Adaptations to mindfulness-based interventions for neurological impairment: The SMALL PROMPTS approach.

PURPOSE/OBJECTIVE: Standardized mindfulness-based interventions (MBIs), used for the management of physical and psychological symptoms associated with neurological impairment/injury (NI), have been problematized as lacking accessibility due to their focus on sensory presence and mindful walking. Research is needed to generate formalized recommendations regarding how MBIs may be best adapted to enhance their suitability for people with NI. RESEARCH METHOD/DESIGN: A two-phase qualitative study was completed. First, semistructured interviews were undertaken with eight accredited mindfulness teachers with NI. Interviews reviewed the adaptations participants made in their personal and teaching practice, using thematic analysis, and generated recommendations for adaptations to MBIs specific to people with NI. Second, using the DELPHI method, the adapted practice recommendations were reviewed and revised via three rounds, following cognitive interviews with an expert panel (N = 5 trained mindfulness teachers with NI). RESULTS: Ten core areas for adaptation are proposed and validated, acting as SMALL PROMPTS which can be used to adapt mindfulness-based teaching techniques to the specific requirements of people with NI: (a) Skin/bladder/bowel management; (b) mindful Movement; (c) Accessible training; (d) Language Leadership; (e) Permissive pRactice; (f) Optimizing timelines; (g) Management of posture; (h) inclusion of Pacing; (i) Teaching from experience; and (j) body Scanning. CONCLUSION/IMPLICATIONS: Mindfulness is a highly applicable approach for people with sensory loss, however significant, specific adaptations are required to improve inclusivity and accessibility. The SMALL PROMPTS adaptations increase the accessibility, applicability, and utility of MBIs for populations living with NI, enhancing effective management of physical and psychological wellbeing, and optimizing MBI delivery. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Understanding the Experience of Service Users in an Integrated Care Programme for Obesity and Mental Health: A Qualitative Investigation of Total Wellbeing Luton.

Obesity is a complex public health issue with multiple contributing factors. The emphasis on joined care has led to the development and implementation of a number of integrated care interventions targeting obesity and mental health. The purpose of this study was to examine user experience in an integrated care programme for obesity and mental health in Luton, UK. Semi-structured interviews were conducted with a purposeful sample of service users (N = 14). Interview transcripts were analysed using thematic analysis. Analysis of the interviews identified six main themes for understanding service users' experiences of integrated care: (1) 'A user-centered system', (2) 'Supports behaviour change', (3) 'Valued social support', (4) 'Communication is key', (5) 'Flexible referral process', and (6) 'Positive impact on life'. These themes describe how the service is operated, evidence perceived value service users place on social support in behavior change intervention, and address which service areas work well and which require improvement. The findings of these interviews have offered a significant contribution to understanding what service users value the most in an integrated healthcare setting. Service users value ongoing support and being listened to by healthcare professionals, as well as the camaraderie and knowledge acquisition to support their own behaviour change and promote self-regulation following their participation in the programme.

Factors that facilitate or hinder whole system integrated care for obesity and mental health: a scoping review protocol.

INTRODUCTION: Integrated care aims to improve population health. Obesity and mental health are major health issues worldwide. The complexity of the multifactorial drivers of these public health problems has led to the adoption of a whole system approach. This review aims to highlight factors that influence the planning, implementation and evaluation of whole system integrated care for these conditions. METHODS AND ANALYSIS: Using the framework of Arksey and O' Malley, we will perform a comprehensive search in the following databases: MEDLINE, CINAHL, PsychINFO, PubMed, British Nursing Database, Web of Science, Health Systems Evidence, Cochrane Library and University of York Centre for Reviews and Dissemination. Further hand-search of reference lists and the grey literature will be conducted. The search will be restricted to articles published from 2000 to 2020. The review is expected to be completed by August 2021. Full texts of the potential studies will be screened for the inclusion criteria. Quality of studies will be appraised. Narrative synthesis will be completed using data extracted from the included studies. ETHICS AND DISSEMINATION: A favourable ethics opinion for this study was obtained from the Institute for Health Research Ethics Committee of the University of Bedfordshire (IHREC937). This review expects to identify information relating to factors that facilitate or hinder whole system integrated care for obesity and mental health. The finding from this review will be widely disseminated to stakeholders to inform implementation of whole system integrated care initiatives.

An oral history of health psychology in the UK.

Purpose An oral history of the development of health psychology in the United Kingdom. Methods Standard oral history methods produced interviews with 53 UK health psychologists, averaging 92 min in length. All interviewees entered the field from the 1970s to the 2000s, representing all four countries in the United Kingdom. A reconstructive mode of analysis, along with the few existing sources, was used to create a narrative of the history of health psychology in the United Kingdom. Audio recordings and transcripts will be archived for use by future researchers. Findings In the 1970s, medical schools in London recruited psychologists to teach, while also conducting pragmatic research on issues in healthcare. At the same time, some clinical psychologists began to work with physical health conditions in general hospitals. Partly influenced by developments in the United States and Europe, an identity of 'health psychology' developed and spread to researchers and practitioners doing work in psychology and health. In the 1980s, the field continued to attract researchers, including social psychologists working with health behaviours and outcomes, and clinical psychologists working in health care settings. During this time, it became formalized as a scientific field with the creation of the BPS Health Psychology Section, courses, and journals. In the 1990s, the field moved towards professional practice, which was controversial with other BPS divisions. However, it continued to grow and develop through the 2000s and 2010s. Conclusion Reflections on the development of UK health psychology represent the first historical narrative produced from oral testimony of those who were present at the time. Statement of Contribution What is already known on this subject? Health psychology emerged in the 1970s, initially in the United States following an APA Task Force report. It developed from a range of precursor movements including psychosomatic medicine, while in the United Kingdom medical psychology was an additional precursor. The development of health psychology has been discussed for a range of countries including the United States and others, but historical scholarship relating to the United Kingdom has been limited. What does this study add? From an oral history project, a narrative of UK health psychology's development is built up. Influences included opportunities at medical schools from the 1970s onward. Growing interest in health behaviours as a test of social psychology theory was important. The experiences of clinical psychologists working in health care settings are demonstrated. Multidisciplinary influences on the emergence and shaping of health psychology are evident.