenges and enablers to providing age friendly hospital care in an Australian health system

BackgroundWith ageing global populations, hospitals need to adapt to ensure high quality hospital care for older inpatients. Age friendly hospitals (AFH) aim to establish systems and evidence-based practices which support high quality care for older people, but many of these practices remain poorly implemented. This study aimed to understand barriers and enablers to implementing AFH from the perspective of key stakeholders working within an Australian academic health system.MethodsIn this interpretive phenomenenological study, open-ended interviews were conducted with experienced clinicians, managers, academics and consumer representatives who had peer-recognised interest in improving care of older people in hospital. Initial coding was guided by the Promoting Action on Research Implementation in Health Services (PARIHS) framework. Coding and charting was cross checked by three researchers, and themes validated by an expert reference group. Reporting was guided by COREQ guidelines.ResultsTwenty interviews were completed (8 clinicians, 7 academics, 4 clinical managers, 1 consumer representative). Key elements of AFH were that older people and their families are recognized and valued in care; skilled compassionate staff work in effective teams; and care models and environments support older people across the system. Valuing care of older people underpinned three other key enablers: empowering local leadership, investing in implementation and monitoring, and training and supporting a skilled workforce.ConclusionsProgress towards AFH will require collaborative action from health system managers, clinicians, consumer representatives, policy makers and academic organisations, and reframing the value of caring for older people in hospital.

Design and implementation of a SMART Learning environment for the Upskilling of Cybersecurity professionals in Mauritius

Teaching and Learning confined to within the four walls of a classroom or even online Learning through Massive Online Courses (MOOCs) and other Learning Content Management Systems (LCMS) are no longer seen as the optimal approach for competency and skills development, especially for working professionals. Each of these busy learners have their own training needs and prior knowledge. Adopting the one-size-fits-all teaching approach is definitely not effective, motivating and encouraging. For some learners, the content might be too easy and for others, it might be too difficult. This is why this research presents the use of SMART Learning Environment that makes use of Intelligent Techniques to personalise the learning materials for each learner. This mismatch in skills is becoming a pressing issue and is having a direct impact on the ICT Sector, which is one of the pillars of the Mauritian Economy. This research, therefore, besides proposing a novel approach to learning, also attempts to address an issue of national importance. Data was collected during three phases, namely an Expert Reference Group Discussion, a pre-test questionnaire and a survey questionnaire. The Expert Reference Group Discussion was carried out to further understand the training needs and expectations of Cybersecurity professionals in Mauritius. A SMART Learning Environment making use of Artificial Neural Networks and Backpropagation Algorithm to personalise learning materials was eventually designed and implemented. The major findings of this research were that personalisation of learning materials through the use of a SMART Learning Environment can be used to address the training needs of Cybersecurity professionals in Mauritius.

Promoting mental health and wellbeing in schools: How the Ofsted inspection process can inspire change and what support is needed in schools

The Society set out to consider how the Department for Education could work with Ofsted to introduce a new psychological wellbeing measure into its inspection regime that was accompanied by the provision of additional psychological support. The importance of this work in the current climate was twofold. Firstly, (at the time of writing) as one in eight children and young people have a mental health difficulty it was important that wellbeing and positive mental health were addressed in schools. Secondly, the Ofsted framework sends a clear message about how teachers and schools can prioritise their time, when this is becoming ever increasingly demanding. The Senate campaign’s Expert Reference Group (ERG) contributed to the BPS’ consultation response to the OFSTED inspection framework. Drawing on the expertise of the ERG, we produced a commentary on the need to ensure the mental health needs of children are identified within schools, called for Ofsted to consider their definition of ‘resilience’ and to consider the wider factors which might contribute towards ‘attitudes and behaviour’. In addition to submitting a response to the Ofsted consultation, we produced a policy briefing calling for whole school approaches to mental health and welling and closer scrutiny of these by Ofsted.Ofsted immediately contacted the Society and we secured a meeting with Ofsted’s Deputy Director. We provided an up-to-date bibliography of relevant psychological research to Ofsted’s Head of Research. However, we were disappointed (as was the other kindred organisations) that Ofsted did not make any significant changes. Our briefing was picked up by The Times Educational Supplementwww.tes.com/news/schools-mental-health-support-should-be-inspected-ofstedThe Ofsted Inspection Framework Consultation response can be found here:https://www.bps.org.uk/sites/www.bps.org.uk/files/Policy/Policy%20-%20Files/BPS%20Response%20-%20Ofsted%20Education%20Inspection%20Framework%202019.pdf