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All research records related prevention examples and research

Results 291 - 300 of 328

Prevention services, social care and older people: much discussed but little researched?


A scoping study investigated approaches to prevention services in local authorities which enable older people to retain their independence for as long as possible to maintain their quality of life and reduce pressure on local authority and NHS budgets. The study involved a survey of Directors of Adult Social Services in 9 local authorities to identify what they viewed as their top 3 investments in prevention services for older people, and interviews with lead managers for each intervention. It also reviewed local and national evidence as to whether these interventions lead to a delay or reduction in uptake of social care services This paper summarises the key findings from the research. It explains that the top 3 interventions were reablement (a top 3 approach for all of the local authorities surveyed), technology-based interventions (among the top 3 interventions in 6 authorities), and information and advice (among the top 3 in 3 authorities), while a number of other prevention interventions were identified by one local authority each. It reports on how local authorities seek evidence and guidance on prevention services and factors influencing how local funding was spent, and on assessment of the outcomes and impact of prevention interventions. It also summarises national and local evidence for the top 3 interventions.

Effectiveness and feasibility of virtual reality and gaming system use at home by older adults for enabling physical activity to improve health-related domains: a systematic review

MILLER Kimberly J., et al

Background: Use of virtual reality and commercial gaming systems (VR/gaming) at home by older adults is receiving attention as a means of enabling physical activity. Objective: to summarise evidence for the effectiveness and feasibility of VR/gaming system utilisation by older adults at home for enabling physical activity to improve impairments, activity limitations or participation. Methods: A systematic review searching 12 electronic databases from 1 January 2000–10 July 2012 using key search terms. Two independent reviewers screened yield articles using pre-determined selection criteria, extracted data using customised forms and applied the Cochrane Collaboration Risk of Bias Tool and the Downs and Black Checklist to rate study quality. Results: Fourteen studies investigating the effects of VR/gaming system use by healthy older adults and people with neurological conditions on activity limitations, body functions and physical impairments and cognitive and emotional well-being met the selection criteria. Study quality ratings were low and, therefore, evidence was not strong enough to conclude that interventions were effective. Feasibility was inconsistently reported in studies. Where feasibility was discussed, strong retention (≥70%) and adherence (≥64%) was reported. Initial assistance to use the technologies, and the need for monitoring exertion, aggravation of musculoskeletal symptoms and falls risk were reported. Conclusions: Existing evidence to support the feasibility and effectiveness VR/gaming systems use by older adults at home to enable physical activity to address impairments, activity limitations and participation is weak with a high risk of bias. The findings of this review may inform future, more rigorous research.

Does physical activity reduce burden in carers of people with dementia? A literature review


Objective: Physical exercise has been associated with a range of positive outcomes including improvements in psychological well-being. The aim of the present study was to review current evidence on the effects of physical activity interventions for carers of people with dementia. Methods: A systematic review using electronic databases and key articles of studies that evaluated the effectiveness of physical activity interventions in improving psychological well-being in carers of people with dementia. Relevant papers were scored according to established criteria set by the Cochrane Review Group. Selection criteria for studies were a randomized controlled trial (RCT) design, and comparing physical activity with a control group receiving no specific physical activity intervention. Two reviewers worked independently to select trials, extract data, and assess risk of bias. Results: A total of four RCTs met the inclusion criteria. Studies evaluated home-based supervised physical activity of low to moderate intensity, which included either aerobic exercise, or endurance training. Pooled data showed that physical activity reduced subjective caregiver burden in carers. Conclusions: There is evidence from two RCTs that physical activity reduces subjective caregiver burden for carers of people with dementia. Although statistically significant, the observed benefits should be interpreted with caution as the studies conducted so far have limitations. Further high-quality trials are needed for evaluating the effectiveness of physical activity in improving psychological well-being in carers of people with dementia

Digital reablement: a personalised service to reduce admissions and readmissions to hospitals and nursing homes


Purpose: The purpose of this paper is to consider the importance of digital healthcare through telecare and portable assistive devices in supporting the reengineering of healthcare to deal with the needs of an older and more vulnerable population wishing to remain in their own homes. Design/methodology/approach: It supports the importance of the assessment process to identify hazards associated with independent living, and the possible consequences of accidents. By measuring and prioritising the risks, appropriate management strategies may be introduced to provide a safer home environment. Findings: A process for assessing and managing these risks has been developed. This can be applied to a wide range of different cases and yields solutions that can support independence. Research limitations/implications: The developed digital reablement process can be used to provide vulnerable people with a robust form of risk management. Practical implications: If telecare services follow the process described in this paper then they will improve the outcomes for their users. Originality/value: The process described in this paper is the first attempt to produce a robust assessment process for introducing telecare services in a reablement context.

Prevention is better than cure…

WARD Cally, COOPER Vivien

Purpose: The purpose of this article is to provide a perspective from family carers on the promotion of independence and the prevention of avoidable dependency. Design/methodology/approach: Narrative review and discussion. Findings: Family carers frequently experience their own or their relatives’ needs being met only when they have reached crisis point. A shift to a more preventive approach, delivered in a personalised and family-centred manner, could transform the experiences of people with learning disabilities and their families. Originality/value: Attention is drawn to the importance of strengthening the case for a preventive approach and the role of co-ordinated and strategic leadership in its delivery.

New jobs old roles: working for prevention in a whole-system model of health and social care for older people

SMITH Naomi, BARNES Marian

The ‘Partnerships for Older People Projects’ programme provided government funding for local and health authorities to pilot prevention and intervention services in partnership with the voluntary sector and older people between 2006 and 2009. This evaluation of a pilot in southern England used a Theory of Change approach to gather and reflect on data with different groups involved in the delivery of this model of prevention. This whole-system model, although complex and challenging to implement, was considered overall to have been a success and provided significant learning for partners and stakeholders on the challenges and benefits of working across professional and sectoral boundaries. New posts were created as part of the model – two of these, recruited to and managed by voluntary sector partners, were identified as ‘new jobs’, but echoed ‘old roles’ within community and voluntary sector based health and social care. The authors reflect on the parallels of these roles with previously existing roles and ways of working and reflect on how the whole-system approach of this particular pilot enabled these new jobs to develop in appropriate and successful ways.

How psychological telehealth can alleviate society's mental health burden: a literature review


The authors believe that with the current and growing prevalence of mental illness a major shift and expansion of clinical practice must occur to overcome the mental health burden and facilitate positive change. This article offers an outline of, and case for, incorporating telehealth in mental health practice. For the purposes of this review, telehealth specifically refers to synchronous web camera-based interventions. Novel options, including mHealth (mobile) and the use of computer tablets, are discussed. The implications for practice including training are considered, as well as potential future directions for the field. It is concluded that the available data supports telehealth as an effective mode for the treatment of clients who are unable to pursue mental health services as they are available. It appears that with careful planning, telehealth systems can significantly impact the quality, timeliness, and availability of services in almost any mental health care system. The authors emphasise that the goal is not to substitute for a “real” person but to integrate telehealth into overall provision. In some cases a consistent face-to-face interaction may be the best care but this may not always be possible. The authors conclude by emphasising the importance of appropriate training for the mental health professionals if telehealth is to be effectively.

Right care, first time: services supporting safe hospital discharge and preventing hospital admission and readmission


Older people represent the main in-patient group, at any one time occupying more than two-thirds of acute hospital in-patient beds. Providers and commissioners need to put in place cost-effective, community based services, which can both prevent the need for hospital admission and safely reduce length of stay for older people. A hospital admission can occur when an older person has reached breaking point because of a combination of problems that have been building up before admission: social circumstances (such as living alone or having caring responsibilities) or general frailty. The aim of this publication is to disseminate examples of positive practice in avoiding hospital admission, supporting safe discharge and preventing readmission for older people. This publication highlights 5 examples of local Age UK services, charting the ‘pathway’ of prevention from identifying older people in the local community who may be at risk, to supporting people who are in A&E, and ensuring that discharge from in-patient care is safe and well co-ordinated.

Prevention matters: delivering a prevention-focused model for adult services in Buckinghamshire County Council


Sets out a prevention-focused model of adult health and social care services which place emphasis on maintaining people’s independence and resilience; preventing deterioration into substantial or critical categories of need. The document outlines the current system challenges, the existing lack of joint working between sectors and services, a reactive approach to creating support services and networks and a lack of confidence or capacity to innovate and invest in prevention without an evidence base or business case. It then presents a framework for building the evidence for investment in prevention, proposing a measurement methodology and a definition of the target user group and of outcomes and impact. The document puts forward a new prevention-orientated service model, identifying the high‐level functions, which are shared by different agents and delivery mechanisms, on which the model rests. These are: intelligence and knowledge about the effectiveness of prevention‐related activities, bridging and building networks between formal and informal service delivery, connecting people, maximising existing resources and motivating and enabling. The document examines the core components of the model, which include an intelligence hub, a volunteer hub, community links officers, and community prevention officers. Funding and implementation considerations are also included.

Preventive home visits for mortality, morbidity, and institutionalization in older adults: a systematic review and meta-analysis

MAYO-WILSON Evan, et al

Background: Home visits for older adults aim to prevent cognitive and functional impairment, thus reducing institutionalisation and mortality. Visitors may provide information, investigate untreated problems, encourage medication compliance, and provide referrals to services. Methods and Findings: Data Sources: Ten databases including CENTRAL and Medline searched through December 2012. Study Selection: Randomised controlled trials enrolling community-dwelling persons without dementia aged over 65 years. Interventions included visits at home by a health or social care professional that were not related to hospital discharge. Two authors independently extracted data. Outcomes were pooled using random effects. Main Outcomes and Measures used were mortality, institutionalisation, hospitalisation, falls, injuries, physical functioning, cognitive functioning, quality of life, and psychiatric illness. Results: Sixty-four studies with 28642 participants were included. Home visits were not associated with absolute reductions in mortality at longest follow-up, but some programmes may have small relative effects. There was moderate quality evidence of no overall effect on the number of people institutionalised. There was high quality evidence for number of people who fell, which is consistent with no effect or a small effect, but there was no evidence that these interventions increased independent living. There was low and very low quality evidence of effects for quality of life and physical functioning respectively, but these may not be clinically important. Conclusions: Home visiting is not consistently associated with differences in mortality or independent living, and investigations of heterogeneity did not identify any programmes that are associated with consistent benefits. Due to poor reporting of intervention components and delivery, the authors cannot exclude the possibility that some programmes may be effective.

Results 291 - 300 of 328

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