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Results for 'evaluation'

Results 1 - 10 of 145

The Community Navigator Study: results from a feasibility randomised controlled trial of a programme to reduce loneliness for people with complex anxiety or depression

BRYNMOR Lloyd-Evans, et al
2020

Background: Loneliness is common among people with mental health problems and predicts poorer recovery from depression and anxiety. Needs for support with loneliness and social relationships are often under-addressed in mental health services. The Community Navigator programme was designed to reduce loneliness for adults (aged 18 and above) with complex depression or anxiety who were using secondary mental health services. Acceptability and feasibility of the programme and a trial evaluation were tested in a feasibility randomised controlled trial with qualitative evaluation. Methods: Forty participants with depression or anxiety using secondary mental health services were recruited from mental health services in two London sites and randomised to receive: the Community Navigator programme over six months in addition to routine care (n = 30); or routine care (n = 10). Measures of loneliness, depression, other clinical and social outcomes and service use were collected at baseline and six-months follow-up. Levels of engagement in the programme and rates of trial recruitment and retention were assessed. Programme delivery was assessed through session logs completed by Community Navigators. The acceptability of the programme was explored through qualitative interviews (n = 32) with intervention group participants, their family and friends, programme providers and other involved staff. Results: Forty participants were recruited in four months from 65 eligible potential participants asked. No one withdrew from the trial. Follow-up interviews were completed with 35 participants (88%). Process records indicated the programme was delivered as intended: there was a median of seven meetings with their Community Navigator (of a maximum ten) per treatment group participant. Qualitative interviews indicated good acceptability of the programme to stakeholders, and potential utility in reducing loneliness and depression and anxiety. Conclusions: A definitive, multi-site randomised controlled trial is recommended to evaluate the effectiveness and cost-effectiveness of the Community Navigator programme for people with complex anxiety and depression in secondary mental health services.

Signposting and navigation services for older people: economic evidence

BAUER Annette, et al
2019

Health, social care and other local government services can help ‘signpost’ or facilitate links to community and voluntary organisations that can help address social isolation and loneliness. This summary presents evidence on the effectiveness and cost-effectiveness of signposting and navigation to tackle loneliness experienced by older people. It draws on evidence from a systematic review funded by The Campaign to End Loneliness. The evidence suggests that signposting and navigation services have the potential to achieve positive return on investments. However, evidence is restricted to a few small-scale studies and modelling. Further research is needed to test those findings.

Help-at-home for older people: economic evidence

BAUER Annette, TINELLI Michela, GUY Danielle
2019

This case summary provides economic evidence on Help-at-home schemes for older people, drawing on an economic evaluation of a scheme run by Age UK in England. Help-at-home schemes are usually run by voluntary and community organisations, and provide older people with a range of community support services to support older people living in their own homes. These services can include emotional, social, practical and financial support. Evidence from the evaluation suggests that Help-at-home schemes save local government and the NHS around £1500 per person per year, owing to people remaining longer in their homes, fewer GP appointments, and fewer hospital admissions. Volunteers providing support may also benefit, making them more likely to find jobs after gaining skills through volunteering. The summary notes that many of the benefits of help-at-home schemes are likely to depend on local infrastructures and how such schemes are run, making it hard to generalise their value.

British Red Cross 'Support at Home' hospital discharge scheme. A small-scale social care intervention: economic evidence

KNAPP Martin, et al
2019

This case summary presents economic evidence on British Red Cross 'Support at Home' hospital discharge scheme. Through the scheme volunteers offer short-term (4–12 week) practical and emotional support for older people recently discharged from the hospital. A British Red Cross evaluation of the schemes effectiveness identified benefits such as enabling safe discharge, supporting carers and enabling patient advocacy. The intervention costs an average £169 per person, including volunteer time. The programme led to savings from older people needing less help with daily activities and improvements in wellbeing. These savings amounted to £884 per person on average (costs are at 2011 price levels). The summary notes that the quality of evidence on the evaluation was not high due to a lack of control group.

CLS Evidence and Learning Briefings 2020. Paper 3: understanding the nature of change in delivering Community Led Support

CARRIER Jane
2020

One of six briefings to share evaluation findings and lessons from a project to explore the impacts of community led support across the UK. Community led support is a place-based approach to achieving change in health and social care services, through working closely with local communities and partners in the voluntary, community, business and public sectors. The paper draws on analysis of the second round of evaluation across sites who joined the programme between 2014-15 and 2018-19. It highlights ten priority actions to help to achieve, implement and sustain community led support. Key factors for success include knowing what works and doesn’t work in each place, what other related developments are already in place (such as Local Area Coordination, social prescribers and wellbeing coordinators), who the local players are right across the system (including in the community) and how best to work respectfully alongside them.

CLS Evidence and Learning Briefings. Paper 5: Community Led Support in Scotland

HAYDEN Carol, BROWN Helen, TORRANCE Elaine
2020

One of six briefings to share findings and lessons from a project to explore the impacts of community led support across the UK. Community led support is a place-based approach to achieving change in health and social care services, through working closely with local communities and partners in the voluntary, community, business and public sectors. This briefing paper looks at the UK-wide headline findings and lessons in relation to evidence from Scotland, including how this can contribute to delivering the Scottish Government’s existing and emerging policy priorities. The findings show that community led support in Scotland is improving outcomes for individuals, achieving efficiencies for local Health and Social Care Partnerships (HSCPs), and is contributing to public service reform. It shows the benefits of public bodies and other partners working together around a shared vision and values to effect change.

CLS Evidence and Learning Briefings 2020. Paper 6a: Learning from local approaches to implementing Community Led Support in Somerset

HARFLETT Naomi, BOWN Helen
2020

One of six briefings to share findings and lessons from a project to explore the impacts of community led support across the UK. Community led support is a place-based approach to achieving change in health and social care services, through working closely with local communities and partners in the voluntary, community, business and public sectors. This briefing paper shares findings from the Somerset site to examine whether Community Led Support could deliver better outcomes for the same or less resource. Outcome data examined included: outcomes for individuals (e.g. wellbeing, physical and mental health, social isolation/connections); costs to adult social care and other related services; use of adult social care; and use of voluntary and community sector organisations. Evidence suggests that Community Led Support in Somerset has resulted in a range of positive impacts. The report also highlights findings from data drawn from an analysis of 4 other CLS sites in England who have been running for a similar length of time from 2014-15. A second, linked case study (paper 6B) will share findings and lessons from Scottish Borders.

Effectiveness of multifactorial interventions in preventing falls among older adults in the community: a systematic review and meta-analysis.

LEE Seon Heui, YU Soyoung
2020

Background: Falls often cause unexpected injuries that older adults find difficult to recover from (e.g., hip and other major fractures, intracranial bleeding); therefore, fall prevention and interventions are of particular significance. Objectives: This study aimed to examine the effectiveness of multifactorial fall prevention interventions among community-dwelling older adults and compare subgroups that differed in terms of their degree of fall risk and the intensity and components of interventions. Methods: An exhaustive systematic literature search was undertaken using the following databases: Ovid-Medline, Ovid-Embase, and the Cochrane Central Register of Controlled Trials (Central). Two investigators independently extracted data and assessed the quality of the studies by examining the risk of bias. This study conducted a meta-analysis of randomized controlled trials that had been published up to March 31st, 2019, using Review Manager. Results: Of 1,328 studies, 45 articles were relevant to this study. In total, 29 studies included participants in the high-risk group, 3 in the frail group, and 13 in the healthy older adult group. Additionally, 28 and 17 studies used active and referral multifactorial interventions, respectively. Multifactorial interventions included the following components: exercise, education, environmental modification, medication, mobility aids, and vision and psychological management. Multifactorial interventions significantly reduced fall rates in the high-risk (risk ratio 0.66; 95% confidence interval 0.52–0.84) and healthy groups (risk ratio 0.72; 95% confidence interval 0.58–0.89), when compared to the control group. Active multifactorial interventions (risk ratio 0.64; 95% confidence interval 0.51–0.80) and those featuring exercise (risk ratio 0.66; 95% confidence interval 0.54–0.80) and environmental modification also showed significantly reduced fall rates (risk ratio 0.65; 95% confidence interval 0.54–0.79) compared to usual care. Multifactorial interventions had a significantly lower number of people who experienced falls during the study period compared to usual care in the healthy group (risk ratio 0.77; 95% confidence interval 0.62–0.95). Active multifactorial interventions (risk ratio 0.73; 95% confidence interval 0.60–0.89) and those featuring exercise (risk ratio 0.79; 95% confidence interval 0.66–0.95) and environmental modification (risk ratio 0.80; 95% confidence interval 0.68–0.95) had a significantly lower number of people who experienced falls compared to those receiving usual care. Conclusions: Active multifactorial interventions had positive effects on fall rates and the number of people experiencing falls. Thus, healthcare workers, including nurses, should be involved in planning fall prevention programs so that older adults can be provided with optimal care; multifactorial interventions that include exercise and environmental modification are particularly effective in reducing falls.

Efficacy and generalizability of falls prevention interventions in nursing homes: a systematic review and meta-analysis

GULKA Heidi J, et al
2020

Objectives: To determine the efficacy of fall intervention programs in nursing homes (NHs) and the generalizability of these interventions to people living with cognitive impairment and dementia. Design: Systematic review and meta-analysis. Setting and Participants: NH residents (n = 30,057) living in NHs defined as residential facilities that provide 24-hours-a-day surveillance, personal care, and some clinical care for persons who are typically aged ≥65 years with multiple complex chronic health conditions. Methods: Meta-analysis of falls prevention interventions on number of falls, fallers, and recurrent fallers. Results: Thirty-six studies met inclusion criteria for the systematic review. Overall, fall prevention interventions reduced the number of falls [risk ratio (RR) = 0.73, 95% confidence interval (CI) = 0.60-0.88], fallers (RR = 0.80, 95% CI = 0.72-0.89), and recurrent fallers (RR = 0.70, 95% CI = 0.60-0.81). Subanalyses revealed that single interventions have a significant effect on reducing fallers (RR = 0.78, 95% CI = 0.69-0.89) and recurrent fallers (RR = 0.60, 95% CI = 0.52-0.70), whereas multiple interventions reduce fallers (RR = 0.69, 95% CI = 0.39-0.97) and multifactorial interventions reduce number of falls (RR = 0.65, 95% CI = 0.45-0.94). Conclusions and Implications: Exercise as a single intervention reduced the number of fallers and recurrent fallers by 36% and 41%, respectively, in people living in NHs. Other effective interventions included staff education and multiple and multifactorial interventions. However, more research on exercise including people with cognitive impairment and dementia is needed to improve the generalizability of these interventions to the typical NH resident.

Regular doses of nature: the efficacy of green exercise interventions for mental wellbeing

ROGERSON Mike, et al
2020

This study investigated the efficacy of medium-term Green Exercise (GE; being physically active within a natural environment) interventions for improving wellbeing, by pooling data collected at the start and end of participants’ engagement with a range of GE interventions. Hypotheses were that (i) interventions would show good efficacy for improving wellbeing in the overall sample; (ii) compared to participants reporting ‘average to high’ wellbeing at the start of their project, participants with ‘low’ starting wellbeing would report greater improvements post-intervention; and (iii) improvements would significantly differ between age groups. The pooled dataset was categorized in line with UK norms (n = 318) and analyzed using a standardized meta-analysis approach. Effect size was large: g = 0.812 (95% CI [0.599, 1.025]), and differences in wellbeing changes associated with project duration, age or sex were not statistically significant. Compared to those reporting ‘average-high’ starting wellbeing, participants reporting ‘low’ starting wellbeing exhibited greater improvements (BCa 95% CI [−31.8, −26.5]), with 60.8% moving into the ‘average-high’ wellbeing category. GE can play an important role in facilitating wellbeing and can provide alternative pathways for health and social care practice. Public health commissioners should consider integrating such interventions for patients experiencing low wellbeing or associated comorbidities.

Results 1 - 10 of 145

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