Operationalising a Recovery-Oriented Support and Information Programme Online: The EOLAS Programme.

Evidence demonstrates that psychoeducation interventions have clinical and recovery-related benefits for people experiencing psychosis and their family members. The EOLAS programmes are one example of recovery-oriented psychoeducation programmes for psychosis. They differ from other programmes in that they are co-designed and co-facilitated (peer and clinician) group programmes. Due to the COVID-19 pandemic, EOLAS went online using a videoconferencing platform. The study examined the feasibility, acceptability and usefulness of EOLAS-Online and explored whether some of the positive recovery outcomes reported by attendees regarding the in-person programmes were replicated online. Data were collected through an online survey and semi-structured interviews. Quantitative data were analysed using descriptive statistics. Thematic analysis was used for qualitative data. Fifteen attendees (40% of attendees) completed the surveys and eight participated in interviews. A total of 80% were satisfied/very satisfied with the programme. The programme was rated highly for increased knowledge of mental health, coping strategies, and engaging with peers. The use of technology was mostly unproblematic, although some audio and video-related challenges were identified. Engaging with the online programme was experienced positively, including facilitator support to engage. The overall findings indicate that EOLAS-Online is feasible, acceptable and useful in supporting attendees' recovery journeys.

Knowledge, attitudes and self-reported practices of healthcare professionals on Carbapenemase Producing Enterobacterales (CPE): A cross sectional study.

A self-administered validated questionnaire was used to assess the knowledge, attitude and self-reported practices among 109 healthcare professionals in an acute hospital in Ireland on Carbapenemase Producing Enterobacterales. Respondents mean knowledge and self-reported practices scores of CPE were 11.27 (±2.076) and 6.35 (±.846), respectively. Nurses self-reported practice scores were significantly higher than doctors (P<.001). The mean positive attitude score towards CPE management was 10.06 (±1.252). This study demonstrated that healthcare professionals were knowledgeable on the topic of CPE, however there was deficiency in some aspects of knowledge that is relevant to control of CPE transmission.

"I'm not being serviced; I'm being cared for": A mixed methods study of patients' and nurses' perceptions of community oncology nursing delivered by a Community Intervention Team.

PURPOSE: Many patients do not have access to community oncology nursing care in a primary setting and are completely reliant on tertiary hospital care. The aim of this study is to gain an understanding of oncology patients' and nurses' perceptions of community oncology nursing, delivered by an urban Community Intervention Team (CIT) in Ireland. METHODS: A descriptive, concurrent mixed methods approach was used which included semi-structured interviews with 14 oncology patients and an online survey of 27 hospital and community nurses. Thematic analysis and descriptive statistics were used to analyse the data. RESULTS: Six broad themes captured patients' views. Right care related to patients' satisfaction with the range of care available. Right place reflected positive views of the physical setting and the option for homecare for those that needed it. Right time represented patients' comments about the increased appointment efficiency, flexibility, and availability of the service out-of-hours, compared to hospital-based care. Right people was based on patients' portrayals of community cancer nurses as professional, confident, friendly, reassuring and relatable. Integration and communication reflected the communication between the services and patients' impressions of how the services were integrated together. The last theme was improvements to the CIT service. Hospital nurses reported satisfaction with the CIT service while CIT nurses responses suggest the need for better communication with hospital partners. CONCLUSION: Patients had positive perceptions of the service provided by the CIT. Both hospital and community cancer nurses were satisfied with the service and reported that they would like to see an expansion of community oncology nursing services delivered by the CIT.

A process evaluation of 'We Can Quit': a community-based smoking cessation intervention targeting women from areas of socio-disadvantage in Ireland.

BACKGROUND: Smoking poses a serious risk of early preventable death and disease especially for women living with socio-economic disadvantage (SED). A smoking cessation programme, 'We Can Quit', was developed in Ireland tailored to SED women. This includes group-based support delivered by trained lay local community facilitators (CFs) and free nicotine replacement therapy (NRT). The intervention was pilot tested in a cluster randomised controlled trial, 'We Can Quit 2'. This paper reports on the WCQ2 process evaluation which assessed feasibility and acceptability of the programme and trial processes. METHODS: Embedded qualitative design using the UK Medical Research Council's process evaluation framework. Semi-structured interviews with trial participants (N = 21) and CFs (N = 8). Thematic analysis was utilised. RESULTS: Peer-modelling, a non-judgemental environment, CFs facilitation of group support were viewed as acceptable programme related factors. Some participants expressed concerns about NRT side effects. Provision of free NRT was welcomed and accepted by participants, although structural barriers made access challenging. Pharmacists took on a role that became larger than originally envisaged - and the majority provided additional support to women in their quit attempts between group meetings which augmented and supplemented the intervention sessions provided by the CFs. Participants reported good acceptance of repeated measures for data collection, but mixed acceptability of provision of saliva samples. Low literacy affected the feasibility of some women to fully engage with programme and trial-related materials. This was despite efforts made by intervention developers and the trial team to make materials (e.g., participant intervention booklet; consent forms and participant information leaflets) accessible while also meeting requirements under 2018 European General Data Protection Regulation legislation. Hypothetical scenarios of direct (e.g., researcher present during programme delivery) and indirect (e.g., audio recordings of programme sessions) observational fidelity assessments for a future definitive trial (DT) were acceptable. CONCLUSIONS: Intervention and trial-related processes were generally feasible and acceptable to participants and CFs. Any future DT will need to take further steps to mitigate structural barriers to accessing free NRT; and the established problem of low literacy and low educational attainment in SED areas, while continuing to comply within the contemporary legislative research environment. TRIAL REGISTRATION: WCQ2 pilot trial ( ISRCTN74721694 ).

The role and activities of the Traveller mental health liaison nurse: Findings from a multi-stakeholder evaluation.

Irish Travellers are a minority ethnic group within the Irish state with a distinct culture and set of traditions. Travellers experience mental health inequalities, high rates of mental ill health, and structural and individual barriers to mental health supports. A Traveller Mental Health Liaison Nurse (TMHLN) was introduced in a healthcare region in Ireland to provide greater mental health-related support to Travellers. This paper presents a description of the TMHLN role following a multi-stakeholder evaluation. The research design was descriptive qualitative and the findings are reported using COREQ criteria. Thirty-four key stakeholders were interviewed individually or as part of focus groups. Thematic analysis generated two broad themes: the role context, and the specific activities of the role. Mental health nursing experience and understanding of local issues and services were key, as was use of language, building trusting relations, creating the metaphorical, and having the physical, space for working. Specific activities involved in-reach and outreach work, including one-to-one mental health support provision, delivery of education/training sessions to Travellers and service providers, (re)establishing links to specialist services, integrated and interagency working, and promoting cultural competency. The findings set out a role with a greater emphasis on the use of recovery technologies, having an emphasis on psychosocial interventions and self-care, and less focus on biomedical technologies, signs and symptoms, and clinical outcomes. This study contributes to knowledge on the role of a MHLN as this relates to working with marginalized minority groups.

The relationship between body mass index and health-related quality of life in urban disadvantaged children.

INTRODUCTION: The study's aim was to establish, for children living in urban disadvantage, the nature and extent of the relationship between body mass index (BMI) and health-related quality of life (HRQoL), including the role of individual and family factors in influencing this relationship. METHODS: Within the context of a longitudinal design, 255 children aged 7-12 years (50 % male) self-reported their HRQoL (Kidscreen-27) and had their height and weight measured at year one and two. One parent/guardian for each child was also assessed at year one with the OSLO Social Support Scale and Hospital Anxiety and Depression Scale. Regression analysis was also conducted. RESULTS: BMI was weakly inversely associated with 'total HRQoL' (r = -.15, p < .05), 'physical well-being' and 'autonomy and parent relations'. Significant differences were found between normal weight and obese children on all but the latter dimension. Neither weight group, however, fell below the average European HRQoL range. BMI predicted physical well-being a year later and vice versa, whilst autonomy and parent relations also predicted BMI a year later. In terms of 'overweight' children (38 %), those approaching adolescence had poorer physical and school well-being than younger children, and those whose parents had moderate-to-severe levels of depression fared worse on school well-being than children whose parents were not depressed. CONCLUSION: The findings suggest that obesity programmes could aim to prevent/reduce obesity and optimise HRQoL in urban disadvantaged preadolescent children whilst also targeting parental mental health difficulties. Future research should examine mediators of the effect of BMI on HRQoL.

Measuring and modelling body mass index among a cohort of urban children living with disadvantage.

AIM: To report on baseline outcomes of body mass index, eating habits and physical activity of a cohort of urban disadvantaged children from a longitudinal evaluation of a school based, health promoting initiative. BACKGROUND: The healthy schools programme was developed for implementation in schools located in disadvantaged areas of Dublin, Ireland. DESIGN: A prospective, cohort study design was implemented. METHOD: A 3-year longitudinal evaluation was conducted in five intervention and two comparison schools between 2009-2011. Data were collected on each participating child to determine their eating habits, levels of physical activity and body mass index at year 1 (baseline), year 2 and year 3. Independent t-tests were used to compare mean values, chi-square and Fishers exact tests were used to compare proportions at baseline. RESULTS: Participation rates were over 50%. Older children reported eating on average more fruit and vegetables than younger children; breakfast was often eaten on the way to, or in school and in one age group 16.7% of intervention children reported they did not eat breakfast that day. Levels of physical activity varied with over 70% of younger children stating they never played a sport. In intervention schools over one quarter of all children were either overweight or obese. A comparison was conducted between the proportion of 9-year olds overweight and obese in our disadvantaged cohort and a national random sample of 8500 9-year olds and no important differences were observed. CONCLUSION: Baseline results indicate that body mass index rates particularly among pre adolescent, urban disadvantaged girls are of concern.

Baseline results of the first healthy schools evaluation among a community of young, Irish, urban disadvantaged children and a comparison of outcomes with international norms.

BACKGROUND: In 2008, the Irish Government initiated a pilot Healthy Schools Programme based on the World Health Organization Health Promoting Schools Model among children attending schools officially designated as urban and disadvantaged. We present here the first results on physical and emotional health and the relationship between childhood depression and demographic and socioeconomic factors. METHODS: The Healthy Schools Programme evaluation was a 3-year longitudinal outcome study among urban disadvantaged children aged 4 to 12 years. Physical and psychological health outcomes were measured using validated, international instruments at baseline. Outcomes at baseline were compared with international norms and where differences were found, results were statistically modeled to determine factors predicting poor outcomes. RESULTS: A total of 552 children responded at baseline, representing over 50% of all eligible children available to participate from 7 schools. Findings at baseline revealed that in general, children did not differ significantly from international norms. However, detailed analysis of the childhood depression scores revealed that in order of importance, psychological well-being, the school environment, social support, and peer relations and age were statistically significant predictors of increased childhood depression in children under 12 years of age. CONCLUSION: Future health and well-being studies in schools among urban disadvantaged children need to broaden their scope to include measures of depression in children under 12 years of age and be cognisant of the impact of the school environment on the mental and emotional health of the very young.

Regional drug user services in times of scarce financial resources: using a rapid assessment response approach to evaluate, plan, and prioritize essential services.

The objective was to assess need, evaluate projects, and devise a roadmap for future provision given budget cuts. The analysis of 30 substance misuse services in towns and rural areas of Ireland was conducted in 2010. Analysis revealed that 24,315 (95% CI 12,928-40,629) individuals were using illegal drugs in 2006, 893 individuals were using opiates, opiate and cocaine use was increasing as was drug use amongst females. Evaluations demonstrated that not all services were meeting emerging needs, services lacked administrative support, and funding needed to be redirected. The RAR approach was useful for policy decisions and budget cuts in times of economic restraint.

A 'mystery shopper' project to evaluate sexual health and contraceptive services for young people in Croydon.

OBJECTIVE: The purpose of the study was to evaluate the accessibility of, and advice provided by, sexual health and advice services for young people in Croydon, UK using a 'mystery shopper' approach. METHODS: Nineteen young people aged 13-21 years were trained as mystery shoppers. The group developed a set of standards, based in part on existing guidelines of best practice, that should be met when working with young people. The group accessed local sexual health services in pairs posing as genuine patients. Using one of four scenarios, the mystery shoppers assessed the service they received against the predefined standards. RESULTS: The main access difficulties occurred in the reception area. Confidentiality was a major concern and was frequently not explained. The advice and information received was generally clearly given and with an appropriate level of detail. CONCLUSIONS: Additional training and support needs to be offered to receptionists. Confidentiality policies and statements need to be more effectively communicated.