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Results for 'prevention'

Results 1 - 10 of 102

A review of the basic principles of sustainable community-based volunteering approaches to tackling loneliness and social isolation among older people

PARKINSON Andy, GRIFFITHS Endaf, TRIER Eva
2018

This study examines the social, economic and environmental conditions that enable community-based volunteering projects to reduce loneliness and isolation in older people to become successful. It also identifies barriers to volunteering approaches, and how they can be tackled. The study involved a literature review, consultation with stakeholders, and an analysis of eight case studies in Wales. Drawing on the findings, it also sets out a Theory of Change to show how programmes have the potential to reduce loneliness and social isolation and provides a framework for the future self-evaluation of programmes. The study found that schemes employ a range of approaches in order to engage and support their clients, including in-home visits, telephone befriending, and group activities. This can be influenced by funding or its ability to support the project’s aims and outcomes. Other key findings highlight the need for schemes to be able to accurately assess the social and emotional status of older people so as to deliver appropriate interventions; for schemes to target effectively to reach those most at risk. It also found that schemes adopting a participatory approach which places local people at the heart and schemes which focused on smaller geographical areas tended to be more effective. The report makes eight recommendations, which include the development of a standard method or tools for monitoring and evaluating volunteer-led schemes.

Effectiveness of complex falls prevention interventions in residential aged care settings: a systematic review

FRANCIS-COAD Jacqueline, et al
2018

Objective: The objective of this review was to synthesize the best available evidence for the effectiveness of complex falls prevention interventions delivered at two or more of the following levels: resident, facility or organization, on fall rates in the residential aged care (RAC) population. Introduction: Preventing falls in the high risk RAC population is a common global goal with acknowledged complexity. Previous meta-analyses have not specifically addressed complexity, described as falls prevention intervention delivery at multiple levels of a RAC organization, to determine its effect on fall outcomes. Inclusion criteria: The current review considered studies that included participants who were aged 65 years and over residing in long-term care settings providing 24-hour supervision and/or care assistance. Studies that evaluated complex falls prevention interventions delivered by single discipline or multidisciplinary teams across at least two or all of the following levels: residents, RAC facility and RAC organization were eligible. Experimental study designs including randomized controlled trials, controlled clinical trials and quasi-experimental trials that reported on measures related to fall incidence were considered, namely, rate of falls (expressed as the number of falls per 1000 occupied bed days), the number of participants who became fallers (expressed as the number of participants who fell once or more) and the rate of injurious falls (expressed as the number of falls with injury per 1000 occupied bed days). Methods: A three-step search strategy was undertaken, commencing with an initial scoping search of MEDLINE and CINAHL databases prior to an extensive search of all relevant published literature, clinical trial registries and gray literature. Two independent reviewers assessed selected studies for methodological validity using the standardized critical appraisal instrument from the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI SUMARI). Data were extracted from the selected studies using the standardized data extraction tool from JBI SUMARI. Quantitative data were pooled in statistical meta-analysis for rate of falls, the number of participants who became fallers and the rate of injurious falls. Meta-analysis was conducted using a random-effect model with heterogeneity assessed using the standard Chi-squared and I2 index. Where statistical pooling was not possible, study findings were presented in narrative form. Results: Twelve studies were included in this review with seven being eligible for meta-analysis. Complex falls prevention interventions delivered at multiple levels in RAC populations did not show a significant effect in reducing fall rates (MD = −1.29; 95% CI [−3.01, 0.43]), or the proportion of residents who fell (OR = 0.76; 95% CI [0.42, 1.38]). However, a sensitivity analysis suggested complex falls prevention interventions delivered with additional resources at multiple levels had a significant positive effect in reducing fall rates (MD = −2.26; 95% CI [−3.72, −0.80]). Conclusions: Complex falls prevention interventions delivered at multiple levels in the RAC population may reduce fall rates when additional staffing, expertise or resources are provided. Organizations may need to determine how resources can be allocated to best address falls prevention management. Future research should continue to investigate which combinations of multifactorial interventions are effective.

Effectiveness of interventions to reduce homelessness: a systematic review and meta-analysis

MUNTHE-KAAS Heather Menzies, BERG Rigmor C., BLAASVAER Nora
2018

This review assesses the effectiveness of interventions combining housing programmes with or without case management as a means to reduce homelessness and increase residential stability for individuals who are homeless, or at risk of becoming homeless. A total of 43 studies were included. The majority of which were conducted in the United States, with three from the United Kingdom and one each from Australia, Canada, and Denmark. Included interventions were found to perform better than the usual services at reducing homelessness or improving housing stability in all comparisons. These interventions were: High- and low-intensity case management (including assertive community treatment); Housing First; critical time intervention; abstinence-contingent housing; non-abstinence-contingent housing with high-intensity case management; housing vouchers; and residential treatment. The review concludes that a range of housing programs and case management interventions appear to reduce homelessness and improve housing stability, compared to usual services. However, the review identified risk of bias in the studies due to poor reporting, lack of blinding, or poor randomization or allocation concealment of participants. The review also identified gaps in the research with respect to: disadvantaged youth; abstinence contingent housing with case management or day treatment; non-abstinence contingent housing comparing group vs independent living; Housing First compared to interventions other than usual services, and; studies outside of the USA.

Interventions to prevent and reduce excessive alcohol consumption in older people: a systematic review and meta-analysis

KELLY Sarah, et al
2018

Background: harmful alcohol consumption is reported to be increasing in older people. To intervene and reduce associated risks, evidence currently available needs to be identified. Methods: two systematic reviews in older populations (55+ years): (1) Interventions to prevent or reduce excessive alcohol consumption; (2) Interventions as (1) also reporting cognitive and dementia outcomes. Comprehensive database searches from 2000 to November 2016 for studies in English, from OECD countries. Alcohol dependence treatment excluded. Data were synthesised narratively and using meta-analysis. Risk of bias was assessed using NICE methodology. Reviews are reported according to PRISMA. Results: thirteen studies were identified, but none with cognition or dementia outcomes. Three related to primary prevention; 10 targeted harmful or hazardous older drinkers. A complex range of interventions, intensity and delivery was found. There was an overall intervention effect for 3- and 6-month outcomes combined (8 studies; 3,591 participants; pooled standard mean difference (SMD) −0.18 (95% CI −0.28, −0.07) and 12 months (6 studies; 2,788 participants SMD −0.16 (95% CI −0.32, −0.01) but risk of bias for most studies was unclear with significant heterogeneity. Limited evidence (three studies) suggested more intensive interventions with personalised feedback, physician advice, educational materials, follow-up could be most effective. However, simple interventions including brief interventions, leaflets, alcohol assessments with advice to reduce drinking could also have a positive effect. Conclusions: alcohol interventions in older people may be effective but studies were at unclear or high risk of bias. Evidence gaps include primary prevention, cost-effectiveness, impact on cognitive and dementia outcomes.

The association between physical activity and social isolation in community-dwelling older adults

ROBINS Lauren M., et al
2018

Objectives: Social isolation is an increasing concern in older community-dwelling adults. There is growing need to determine effective interventions addressing social isolation. This study aimed to determine whether a relationship exists between physical activity (recreational and/or household-based) and social isolation. An examination was conducted for whether group- or home-based falls prevention exercise was associated with social isolation. Methods: Cross-sectional analysis of telephone survey data was used to investigate relationships between physical activity, health, age, gender, living arrangements, ethnicity and participation in group- or home-based falls prevention exercise on social isolation. Univariable and multivariable ordered logistic regression analyses were conducted. Results: Factors found to be significantly associated with reduced social isolation in multivariable analysis included living with a partner/spouse, reporting better general health, higher levels of household-based physical activity (OR = 1.03, CI = 1.01–1.05) and feeling less downhearted/depressed. Being more socially isolated was associated with symptoms of depression and a diagnosis of congestive heart failure (pseudo R2 = 0.104). Discussion: Findings suggest that household-based physical activity is related to social isolation in community-dwelling older adults. Further research is required to determine the nature of this relationship and to investigate the impact of group physical activity interventions on social isolation.

Fall prevention for people with learning disabilities: key points and recommendations for practitioners and researchers

FINLAYSON Janet
2018

Purpose: The purpose of this paper is to provide a narrative review of what is currently known about the high rates of falls, and fall injuries, which are experienced by people with learning disabilities (LDs) throughout their lives. Design/methodology/approach: Narrative review. Current evidence is summarised as key points and recommendations for practitioners and researchers. Findings: People with LDs experience similar rates of falls as older adults in the wider population, but throughout their lives, or at an earlier age. Originality/value: Key points and recommendations are summarised for practitioners and researchers to promote fall prevention strategies and interventions for people with LDs.

Innovative models of health, care and support for adults

SOCIAL CARE INSTITUTE FOR EXCELLENCE
2018

This briefing explains that innovative, often small-scale models of health, social care and support for adults could be scaled up to benefit as many people as possible. The challenge is to make scaling up successful. The briefing is based on research conducted during the spring of 2017 by Nesta, SCIE, Shared Lives Plus and PPL. It includes real life examples and case studies to show how stakeholders are involved in building and growing successful and sustainable innovations in health, care and support which provide new ways of delivering relationship-based care. It also identifies key challenges and facilitators to scaling up innovative models and makes recommendations to help make impactful innovative models become part of mainstream care. It includes case studies from North London Carers – a community network of young professionals and older neighbours which helps to reduce loneliness and increase wellbeing; Age UK’s Personalised Integrated Care programme – which brings together voluntary organisations and health and care services to support for older people living with multiple long-term conditions who are at risk of recurring hospital admission; Shared lives - adults either live with or regularly visit their chosen carer; North Yorkshire Innovation Fund – which provides funding to support voluntary and community organisations providing innovative intervention or prevention measures; and Wigan’s place-based approach. To help innovative models to flourish and scale up, it identifies keys to success as: a shared ambition to embed person- and community-centred ways of working; co-production; a new model of leadership which is collaborative and convening; investment and commissioning in approaches which result in high quality outcomes; and use of data to drive change a willingness to learn from experience.

A return on investment tool for the assessment of falls prevention programmes for older people living in the community

PUBLIC HEALTH ENGLAND
2018

This report presents results of a tool developed by York Health Economics Consortium to assess the potential return on investment (ROI) of falls prevention programmes targeted at older people living in the community. The tool pulls together evidence on the effectiveness and associated costs for four programmes where there was evidence of cost-effectiveness: Otago home exercise, Falls Management Exercise group programme, Tai Chi group exercise, and home assessment and modification. Based on an example analysis, all four interventions were found to be cost-effective, thus producing a positive societal ROI. One out of four interventions was also found to have a positive financial ROI (ie cost savings outweigh the cost of implementation). An accompanying Excel sheet allows for results to be tailored to the local situation based on the knowledge of the user.

Preventative support for adult carers in Wales: rapid review

SOCIAL CARE INSTITUTE FOR EXCELLENCE
2018

This rapid review, commissioned by Social Care Wales, draws on research published since 2012 to identify emerging and promising practice in adult carers support. It focuses on support that takes a preventative approach by providing information and support to reduce or prevent the likelihood of carer crisis and breakdown, and improve the overall quality of carers’ lives. The review identifies key characteristics of effective preventative support services. It presents the review findings across the following key themes: identification and recognition of carers; the provision of information, advice and assistance; and supporting carers for a life outside of their caring role, through services such as respite and short breaks, emotional and employment support. Examples of services and interventions from Wales and England are included throughout. The final section looks at the available evidence on evaluating what works for carers.

Evaluation of a web-based app to assist home-hazard modification in falls prevention

WARD Gillian, WALKER-CLARKE Aimee, HOLLIDAY Nikki
2017

Introduction: Given the impact falls can have on older people and their families, many health and social care services are focused on preventing falls and implementing interventions to reduce future falls. FallCheck is a web app that supports identification of home-hazards and directs users towards self-management strategies to reduce risk of falling. Method: A survey by clinical experts of a beta version of FallCheck was conducted, producing quantitative and qualitative data including issues and attributes identified by respondents. Thirty-six individuals signed up to take part in the study, and 27 respondents took part in the final evaluation survey. Findings: Testing by health and social care professionals found there is scope for using the app as a digital self-assessment tool by people at risk of falls. It has further potential as an effective tool to support environmental/behavioural change to reduce risk of falls. Conclusion: FallCheck was developed from a sound evidence-base to support home-hazard modification as an effective intervention component within a multifactorial intervention to prevent falls. Health and social care professionals found it had good acceptability for use in practice, justifying further testing of the usability and effectiveness of the app in supporting behavioural changes and environmental modifications with people at risk of falling and carers.

Results 1 - 10 of 102

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