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Results for 'outcomes'

Results 1 - 10 of 97

Intergenerational programmes bringing together community dwelling non-familial older adults and children: a systematic review

PETERS Ruth, et al
2021

Background: Social isolation is associated with an increased risk of adverse health outcomes, including functional decline, cognitive decline, and dementia. Intergenerational engagement, i.e. structured or semi structured interactions between non-familial older adults and younger generations is emerging as tool to reduce social isolation in older adults and to benefit children and adults alike. This has great potential for our communities, however, the strength and breadth of the evidence for this is unclear. The researchers undertook a systematic review to summarise the existing evidence for intergenerational interventions with community dwelling non-familial older adults and children, to identify the gaps and to make recommendations for the next steps. Methods: Medline, Embase and PsychInfo were searched from inception to the 28th Sept 2020. Articles were included if they reported research studies evaluating the use of non-familial intergenerational interaction in community dwelling older adults. PROSPERO registration number CRD42020175927 Results: Twenty articles reporting on 16 studies were included. Although all studies reported positive effects in general, numerical outcomes were not recorded in some cases, and outcomes and assessment tools varied and were administered un-blinded. Caution is needed when making interpretations about the efficacy of intergenerational programmes for improving social, health and cognitive outcomes. Discussion: Overall, there is neither strong evidence for nor against community based intergenerational interventions. The increase in popularity of intergenerational programmes alongside the strong perception of potential benefit underscores the urgent need for evidence-based research.

Implementing the Care Act 2014: building social resources to prevent, reduce or delay needs for care and support in adult social care in England

TEW Jerry, et al
2019

This Report is based on research into ‘second wave’ approaches to prevention and capacity building that have become more prominent since the implementation of the Care Act 2014. These approaches involve a fundamental revisioning of the role of local services and seek to maximise resources and opportunities through working in more co-productive ways with citizens, families and communities. The findings are based on a national survey of local authorities and in-depth case study research with stakeholders, beneficiaries and family members in seven local authorities which were promoting one or more ‘second wave’ preventative initiatives. A key findings was that a preventative focus is still relatively new in adult social care and that approaches are often embedded within a variety of strategic initiatives, including: strengths-based models of social work and social care practice (such as 3 Conversations); approaches to social networking and building community capacity (such as Local Area Coordination); mobilising the resources of family and personal networks (through approaches such as Family Group Conferencing, peer support or Community Circles) and targeted ‘upstream’ use of personal budgets. Another finding was that overall, financial pressures were seen as the most important driver towards developing preventative activity, but, at the same time, this was also cited most frequently as the greatest barrier. Other frequently cited barriers to progressing the prevention agenda were competing policy imperatives and, in particular, perceived pressure to make rushed decisions in order to minimise delays in hospital discharge. The report also examines wellbeing outcomes and expenditure. The report makes recommendations for the policy, practice and implementation and evaluation contexts. The reports concludes that there is some strong evidence of the creativity and innovation that is taking place in a significant proportion of local authorities. While progress may not be consistent across the sector, the research shows that a sizable proportion of local authorities have been investing in activity that is designed to increase capacity and capability at individual, family and community levels, and thereby to contribute to preventing, reducing or delaying the need for adult social care services.

Total transformation of care and support

SOCIAL CARE INSTITUTE FOR EXCELLENCE
2017

This updated version of 'Total transformation of care and support: future of care', originally published in 2016, looks at how transformed and integrated health and care could improve outcomes and cost effectiveness of services. It outlines five areas where transformation needs to take place and where health and care systems can help older and disabled people build a good quality life. It identifies six well-evidenced models, which demonstrate how to combine scarce state resources with the capacity of individuals, families and communities. Using data from Birmingham City Council, it explores the potential for scaling up these six schemes, modelling their outcomes, costs and estimated financial benefits. It also highlights key enablers that could help areas implement each scheme. The models cover an initiative to help isolated older people; the Living Well scheme to improve resilience amongst older people; a service to support adults with learning disabilities to become independent; Shared Lives; a scheme to improve hospital discharge, and support for people following a hospital stay. Appendices include a template to help structure conversations with local citizens and stakeholders about transforming. It is the third of SCIE's Future of care series, which aims to stimulate discussion amongst policy-makers and planners about the future of care and support.

Social prescribing could empower patients to address non-medical problems in their lives

NATIONAL INSTITUTE FOR HEALTH RESEARCH
2020

This NIHR Alert reports on a review carried out by researchers on the NIHR Evidence Synthesis Working Group to understand how GP social prescribing schemes work and when they are most effective. Researchers reviewed 118 documents evaluating social prescribing schemes and the link worker role in the UK. They found social prescribing schemes increase patients’ confidence, motivation and the skills to manage their own wellbeing - which may reduce their reliance on GPs. These positive outcomes were only achieved when patients, GPs and healthcare managers were clear about the value of social prescribing schemes and when link workers had sufficient time and resources to form a connection with patients, with the voluntary/community sector and with healthcare staff.

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.

Community exchange and time currencies: a systematic and in-depth thematic review of impact on public health outcomes

LEE C, et al
2020

Objectives: Austerity in government funding, and public service reform, has heightened expectations on UK communities to develop activities and resources supportive of population health and become part of a transformed place-based system of community health and social care. As non-monetary place-based approaches, Community Exchange/Time Currencies could improve social contact and cohesion, and help mobilise families, neighbourhoods, communities and their assets in beneficial ways for health. Despite this interest, the evidence base for health outcomes resulting from such initiatives is underdeveloped. Study design: A systematic review. Methods: A literature review was conducted to identify evidence gaps and advance understanding of the potential of Community Exchange System. Studies were quality assessed, and evidence was synthesised on ‘typology’, population targeted and health-related and wider community outcomes. Results: The overall study quality was low, with few using objective measures of impact on health or well-being, and none reporting costs. Many drew on qualitative accounts of impact on health, well-being and broader community outcomes. Although many studies lacked methodological rigour, there was consistent evidence of positive impacts on key indicators of health and social capital, and the data have potential to inform theory. Conclusions: Methodologies for capturing impacts are often insufficiently robust to inform policy requirements and economic assessment, and there remains a need for objective, systematic evaluation of Community Exchange and Time Currency systems. There is also a strong argument for deeper investigation of ‘programme theories’ underpinning these activities, to better understand what needs to be in place to trigger their potential for generating positive health and well-being outcomes.

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.

The effectiveness of community-based social innovations for healthy ageing in middle- and high-income countries: a systematic review

GHIGA Ioana, et al
2020

Objectives: Community-based social innovations (CBSIs) are one type of intervention that may help to address the complex needs of ageing populations globally. The aim of this research was to assess evidence for the effectiveness and cost-effectiveness of CBSIs involving in such contexts. Methods: This study conducted a systematic review of CBSIs for healthy ageing in middle- and high-income countries, including any CBSI that aimed to empower people aged 50 and over by motivating them to take initiative for their own health and wellbeing. The protocol was registered with Prospero (CRD 42016051622). A comprehensive search was conducted in 15 academic databases and advanced search in Google. This study included published studies from 2000 onwards in any language. Exploratory meta-analysis was conducted for quantitative studies reporting similar outcomes, and qualitative studies were analysed using thematic analysis. Narrative synthesis was conducted. Searches yielded 13,262 unique hits, from which 44 papers met the inclusion criteria. Results: Most studies reported interventions having positive impacts on participants, such as reduced depression, though the majority of studies were classified as being at medium or high risk of bias. There was no evidence on costs or cost-effectiveness and very little reporting of outcomes at an organization or system level. CBSIs have the potential for positive impacts, but with nearly half of studies coming from high-income urban settings (particularly the United Kingdom and the United States of America), there is a lack of generalizability of these findings. Conclusions: This research highlights the need to improve reporting of CBSIs as complex interventions, and for improved conceptualization of these interventions to inform research and practice.

Effects of participating in community assets on quality of life and costs of care: longitudinal cohort study of older people in England

MUNFORD Luke Aaron, et al
2020

Objectives: Improving outcomes for older people with long-term conditions and multimorbidity is a priority. Current policy commits to substantial expansion of social prescribing to community assets, such as charity, voluntary or community groups. This study uses longitudinal data to add to the limited evidence on whether this is associated with better quality of life or lower costs of care. Design: Prospective 18-month cohort survey of self-reported participation in community assets and quality of life linked to administrative care records. Effects of starting and stopping participation estimated using double-robust estimation. Setting: Participation in community asset facilities. Costs of primary and secondary care. Participants 4377 older people with long-term conditions. Intervention Participation in community assets. Primary and secondary outcome measures Quality-adjusted life years (QALYs), healthcare costs and social value estimated using net benefits. Results: Starting to participate in community assets was associated with a 0.017 (95% CI 0.002 to 0.032) gain in QALYs after 6 months, 0.030 (95% CI 0.005 to 0.054) after 12 months and 0.056 (95% CI 0.017 to 0.094) after 18 months. Cumulative effects on care costs were negative in each time period: £−96 (95% CI £−512 to £321) at 6 months; £−283 (95% CI £−926 to £359) at 12 months; and £−453 (95% CI £−1366 to £461) at 18 months. The net benefit of starting to participate was £1956 (95% CI £209 to £3703) per participant at 18 months. Stopping participation was associated with larger negative impacts of −0.102 (95% CI −0.173 to −0.031) QALYs and £1335.33 (95% CI £112.85 to £2557.81) higher costs after 18 months. Conclusions: Participation in community assets by older people with long-term conditions is associated with improved quality of life and reduced costs of care. Sustaining that participation is important because there are considerable health changes associated with stopping. The results support the inclusion of community assets as part of an integrated care model for older patients.

Results 1 - 10 of 97

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