Pharmacy: a way forward for public health

This document sets out a range of opportunities for pharmacy teams working in communities, and through their daily interactions with patients and the public, to play an important role in protecting and improving the health of the nation. | Public Health England

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Image source: Corbin Keech – Flickr // CC BY-NC-ND 2.0

Community pharmacy teams play a pivotal role as a community and health asset in communities. Making healthy choices such as stopping smoking, improving diet and nutrition, increasing physical activity, losing weight and reducing alcohol consumption through pharmacy teams could make a significant contribution to reducing the risk of disease, improving health outcomes for those with long term conditions, reducing premature death and improving mental wellbeing.

This document provides a menu of interventions that could be delivered by pharmacy teams in the primary and community sectors to improve the health and wellbeing of the nation.

Full document: Pharmacy: A way forward for public health opportunities for action through pharmacy for public health.

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Barriers and facilitators of a community-based childhood weight management programme

To explore the barriers and facilitators experienced by those implementing a government-funded, community-based childhood weight management programme | BMJ Open

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Image source: Jixuan Zhou – Flickr // CC BY-NC-SA 2.0

Results: Most barriers occurred at the level of the organisational context. For all stakeholders, barriers arose due to the multidisciplinary nature of the programme, including the lack of role clarity and added complexity of working in different locations. Health professionals’ low-perceived self-efficacy in approaching the subject of weight with parents and parental resistance to hearing about their child’s weight status were barriers to programme implementation at the individual professional and patient levels, respectively. The main facilitators of implementation, occurring at the level of the health professional, included stakeholders’ recognition of the need for a weight management programme and personal interest in the area of childhood obesity. Having a local lead and supportive colleagues were further implementation drivers.

Conclusions: This study highlights the complexities associated with implementing a multidisciplinary childhood weight management programme, particularly translating such a programme to a community setting. Our results suggest the assignment of clear roles and responsibilities, the provision of sufficient practical training and resources, and organisational support play pivotal roles in overcoming barriers to change. This evidence can be used to develop an implementation plan to support the translation of interventions into real-world settings.

Full reference: Kelleher, E. et al (2017) Barriers and facilitators to the implementation of a community-based, multidisciplinary, family-focused childhood weight management programme in Ireland: a qualitative study. BMJ Open. 7:e016459.

Preventing depression in low-income mothers

It is well-established that women in low-income households have an increased risk of developing mental health problems, in particular depression | The Mental Elf

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Studies have found that these women are around twice as likely to develop the disorder compared with those from higher-income households (Hobfoll et al, 1995). Low-income women are also less likely to seek and receive appropriate treatment, in part because of the associated costs (Lennon et al, 2001).

For women who are mothers, this is especially consequential: parental depression has been linked with developmental, emotional and mental health problems in children (McDaniel et al., 2013). In the United States this has been highlighted as a public health concern, and it is increasingly being recognised that community-based services offer valuable opportunities to reach those for whom help is less accessible.

Head Start is a US government-funded service aimed at families at or below the federal poverty level with young children under five. They use a case-management structure to establish a healthy family environment in order to look after the child’s development and wellbeing. Depression affects almost half of the mothers at Head Start. A recent study by Silverstein et al. (2017) examines the efficacy of embedding a depression prevention strategy in the Head Start program.

Feasibility of a UK community-based, eTherapy mental health service in Greater Manchester

There is increasing evidence to support the effectiveness of eTherapies for mental health, although limited data have been reported from community-based services | BMJ Open

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Results: Data indicated baseline differences, with the Breaking Free Online group having higher scores for depression and anxiety than the Living Life to the Full Interactive and Sleepio  groups. Promising improvements in mental health scores were found within all three groups, as were significant reductions in numbers of service users reaching clinical threshold scores for mental health difficulties. Number of days of engagement was not related to change from baseline for the Living Life to the Full or Sleepio programmes but was associated with degree of change for Breaking Free Online.

Conclusion: Data presented provide evidence for feasibility of this eTherapy delivery model in supporting service users with a range of mental health difficulties and suggest that eTherapies may be a useful addition to treatment offering in community-based services.

Full reference: Elison, S. et al. (2017) Feasibility of a UK community-based, eTherapy mental health service in Greater Manchester: repeated-measures and between-groups study of ‘Living Life to the Full Interactive’, ‘Sleepio’ and ‘Breaking Free Online’ at ‘Self Help Services’. BMJ Open. 7:e016392

Social prescribing: less rhetoric and more reality

Bickerdike, L. et al. (2017) BMJ Open. 7:e013384.

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Objectives: Social prescribing is a way of linking patients in primary care with sources of support within the community to help improve their health and well-being. Social prescribing programmes are being widely promoted and adopted in the UK National Health Service and so we conducted a systematic review to assess the evidence for their effectiveness.

Conclusions: Social prescribing is being widely advocated and implemented but current evidence fails to provide sufficient detail to judge either success or value for money. If social prescribing is to realise its potential, future evaluations must be comparative by design and consider when, by whom, for whom, how well and at what cost.

Read the full article here

Interventions for single parents should also recognise the needs of lone fathers

Chiu, M. et al. (2017) Journal of Epidemiology & Community Health. 71(5) pp. 417-423

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Background: Lone parenthood is associated with poorer health; however, the vast majority of previous studies have examined lone mothers and only a few have focused on lone fathers. We aimed to examine the self-rated health and mental health status among a large population-based cross-sectional sample of Canadian lone fathers compared with both partnered fathers and lone mothers.

Conclusions: In this large population-based study, lone fathers had worse self-rated health and mental health than partnered fathers and similarly poor self-rated health and mental health as lone mothers. Interventions, supports and social policies designed for single parents should also recognise the needs of lone fathers.

Read the full article here

Implementing a people powered approach to health

This report gathers a wide range of insights taken from three community sites on how to implement a people powered approach to health and wellbeing.

These three main insights were found to be the most important to making a difference on the ground:

  • Helping people help themselves
  • Creating opportunities for people to help one another
  • Creating value between the professional and social spheres – helping health and care

Mobilising Communities was a short, experimental programme aimed at exploring the practical applications of the idea of ‘social movements’ in health in three communities in England.

The objective of the programme was to work with three sites to explore the opportunities to support effective ways of combining people power and community resources, together with publicly funded services, for better health outcomes across local communities.

The report goes into detail on how each of the three insights above can be developed to support a social movement in health for people and communities.

Download the full report: Mobilising Communities: Insights on Community Action for Health and Wellbeing