Resource Pack Research Articles

Employer schemes to encourage walking to work: feasibility study incorporating an exploratory randomised controlled trial

BackgroundPhysical inactivity increases the risk of many chronic diseases, including coronary heart disease, type 2 diabetes, obesity and some cancers. Increasing physical activity levels, particularly among the most sedentary, is an important aim of current public health policy in the UK. An opportunity for working adults to increase physical activity levels may be through walking during the daily commute.ObjectivesTo build on existing knowledge and resources to develop an employer-led scheme to increase walking to work; to test the feasibility of implementing and evaluating the intervention; and to explore other requirements of a full-scale trial.DesignFeasibility study incorporating phase 1 resource review, focus groups with employees and interviews with employers in three workplaces (one small, one medium and one large); and phase 2 exploratory cluster randomised controlled trial (RCT) including process and economic evaluations.SettingWorkplaces (eight small, five medium and four large) in Bristol.ParticipantsOne hundred and eighty-seven employees (89 male and 98 female) at baseline.InterventionsWalk to Work promoters were recruited and trained about the health, social, economic and environmental benefits of walking to work and how to identify and promote safe walking routes for employees. They were given resource packs based on nine key behaviour change techniques. The role of the Walk to Work promoter was to encourage participating employees in their workplace to walk to work; to help to identify walking routes; to encourage goal setting; and to provide additional encouragement through four contacts over the following 10 weeks (face to face, e-mail or telephone, as appropriate).Main outcome measuresRecruitment and retention rates; sample size calculation and estimation of the intracluster correlation coefficient (ICC); acceptability of the intervention and evaluation methods; and estimation of costs.ResultsWorkplace and employee recruitment appeared to be restricted by the initial requirement to identify employees living within 2 miles of the workplace. Once recruited, no workplace withdrew from the study between baseline and 1-year follow-up. It proved feasible to recruit and train workplace Walk to Work promoters. The response rate was 132 (71%) at 1-year follow-up. Although the study was not powered to measure effectiveness, accelerometer data suggest that overall physical activity and moderate to vigorous physical activity (MVPA) were higher in the intervention arm than in the control arm at 1-year follow-up. The ICC was estimated at 0.12 (95% confidence interval 0.00 to 0.30). Based on an average cluster size of eight, an ICC of 0.15 and attrition of 25%, a total sample size of 678 would have 80% power with 5% significance to detect a 15% increase in mean MVPA. The average cost of the intervention was estimated at £441 per workplace. Activity levels were similar in the intervention and control arms at baseline.ConclusionsThe intervention and evaluation were feasible, and acceptable to participants. There was sufficient evidence of promise to justify a full-scale trial incorporating lessons learned during the feasibility study. Future work: an application is being submitted for a follow-on full-scale cluster RCT.Trial registrationCurrent Controlled Trials ISRCTN72882329.FundingThis project was funded by the NIHR Public Health Research programme and will be published in full inPublic Health Research; Vol. 3, No. 4. See the NIHR Journals Library website for further project information. The work was undertaken with the support of The Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), a UK Clinical Research Collaboration Public Health Research Centre of Excellence. Joint funding (MR/KO232331/1) from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the Welsh Government and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged.

Thérapie par remédiation cognitive chez les enfants : données de la littérature et application clinique dans un service de psychiatrie de l’enfant et de l’adolescent

The hypothesis of cerebral plasticity in psychiatric disorders has encouraged clinicians to develop cognitive remediation therapy (CRT), a new therapeutic approach based on attention, memory, planning, and mental flexibility tasks. The first cognitive remediation programs were developed and validated for adults with schizophrenia and were shown to have a positive impact on executive functions as well as on quality of life. In children and adolescents, researchers emphasized the existence of executive dysfunction in neurodevelopmental disorders such as autistic spectrum disorder, attention deficit disorder, and eating disorders. For these disorders, neuropsychological studies suggest that memory, planning, attention and mental flexibility are impaired. Despite the paucity of studies on cognitive remediation (CR) in children, preliminary results have suggested, as in adults with schizophrenia, good compliance and optimization of executive functioning. Consequently, programs dedicated to young subjects were developed in English-speaking countries, and the Department of Child and Adolescent Psychiatry of Sainte Anne Hospital (Paris) developed a new CR program for children with attention deficit disorder, academic problems, or eating disorders. These programs complete the field of CRT proposed by Sainte Anne Hospital's Remediation and Psychosocial Rehabilitation Reference Center, initially designed for adults with schizophrenia. Our team used and adapted validated tools such as Delahunty and Wykes's CRT program (translated and validated in French by Amado and Franck) and Lindvall and Lask's CRT Resource Pack. One program was developed for an adolescent with anorexia nervosa and applied to the subject and her family, but the purpose of this paper is to present a CR approach for children with attention deficit disorder or academic disorder, a 6-month program based on paper-pencil tasks and board and card games. The team was trained in different kinds of cognitive remediation, and the program was applied by a clinical nurse with the supervision of a child and adolescent psychiatrist and the department's neuropsychologists. Paper-pencil tasks were adapted from the CRT program for adults; the card and board games used were geometric figures, illusions, Rush Hour(®), Set(®), Jungle Speed(®), Color Addict(®), etc. These games are available in stores and the program can be applied at home, which helps families set aside their preoccupations with their child's academic performance. Diagnostic and neuropsychological evaluations were done before the beginning of the therapy and repeated at the end of the 6-month program. This program does not ignore the metapsychological impact of the therapy, and work on self-esteem is also done. The presence of the therapist is necessary, which seems better than a computer program, which cannot encourage the young subject in the same personalized and empathetic way. We therefore conducted the first clinical feasibility trial of cognitive remediation in young subjects and present a clinical case of a 6-year-old boy with attention deficit disorder and academic disorder. The results of neuropsychological evaluations before and after therapy suggest improvement in executive functions and better self-esteem. Satisfaction for the boy and his family was high. Even if these results need to be replicated, cognitive remediation appears to be a new therapeutic tool, complementary to classical approaches used in childhood psychiatric disorders. The Department of Child and Adolescent Psychiatry will submit this program to a research program conducted by the National Health Department to study the impact of this approach in a controlled study.

Moving Forward: A Qualitative Research Inquiry to Inform the Development of a Resource Pack for Women Following Primary Breast Cancer Treatment

While the UK charity Breast Cancer Care has extensive resources for women with breast cancer, this research partnership developed the first resource driven and informed by primary research with these women, exploring their needs and developing the resource according to need. Data were collected from focus groups with breast cancer survivors and telephone interviews with health professionals and experts, which explored the needs of women after primary cancer treatment, and were analyzed using thematic analysis. As well as information, these women needed resources to help them regain control over life, adapt to a changed body, and restore lost confidence.

Understanding requirements in the foreign language course books

In teaching foreign languages, understanding course book requirements needs special attention, because a problem can appear not only because of interpreting implicit messages, but also because of understanding explicitly stated requirements. In the empirical research, by the method of testing, it has been examined in which extent the students understand requirements in primary school course books for five foreign languages: English, French, Italian, German and Spanish. Results show that, apart from English, as the first foreign language, comprehension of requirements is unsatisfactory, and these difficulties in understanding appear because of inappropriate requirements for language competencies of students and because of inattentive reading and interpreting. In the paper, we stated possible reasons of insufficient understanding, and based on this there were some basic directions for treating requirements for completing or adapting the course book resource pack, as well as during the process of teaching and learning.

ActiveSmart physical activity behaviour change program

Introduction: ActiveSmart is the Department of Sport and Recreation’s (DSR) personalised behaviour change program that is tailored to engage individuals and households in adopting ormaintaining physical activity. The primary objective of ActiveSmart is to increase participation in all forms of physical activity to build social capital, community connectedness and improve health. The approach is facilitative and responsive to the needs of participants and results in an uptake of active recreation, sport and an increase in the use of local infrastructure. ActiveSmart has been delivered in the Cities of Rockingham 2009, Geraldton 2011 (Phase 1) and a top up service to Geraldton participants in 2013 (Phase 2). Methods: ActiveSmart Geraldton Phase 1: Formative Research was conducted to understand physical activity levels and behaviour; Welcome Letters were sent inviting 10,000 households to participate; Recruitment of 4089 households into the program via telephone and community events; Local Resources and Small Steps to help people get started were identified through recruitment conversations; Resource Packs were hand delivered to participants homes; Coaching and Goal Setting was provided to 2371 participants who opted into the intense service, which included a phone call every 3–4 weeks to offer support and facilitate goal setting over a six month period; Evaluation involved pre and post surveys to measure the impact of the program. ActiveSmart Geraldton Phase 2 re-engaged 922 households from Phase 1 participants to build upon the previous program and determine the longitudinal impact 18months later, this involved awelcome letter and 2 follow up phone calls. Results: ActiveSmart Geraldton Phase 1 participants reported a 15min increase in physical activity per person, per day; 19% of participants moved from insufficient to sufficient levels of physical activity; and 21% of participants moved from doing no vigorous physical activity to doing at least one session perweek. Participants reported feeling better, more connected and achieving goals. ActiveSmart Geraldton Phase 2 resulted in an additional 5min increase in physical activity per person, per day (above the 15min increase gained in Phase 1); and an additional 4.5% of participants moved from insufficient to sufficient levels of physical activity. A Benefit Cost Analysis found $1 invested in ActiveSmart saves $25 in the health budget over 10 years. Discussion: This project effectively moves people beyond just awareness of the need to be active – it gives them the support needed to actually get started and sustain new behaviours.

Impact of New Guidelines and Educational Program on Awareness of Medical Fitness to Drive Among General Practitioners in Ireland

Objective: To investigate changes in attitudes, resources, and practices of general practitioners (GPs) toward evaluating medical fitness to drive (MFTD) following the publication of national guidelines and an extensive educational programme in traffic medicine.Method: Postal questionnaire survey to GPs (n = 1,000) in November 2013.Results: The final response rate was 46%. GPs are confident (57%) or very confident (14%) in assessing MFTD. There is a high awareness of the new Irish guidelines, with 86% of GPs using them for assistance in assessing MFTD. GPs are divided as to whether GPs (49%) or practitioners specially trained to assess MFTD (44%) should be primarily responsible for assessing MFTD. GPs expressed interest in traffic medicine educational programs, most notably a resource pack for continuous medical education (CME) Small Group learning (87%), MFTD software (71%), and an online moodle (68%). Many (68%) remain concerned about their liability in regard to MFTD assessments.Conclusion: Irish GPs are confident in assessing MFTD and show a high level of awareness of the new guidelines. There is a clear interest among GPs in further educational supports and training in traffic medicine, particularly MFTD assessments.

NHS England issues alert and resource packs for managing sepsis.

THE GOVERNMENT has been criticised by MPs for its lack of urgency in preventing deaths from sepsis. An estimated 37,000 patients in England die of the condition every year because of failings such as delayed examination and inadequate record taking.

“Care … about physical activity” in care homes in Scotland

Purpose – The purpose of this paper is to outline an approach being taken, to improve opportunities and increase levels of physical activity amongst residents in care homes in Scotland, which has the potential to make a significant difference to the quality of lives. The approach is designed to raise awareness about the importance of physical activity, increase skills, knowledge and capacity amongst the workforce. Design/methodology/approach – The paper describes the reasons for promoting physical activity in care homes. It describes the challenge to this, associated issues and introduces you to a resource pack which offers solutions to care homes through a self-improvement process. It provides a case study which exemplifies how the ideas can be applied on a day-to-day basis. Findings – The paper provides insights into the challenges in the care home sector to promoting physical activity and offers some ways round these. It describes two strategies within the new resource pack to support care home residents to make person centred physical activity choices. Practical implications – This paper suggests that to promote physical activity in a care home the choices and needs of an individual must be the starting point. It requires partnership working and good leadership where staff have the permission to work in a new way. It suggests that risk enablement is key and the benefits of physical activity outweigh the risks even with frail older people. Originality/value – This paper promotes a new resource pack for care homes in Scotland for promoting an active life based on a self-improvement process.

Rationale and study protocol of the EASY Minds (Encouraging Activity to Stimulate Young Minds) program: cluster randomized controlled trial of a primary school-based physical activity integration program for mathematics.

BackgroundNovel strategies are required to increase school-based physical activity levels of children. Integrating physical activity in mathematics lessons may lead to improvements in students’ physical activity levels as well as enjoyment, engagement and learning. The primary aim of this study is to evaluate the impact of a curriculum-based physical activity integration program known as EASY Minds (Encouraging Activity to Stimulate Young Minds) on children’s daily school time physical activity levels. Secondary aims include exploring the impact of EASY Minds on their engagement and ‘on task’ behaviour in mathematics.Methods/DesignGrade 5/6 classes from eight public schools in New South Wales, Australia will be randomly allocated to intervention (n = 4) or control (n = 4) groups. Teachers from the intervention group will receive one day of professional development, a resource pack and asked to adapt their lessons to embed movement-based learning in their daily mathematics program in at least three lessons per week over a six week period. Intervention support will be provided via a weekly email and three lesson observations. The primary outcomes will be children’s physical activity levels (accelerometry) across both the school day and during mathematics lessons (moderate-to-vigorous physical activity and sedentary time). Children’s ‘on-task’ behaviour, enjoyment of mathematics and mathematics attainment will be assessed as secondary outcomes. A detailed process evaluation will be undertaken.DiscussionEASY Minds is an innovative intervention that has the potential to improve key physical and academic outcomes for primary school aged children and help guide policy and practice regarding the teaching of mathematics.Trial registration noAustralian and New Zealand Clinical Trials Register ACTRN12613000637741 13/05/2013.

Gay penguins, sissy ducklings … and beyond? Exploring gender and sexuality diversity through children's literature

ABSTRACTFrom 2006 to 2008 UK-based primary school teachers in the No Outsiders project explored possibilities for addressing sexualities equality in their classrooms. What all teachers had in common was a resource pack that included 27 children's books exploring themes of gender and sexuality diversity either directly or indirectly (i.e. by the presence of same-sex parents or gender non-normative characters). While such books have the potential to productively trouble the heteronormative spaces of schools by the mere presence of characters who do not conform to sex/gender/sexuality expectations, some of them have also been criticized for reproducing heteronormative family structures and implicit values and failing to go beyond ‘vanilla strategies’ that feel safe in primary school settings. The experiences and reflections of the No Outsiders project members can help educators plan not only which kinds of literature to use but also how to incorporate such texts into the curriculum.

"It's alright to ask for help": findings from a qualitative study exploring the information and support needs of family carers at the end of life.

BackgroundFamily carers play an essential role in providing end-of-life care to their relatives but have been found to experience uncertainty and a lack of confidence in fulfilling their caregiving roles, prompting recent calls for educational or information based resources to be developed for carers.MethodsWe carried out four focus groups with Clinical Nurse Specialists, healthcare assistants, former and current carers at a hospice in the UK, to explore the information and support needs of family carers.ResultsOur findings support previous research by highlighting a number of care situations where carers experience uncertainty and could seemingly benefit from greater information or instruction. Three main themes were identified which reflected carer experiences and needs in relation to potential information giving or educational interventions. These have been described as the knowledge and competence of carers; the preparedness of carers and low levels of carer identification with, and confidence in their roles as ‘carers’, which influences help seeking behaviours; and in turn how potential supportive interventions might be received by carers.ConclusionsFamily carers experience multiple needs for information and education, but meeting these needs remains a challenge. Our results suggest three domains which could underpin this type of intervention: developing knowledge and competence; facilitating preparedness; supporting role recognition and confidence building. We recommend an integrated information giving approach which addresses these domains by combining a resource pack for carers with a more explicit acknowledging role for health professionals. Together these could provide key information and also build confidence amongst family carers to ask for further support and advice as needed.

PRIMARY AND SECONDARY HARM PREVENTION–EATING DISORDERS IN BRITISH ATHLETICS

BackgroundEating disorders are prevalent in athletics and impact on health and performance. Knowledge of how the sports environment contributes to risk can be translated into effective prevention and harm reduction.ObjectivesTo...

‘Back on Track’ – development of a school-based back care education programme

There is a high prevalence of back and neck pain among school children,1 with estimations that 50% of 14-year-olds have experienced back pain.2 Adolescent back pain sufferers are more likely to experience back pain as an adult, and problems can begin at primary school age.3,4 It is widely understood that the risk for back pain in young people is mul- tifactorial; however, the school environ- ment is an important consideration as children spend 30% of their time there.5,6Abertawe Bro-Morgannwg University Health Board serves a population of 500,000 individuals in South Wales. The percentage of paediatric referrals to physiotherapy for back and neck pain increased from 2.1% in September 2011 to 4.5% in March 2012. A project was introduced to ascertain whether local school children's backs are 'fit for the future'. The aims of the project were to investigate the prevalence of back and/or neck pain in school children in the Neath/ Port Talbot locality, identify the possible contributing risk fac- tors and raise awareness of the importance of applying practical back care education in the school environment.In June 2012, a questionnaire-based study was undertaken with a purposive sample of 204 young people from two primary schools (n = 78) and one senior school (n = 126) in the local area, spanning pupils aged from 7 to 15 years. The questionnaire addressed some key risk factors predisposing young people to back and neck pain and included school bag weight, school furniture, general lifestyle, and previous back pain.7,8 It is recognised that psychosocial factors may play a significant role in the development of back pain in young people;5,6 however, investigating such issues was beyond the scope of this physiotherapy-led initiative, and attempting to discuss sensitive subject matter with pupils could be seen as inappropriate within the school environment.Results of the questionnaire found that a total of 72% of the primary school sample reported back and/or neck pain in the past year and 36% within the last week prior to the questionnaire taking place. A total of 64% of the secondary school-aged pupils reported back and/or neck pain in the past year and 33% in past week. A total of 89% of pupils ques- tioned had not reported their back/neck pain to anyone, but 78% wanted teach- ing on how to keep their backs healthy.A number of questions addressed some of the school activity-related risk factors associated with back and neck pain in young people. For primary school children, sitting in assembly and sitting on the floor were the most problematic activities reported. For secondary school children, it was carry- ing their school bag; 15% of 11- to 12-year-olds carried a bag that weighed 10% of their body weight or greater. The literature recommends no more than 10%-15% of body weight.9These results may suggest that grow- ing spines are being affected, and back and neck pain in young people is a prob- lem which needs further investigation. The information obtained also supports the knowledge that many possible risk factors for back/neck pain in children are school-related, such as bag weight, uncomfortable seating and prolonged periods of sitting.10These results led to several local and national press releases along with a BBC Radio Wales live interview during August 2012 in time with pupils' return to school. There was also the opportunity to pre- sent the findings to Neath/Port Talbot primary and secondary school teachers during the Autumn term of 2012. Following on from this, a resource pack entitled 'Back on Track - a school-based back care education programme' evolved as a collaborative with a physio- therapist in England.A comprehensive school in Port Talbot was willing for 'Back on Track' to be piloted with Year 8 pupils aged 12/13 years who had participated in the initial questionnaire. In the spring/summer term 2013, paediatric physiotherapists delivered 'Back on Track' to 106 pupils as part of their pastoral care curriculum. …

Evidence review study of public health interventions in policing: an example of translating evidence into practice for implementation of effective interventions for crime reduction

BackgroundWe describe the use of a study group to assess the potential effectiveness of proactive and place-based approaches to reduce crime in two localities that focused on domestic violence (DV). Evidence-based policing operates under the same principles as evidence-based medicine to use the best scientific evidence. Research and analysis became part of the conversation about how to reduce crime, increase legitimacy, and address internal problems, in an effort to make the large body of research evidence more accessible to practitioners in terms of both generalised principles and specific examples of interventions. MethodsWe used a Campbell Collaboration systematic review that has been developed in the USA into an online practice translation instrument (resource pack) by Lum, Koper, and Telep (2009), called the evidence-based policing matrix. Using rapid appraisal theory, a study group of multidisciplinary stakeholders appraised the evidence presented in the matrix. They first prioritised DV over other crimes on the basis of recent statistical and performance information before appraising summaries of 16 intervention research papers specifically on DV to identify and prioritise the most promising interventions that could be transferred or adapted as part of a local action plan through a series of structured and facilitated meetings, resulting in an evidence report with recommendations. FindingsIn both Derbyshire and Sandwell, numbers of DV calls to the police are estimated annually (n=6000). DV incidents are under-reported. The study group established locally that around 80% of perpetrators of DV may not receive any further advice or intervention after the first reported incident to the police and will return into the community without any conditions imposed. Therefore, the group decided to focus on DV. The rapid appraisal process undertaken by the group identified arrest as an effective police response for reduction of DV, but there were several contextual factors to consider when developing an appropriate local policy response. The consensus that emerged within the study group was that arrest was the start of a process that should include other interventions for the victim and the perpetrator, and the applicability of this process was explored within Derbyshire and Sandwell contexts by drawing on local professional knowledge. The study suggested six potential types of interventions: mandatory arrest; system-initiated warrants for suspects absent at the scene; follow-up home visit interventions; DV unit; public education programme; and treatment programmes. InterpretationWe describe a novel example of use of science and knowledge transfer methodology to transfer evidence to police as joint partners. The police are using these findings to implement changes in their arrest policies and are designing new programmes for perpetrators to be implemented after arrest on the basis of a victim-led restorative justice approach, whereby a perpetrator who admits the offence can access specialised services aimed at future prevention. Derbyshire is piloting the domestic abuse perpetrator scheme and Sandwell is designing a similar intervention. For public health, police, and other organisations to collaborate, they came together under the theme of prevention and reduction of violence to improve the wider determinants of health. Key to this process is motivation and alliance with the community safety partnership; acceptance within the police of recommendations from front-line staff involved in the knowledge translation process; and understanding of limitations of data for statistical evidence. FundingDepartment of Health National Institute for Health Research, Birmingham and Black Country Collaboration for Leadership in Applied Health Research and Care programme.

The Distress Management System for Stroke (DMSS): An approach for screening and initial intervention for post-stroke psychological distress

Aim: To develop a practical system to enable nurses to screen for psychological distress following stroke. Background: Mood disorders and psychological distress are prevalent following stroke, but often go undetected and therefore untreated. National guidelines recommend screening for distress, but the evidence suggests that there are significant barriers to the implementation of post-stroke mood and psychological distress screening programmes. One barrier relates to limitations of questionnaire methods for identifying distress. Specifically, existing mood questionnaires are often too lengthy; miss important emotional changes that result from stroke; and do not necessarily point nurses towards the most helpful intervention approaches. Methods: We sought to develop a brief, clinically valid screening system that could be used by nurses to identify the levels of psychological distress experienced by stroke survivors. As well as determining levels of distress, the system was intended to aid the identification of first-line interventions that nurses could offer to alleviate distress. Results: A screening system was identified from the oncology literature (the Distress Management System [DMS]) that appeared to meet the broad requirements for screening for stroke-related distress. To tailor the DMS for stroke settings, we obtained feedback on the components of the DMS from stroke survivors and stroke nurses, and also consulted the research literature. This led us to: (1) retain the distress screening component of the DMS, the ‘Distress Thermometer’; (2) modify the DMS’s ‘Concerns Checklist’ to reflect the main problems encountered after stroke; and (3) add a ‘Resource Pack’ to the screening system to enable nurses to offer first-line interventions targeted at individuals’ distress. The result, the Distress Management System for Stroke (DMSS), is presented in full in this paper. Conclusion: The DMSS is a potentially useful tool for nurses working in stroke settings. It is brief, straightforward to administer, captures the main emotional concerns of stroke survivors, and the findings from the DMSS can be used to structure interventions for psychological distress. Future work is required, however, to establish the DMSS’s reliability, validity and clinical effectiveness.

Does training in motivational interviewing for community pharmacists improve outcomes for methadone patients? A cluster randomised controlled trial

Feasibility of pharmacist delivered motivational interviewing (MI) to methadone patients has been demonstrated, but its efficacy is untested. This study aimed to determine whether pharmacists trained in MI techniques can improve methadone outcomes. A cluster randomised controlled trial by pharmacy, with community pharmacies across Scotland providing supervised methadone to >10 daily patients, aged >18 years, started on methadone <24 months. Pharmacies were randomised to intervention or control. Intervention pharmacists received MI training and a resource pack. Control pharmacists continued with normal practice. Primary outcome was illicit heroin use. Secondary outcomes were treatment retention, substance use, injecting behaviour, psychological/physical health, treatment satisfaction and patient feedback. Data were collected via structured interviews at baseline and 6 months. Seventy-six pharmacies recruited 542 patients (295 intervention, 247 control), mean age 32 years; 64% male; 91% unemployed; mean treatment length 9 months. No significant difference in outcomes between groups for illicit heroin use (32.4% cf. 31.4%), although within-groups use reduced (P < 0.001); treatment retention was higher in the intervention group but not significantly (88% cf. 81%; P = 0.34); no significant difference between groups in treatment satisfaction, although this improved significantly in intervention (P < 0.05). More intervention than control patients said pharmacists had 'spoken more,' which approached statistical significance (P = 0.06), and more intervention patients found this useful (P < 0.05). Limited intervention delivery may have reduced study power. The intervention did not significantly reduce heroin use, but there are indications of positive benefits from increased communication and treatment satisfaction.

Developing and evaluating cognitive remediation therapy (CRT) for adolescents with anorexia nervosa: A feasibility study

Cognitive Remediation Therapy (CRT) aims at improving neuropsychological weaknesses and associated thinking styles in patients with anorexia nervosa (AN). It has only recently been developed for adolescents with AN, and evidence of its applicability for this particular patient group is limited. This study aimed to test the feasibility of individually tailored and delivered CRT for young females with AN. A sample of 20 in- and outpatients (13-18 years) with AN participated in once- or twice weekly individual CRT sessions. The CRT materials used were available in a "CRT Resource Pack." Feasibility was assessed with regards to the recruitment process, the delivery of the intervention, the materials used and clinical experiences. Overall results indicate that the intervention was feasible with regards to (a) the recruitment of both in- and outpatients, (b) individual tailoring and delivery, (c) the CRT materials adapted to suit young females with AN, and (d) the acceptability for clinicians involved in the study. There were no voluntary dropouts, with 19 of 20 patients completing the entire course of treatment. The findings have implications for the refinement of CRT for the youngest AN population, and strengthens our understanding of the core components in the development and evaluation of novel interventions targeting AN. This study will help inform the design of a subsequent randomized controlled trial.

G210 Health and Education Working in Collaboration to Reduce Emergency Department Attendances Through Engaging with Children About the NHS and How to Use It

AimTo work collaboratively with education to produce a lesson planner and teacher resource pack for use in primary schools to teach children about the NHS and how to stay healthy.To...

Resource pack helps trusts to promote awareness about clinical research to patients

Resource pack helps trusts to promote awareness about clinical research to patients

Joy, Exercise, Enjoyment, Getting out: A Qualitative Study of Older People's Experience of Cycling in Sydney, Australia

Introduction. Cycling can be an enjoyable way to meet physical activity recommendations and is suitable for older people; however cycling participation by older Australians is low. This qualitative study explored motivators, enablers, and barriers to cycling among older people through an age-targeted cycling promotion program. Methods. Seventeen adults who aged 50–75 years participated in a 12-week cycling promotion program which included a cycling skills course, mentor, and resource pack. Semistructured interviews at the beginning and end of the program explored motivators, enablers, and barriers to cycling. Results. Fitness and recreation were the primary motivators for cycling. The biggest barrier was fear of cars and traffic, and the cycling skills course was the most important enabler for improving participants' confidence. Reported outcomes from cycling included improved quality of life (better mental health, social benefit, and empowerment) and improved physical health. Conclusions. A simple cycling program increased cycling participation among older people. This work confirms the importance of improving confidence in this age group through a skills course, mentors, and maps and highlights additional strategies for promoting cycling, such as ongoing improvement to infrastructure and advertising.