Support For People Research Articles

Asking to thrive: structures supporting young men’s behavioural health in Belfast, Northern Ireland

Abstract Background Men in Northern Ireland are three times more likely to die by suicide and psychiatric morbidity is significantly higher than for the United Kingdom overall, in part due to the Troubles, a 30-year conflict during which there were 34,000 shootings, 14,000 bombings, and 3,500 deaths. Prior studies suggest strong friendships and high collective efficacy in communities are protective against suicide and self-harm in adolescents and that inquiring about supportive people and structures directly-rather than through parental intermediaries-yields more accurate responses. Methods Semi-structured interviews were conducted with 30 adolescent males aged 16-19 from working-class communities across Belfast. Participants were recruited via trusted community partners and often had experiences with sectarianism and restorative justice. A deductive thematic analysis was conducted of interview transcripts, supplemented by responses to the Self-Harm Inventory and a modified Collective Efficacy Scale. Analyses were completed in NVivo and RStudio. Results In addition to male peer friendships in which they could share confidences, participants strongly endorsed the value of youth work organisations as keystones in supporting not only their own behavioural health through positive modelling but also the reduction of antisocial and sectarian behaviours in their communities. Participants named specific aspects of these structures they found most useful, including demonstrating “masculine success” though community engagement and family life, providing a safe venue for socialising, and delivering restorative justice programming. Conclusions Findings from this study suggest that youth work programming is an important component of both adolescent behavioural health promotion and community safety through the reduction of sectarian and other antisocial behaviours. Participants expressed dismay at the reduction of these services and endorsed both their personal and wider community importance. Key messages • Youth workers may provide valuable positive modelling and behavioural health support to the young men. • Youth work programmes may function both for behavioural health promotion and community violence reduction in Belfast, Northern Ireland.

Analysis of parents’ needs regarding sexual and reproductive health issues of their children

Abstract Background Promoting sexual and reproductive health is a key intervention for young people’s health and well-being. Studies have shown that young people have a need to be supported by a strong network and that parents are considered an important source of information. The aim of our work was to understand the needs and critical issues parents face when raising the topic of sexual and reproductive health with their children in order to strengthen their skills and provide the best tools to support young people. Methods A qualitative focus group research methodology was used; a sexual psychologist facilitated the meetings. Parents of children attending secondary schools in Udine (Italy) in the 2022/2023 school year were invited to participate in the project. The meetings were recorded and transcribed verbatim by two independent researchers. Following an inductive method, recurring themes were extrapolated to represent the main categories and more specific subcategories. Results 46 parents participated in the focus group; 76% of them had no experience with sexual and affective education. Parents felt that sex education was useful in providing accurate information, preventing risks and promoting respect and relationships with others; however, there were concerns that the values taught were not consistent with those of the family. The topic was found to be difficult to discuss with children, both in terms of technical/scientific aspects and addressing issues such as gender identity and sexual orientation. Parents would like to understand what the right communication key is to discuss with their children in an atmosphere of trust. Conclusions Parents recognized the importance of the topic and saw the need to deepen some aspects, especially in terms of relationship and communication. The results of this work will be a useful starting point for the creation of ad hoc pathways aimed at parents to strengthen the relationship with their children. Key messages • Parents want to overcome difficulties by finding the right key to communicate with their children. • Supporting young people and their network to promote sexual and reproductive health is essential.

HCA PIECESTM Care Coach Program: Peer to peer approach to promote person-centred care in long-term care

In Long-Term Care (LTC) settings, the potentially inappropriate use of antipsychotics for behavioural and psychological symptoms of dementia is a persistent issue, with high rates despite limited benefit and serious risk. Best practice is a non-pharmacological, person-centred approach to care, though this can be challenging in LTC settings. To help address this gap, we developed the PIECESTM HCA Care Coach Program and described its implementation and outcomes observed at 13 LTC homes. This program empowers Health Care aides with training, tools, and processes to practice the principles of person-centred care and provide peer mentorship to the care team. After 1 year, we found declining antipsychotics use (by 4.4%) and positive indicators of improved staff experience and improved resident quality of life. The Care Coach Program can be adapted and spread to a variety of LTC settings to help reduce potentially inappropriate antipsychotic use and better support people living with dementia.

Experiences of health services for adults with cerebral palsy, their support people, and service providers.

Experiences of health services for adults with cerebral palsy, their support people, and service providers.

Supporting young people through the COVID-19 pandemic and beyond: a multi-site qualitative longitudinal study

BackgroundThroughout the COVID-19 pandemic, youth have experienced substantial stress due to abrupt changes in education, finances, and social life, compounding pre-existing stressors. With youth (ages 15–26) often at critical points in development, they are vulnerable to long-term mental health challenges brought on by pandemic trauma.MethodsTo identify youth experiences throughout the pandemic and examine changes over time, we conducted semi-structured interviews among n = 141 youth in two Canadian provinces (Ontario and British Columbia) and across the country of Ireland at three time points over the course of more than one year (August 2020-October 2021). We conducted a qualitative longitudinal analysis using an inductive content approach.ResultsCategories identified were (1) coping with hardship; (2) opportunities for growth; (3) adapting to new ways of accessing services; (4) mixed views on the pandemic: attitudes, behaviour, and perception of policy response; (5) navigating COVID-19 information; (6) transitioning to life after the pandemic; and (7) youth-led recommendations for government and service response. The findings also reveal trends in health and wellness in accordance with prolonged periods of lockdown, changes in weather, and return to normalcy after the availability of COVID-19 vaccines. Key recommendations from youth include incorporating youth voice into decision making, communicating public health information effectively to youth, enhancing service delivery post-pandemic, and planning for future pandemics.ConclusionsThese results provide insights into the extensive longitudinal impacts of the COVID-19 pandemic on young people across three geographical locations. Actively involving youth in decision making roles for future pandemics or public health emergencies is critical.

The Role of Adult Social Care in Supporting People with Learning Disabilities Who Rent Their Own Homes in England

The Role of Adult Social Care in Supporting People with Learning Disabilities Who Rent Their Own Homes in England

Attitudes towards being offered a choice of self-sampling or clinician sampling for cervical screening: A cross-sectional survey of women taking part in a clinical validation of HPV self-collection devices.

Primary human papillomavirus (HPV) testing in cervical screening offers the opportunity for women to be given a choice between HPV self-sampling and traditional clinician screening. This study assessed attitudes towards a choice and anticipated future preference among women who had collected a vaginal self-sample alongside their usual cervical screen. Thirty-eight general practices across five areas in England. Overall, 2323 women (24-65 years; response rate: 48%) completed a survey after collecting a self-sample and having a clinician screen at their GP practice. We asked which test they preferred and assessed attitudes to being offered a choice. We explored age, education, ethnicity and screening experience as predictors of attitudes towards a choice and anticipated future choice. Most participants felt they would like a choice between self-sampling and clinician screening (85%) and thought this would improve screening for them (72%). However, 23% felt it would be difficult to choose, 15% would worry about making a choice, and nearly half would prefer a recommendation (48%). Compared with women with degree-level education, those with fewer qualifications were more likely to say they would worry about having a choice or would not want a choice (p < 0.001). The majority said they would choose to self-sample at home if offered a choice in the future (69%; n = 1602/2320). Self-sampling is likely to be popular, but offering a choice could cause worry for some people and many would prefer a recommendation. Supporting people to make a choice will be important, particularly for those with lower levels of education.

Policy, system and service design influence on healthcare inequities for people with end-of-life chronic obstructive airways disease, their support people and health professionals

BackgroundPeople with end-of-life chronic obstructive pulmonary disease (COPD) experience debilitating physical limitations, with a high mortality rate. Our research has shown health system design and delivery leads to inequitable outcomes. Enabling people with end-of-life COPD, their support people, and health professionals to partner in setting the agenda for resource allocation may inform health service improvement.DesignQualitative methodology utilising focus groups including patients, family, friends, informal support people, health care workers and professionals.MethodsThe analysis, utilising critical theory and Actor-Network theory, positioned people with severe COPD, their support people and health professionals as experts in end-of-life care. Analyses triangulated these perspectives, and were reviewed by the research investigators and an expert reference group.ResultsParticipants (n=74) in seven focus groups reported their experiences of inequity within the healthcare system. Equity was an overarching phenomenon identified by participants, with three specific themes being described: policy design, system design, and service design.ConclusionExperiences of patients, their support people and health professionals as experts in end-of-life COPD care can inform health systems and health service design to address current inequities in funding and delivery of care for end-of-life COPD.

Predecessors of Behavioural Initiatives by People With Profound Intellectual Disabilities During Their Interactions With Support Staff: An Exploratory Microanalytical Analysis

ABSTRACTBackgroundInitiating meaningful moments of interaction with people with profound intellectual disabilities can prove to be difficult for support staff. Exploring the behaviour of support staff that precedes the initiations of behaviour by people with profound intellectual disabilities helps to shed light upon the potential facilitating effects of staff behaviour.MethodsThree meaningful moments of interaction between support staff and people with profound intellectual disabilities that were recorded were then microanalytically coded, along with the initial onset of these moments. Each behaviour initiated by people with profound intellectual disabilities was examined to see what specific behaviour by the support staff began precedingly.FindingsThe most frequently displayed ‘staff–client’ behavioural sequences were ‘looking’, ‘moving with head’, ‘moving with arms’ or ‘vocalisation’ of support staff followed by the person with profound intellectual disabilities ‘moving with head’, the staff member ‘moving with arms’ followed by the person with profound intellectual disabilities ‘moving with arms’ and the staff member ‘touching’ followed by the person with profound intellectual disabilities ‘vocalising’. These behavioural sequences occurred less frequently during meaningful moments of interaction in comparison to their onset.ConclusionsIt is important that support staff are cognisant of all the (subtle) behavioural changes in people with profound intellectual disabilities (especially movements with their head) to discern potential behavioural responses. Moreover, they should be cognisant of their own behaviour, insofar as the conscious use of behaviour may facilitate the development of meaningful interactions.

Evaluating a volunteer 'Health Champions' intervention supporting people with severe mental illness to manage their physical health: feasibility hybrid randomised controlled trial.

People with severe mental illness (SMI) have worse physical health than the general population. There is evidence that support from volunteers can help the mental health of people with SMI, but little evidence regarding the support they can give for physical health. To evaluate the feasibility of an intervention where volunteer 'Health Champions' support people with SMI in managing their physical health. A feasibility hybrid randomised controlled trial conducted in mental health teams with people with SMI. Volunteers delivered the Health Champions intervention. We collected data on the feasibility of delivering the intervention, and clinical and cost-effectiveness. Participants were randomised by a statistician independent of the research team, to either having a Health Champion or treatment as usual. Blinding was not done. We recruited 48 participants: 27 to the intervention group and 21 to the control group. Data were analysed for 34 participants. No changes were found in clinical effectiveness for either group. Implementation outcomes measures showed high acceptability, feasibility and appropriateness, but with low response rates. No adverse events were identified in either group. Interviews with participants found they identified changes they had made to their physical health. The cost of implementing the intervention was £312 per participant. The Health Champion intervention was feasible to implement, but the implementation of the study measures was problematic. Participants found the intervention acceptable, feasible and appropriate, and it led them to make changes in their physical health. A larger trial is recommended, with tailored implementation outcome measures.

Pope Francis as an influential leader? How papal statements affect public attitudes toward anti-poverty measures

Abstract Pope Francis has been very active in the public debate on several key social and political issues, gaining a role that foregoes the sphere of religiosity and morality. Overall, he has been perceived by the media and the general public as a leftist figure and even a modernizer. Nonetheless, little is known about the influence of Pope Francis' positions on public opinion, especially beyond the climate change issue and outside the US context. In this regard, this paper contributes to the analysis of the Francis effect on public support for poverty alleviation measures. By employing a survey experiment carried out in Italy, we therefore tested whether the papal endorsement of an anti-poverty measure during the COVID-19 pandemic affected people's support for it. The results highlighted a generalized Francis effect among the Italian public. In addition, trust in the Pope and leftist political orientation substantially enhanced this effect, while the same only partially applies to individual religiosity.

Wireless Technology Supporting People to Live a Fulfilling Social Life

Wireless Technology Supporting People to Live a Fulfilling Social Life

Reading well for dementia – how can reading support people affected by dementia?

The Reading Agency’s Reading Well for dementia scheme is an evidence-based curated collection of books and resources to support the health and wellbeing of people living with dementia, their carers and family members, including younger children. This paper explores the evidence-based methodology behind the development of the scheme, including how people with lived experience were involved in the co-production and book selection processes. It will also examine the evidence on the benefits of reading to those affected by dementia, and the impact that Reading Well for dementia has already had on those accessing the scheme.

Evaluation of local people's perceptions, satisfaction, and support for tourism regarding the Şanlıurfa culture route festival

This study aims to determine the participants' perceptions, satisfaction, and support for tourism regarding the Şanlıurfa Culture Route Festival. The participants' perceptions of the festival's social, individual, economic, and touristic benefits significantly influence their satisfaction levels. Among these, perceived economic and personal benefits impact festival satisfaction the most. Furthermore, participants' satisfaction with the festival substantially affects their support for tourism development. Accordingly, the positive perception of the benefits associated with the festival influences satisfaction levels, and high satisfaction levels directly impact tourism development support in the destination. Analysing the averages of the responses given by participants to the scales, it is found that the festival helps alleviate daily stress, contributes to the promotion of the region, provides social interaction opportunities for local people, increases the business volume of local enterprises and that the events organised during the festival are sufficient. Additionally, it has been observed that participants intend to attend the Culture Route Festival again and strongly support tourism development.

“Everyone’s brains are different…you can’t just have one therapy plan to suit everyone” – A qualitative investigation of community-based rehabilitation services following traumatic brain injury

Purpose To examine the lived experiences of adults who have received community-based rehabilitation (CBR) services in Australia or New Zealand for cognitive-communication disorders (CCDs) following traumatic brain injury (TBI) and their support people. Participants’ recommendations for future models of care were also explored to enhance rehabilitation services for people with TBI. Method A qualitative descriptive approach grounded in phenomenology was used, whereby semi-structured interviews were conducted with each participant. A total of 28 interviews were completed, four in-person and 24 via video conferencing. Two participant groups were recruited: Adults with TBI; and their support people. Sixteen adults with a self-reported diagnosis of cognitive-communication disorder (CCD) following TBI who had received CBR and 12 support people were included. Interviews were analysed using reflexive thematic analysis. Result Four themes were identified by the participant groups indicating the core pillars of CBR models of care. They included the importance of: (a) accessible and inclusive CBR services; (b) specialised clinical skills and treatment approaches; the acknowledgment that (c) knowledge is power; and the significance of (d) peer networks and support. Conclusion This study further advances the evidence base of how services can be optimised to meet the complex needs of adults with CCDs following a TBI. Clinicians, researchers, and service providers should endeavour to incorporate the four core pillars outlined to enhance future CBR models of care for this clinical population.

COVID-Related Visitor Restrictions and Childbirth Experiences in One US Hospital.

The objective of this study was to explore childbirth experiences during COVID-19 visitor restrictions. We used a descriptive phenomenological approach in our study, which took place in a postpartum unit at a level IV birthing hospital in the Mideastern United States, where 3617 births occurred in 2019. A total of 22 participants who were older than 18 years, who gave birth at 37 weeks gestation or more, and who had at least 1 birth experience in the United States prior to the COVID-19 pandemic participated in this study. We assessed participants' birth experiences before and during COVID-19 visitor restrictions through in-depth interviews. Participant perspectives revealed the following 6 themes after an iterative analysis: A Shared Personal Connection is a Valued Trait, A Female Support Person is Important, Nurses Went the Extra Mile, Support People Help with Decision-Making, Two is an Ideal Number of Support People, and Increased Psychological Burden. These findings are vital to inform hospital visitor policies moving forward in the endemic reality of COVID-19 pandemic.

Dementia Friendly communities (DFCs) to improve quality of life for people with dementia: a realist review

BackgroundCurrently, there are more than 55 million people living with dementia worldwide. Supporting people with dementia to live as independently as possible in their communities is a global public health objective. There is limited research exploring the implementation of such interventions in the community context. The aim of the review was to create and refine programme theory – in the form of context mechanism-outcome configurations – on how the characteristics of dementia-friendly communities (DFCs) as geographical locations interact with their social and organisational contexts to understand what works for whom and why.MethodsThis realist review sourced literature from 5 electronic databases: Cochrane Library, CINAHL, Medline, Scopus, PsychINFO and Google Scholar, as well as relevant websites such as Alzheimer’s Society to identify grey literature. Methodological rigour was assessed using the Joanna Briggs Institute critical appraisal tool.ResultsSeven papers were included in this realist review that focused on DFCs in a geographical context The implementation of DFC interventions emerged as a process characterised by two pivotal implementation phases, intricately linked with sub-interventions. The first intervention, termed Hierarchy Commitment (I1a/b), involves the formalisation of agreements by businesses and organizations, along with the implementation of dementia-friendly action plans. Additionally, Educational Resources (I1c) play a significant role in this phase, engaging individuals with dementia and their caregivers in educational initiatives. The second phase, Geographical/Environmental Requirements (I2), encompasses the establishment of effective dementia-friendly signage, accessible meeting places, and community support.ConclusionsThis realist review highlighted a theoretical framework that might guide the development of dementia-friendly communities to enhance the experiences of individuals with dementia and their caregivers within DFCs. Emphasising the need for a theoretical framework in developing geographical DFCs, the review outlines contextual elements, mechanisms, and outcomes, providing a foundation for future studies. The ultimate goal is to establish a robust body of evidence for the sustainable implementation of dementia-friendly communities, thereby improving the quality of life for those with dementia.Study registrationThis study is registered as PROSPERO 2022 CRD42022317784.

Phobia: Supporting children and young people with specific fears

Research suggests that around 10% of children and teenagers have a specific phobia that significantly affects their mental health, functioning and development. Stephanie Thornton looks at the incidence, causes and interventions.

Implementation and Clinical Outcomes of Blood Flow Restriction Training on Adults With Cerebral Palsy: A Case Series.

Cerebral palsy (CP) is a congenital neurological disorder that causes musculoskeletal weakness and biomechanical dysfunctions. Strength training guidelines recommend at least 70% of 1-repetition maximum to increase muscle strength and mass. However, individuals with CP may not tolerate such high exercise intensity. Blood flow restriction (BFR) can induce similar gains in strength and muscle mass using loads as low as 20% to 30% 1-repetition maximum. This case series described the safety, feasibility, and acceptability of BFR in adults with CP and examined changes in muscle mass and strength. Three male participants with gross motor function classification system level 3 CP underwent strength training using a periodized 8-week BFR protocol. Outcomes included: Safety via blood pressure during and post-BFR exercises in addition to adverse event tracking; Feasibility via number of support people and time-duration of BFR exercises; Acceptability via rate of perceived discomfort (0-10) and qualitative interviews; Muscle Mass via ultrasonographic cross-sectional area of the quadriceps and hamstring; and Strength via (1) 3-repetition maximum in the leg press and knee extension, (2) isometric knee flexor and extensor muscle force measured with a hand-held dynamometer, and (3) 30-second sit-to-stand test. Participants replaced 2 exercises from their current regimen with seated knee extension and leg press exercises using progressively higher limb occlusion pressure and exercise intensity. Limb occlusion pressure started at 60%, by week 4 progressed to 80%, and then remained constant. The exercise repetition scheme progressed from fixed nonfailure repetition sets to failure-based repetition sets. Blood pressure never exceeded safety threshold, and no adverse events were reported. The BFR training was time-consuming and resource-intensive, but well-tolerated by participants (rate of perceived discomfort with a mean value of 5.8, 100% protocol adherence). Strength, as measured by 3-repetition maximum testing and 30-second sit-to-stand test, increased, but isometric muscle force and muscle mass changes were inconsistent. Blood flow restriction may be an effective means to increase strength in adults with CP who cannot tolerate high-intensity resistance training. Future research should compare BFR to traditional strength training and investigate mediators of strength changes in this population. for more insights from the authors (see the Video, Supplemental Digital Content available at: http://links.lww.com/JNPT/A473 ).

Contextual Factors Influencing Online Support Providers’ Motivations and Message Provision

This study examined how contextual factors influence support providers’ motivations and message provision. Participants (N = 602) provided supportive messages in response to support-seeking posts sent either publicly or privately through either Facebook or an online support group. Findings revealed that providers’ motivations and message provision varied as a function of the channel and privacy of communication. Moderated mediation analyses showed that privacy moderated the indirect effect of channel on verbal person-centered message provision through approach motivation. This project advances extant understanding regarding direct and indirect effects of contextual factors and motivations on the quality of supportive messages people produce.