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The four essential elements of an asset-based community development process


This paper provides an overview of Asset-Based Community Development (ABCD) and discusses the four essential elements of the (ABCD) process that make it distinct from other approaches. The paper describes these as: resources - the assets that communities create but services so often ignore, such as individual resident contributions, local groups and the natural and built environment; methods - the assumption that communities can and should drive change themselves; functions - the essential functions that communities can perform for themselves, such as enabling health, shaping local economies, and co-recreating; and evaluation - the questions that can be used to evaluate an ABCD process and assess the effectiveness of community life.

Creativity in care: evaluation report


An evaluation of Creativity in Care, a programme commissioned by Nottinghamshire County Council which explored creative approaches to promoting well-being for older people in care and ways of overcoming the barriers that face staff, carers and homes in trying to provide creative and imaginative environments for older people. This report reviews the outcomes of three aspects of the programme: the artist residency, creative mentoring and training. It also sets out recommendations based on the findings. The evaluation identifies the main learning outcomes of the programme as: learning – new approaches were developed by staff resulting in improved motivation and engagement of residents; social skills – positive interaction between residents increased, with one to one work supporting social engagement for the more isolated residents; and value – an improved sense of wellbeing was gained through participation in the arts, with improved levels of confidence and increased decision making; Legacy - the programme led to improved communication, networking and sharing between care homes. Training was also accessed by residential care staff to put into practice beyond the life of the programme.

Disabled Facilities Grant (DFG) and other adaptations: external review

MACKINTOSH Shelia, et al

This review, commissioned by the Department of Health and Social Care, looks at how the Disabled Facilities Grant (DFG) currently operates and makes evidence based recommendations for how it should change in the future. It review aims to develop more effective ways of supporting more people to live in suitable housing so they can stay independent for longer and makes the case for more joint working across housing, health and social care. The focus of the review is on how the disabled or older person can be put at the centre of service provision and what would make it easier for them to access services. It also looks at the role of DFG in prevention and how it can deliver this more effectively. It draws on a range of evidence, including: analysis of data from LOGASnet returns; consultation events attended by local authorities and home improvement agencies; interviews with staff from selected local authorities; and a short review of the academic, policy and practice literature. The conclusions and recommendations include: renaming the grant to reflect that it is part of a broader set interventions to help people remain independent; improved integration of services; better partnership working between health and care and different professions; raising the upper limit of the grant; and changes to the current formula for allocating funding; and updating of the existing means testing regulations. The review also identifies additional research to be carried out.

Understanding the effectiveness and mechanisms of a social prescribing service: a mixed method analysis

WOODALL James, et al

Background: Evidence of the effectiveness of social prescribing is inconclusive causing commissioning challenges. This research focusses on a social prescribing scheme in Northern England which deploys ‘Wellbeing Coordinators’ who offer support to individuals, providing advice on local groups and services in their community. The research sought to understand the outcomes of the service and, in addition, the processes which supported delivery. Methods: Quantitative data was gathered from service users at the point they entered the service and also at the point they exited. Qualitative interviews were also undertaken with service users to gather further understanding of the service and any positive or negative outcomes achieved. In addition, a focus group discussion was also conducted with members of social prescribing staff to ascertain their perspectives of the service both from an operational and strategic perspective. Results: In total, 342 participants provided complete wellbeing data at baseline and post stage and 26 semi-structured qualitative interviews were carried out. Improvements in participants’ well-being, and perceived levels of health and social connectedness as well as reductions in anxiety was demonstrated. In many cases, the social prescribing service had enabled individuals to have a more positive and optimistic view of their life often through offering opportunities to engage in a range of hobbies and activities in the local community. The data on reductions in future access to primary care was inconclusive. Some evidence was found to show that men may have greater benefit from social prescribing than women. Some of the processes which increased the likelihood of success on the social prescribing scheme included the sustained and flexible relationship between the service user and the Wellbeing Coordinator and a strong and vibrant voluntary and community sector. Conclusions: Social prescribing has the potential to address the health and social needs of individuals and communities. This research has shown a range of positive outcomes as a result of service users engaging with the service. Social prescribing should be conceptualised as one way to support primary care and tackle unmet needs.

Interventions to address social connectedness and loneliness for older adults: a scoping review

O'ROURKE Hannah M., COLLINS Laura, SIDANI Souraya

Background: Older adults are at risk for loneliness, and interventions to promote social connectedness are needed to directly address this problem. The nature of interventions aimed to affect the distinct, subjective concepts of loneliness/social connectedness has not been clearly described. The purpose of this review was to map the literature on interventions and strategies to affect loneliness/social connectedness for older adults. Methods: A comprehensive scoping review was conducted. Six electronic databases were searched from inception in July 2015, resulting in 5530 unique records. Standardized inclusion/exclusion criteria were applied, resulting in a set of 44 studies (reported in 54 articles) for further analysis. Data were extracted to describe the interventions and strategies, and the context of the included studies. Analytic techniques included calculating frequencies, manifest content analysis and meta-summary. Results: Interventions were described or evaluated in 39 studies, and five studies described strategies to affect loneliness/social connectedness of older adults or their caregivers in a qualitative descriptive study. The studies were often conducted in the United States (38.6%) among community dwelling (54.5%), cognitively intact (31.8%), and female-majority (86.4%) samples. Few focused on non-white participants (4.5%). Strategies described most often were engaging in purposeful activity and maintaining contact with one’s social network. Of nine intervention types identified, the most frequently described were One-to-One Personal Contact and Group Activity. Authors held divergent views of why the same type of intervention might impact social connectedness, but social contact was the most frequently conceptualized influencing factor targeted, both within and across intervention types. Conclusions: Research to test the divergent theories of why interventions work is needed to advance understanding of intervention mechanisms. Innovative conceptualizations of intervention targets are needed, such as purposeful activity, that move beyond the current focus on the objective social network as a way to promote social connectedness for older adults.

A mixed methods case study exploring the impact of membership of a multi-activity, multicentre community group on social wellbeing of older adults

LINDSAY-SMITH Gabrielle, et al

Background: Social wellbeing factors such as loneliness and social support have a major impact on the health of older adults and can contribute to physical and mental wellbeing. However, with increasing age, social contacts and social support typically decrease and levels of loneliness increase. Group social engagement appears to have additional benefits for the health of older adults compared to socialising individually with friends and family, but further research is required to confirm whether group activities can be beneficial for the social wellbeing of older adults. Methods: This one-year longitudinal mixed methods study investigated the effect of joining a community group, offering a range of social and physical activities, on social wellbeing of adults with a mean age of 70. The study combined a quantitative survey assessing loneliness and social support (n = 28; three time-points, analysed using linear mixed models) and a qualitative focus group study (n = 11, analysed using thematic analysis) of members from Life Activities Clubs Victoria, Australia. Results: There was a significant reduction in loneliness (p = 0.023) and a trend toward an increase in social support (p = 0.056) in the first year after joining. The focus group confirmed these observations and suggested that social support may take longer than 1 year to develop. Focus groups also identified that group membership provided important opportunities for developing new and diverse social connections through shared interest and experience. These connections were key in improving the social wellbeing of members, especially in their sense of feeling supported or connected and less lonely. Participants agreed that increasing connections was especially beneficial following significant life events such as retirement, moving to a new house or partners becoming unwell. Conclusions: Becoming a member of a community group offering social and physical activities may improve social wellbeing in older adults, especially following significant life events such as retirement or moving-house, where social network changes. These results indicate that ageing policy and strategies would benefit from encouraging long-term participation in social groups to assist in adapting to changes that occur in later life and optimise healthy ageing.

Economic evaluations of falls prevention programs for older adults: a systematic review

OLIJ Branko F., et al

Objectives: To provide a comprehensive overview of economic evaluations of falls prevention programs and to evaluate the methodology and quality of these studies. Design: Systematic review of economic evaluations on falls prevention programs. Setting: Studies (N=31) of community‐dwelling older adults (n=25), of older adults living in residential care facilities (n=3), and of both populations (n=3) published before May 2017. Participants: Adults aged 60 and older. Measurements: Information on study characteristics and health economics was collected. Study quality was appraised using the 20‐item Consensus on Health Economic Criteria. Results: Economic evaluations of falls prevention through exercise (n = 9), home assessment (n = 6), medication adjustment (n = 4), multifactorial programs (n = 11), and various other programs (n = 13) were identified. Approximately two‐thirds of all reported incremental cost‐effectiveness ratios (ICERs) with quality‐adjusted life‐years (QALYs) as outcome were below the willingness‐to‐pay threshold of $50,000 per QALY. All studies on home assessment and medication adjustment programs reported favorable ICERs, whereas the results of studies on exercise and multifactorial programs were inconsistent. The overall methodological quality of the studies was good, although there was variation between studies. Conclusion: The majority of the reported ICERs indicated that falls prevention programs were cost‐effective, but methodological differences between studies hampered direct comparison of the cost‐effectiveness of program types. The results imply that investing in falls prevention programs for adults aged 60 and older is cost‐effective. Home assessment programs (ICERs < $40,000/QALY) were the most cost‐effective type of program for community‐dwelling older adults, and medication adjustment programs (ICERs < $13,000/QALY) were the most cost‐effective type of program for older adults living in a residential care facility.

Managing better: a critical prevention study


A case study of Bridgend County Care and Repair's Managing Better service. The service is a three year programme funded by the Welsh Government, which has been co-produced by Care & Repair Cymru, RNIB Cymru and Action on Hearing Loss Cymru. The report shows how Managing Better is working across primary, secondary, and social care, to develop interventions and prevent avoidable pressures on public services. The service has a focus on increasing independence, reducing dependency and improving personal resilience. Individual case studies are included which show how Managing Better has operated in Bridgend and that by effectively targeting interventions service users' quality of life can be much improved and pressure on public services can be reduced. The case studies include services for patients moving from hospital to home patients, and helping people with visual impairment or hearing impairment to live independently at home. It is estimated that every £1 invested in Managing Better yields a £4 saving in other services.

Managing Better good practice guide


This guide aims to inform good practice when supporting older people to live independently at home, working with them to ensure their homes are safe, warm and accessible. It highlights partnership working between Care & Repair Cymru, RNIB Cymru and Action on Hearing Loss Cymru to develop an initiative providing support to older people with sensory loss or who are vulnerable in other ways, helping them to retain their independence and remain living in their own homes, with an emphasis on joint working across health, social care and the third sector. The guide includes a number of individual case studies and highlights good practice examples from the Managing Better service to provide a resource for all Care and Repair caseworkers

Developing peer support in the community: a toolkit


A toolkit to help people to plan and run mental health peer support in the community. The toolkit will be especially useful for those wanting to set up new projects or those involved in commissioning peer support. It outlines the three main approaches to community-based peer support and lists a core set of values underpinning peer support, and make it different from other forms of mental health support. It also looks at how peer support might be organised and provides guidance on how to better understand and communicate the impact of groups. Sections of the toolkit include reflection questions and activities which were developed alongside more than 10 groups and projects. Links to useful resources are included. The toolkit is based upon research undertaken by the Side by Side evaluation partners, which included St George’s, University of London, the McPin Foundation, and the London School of Economics.

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LAUGH research project

LAUGH research project New practice example about a research project to develop highly personalised, playful objects for people with advanced dementia
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