STORRE Community: This community contains the ePrints and eTheses produced by the Faculty's staff and students.This community contains the ePrints and eTheses produced by the Faculty's staff and students.http://hdl.handle.net/1893/2042024-03-28T19:25:39Z2024-03-28T19:25:39ZDevelopment of an intervention for reducing infant bathing frequencyUssher, MichaelGoldsmith, LPPerkin, MRWahlich, CChandrasekaran, LCornelius, VBoyle, RJFlohr, CRoberts, RJWillis, KUssher, Mhttp://hdl.handle.net/1893/358552024-03-14T01:03:55ZTitle: Development of an intervention for reducing infant bathing frequency
Author(s): Ussher, Michael; Goldsmith, LP; Perkin, MR; Wahlich, C; Chandrasekaran, L; Cornelius, V; Boyle, RJ; Flohr, C; Roberts, RJ; Willis, K; Ussher, M
Abstract: Background Bathing babies less frequently and intensively in the first six months of life may prevent eczema, but this has not yet been definitively tested in a randomised controlled trial. Such a trial would require evidence-based support to help parents engage with a minimal bathing routine. The present study reports the development of this support. Methods We adopted a four-stage design process: (i) Pregnant women and their families (n = 31) were interviewed to ascertain key barriers and facilitators towards following the minimal bathing intervention. (ii) These barriers and facilitators were mapped to behaviour change techniques, focussing on the intervention types of education, persuasion and environmental restructuring, alongside appropriate modes of delivery, and prototype intervention materials were developed. (iii) We iteratively refined these materials in a workshop with multidisciplinary experts and Patient and Public Involvement and Engagement (PPIE) representatives (n = 13) and an (iv) intervention walkthrough with families (n = 5). The design process was informed by the Behaviour Change Wheel, Theoretical framework of acceptability and the Template for intervention description and replication. Results Social influences and motivational factors are likely to influence both uptake and adherence to the intervention. Anticipated emotional reward from participating in research for the benefit of others was indicated to be a strong facilitator for intervention uptake. Alternatives to bathing, having fun with the baby and the night-time routine, alongside family support, were notable facilitators suggested to aid adherence to the intervention. Barriers included hygiene concerns and anticipated negative social appraisal. Barriers and facilitators were mapped to thirty-six behaviour change techniques, focussing on the intervention types of education, persuasion and environmental restructuring, all of which were embedded into the package of support. The prototype intervention materials received positive feedback from the expert workshop and study walkthrough with families. The final package of support comprises printed and digital prompts and cues, a study booklet, video, and digital tool for self-monitoring. Conclusions The intervention design process incorporated the ‘real world’ views and experiences of families, experts and PPIE representatives, alongside criteria for designing behavioural interventions. The effectiveness of the package of support will be tested in a feasibility trial and embedded process evaluation.Clinical effectiveness of vaginal pessary self-management vs clinic-based care for pelvic organ prolapse (TOPSY): a randomised controlled superiority trialHagen, SuzanneKearney, RohnaGoodman, KirsteenBest, CatherineElders, AndrewMelone, LynnDwyer, LucyDembinsky, MelanieGraham, MargaretAgur, WaelBreeman, SuzanneCulverhouse, JaneForrest, AngelaForrest, MarkBugge, Carolhttp://hdl.handle.net/1893/358392024-03-07T01:10:37Z2023-12-01T00:00:00ZTitle: Clinical effectiveness of vaginal pessary self-management vs clinic-based care for pelvic organ prolapse (TOPSY): a randomised controlled superiority trial
Author(s): Hagen, Suzanne; Kearney, Rohna; Goodman, Kirsteen; Best, Catherine; Elders, Andrew; Melone, Lynn; Dwyer, Lucy; Dembinsky, Melanie; Graham, Margaret; Agur, Wael; Breeman, Suzanne; Culverhouse, Jane; Forrest, Angela; Forrest, Mark; Bugge, Carol
Abstract: Summary Background Prolapse affects 30–40% of women. Those using a pessary for prolapse usually receive care as an outpatient. This trial determined effectiveness and cost-effectiveness of pessary self-management (SM) vs clinic-based care (CBC) in relation to condition-specific quality of life (QoL). Methods Parallel-group, superiority randomised controlled trial, recruiting from 16 May 2018 to 7 February 2020, with follow-up to 17 September 2021. Women attending pessary clinics, ≥18 years, using a pessary (except Shelf, Gellhorn or Cube), with pessary retained ≥2 weeks were eligible. Limited manual dexterity; cognitive deficit; pregnancy; or requirement for non-English teaching were exclusions. SM group received a 30-min teaching session; information leaflet; 2-week follow-up call; and telephone support. CBC group received usual routine appointments. The primary clinical outcome was pelvic floor-specific QoL (PFIQ-7), and incremental net monetary benefit for cost-effectiveness, 18 months post-randomisation. Group allocation was by remote web-based application, minimised on age, user type (new/existing) and centre. Participants, intervention deliverers, researchers and the statistician were not blinded. The primary analysis was intention-to-treat based. Trial registration: https://doi.org/10.1186/ISRCTN62510577. Findings The requisite 340 women were randomised (169 SM, 171 CBC) across 21 centres. There was not a statistically significant difference between groups in PFIQ-7 at 18 months (mean SM 32.3 vs CBC 32.5, adjusted mean difference SM-CBC −0.03, 95% CI −9.32 to 9.25). SM was less costly than CBC. The incremental net benefit of SM was £564 (SE £581, 95% CI −£576 to £1704). A lower percentage of pessary complications was reported in the SM group (mean SM 16.7% vs CBC 22.0%, adjusted mean difference −3.83%, 95% CI –6.86% to −0.81%). There was no meaningful difference in general self-efficacy. Self-managing women were more confident in self-management activities. There were no reported suspected unexpected serious adverse reactions, and 31 unrelated serious adverse events (17 SM, 14 CBC). Interpretation Pessary self-management is cost-effective, does not improve or worsen QoL compared to CBC, and has a lower complication rate. Funding National Institute for Health and Care Research, Health Technology Assessment Programme (16/82/01).2023-12-01T00:00:00ZCultural adaptation of a text message library designed to support diet, activity and weight management behaviour in the postpartum period in the UK: the Supporting MumS (SMS) StudySpyreli, EleniCaperon, LizzieAnsell, EmmaAhern, SaraBridges, SallyHoddinott, PatriciaMcKinley, Michellehttp://hdl.handle.net/1893/358382024-03-07T01:09:54Z2024-02-08T00:00:00ZTitle: Cultural adaptation of a text message library designed to support diet, activity and weight management behaviour in the postpartum period in the UK: the Supporting MumS (SMS) Study
Author(s): Spyreli, Eleni; Caperon, Lizzie; Ansell, Emma; Ahern, Sara; Bridges, Sally; Hoddinott, Patricia; McKinley, Michelle
Abstract: The Supporting MumS library of text messages was developed with extensive personal and public involvement (PPI) to help with postpartum weight management and was successfully tested in a feasibility study in Northern Ireland. Before conducting an effectiveness trial, further PPI work was needed to ensure that the dietary and lifestyle advice offered within the SMS text message library was acceptable and culturally relevant for a wide range of women across the United Kingdom (UK). Recruitment was facilitated by existing community networks that helped capture a culturally diverse group of postpartum women who have struggled with their weight. Nineteen women took part in the PPI exercise: n = 4 African–Caribbean (living in London), n = 8 Asian (Bradford), n = 7 white (Scotland). The PPI work followed an iterative process with initial online group discussions, where selected text messages were reviewed and feedback was sought on their language, tone and cultural relevance. This was followed by message adaptation and re-review. Following initial group discussions to understand the main areas for adaptation, PPI work was carried out with individual mums who reviewed the entire library of text messages and provided feedback on all adaptations. Mums liked the humour and the supportive tone of the messages and approximately 15% of the messages were left unchanged. Suggested edits to ensure the messages were acceptable and relevant to women from a range of cultural backgrounds were minor in nature. Suggestions provided by PPI representatives were mainly in relation to broadening the relevance of snack ideas, recipes, food preparation advice, shopping habits (e.g., click and collect services) and workout ideas. Additional feedback included removing colloquialisms and idioms, the meaning of which may be confusing for somebody not familiar with them or a non-native English speaker (e.g., ‘run out of steam’). Personal and Public Involvement provided helpful suggestions for the cultural and regional adaptation of a lifestyle text message intervention in the postpartum period. The effectiveness and cost-effectiveness of the Supporting MumS study will be tested in a UK-wide trial.2024-02-08T00:00:00ZUse of nicotine replacement therapy to reduce children’s exposure to second-hand smoke in the home: a qualitative pilot study involving local community pharmaciesHowell, RebeccaMcBurney, StephenDi Tano, GiovannaBoags, AileenRowa-Dewar, NenehDobson, RuaraidhO’Donnell, Rachelhttp://hdl.handle.net/1893/358352024-03-07T01:08:47Z2023-12-20T00:00:00ZTitle: Use of nicotine replacement therapy to reduce children’s exposure to second-hand smoke in the home: a qualitative pilot study involving local community pharmacies
Author(s): Howell, Rebecca; McBurney, Stephen; Di Tano, Giovanna; Boags, Aileen; Rowa-Dewar, Neneh; Dobson, Ruaraidh; O’Donnell, Rachel
Abstract: Background In Scotland, and in several other countries, most second-hand smoke exposure now occurs in low-income households, where housing constraints and sole parenting often make it harder to create a smoke-free home. This pilot study provided people who smoke with a free 12-week supply of nicotine replacement therapy through local community pharmacies to reduce smoking indoors. Methods Twenty-five parents/caregivers who smoked in the home and cared for children at least weekly were recruited via Facebook during the COVID-19 pandemic. Air quality (PM2.5) was monitored in participant homes for seven days before their first pharmacy visit and 12 weeks later. Qualitative interviews (N = 14) were conducted with 13 participants who completed the study and one who withdrew part-way through. The interviews explored views/experiences of using nicotine replacement therapy to help create a smoke-free home. Another participant took part in a shorter telephone discussion at their request, with detailed notes taken by the interviewer, because of their speech disorder. Results Three participants reported smoking outdoors only, one of whom subsequently quit smoking. Six participants reported reduced cigarette consumption by 50% in the home, four reported no (sustained) reduction and one reported increased smoking indoors. Self-reported outcomes were not always consistent with PM2.5 readings. Participants’ experiences of accessing nicotine replacement therapy through community pharmacies varied. Some suggested ongoing support to use nicotine replacement products could better assist behavioural change, and that access could be streamlined by posting products to the home. Several suggested that focusing on changing home smoking behaviours using nicotine replacement therapy might facilitate a future quit attempt. Conclusion Access to free nicotine replacement therapy for temporary use indoors may support some people who smoke to reduce children’s exposure to second-hand smoke. Our findings confirm the need to modify the intervention before undertaking a definitive trial to assess the effectiveness of this approach. This work is now underway.2023-12-20T00:00:00Z