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Results for 'evaluation'

Results 1 - 10 of 124

What approaches to social prescribing work, for whom, and in what circumstances? A realist review

HUSK Kerryn, et al

The use of non‐medical referral, community referral or social prescribing interventions has been proposed as a cost‐effective alternative to help those with long‐term conditions manage their illness and improve health and well‐being. However, the evidence base for social prescribing currently lags considerably behind practice. In this paper, we explore what is known about whether different methods of social prescribing referral and supported uptake do (or do not) work. Supported by an Expert Advisory Group, we conducted a realist review in two phases. The first identified evidence specifically relating to social prescribing in order to develop programme theories in the form of ‘if‐then’ statements, articulating how social prescribing models are expected to work. In the second phase, we aimed to clarify these processes and include broader evidence to better explain the proposed mechanisms. The first phase resulted in 109 studies contributing to the synthesis, and the second phase 34. We generated 40 statements relating to organising principles of how the referral takes place (Enrolment), is accepted (Engagement), and completing an activity (Adherence). Six of these statements were prioritised using web‐based nominal group technique by our Expert Group. Studies indicate that patients are more likely to enrol if they believe the social prescription will be of benefit, the referral is presented in an acceptable way that matches their needs and expectations, and concerns elicited and addressed appropriately by the referrer. Patients are more likely to engage if the activity is both accessible and transit to the first session supported. Adherence to activity programmes can be impacted through having an activity leader who is skilled and knowledgeable or through changes in the patient's conditions or symptoms. However, the evidence base is not sufficiently developed methodologically for us to make any general inferences about effectiveness of particular models or approaches.

Older people and social isolation: a review of the evidence


A review of the current literature and evidence on effective interventions to tackle social isolation amongst older people. Based on the findings from the review, the report recommends that: interventions should be targeted at those most at-risk; base their activities on the evidence of what works; and focus on providing group activities, particularly those which have an arts, educational learning or social focus and are participatory. It also recommends exploring the use of using new technologies, such as the internet and Skype.

The effectiveness of interventions for reducing subjective and objective social isolation among people with mental health problems: a systematic review

MA Ruimin, et al

Purpose: Subjective and objective social isolation are important factors contributing to both physical and mental health problems, including premature mortality and depression. This systematic review evaluated the current evidence for the effectiveness of interventions to improve subjective and/or objective social isolation for people with mental health problems. Primary outcomes of interest included loneliness, perceived social support, and objective social isolation. Methods: Three databases were searched for relevant randomised controlled trials (RCTs). Studies were included if they evaluated interventions for people with mental health problems and had objective and/or subjective social isolation (including loneliness) as their primary outcome, or as one of a number of outcomes with none identified as primary. Results: In total, 30 RCTs met the review’s inclusion criteria: 15 included subjective social isolation as an outcome and 11 included objective social isolation. The remaining four evaluated both outcomes. There was considerable variability between trials in types of intervention and participants’ characteristics. Significant results were reported in a minority of trials, but methodological limitations, such as small sample size, restricted conclusions from many studies. Conclusion: The evidence is not yet strong enough to make specific recommendations for practice. Preliminary evidence suggests that promising interventions may include cognitive modification for subjective social isolation, and interventions with mixed strategies and supported socialisation for objective social isolation. This study highlights the need for more thorough, theory-driven intervention development and for well-designed and adequately powered RCTs.

Evaluating social care prevention in England: challenges and opportunities


Context: The Care Act 2014 placed a statutory duty on adult social care (ASC) to prevent and delay the development of needs for care and support. There is little clarity about how to translate this national obligation into effective local practice. Objectives: This exploratory study sought to lay the foundations for understanding approaches to this new duty by identifying: emerging local understandings of prevention; associated implementation strate­gies; and the potential for designing evaluation frameworks. Methods: Local perspectives were secured through: in-depth interviews in six English local authorities; reviews of local strategy, implementation documents and reviews of data sources; and methods for evaluating local initiatives in sampled authorities. Findings: The findings indicate important differences between and within local authorities in conceptuali­sations of prevention. Although willingness to commission services was strongly linked to the availability of evidence on what works in prevention, council conducted limited local evaluations. This study also found limited collaboration between ASC and Health in developing joint prevention approaches, in part due to differ­ences in conceptualisation and also constraints arising from different priorities and information systems. Limitations: The exploratory nature of the study and the small sample size limits the generalisability of its findings. Overall, the number of local authorities and respondents allowed us to explore a range of local views, opinions and practices related to the prevention agenda in a variety of contexts, however the findings are not generalisable to all English local authorities. Implications: This study suggests that the limited local evidence about prevention, combined with finan­cial austerity, may lead to disproportionate investment in a small number of interventions where existing evidence suggests cost-savings potential, which, in turn, may impact authorities’ ability to fulfil their statutory duties related to preventing and delaying the needs for care and support. In this connection, this study highlights the potential for developing local evaluation strategies utilising existing but largely unexploited local administrative data collections.

A systematic review of interventions for loneliness among older adults living in long-term care facilities

QUAN Nicolas G., et al

Objectives: This study aimed to review loneliness interventions for older adults living in long-term care (LTC) facilities over the past 10 years, to categorise interventions by type, and to compare effectiveness of loneliness interventions in these settings. Methods: Systematic review followed PRISMA guidelines. Articles matching search criteria were collected from PubMed, PsycINFO, and Web of Science from 2009 to 2019. The inclusion criteria were as follows: 1) English language, 2) intervention studies with a quantitative measure that compares pre-trial to post-trial changes, 3) loneliness as a primary or secondary outcome 4) subjects age >65, and 5) subjects living in a LTC facility, such as a nursing home, assisted-living, or hospice. Results: A total of 15 intervention studies qualified for systematic review. Most of these interventions were psychological therapies and leisure/skill development interventions. Approximately, 87% of studies reported significant decreases in loneliness following intervention. Laughter therapy, horticultural therapy, and reminiscence therapy were associated with the greatest decreases in loneliness. Discussion: Results suggest that, although less common than interventions in the community, there are several effective interventions to reduce loneliness among older adults living in LTC facilities. Lack of standardised measures and high-quality studies limits comparisons between intervention types and generalizability to different populations.

The effect of music on wellbeing - case studies


This article reports on a small scale study of the impact of personalised music on residents living with dementia in a care home. Three care homes (Fremantle Trust's Lent Rise House, Lewin House and Meadowside care homes) and nine people living with dementia took part in the two week study. Care staff and activity organisers selected times of day (and night) to play music or a radio station with the resident. The researchers collaborated with Unforgettable (now part of Live Better with Dementia), a company allied to the non-profit organisation Music and Memory which donates iPods to people living in care homes to deliver the intervention. Findings:Qualitative statements from the care homes were invariably positive. Personalised music was found to reduce agitation and improve mood. None of the people living with dementia were able to initiate music themselves, so it required either staff or visitors to play it. Conclusion: the findings suggest that, when compiled in a person-centred way, music can be a source of comfort and calm. It can counter distressing events, alleviate anxiety, and increase sociability. The paper also includes some implications for practice or tips on how to provide personalised music in care homes.

Animal-assisted therapy for dementia (Review)

LAI NM, et al

Background: A range of new therapeutic strategies has been evaluated in research, and the use of trained animals in therapy sessions, termed animal‐assisted therapy (AAT), is receiving increasing attention. Objectives: To evaluate the efficacy and safety of animal‐assisted therapy for people with dementia. Search methods: Medical databases were searched for this review to September 2019. Key characteristics of included studies: This study included nine randomised controlled trials (clinical studies where people are randomly put into one of two or more treatment groups), involving 305 people with dementia, which compared AAT to a control treatment (either usual care or an alternative treatment). All studies took place in Europe or the US. Seven studies compared AAT to usual care or to another activity which had nothing to do with animals. Two studies compared AAT (using live animals) to the use of robotic animals. One study compared AAT to the use of a soft toy cat. Key findings: this study found evidence from two studies with 83 participants that people with dementia who had AAT were possibly slightly less depressed at the end of treatment than people who had standard care or other interventions not related to animals. The study also found evidence from three studies with 164 participants that people who received AAT had no clear difference in their quality of life compared to those who did not. However, the study found no evidence of an effect on social functioning (interactions with their environment and families), behaviour, agitation, activities of daily living, self‐care ability or balance. There were no clear differences when AAT was compared with the use of a robotic animal in two studies, or with the use of a soft toy cat in one study. Conclusions: AAT may slightly reduce depressive symptoms. Otherwise, no conclusions can yet be drawn on whether AAT is beneficial or safe for people with dementia. The small size of the included studies, and the diversity of outcomes and outcome measures, were major issues. The researchers recommend further well‐conducted studies with the inclusion of important outcomes such as emotional and social well‐being, quality of life, side effects, and effects on the animals.

The impact of social prescribing services on service users: a systematic review of the evidence


Background: Social prescribing initiatives are widely implemented in the UK National Health Service to integrate health and social care. Social prescribing is a service in primary care that links patients with non-medical needs to sources of support provided by the community and voluntary sector to help improve their health and wellbeing. Such programmes usually include navigators, who work with referred patients and issue onward referrals to sources of non-medical support. This systematic review aimed to assess the evidence of service user outcomes of social prescribing programmes based on primary care and involving navigators. Methods: 11 databases, the grey literature, and the reference lists of relevant studies were searched to identify the available evidence on the impact of social prescribing on service users. Searches were limited to literature written in English. No date restrictions were applied, and searches were conducted to June 2018. Findings were synthesised narratively, employing thematic analysis. The Mixed Methods Appraisal Tool Version 2011 was used to evaluate the methodological quality of included studies. Results: Sixteen studies met the inclusion criteria. The evidence base is mixed, some studies found improvements in health and wellbeing, health-related behaviours, self-concepts, feelings, social contacts and day-to-day functioning post-social prescribing, whereas others have not. The review also shows that the evaluation methodologies utilised were variable in quality. Conclusion: In order to assess the success of social prescribing services, more high quality and comparable evaluations need to be conducted in the future.

The impact of telehealth on use of hospital care and mortality: research summary


The impact of telehealth on hospital use, patient admission and mortality were evaluated in three trial sites in England. The sites were from the Department of Health’s Whole System Demonstrator pilots. The evaluation focused on the use of telehealth to people with chronic obstructive pulmonary disease, diabetes or heart failure. It used a large randomised controlled trial which included over 3,000 participants (1,584 control and 1,570 intervention) in which groups of patients either received the telehealth intervention or acted as controls by receiving their usual care. Statistically significant differences in rates of emergency hospital admission and mortality were found during the twelve months of the trial between control and intervention groups. For intervention patients, the overall costs of hospital care (including emergency admissions, elective admissions and outpatient attendances) were £188 per patient less than those for controls. However, this cost difference was not statistically significant. As well as summarising the main findings the research summary highlights the limitations of the research and other issues that need to be considered in relation to the findings.

A systematic review of loneliness interventions among non-elderly adults

BESSAHA Melissa L., et al

Loneliness - the subjective experience of social isolation—is an important indicator of quality of life for adults and a major determinant of health. While much research has focused on interventions to alleviate loneliness in elderly populations, there has been no systematic investigation of loneliness interventions targeting the non-elderly adult population. The aim of this systematic review is to summarise current understanding on the effectiveness of interventions for alleviating loneliness among non-elderly adults. Littell et al.’s (Systematic reviews and meta-analysis, Oxford University Press, New York, 2008) systematic review process was used to organise, synthesise, and critique findings. An electronic search was conducted using relevant databases (CINAHL, Pubmed, PsycINFO, Social Work Abstracts) and keywords and index terms for three concepts: age, loneliness outcome, and intervention study. Study selection was limited to studies conducted in English, assessed a primary outcome measure of loneliness, and included a population of non-elderly adults ages 18 to 64. Out of 5813 studies identified for initial screening, 264 studies underwent full-text review, and 68 studies met inclusion criteria. Pairs of reviewers extracted and synthesised data including research design, sampling techniques, and outcomes. Results are grouped by primary sub-populations in which interventions were conducted including people with mental illnesses; disabilities; chronic illnesses; military members; parents and caregivers; immigrants and refugees; and other marginalised groups. Several interventions, particularly those involving technology and support groups, significantly reduced loneliness. This review informs clinical social work practice around programs that reduce loneliness and its consequences among specific sub-populations of non-elderly adults.

Results 1 - 10 of 124


Moving Memory

Moving Memory Practice example about how the Moving Memory Dance Theatre Company is challenging perceived notions of age and ageing.

Chatty Cafe Scheme

Chatty Cafe Scheme Practice example about how the Chatty Cafe Scheme is helping to tackle loneliness by bringing people of all ages together

Oomph! Wellness

Oomph! Wellness Practice example about how Oomph! Wellness is supporting staff to get older adults active and combat growing levels of social isolation


KOMP Practice example about how KOMP, designed by No Isolation is helping older people stay connected with their families

LAUGH research project

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