Joseph Akanuwe receives PhD for work on communicating cancer risk

Joseph Akanuwe, doctoral student at CaHRU was recently confirmed by the College of Social Science Research Degrees Board that he be awarded his PhD for his thesis ‘Exploring service user and practitioner perspectives of using cancer risk assessment tools in primary care consultations. Cancer risk prediction tools are novel tools that combine risk factors and symptoms to predict an individual’s risk of developing cancer.

WP_20160208_16_16_01_RichThe work included a systematic scoping review followed by interviews of 19 service users and 17 primary care practitioners, the latter before and after they had used the tools in patient consultations. Participants suggested ways to best communicate cancer risk to patients in primary care consultations, emphasising the importance of: tailoring visual representation of risk; being open and honest; informing and involving patients in use of cancer risk prediction tools and providing time for listening, explaining and reassuring in the context of a professional approach.

He also found barriers to the uptake of cancer risk prediction tools including: the additional time required; worry and anxiety generated by referral for investigations; potential for over-referral; practitioner scepticism about using the new tool; and the need for evidence of effectiveness before introducing cancer risk prediction tools in general practice consultations. These barriers were perceived before the use of the tools. The findings add to the knowledge and understanding of how best to communicate cancer risk information to patients when using cancer risk prediction tools. Joseph was supervised by Profs Niro Siriwardena and Sara Owen, together with Dr Sharon Black.

By Prof Niro Siriwardena

Improvement Science and Research Methods seminar: Dr Matthew Harris on ‘Frugal and reverse innovation’

CaHRU_logotypeThe latest Community and Health Research Unit (CaHRU)/Lincoln Institute for Health (LIH) Improvement Science and Research Methods seminar was given on April 24th 2018 by Dr Matthew Harris, Clinical Senior Lecturer in Public Health, jointly appointed between the Department of Primary Care and Public Health, and the Institute of Global Health Innovation, Imperial College London. He is also an Honorary Consultant in Public Health Medicine at Imperial College Healthcare NHS Trust.

matthewharrisDr Harris worked for several years as a primary care physician in Brazil, as a WHO Polio Consultant in Ethiopia, as an HIV Technical Consultant in Mozambique and as a Global Health Advisor to the UK Department of Health. In 2014 he was awarded a prestigious Harkness Fellowship from the US Commonwealth Fund where he was a Visiting Research Assistant Professor at New York University, exploring cognitive biases in evidence interpretation in the context of Reverse Innovation.

indiaHe explained the concept of frugal innovations, usually low cost, often repurposed technologies, developed for resource-poor settings such as developing country health systems but increasingly relevant in the context of worsening resource constraints in Western health settings. The concept of frugal innovations is becoming important in the UK, where there is an imperative to identify those innovations that may perform equally but at lower cost. Bringing these frugal innovations from low-income countries into the NHS (so-called ‘reverse innovation’) is an emerging field in which Dr Harris is an acknowledged expert.

LIFH-logo-web2In his excellent and thoughtful seminar, Dr Harris discussed examples of frugal innovations such as a low cost portable ECG machine or cataract surgery delivered on a large scale in India, a new orthopaedic drill cover created in Africa, and a community health worker programme in Brazil. He also explored the challenges and barriers to identifying, adapting and adopting frugal innovations, touching on a diversity of literatures including diffusion of innovation, cognitive psychology and post-colonialism.

Prof Niro Siriwardena

[su_document url=”” width=”660″ responsive=”no”]Multi-morbidity, goal-oriented care, the community and equity[/su_document]

Identifying barriers and facilitators to ambulance service assessment and treatment of acute asthma: a focus group study

d-shawResearchers in CaHRU and East Midlands Ambulance Service NHS Trust (EMAS) have published a new study: “Identifying barriers and facilitators to ambulance service assessment and treatment of acute asthma: a focus group study” in BMC Emergency Medicine. The study’s lead author was Deborah Shaw of the Clinical Audit and Research Department at EMAS and visiting fellow at CaHRU. She was supported in the work by Prof Niro Siriwardena, director of CaHRU and associate clinical director at EMAS.

EMAS - A&E 9_750The authors aimed to explore paramedics’ attitudes, perceptions and beliefs about prehospital management of asthma, to identify barriers and facilitators to guideline adherence, acknowledging variations in prehospital care for asthma. The investigators interviewed paramedics and managers and their analysis identified that guidelines should be made more relevant to ambulance service care; barriers to assessment; conflicts between clinicians’ and patients’ expectations; complex ambulance service processes and equipment; and opportunities for improved prehospital education, information, communication, support and care pathways for asthma.

EMAS - PTS 2_750The service has already used these findings to improve prehospital care for people with asthma and other chronic respiratory conditions.