Third-sector Organizations Research Articles

Experiences and views of people who frequently call emergency ambulance services: A qualitative study of UK service users.

People who call emergency ambulances frequently are often vulnerable because of health and social circumstances, have unresolved problems or cannot access appropriate care. They have higher mortality rates. Case management by interdisciplinary teams can help reduce demand for emergency servicesand is available in some UK regions. We report results of interviews with people who use emergency ambulance services frequently to understand their experiences of calling and receiving treatment. We used a two-stage recruitment process. A UK ambulance service identified six people who were known to them as frequently calling emergency services. Through third-sector organisations, we also recruited nine individuals with healthcare experiences reflecting the characteristics of people who call frequently. We gained informed consent to record and transcribe all telephone interviews. We used thematic analysis to explore the results. People said they make frequent calls to emergency ambulance services as a last resortwhen they perceive their care needs are urgent and other routes to help have failed. Those with the most complex health needs generally felt their immediate requirements were not resolved and underlying mental and physical problems led them to call again. A third of respondents were also attended to by police and were arrested for behaviour associated with their health needs. Those callers receiving case management did not know they were selected for this. Some respondents were concerned that case management could label frequent callers as troublemakers. People who make frequent calls to emergency ambulance services feel their health and care needs are urgent and ongoing. They cannot see alternative ways to receive help and resolve problems. Communication between health professionals and service users appears inadequate. More research is needed to understand service users'motivations and requirements to inform design and delivery of accessible and effective services. People with relevant experience were involved indeveloping, undertaking and disseminating this research. Two public contributors helped design and deliver the study, including developing and analysing service user interviews and drafting this paper. Eight public members of a Lived Experience Advisory Panel contributed at key stages of study design, interpretation and dissemination. Two more public contributors were members of an independent Study Steering Committee.

‘My Data’ project: Understanding the perceptions of administrative data usage for research of people who use drugs

ObjectivesAdministrative data research requires trust that data will be used sensitively and wisely. People who use drugs are frequently stigmatised, and trust may be a particular barrier. This project aims to understand the perceptions of people who use drugs around the use of their administrative health data for research purposes.
 MethodsThis project will work with Restoration Fife, a third-sector organisation based in Fife, Scotland, that supports people who use drugs. We are conducting focus groups exploring how administrative health data are used in research from the perspectives of people who use drugs, including discussion around different types/sources of data. Data will be analysed using the Framework approach. We will also work with an artist and members of Restoration Fife, to co-produce a short, animated film about how administrative data are used in research around drug use, in order to educate the wider population about how their data are used.
 Results*This presentation will discuss findings from the focus groups on the perceptions of usage of administrative data for different types of research. It will also discuss the use of administrative data in the context of findings from previous studies involving general populations and populations with other vulnerabilities, such as care-experienced populations and people with mental health difficulties. We will also provide a viewing of the film within this paper session.
 *This project is funded by Research Data Scotland and runs from April to September 2023: all results will therefore be available by the time of the ADR conference in November 2023.
 ConclusionsEvidence suggests low levels of public awareness of how and why data are used. We know little about perceptions of people who use drugs, for whom trust of services may be a particular issue. This study uses innovative methods to provide a platform for voices rarely heard in this context.

Non-clinically trained facilitators' experiences of remote psychosocial interventions for older adults with memory loss and their family carers.

Dementia is the seventh leading cause of global mortality, with cases increasing. Psychosocial interventions might help prevent dementia and improve quality of life. Although it is cost-effective for non-clinically trained staff to deliver these, concerns are raised and little is known about the resulting impact on staff, especially for remote interventions. To explore how non-clinically trained facilitators experienced delivering remote, one-to-one and group-based psychosocial interventions with older adults with memory loss and their family carers, under training and supervision. We conducted a secondary thematic analysis of interviews with non-clinically trained facilitators, employed by universities, the National Health Service and third-sector organisations, who facilitated either of two manualised interventions: the APPLE-Tree group dementia prevention for people with mild memory loss or the NIDUS-Family one-to-one dyadic intervention for people living with dementia and their family carers. The overarching theme of building confidence in developing therapeutic relationships was explained with subthemes that described the roles of positioning expertise (subtheme 1), developing clinical skills (subtheme 2), peer support (subtheme 3) in enabling this process and remote delivery as a potential barrier to it (subtheme 4). Non-clinically trained facilitators can have positive experiences delivering remote psychosocial interventions with older adults. Differences in life experience could compound initial fears of being 'in at the deep end' and 'exposed' as lacking expertise. Fears were allayed by experiencing positive therapeutic relationships and outcomes, and by growing confidence. For this to happen, appropriate training and supervision is needed, alongside accounting for the challenges of remote delivery.

Approaches to cyber security in small and medium-sized enterprises: Why it needs to change

Over the last decade, the growth in technology has created numerous opportunities for businesses to improve efficiency, develop new products and services and reach new customers. But it has also provided an opportunity for the criminal fraternity to find new, and incredibly lucrative, ways of targeting victims from anywhere in the world. This has led to cybercrime becoming one of the fastest-growing types of crime affecting individuals, businesses and third-sector organisations alike. For example, in England and Wales, official government statistics show the number of cybercrime incidents has risen by 89 per cent in the past year alone. This paper describes the effect cybercrime has on small and medium-sized enterprises (SMEs), in particular those at the smaller end of the spectrum. The paper explains why SMEs are among the most vulnerable to a breach or an attack and what challenges they face against this growing threat. The paper also describes what the UK government is doing to support SMEs specifically.

Where do those experiencing sexual violence seek help and is routine enquiry acceptable within a sexual healthcare setting? Findings from a population-based survey

ObjectivesMost sexual violence (SV) remains undisclosed to healthcare professionals. The aims of this study were to identify where support would be sought after SV and whether routine enquiry about SV...

Evaluating a Smartphone App (MeT4VeT) to Support the Mental Health of UK Armed Forces Veterans: Feasibility Randomized Controlled Trial.

Previous research demonstrates that less than 50% of military veterans experiencing mental health difficulties seek formal support. Veterans often struggle to identify problems as mental health difficulties. In addition, they may fail to recognize the need for support before reaching a crisis point and face difficulties navigating care pathways to access support. A feasibility trial was conducted to assess a novel digital smartphone app (Mental Health Toolkit for Veterans Project [MeT4VeT]) for UK Armed Forces (UKAF) veterans experiencing mental health difficulties. The trial aimed to explore the feasibility and acceptability of trial procedures for a later randomized controlled trial (RCT) and to assess the acceptability of the MeT4VeT app. Participants were recruited at UK military medical centers, by advertising on social media, and through veteran third-sector organizations between February and November 2021, and assessed for eligibility (male, owned a smartphone, served at least 2 years in the UKAF, left the UKAF within the last 2 years, not undertaking formal mental health treatment). Eligible participants were assigned, on a 1:1 ratio, to either the intervention group (full app) or a control group (noninteractive app with signposting information). Three key objectives were determined a priori to assess the practicality of running an RCT including an assessment of recruitment and retention, evaluation of the technical app delivery and measurement processes, and acceptability and usability of the intervention. In total, 791 individuals completed the participant information sheet, of which 261 (33%) were ineligible, 377 (48%) declined or were unable to be contacted for consent, and 103 (13%) did not download the app or complete the baseline measures. Of this, 50 participants completed baseline measures and were randomly assigned to the intervention group (n=24) or the control group (n=26). The trial was effective at enabling both the technical delivery of the intervention and collection of outcome measures, with improvements in mental health demonstrated for the intervention group from baseline to the 3-month follow-up. Recruitment and retention challenges were highlighted with only 50 out of the 530 eligible participants enrolled in the trial. The acceptability and usability of the MeT4VeT app were generally supported, and it was reported to be a useful, accessible way for veterans to monitor and manage their mental health. The results highlighted that further work is needed to refine recruitment processes and maintain engagement with the app. Following this, an RCT can be considered to robustly assess the ability of the app to positively affect mental health outcomes indicated within this trial. ClinicalTrials.gov NCT05993676; https://clinicaltrials.gov/ct2/show/NCT05993676.

Using Therapeutic Photography in Social Work—An Interpretive Phenomenological Analysis of the Dynamics within a Group Programme

Abstract Therapeutic photography is the practice of using photography in order to explore issues and reach defined outcomes with people who use services. It has been deemed to be an accessible tool which can have a positive impact on self-esteem, self-efficacy and empowerment. Using interpretive phenomenological analysis, this research analyses observations and focus group feedback from a group of participants receiving support from a third-sector organisation for mental health issues. Specifically, the data were analysed to look at how a therapeutic photography programme contributed to group dynamics, exploration and outcomes. Three inter-related super-ordinate themes were identified, these being (1) exposing the self; (2) searching; and (3) developing the self. These themes centred around the identity of the participants as they explored their photographs and associated narratives. The results suggest that the medium of photography contributes to enhanced self-disclosure and social bonding through the familiarity of engaging with photographs. The photographs also enable participants to feel in control of the information shared, facilitating the level of exploration and personal learning around identity and roles and could be beneficial in social work with groups where these outcomes are sought.

Co-creation of a complex, multicomponent rehabilitation intervention and feasibility trial protocol for the PostUraL tachycardia Syndrome Exercise (PULSE) study

BackgroundThere is a dearth of research to support the treatment of people with postural tachycardia syndrome (PoTS). Despite expert consensus suggesting exercise is recommended for this patient group, there are no randomised control trials examining this rigorously. The aim was to co-create a feasibility trial protocol and a rehabilitation intervention for people living with PoTS.MethodsThe intervention and feasibility trial design were co-created as part of the PostUraL tachycardia Syndrome Exercise (PULSE) study. We used the ‘three co’s framework’ of co-define, co-design and co-refine. Recruitment included key national charities and National Health Service Trusts treating people living with PoTS in the UK. Eighteen patient and public involvement members attended the co-define session, and 16 co-creators with a mix of expertise attended the subsequent co-design and co-refine sessions. Seven intervention practitioners were trained in the rehabilitation intervention, providing feedback for further co-refinement.ResultsThe final co-created intervention comprises online physical activity, and lifestyle and behaviour change support sessions. It is based on functional movement activities using a patient-centred approach tailored to individual needs. Physical activity intensity is guided by individuals’ perception of effort rather than by objective measures. Recumbent bikes are provided for home use. Patients deemed randomisation to be acceptable because research in this area was considered important.ConclusionsAn innovative approach was used to co-create the PULSE intervention and feasibility trial protocol to meet the evidence-based and logistical needs of people living with PoTS, clinicians, service deliverers, third-sector organisations, academics and funders. This can be used as a successful example and template for future research internationally. People living with PoTS were recognised as experts and involved in every aspect of conceptualisation, design and refinement. This complex rehabilitation intervention is currently being tested in a randomised feasibility trial comparing the PULSE intervention with best-practice usual care for people living with PoTS.Trial registrationISRCTN45323485 was registered on April 7, 2020.

Circular Water Management in Public Space—Experimental Feasibility Studies in Different Urban Contexts

Several studies highlight the risks related to the growing water crisis, worsened by the effects of pollution, which increasingly make water sources non-potable. The current water-sensitive urban design (WSUD) approach improves resource efficiency and implements urban livability by combining natural water flows with all the scales of the urban landscape. The logistic and operational management of water disposal/treatment and distribution requires performing service design according to cities’ physical and morphological features, starting from their architectural and landscape characteristics. This paper aims to prove that different landscapes can offer different inspirations and possibilities to imagine a WSUD-coherent system, fulfilling the integration requirements with the urban system. For this purpose, three case studies, differing by dimension, morphology, and urban typology, are analyzed, experimenting with circular water usage with no resource waste. This research proposes concrete actions such as conservation, restoration or addition of permeable surfaces, the installation of new accumulation and treatment systems, and the use of water-saving devices. Starting from redesigning the water system, they can also include punctual redevelopment interventions on the urban built environments and opportunities for network development with public administrations, private businesses, third-sector organizations, and end users. This experimentation has led to water savings of up to 80% of the current consumption scenario.

Is partnership working? Complexities and barriers in the development of community safety practice in Wales

AbstractCommunity safety in England and Wales underwent significant change a quarter of a century ago when community safety partnerships (CSPs) were introduced as part of the Crime and Disorder Act 1998. Measures to reduce or prevent anti-social behaviour and crime became the responsibility of not just the police but multiple public and third-sector organisations working in partnership. In Wales, additional complexity exists due to most CSP partners operating and working under both the UK, and Welsh Government remit. Findings from mixed-methods research into the training needs of community safety professionals in Wales revealed that support was needed in several areas of practice, including the practicing of meaningful ‘partnership’ working and problem solving. However, given the complex partnership landscape in Wales and lack of clarity around partnership governance, coupled with a seeming overreliance on the police and local government within community safety, the success of collaborative learning and development plans is limited.

Third-Sector Organizations in Area-Based Initiatives: Instruments for Public Policies or Partners in Co-Production?

Area-based initiatives are central government strategies for community development in particularly deprived urban areas. A core strategy in ABIs is to involve third-sector organizations through co-production. In these areas, the organized civil society is weak, and the public sector has special interests and a willingness to use resources. We ask: if and how can co-production be developed in areas with such power assymetries? Through documents and qualitative interviews, we examined seven ABIs in Norway. We find that managerial ability and coordination, autonomy of action, and, especially, the possession of resources are important dimensions for understanding the development of a co-productive relationship. In the ABIs, we find considerable interdependence between TSO and municipalities as both actors lack resources needed to fulfill their respective goals. This interdependence facilitated co-production.

The Relationship Between Public Administration and Third Sector Organizations: Voluntary Failure Theory and Beyond

Abstract Among Lester Salamon’s early theoretical contributions was the introduction of the “Voluntary Failure” concept. In a series of articles published in the second half of the 1980s (Salamon, L. M. 1987a. “Of Market Failure, Voluntary Failure, and Third-Party Government: Toward a Theory of Government-Nonprofit Relations in the Modern Welfare State.” Journal of Voluntary Action Research 16 (1–2): 29–49. Reprinted in Salamon (1995): 33–49, Salamon, L. M. 1987b. “Partners in Public Service: The Scope and Theory of Government-Nonprofit Relations,” In The Nonprofit Sector. A Research Handbook, edited by W. Powell Walter, 99–117. New Haven: Yale University Press, Salamon, L. M. 1989. “The Voluntary Sector and the Future of the Welfare State.” Nonprofit and Voluntary Sector Quarterly 18 (1): 11–24. Reprinted in Salamon (1995): 203–19) Salamon rejects the existing theories concerning the existence and the growth of nonprofit entities, both demand-side theories such as “government failure” (Weisbrod) and “contract failure” (Hansmann) and supply-side theories (James). He introduces the so-called “third-party government” approach underlining the interdependence between the state and various other (profit and nonprofit) social actors (Salamon Lester M. and Toepler S. 2015. “Government–Nonprofit Cooperation: Anomaly or Necessity?” Voluntas 26: 2155–77). The “voluntary failure theory” is based on the recognition of four limits of nonprofit organizations’ action: (a) philanthropic insufficiency; (b) philanthropic particularism; (c) philanthropic paternalism; (d) philanthropic amateurism. These shortcomings can be overcome by the creation of an institutional framework of collaboration between the public administration and the most organized part of civil society, namely the so-called third-sector organizations. The aim of this paper is to open a discussion around the adequacy of the above-mentioned approach to explain the complex configurations that current relationships between public administration and third sector organizations have assumed in Western democracies, especially in the field of welfare policies. We will do so through the analysis of the recent scientific literature on government-nonprofit relationships, with a particular focus on the so-called “new public governance” (Osborne Stephen, P. 2006. “The New Public Governance?” Public Management Review 8 (3): 377–87, Osborne Stephen, P. ed. 2009. The New Public Governance? Emerging Perspectives on the Theory and Practice of Public Governance. London: Routledge) and the co-creation and co-production paradigm (Torfing, J., E. Sørensen., and A. Røiseland. 2016. “Transforming the Public Sector into an Arena for Co-creation: Barriers, Drivers, Benefits, and Ways Forward.” Administration & Society: 1–31), that emphasize the involvement of citizens (i.e. users or clients) and their associations in the definition of the policies, programs, and services directed to them.

Third-Sector Advocacy: An Exploration of the Work of Community Food Providers

This article explores advocative work of third-sector community food providers in Scotland. The article argues these organisations can contribute to tackling household food insecurity through their advocative work, recognising that state-led policy on household income is needed. Capturing the advocacy of these organisations, rather than focussing solely on their service provision can provide insight that is largely missing from existing community food scholarships. The research adopts a quasi-ethnographic qualitative approach with 16 grassroots community food providers and 5 meso-level support organisations. The findings identify advocacy practices undertaken, targeted at political and public audiences and national and local institutional layers. It highlights the tensions of this work, including fears of exacerbating a failing system. The findings also evidence a complementary, symbiotic, and reciprocally strengthening relationship between service provision and advocacy by third-sector organisations. These contributions demonstrate the potential of this sector to contribute to social change required to address the root causes of household food insecurity.

A qualitative study on lived experience of self-harm in South Asians in the UK: From reasons to recovery.

Self-harm rates and clinical presentations differ by ethnicity. South Asian women are at risk of self-harm. Previous research suggested investigating individuals' experiences with self-harm with qualitative studies in developing self-harm prevention strategies. This research aims to explore self-harm experiences among South Asians in the United Kingdom. Qualitative study. Participants were recruited via third-sector organizations and online platforms. Semi-structured interviews were conducted with 11 South Asian individuals with a history of self-harm living in the United Kingdom. The data were analysed based on a reflective thematic analysis approach. Results revealed four main themes: (1) reasons for self-harm; (2) recovery journey; (3) culture and mental health; and (4) the transition to suicidal thoughts and behaviours. Reasons for self-harm included negative life circumstances, social life difficulties, challenges faced during COVID-19 and mental health problems. Participants described their recovery journey by acknowledging the role of professional help, self-care, psychoeducation and personal growth, improving social relationships,and faith and spirituality. Cultural factors included generational differences and stigma. Culturally adapted psychological interventions were perceived as promising. The reported transition from self-harm to suicidal behaviours was linked to experiencing major stressful life events and the use of severe methods of self-harm. The findings suggest that socio-cultural factors impact mental health and recovery processes among South Asians. Mental health services should consider improving culturally sensitive clinical practices in responding to self-harm among South Asian communities.

The social imaginaries on governance through data: Q-methodological analysis of data professionals' views in the field of mobility

This study strives to contribute to the discussions on the increasing use of data in organisational settings within specific contexts like governance and control of spatial mobilities. Whereas legal, regulatory, and technical aspects are widely studied, there is less knowledge about public discourses on data, especially the data professionals' interpretations (re)constructing these understandings. This study conducted Q-methodological interviews among data professionals employed in the mobility domain in Estonia—a leading digital society—who work in public, private, and third-sector organisations. The findings show the emergence of four discourses on data: (I) data-based liberal internationalism and equal access; (II) integrative data activities through cooperation and disciplinary continuity; (III) (big)data self-reflections and organisational data culture; and (IV) data discrimination aware data practices and privacy protection. Thus, governance through data does not constitute a single imaginary future but creates various scenarios across the types of both data and mobility and the sector. We propose that governance through data emerges in these discourses not only as ‘enculturation’, where data are seen as an ultimate medium of knowledge, but as ‘acculturation’—critically self-reflexive learning through data as a form of change in organisations and among data professionals.

Enacting “Bottom-up” Solidarity in Labor Market Integration for Refugees in England

Abstract This article examines the role that third sector organizations (TSOs) play in supporting refugees’ access to the labor market in England. TSO practices are conceptualized through the notion of “bottom-up” solidarity. Data gathered through interviews with refugees and representatives from charities, social enterprises, and public authorities are used to identify how TSO actors enact bottom-up solidarity and, in turn, facilitate integration of refugees into the labor market. The findings show how labor market transition is built on the transformation of the wider circumstances faced by refugees. Data also demonstrates how the creation of direct employment opportunities, coupled with intermediation and trust brokerage, and alongside episodic and extended coaching, is key to enacting “bottom-up” solidarity.

No two-party game: how third-sector organizations alter administrative burden and improve social equity

ABSTRACT Administrative burdens limit access to government services and threaten social equity due to their disproportionate impact on disadvantaged groups. Third sector organizations can reduce administrative burdens and help individuals to overcome them. Both theoretically and empirically we know little about the different ways in which third-sector organizations do so. Through a longitudinal case study of the Dutch volunteer organization ‘Debt Aid Buddy’, we identify that third-sector organizations can alter administrative burdens as policy entrepreneurs, boundary spanners, co-producers, stewards, and crisis managers. Studying the implementation of these roles can integrate administrative burden research with literature on New Public Governance.

The third sector and democracy in Australia: neoliberal governance and the repression of advocacy

ABSTRACT Pluralism is a key component of liberal democracy, ensuring that diverse groups of citizens have opportunities to contribute to the governance of their society. Third sector organisations (TSOs) are central to pluralist democracy, representing diverse interests through advocacy. Advocacy has many forms but the most visible are protests or public demonstrations aimed at widespread public engagement. However, curtailing advocacy capacity for TSOs has been a political objective of conservative governments for several decades, with the Morrison-led Liberal/National Party government re-engaging in this behaviour. The article illuminates this behaviour through a case study of a recent legislative proposal (2021) to limit TSO advocacy. A qualitative discourse analysis of government and parliamentary materials shows how the state masked proposed changes through an illiberal and populist tactic that narrowed the focus to a narrative of ‘trust’ and uncertainty lacking an evidentiary basis and despite recognition of the potential impact on Australian democracy.

Health Promotion in Debate: The Role of Women Leaders in the Favelas of Rio de Janeiro, Brazil.

This study aimed to discuss the actions of women leaders in favelas in Rio de Janeiro, Brazil, regarding the health promotion of people residing in territories affected by urban violence and inequalities. The understanding of social determinants of health (SDH) is not unequivocal and challenges us to expand our practices in health promotion and equity. A mixed-methods study was conducted with 200 women living in 169 favelas of Rio de Janeiro between 2018 and 2022. Questionnaires and semi-structured face-to-face interviews followed by thematic analysis were conducted. The analysis focused on the socio-demographic profile, community activism, and health promotion strategies undertaken by these groups, expanding knowledge on the experiences of these leaders in confronting social injustices. Results showed that participants performed health promotion actions in their communities by 1. strengthening popular participation and human rights, 2. creating environments favorable to health, and 3. developing personal skills towards social participation in policy design through mobilizing health services and third-sector organizations. With the limited presence of government public agents in these spaces, participants assumed roles as managers of local demands, and, by means of resistance, intersectionality, and solidarity, they transformed this micro-power into the potential for social transformation.

The institutional shaping of third sector organizations: Empirical evidence from Italian provinces

AbstractBy relying on province‐level data from Italy, this paper empirically studies the factors that correlate with the development of third sector organizations (TSOs) in the Italian territory. Moving beyond traditional explanations of TSOs development based on population heterogeneity theories, our analysis points to the role of public institutions as key driving factors of Italian TSOs development. It specifically suggests that public authorities may shape the development of TSOs through three different, albeit interconnected, institutional dimensions: (1) control of corruption—that is, design and implementation of policies and regulations to prevent corruption and strengthen trust in the relationships between public authorities and TSOs; (2) rule of law—that is, creation of stable legal frameworks to reduce the uncertainty faced by TSOs when collaborating with the public sector and to limit arbitrary decisions by politicians and bureaucrats; (3) government effectiveness—that is, improving governments’ credibility and administrative capacity to provide grants and funds to TSOs for social and public services delivery.