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Article ; Online: Financial adversity and subsequent health and wellbeing during the COVID-19 pandemic in the UK

Tom May / Henry Aughterson / Daisy Fancourt / Alexandra Burton

SSM: Qualitative Research in Health, Vol 3, Iss , Pp 100224- (2023)

A qualitative interview study

2023

Abstract: Aims: There are concerns that the economic impacts of the COVID-19 pandemic, including employment inactivity and job loss, will have consequences for the UK population's health and wellbeing. However, there is limited qualitative research into how ... ...

Abstract	Aims: There are concerns that the economic impacts of the COVID-19 pandemic, including employment inactivity and job loss, will have consequences for the UK population's health and wellbeing. However, there is limited qualitative research into how financial adversity contributes to poor health outcomes in this context. This study aimed to explore forms of financial adversity experienced during the pandemic and their subsequent impacts for health and wellbeing. Methods: Qualitative semi-structured interviews with 20 people who experienced a form of financial adversity during the pandemic and six service providers employed in social welfare support services. Data were analysed using reflexive thematic analysis. Results: Two main sources of financial adversity were identified: reductions in household incomes and increased living costs which engendered emotional and physical burdens. Coping strategies included increased financial borrowing, support from informal and formal networks and cutting back on energy use, food and non-essential items. Conclusion: Our study highlighted exposure to multiple financial adversities because of the pandemic and how these experiences led to poor mental and physical health. The findings underline the importance of measures attending to the immediate needs of individuals, including accessible, co-located financial and psychological services, as well as broader measures that seek to reduce social and economic inequalities.
Keywords	Financial adversity ; Mental health ; Wellbeing ; COVID-19 ; Qualitative ; Social determinants ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2023-06-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The Impact of the COVID-19 Pandemic and Associated Societal Restrictions on People Experiencing Homelessness (PEH)

Jo Dawes / Tom May / Daisy Fancourt / Alexandra Burton

International Journal of Environmental Research and Public Health, Vol 19, Iss 15526, p

A Qualitative Interview Study with PEH and Service Providers in the UK

2022 Volume 15526

Abstract: People experiencing homelessness (PEH) faced unique challenges during the COVID-19 pandemic, including changes to accommodation availability, societal restrictions impacting access to essentials like food, and services moving to online and remote access. ...

Abstract	People experiencing homelessness (PEH) faced unique challenges during the COVID-19 pandemic, including changes to accommodation availability, societal restrictions impacting access to essentials like food, and services moving to online and remote access. This in-depth qualitative research aims to add to the existing, but limited research exploring how the pandemic affected PEH. 33 semi-structured qualitative interviews (22 with PEH during the pandemic and 11 with homelessness sector service providers) were undertaken in the United Kingdom between April 2021 and January 2022. Interviews were audio-recorded, transcribed and analysed using reflexive thematic analysis. To ensure consistency of coding, 10% of interviews were coded by two researchers. The PEH sample was 50% female, aged 24–59 years, 59% white British, and included people who had lived in hostels/hotels, with friends/family, and on the streets during the COVID-19 pandemic. Providers came from varied services, including support charities, housing, and addiction services. Five key themes were identified: (i) the understanding of and adherence to public health guidance and restrictions; (ii) the experience of people accommodated by the ‘Everyone In’ initiative; (iii) the impact of social distancing guidelines on PEH experiences in public spaces; (iv) the importance of social support and connections to others; and (v) how homelessness services adapted their provision. Policy makers and public health communicators must learn from PEH to maximize the effectiveness of future public health strategies. Housing providers and support services should recognize the implications of imposing a lack of choice on people who need accommodation during a public health emergency. The loss of usual support for PEH triggered a loss of ability to rely on usual ‘survival strategies’, which negatively influenced their health. This research highlights successes and difficulties in supporting PEH during the COVID-19 pandemic and informs planning for similar public health events.
Keywords	homelessness ; COVID-19 ; health ; housing ; support services ; coping ; Medicine ; R
Subject code	360
Language	English
Publishing date	2022-11-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: What are the active ingredients of ‘arts in health’ activities? Development of the INgredients iN ArTs in hEalth (INNATE) Framework [version 2; peer review

Alexandra Burton / Katey Warran / Daisy Fancourt

Wellcome Open Research, Vol

2 approved]

2022 Volume 7

Abstract: Background: There is a scarcity of research concerning what it is about arts engagement that may activate causal mechanisms leading to effects on health and wellbeing: their active ingredients. Further, the limited studies that do exist have tended to be ...

Abstract	Background: There is a scarcity of research concerning what it is about arts engagement that may activate causal mechanisms leading to effects on health and wellbeing: their active ingredients. Further, the limited studies that do exist have tended to be relevant to specific contexts and types of art forms. The aim of this study was to carry out a comprehensive mapping of potential active ingredients, construct a shared language, and propose a framework and toolkit to support the design, implementation, and evaluation of arts in health activities. Methods: Drawing upon Rapid Appraisal techniques and collaborating with 64 participants working in arts in health, we engaged in a three-phase process: 1) scoping review to inform the development of an initial framework; 2) consultation on the initial framework; and 3) analysis and construction of the INNATE framework. Results: The study identified 139 potential active ingredients within the overarching categories of project, people, and contexts. Project components relate directly to the content of the arts activity itself, intrinsic to what the activity is. The people category denotes how people interact through engagement with the activity and who is involved in this interaction, including activity facilitation. Contexts relates to the activity setting comprising the aggregate of place(s), things, and surroundings. Aligning with complexity science, ingredients may interconnect or feed into one another to prompt mechanisms, and may not be experienced as distinct by participants. Conclusions: Our mapping exercise is the most extensive to date. In relation to arts in health activities, the INNATE framework can support with: design and implementation, such as co-producing an intervention to meet the needs of a particular population; evaluation, such as facilitating the comparison of different interventions and their efficacy; and replication, scalability, and sustainability through enabling detailed reporting and articulation of what an arts in health activity entails.
Keywords	Active ingredients ; components ; arts and culture ; arts interventions ; arts in health ; eng ; Medicine ; R ; Science ; Q
Subject code	796
Language	English
Publishing date	2022-04-01T00:00:00Z
Publisher	Wellcome
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Exploring Barriers and Facilitators to Physical Activity during the COVID-19 Pandemic

Charlotte Roche / Abigail Fisher / Daisy Fancourt / Alexandra Burton

International Journal of Environmental Research and Public Health, Vol 19, Iss 9169, p

A Qualitative Study

2022 Volume 9169

Abstract: Quantitative data show that physical activity (PA) reduced during the COVID-19 pandemic, with differential impacts across demographic groups. Qualitative research is limited; thus, this study aimed to understand barriers and facilitators to PA during the ...

Abstract	Quantitative data show that physical activity (PA) reduced during the COVID-19 pandemic, with differential impacts across demographic groups. Qualitative research is limited; thus, this study aimed to understand barriers and facilitators to PA during the pandemic, focusing on groups more likely to have been affected by restrictions, and to map these onto the capability, opportunity, motivation model of behaviour (COM-B). One-to-one interviews were conducted with younger (aged 18–24) and older adults (aged 70+), those with long-term physical or mental health conditions, and parents of young children. Themes were identified using reflexive thematic analysis and were mapped onto COM-B domains. A total of 116 participants contributed (aged 18–93, 61% female, 71% White British). Key themes were the importance of the outdoor environment, impact of COVID-19 restrictions, fear of contracting COVID-19, and level of engagement with home exercise. Caring responsibilities and conflicting priorities were a barrier. PA as a method of socialising, establishing new routines, and the importance of PA for protecting mental health were motivators. Most themes mapped onto the physical opportunity (environmental factors) and reflective motivation (evaluations/plans) COM-B domains. Future interventions should target these domains during pandemics (e.g., adapting PA guidance depending on location and giving education on the health benefits of PA).
Keywords	COVID-19 ; United Kingdom ; physical activity ; COM-B model ; qualitative ; Medicine ; R
Subject code	796
Language	English
Publishing date	2022-07-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Public opinion about the UK government during COVID-19 and implications for public health

Liam Wright / Alexandra Burton / Alison McKinlay / Andrew Steptoe / Daisy Fancourt

PLoS ONE, Vol 17, Iss 4, p e

A topic modeling analysis of open-ended survey response data.

2022 Volume 0264134

Abstract: Background Confidence in the central UK Government has declined since the beginning of the COVID-19 pandemic, and while this may be linked to specific government actions to curb the spread of the virus, understanding is still incomplete. Examining public ...

Abstract	Background Confidence in the central UK Government has declined since the beginning of the COVID-19 pandemic, and while this may be linked to specific government actions to curb the spread of the virus, understanding is still incomplete. Examining public opinion is important, as research suggests that low confidence in government increases the extent of non-compliance with infection-dampening rules (for instance, social distancing); however, the detailed reasons for this association are still unclear. Methods To understand public opinion on the central UK government during the first phase of the COVID-19 pandemic, we used structural topic modeling, a text mining technique, to extract themes from over 4000 free-text survey responses, collected between 14 October and 26 November 2020. Results We identified eleven topics, among which were topics related to perceived government corruption and cronyism, complaints about inconsistency in rules and messaging, lack of clear planning, and lack of openness and transparency. Participants reported that elements of the government's approach had made it difficult to comply with guidelines (e.g., changing rules) or were having impacts on mental wellbeing (e.g., inability to plan for the future). Conclusions Results suggested that consistent, transparent communication and messaging from the government is critical to improving compliance with measures to contain the virus, as well as protecting mental health during health emergencies.
Keywords	Medicine ; R ; Science ; Q
Subject code	340
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Public opinion about the UK government during COVID-19 and implications for public health

Liam Wright / Alexandra Burton / Alison McKinlay / Andrew Steptoe / Daisy Fancourt

PLoS ONE, Vol 17, Iss

A topic modeling analysis of open-ended survey response data

2022 Volume 4

Abstract	Background Confidence in the central UK Government has declined since the beginning of the COVID-19 pandemic, and while this may be linked to specific government actions to curb the spread of the virus, understanding is still incomplete. Examining public opinion is important, as research suggests that low confidence in government increases the extent of non-compliance with infection-dampening rules (for instance, social distancing); however, the detailed reasons for this association are still unclear. Methods To understand public opinion on the central UK government during the first phase of the COVID-19 pandemic, we used structural topic modeling, a text mining technique, to extract themes from over 4000 free-text survey responses, collected between 14 October and 26 November 2020. Results We identified eleven topics, among which were topics related to perceived government corruption and cronyism, complaints about inconsistency in rules and messaging, lack of clear planning, and lack of openness and transparency. Participants reported that elements of the government’s approach had made it difficult to comply with guidelines (e.g., changing rules) or were having impacts on mental wellbeing (e.g., inability to plan for the future). Conclusions Results suggested that consistent, transparent communication and messaging from the government is critical to improving compliance with measures to contain the virus, as well as protecting mental health during health emergencies.
Keywords	Medicine ; R ; Science ; Q
Subject code	340
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: ‘You’re just there, alone in your room with your thoughts’

Daisy Fancourt / Alexandra Burton / Alison R McKinlay / Jo Dawes / Tom May

BMJ Open, Vol 12, Iss

a qualitative study about the psychosocial impact of the COVID-19 pandemic among young people living in the UK

2022 Volume 2

Keywords	Medicine ; R
Language	English
Publishing date	2022-02-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Implementing a singing-based intervention for postpartum depression in Denmark and Romania

Katey Warran / Calum Smith / Hanna Ugron / Oana Blaga / Nicolai Lund Ladegaard / Louise Frøkjær Carstens / Lucy Nicholls / Alexandra Burton / Rarita Zbranca / Mikkel Ottow / Daisy Fancourt / Nils Fietje

Frontiers in Medicine, Vol

a brief research report

2023 Volume 10

Abstract: BackgroundThere is a burgeoning evidence-base that demonstrates the positive impact of the arts on our health, wellbeing, and health behaviors. However, very few studies have focused on how to optimize the implementation of these activities for different ...

Abstract	BackgroundThere is a burgeoning evidence-base that demonstrates the positive impact of the arts on our health, wellbeing, and health behaviors. However, very few studies have focused on how to optimize the implementation of these activities for different sociocultural contexts. Due to the increasing interest in scaling effective arts interventions as part of public health strategies, and in line with global goals of achieving health equity, this is an essential focus.AimUsing the case study of a singing for post-partum depression (PPD) intervention with empirically-demonstrated clinical effects, this brief research report explores implementation of an arts and health intervention that has been successful in the United Kingdom (“Music and Motherhood”) for the new contexts of Silkeborg (Denmark) and Cluj-Napoca (Romania).MethodsData was collected from participants at all levels of the implementation structure including at local and management levels. The study draws on qualitative implementation data to explore participant experiences, including one-to-one interviews, written testimonies, meeting minutes, ethnographic researcher reflections and focus groups, including data from 46 participants in total.Results and conclusionWe explore implementation and adaptation across five key themes: (1) acceptability and feasibility; (2) practical and structural barriers and enablers; (3) adoption and sustainability; (4) broader contextual factors affecting implementation and sustainability; and (5) project structure and processes. Taken together, the themes demonstrate that arts interventions need to be adapted in culturally sensitive ways by stakeholders who have local knowledge of their environments. This research serves as an informative foundation for use by other researchers that aim to expand the reach and impact of arts-based interventions.
Keywords	art and health ; culture and health ; postpartum depression ; implementation ; feasibility ; Medicine (General) ; R5-920
Subject code	306
Language	English
Publishing date	2023-12-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Correction

Trials, Vol 25, Iss 1, Pp 1-

Clinical and cost-effectiveness of a New psychosocial intervention to support Independence in Dementia (NIDUS-family) for family carers and people living with dementia in their own homes: a randomised controlled trial

2024 Volume 1

Keywords	Medicine (General) ; R5-920
Language	English
Publishing date	2024-01-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A qualitative study exploring the barriers and facilitators of implementing a cardiovascular disease risk reducing intervention for people with severe mental illness into primary care contexts across England

Suzan Hassan / Samira Heinkel / Alexandra Burton / Ruth Blackburn / Tayla McCloud / Jamie Ross / David Osborn / Kate Walters

BMC Health Services Research, Vol 20, Iss 1, Pp 1-

the ‘PRIMROSE’ trial

2020 Volume 15

Abstract: Abstract Background People with severe mental illness (SMI) are at greater risk of earlier mortality due to physical health problems including cardiovascular disease (CVD). There is limited work exploring whether physical health interventions for people ... ...

Abstract	Abstract Background People with severe mental illness (SMI) are at greater risk of earlier mortality due to physical health problems including cardiovascular disease (CVD). There is limited work exploring whether physical health interventions for people with SMI can be embedded and/or adopted within specific healthcare settings. This information is necessary to optimise the development of services and interventions within healthcare settings. This study explores the barriers and facilitators of implementing a nurse-delivered intervention (‘PRIMROSE’) designed to reduce CVD risk in people with SMI in primary care, using Normalisation Process Theory (NPT), a theory that explains the dynamics of embedding or ‘normalising’ a complex intervention within healthcare settings. Methods Semi-structured interviews were conducted between April–December 2016 with patients with SMI at risk of CVD who received the PRIMROSE intervention, and practice nurses and healthcare assistants who delivered it in primary care in England. Interviews were audio recorded, transcribed and analysed using thematic analysis. Emergent themes were then mapped on to constructs of NPT. Results Fifteen patients and 15 staff participated. The implementation of PRIMROSE was affected by the following as categorised by the NPT domains: 1) Coherence, where both staff and patients expressed an understanding of the purpose and value of the intervention, 2) Cognitive participation, including mental health stigma and staff perceptions of the compatibility of the intervention to primary care contexts, 3) Collective action, including 3.1. Interactional workability in terms of lack of patient engagement despite flexible appointment scheduling. The structured nature of the intervention and the need for additional nurse time were considered barriers, 3.2. Relational integration i.e. whereby positive relationships between staff and patients facilitated implementation, and access to ‘in-house’ staff support was considered important, 3.3. Skill-set workability in terms of staff skills, knowledge and training facilitated implementation, 3.4. Contextual integration regarding the accessibility of resources sometimes prevented collective action. 4) Reflexive monitoring, where the staff commonly appraised the intervention by suggesting designated timeslots and technology may improve the intervention. Conclusions Future interventions for physical health in people with SMI could consider the following items to improve implementation: 1) training for practitioners in CVD risk prevention to increase practitioners knowledge of physical interventions 2) training in SMI to increase practitioner confidence to engage with people with SMI and reduce mental health stigma and 3) access to resources including specialist services, additional staff and time. Access to specialist behaviour change services may be beneficial for patients with specific health goals. Additional staff to support workload and share knowledge may also be valuable. More time for appointments with people with SMI may allow practitioners to better meet patient needs.
Keywords	Severe mental illness ; Physical health ; Cardiovascular disease ; Primary care ; Nurse ; Normalisation process theory ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2020-08-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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