On Thursday 3rd September 2015 I was fortunate enough to attend the EMUA Student Conference hosted by The Graduate School at the University of Lincoln. The annual conference provides an excellent opportunity for postgraduate students across the region to network and present their research to their peers in a supportive, inquisitive and encouraging environment.
There was representation from the Universities of Lincoln, Loughborough, Leicester, Derby, Nottingham and De Montfort University, Leicester. The multi-disciplinary nature of the conference meant that students were able to learn about research that could be similar to their own work in terms of subject but also could be completely different in topic and methodology.
The morning began with a fascinating key note from Dr Helen Zulch from the School of Life Sciences at the University of Lincoln. Dr Zulch talked about ‘scholarship and the many faces of impact’ and drew upon her own research expertise in veterinary behavioural medicine as an example of how academic research can impact on both society and individuals. One of the key messages of the presentation was that ‘whatever our motivation, the knowledge and experience that we gain through our research has the potential to impact on others’. Dr Zulch highlighted the fact that even if our research legacy is simply that we instilled an interest and motivation in others to pursue a research career then this is something to be proud of.
Throughout the day there were parallel sessions of oral presentations given by the student delegates. I attended some really interesting talks around subjects as diverse as ‘The gay tree of life: an interdisciplinary approach to homosexuality research’ to ‘Stakeholder perspectives of collaborative working and street works management’. I gave a presentation entitled: ‘Engaging with patients and NHS staff to develop a Patient Reported Experience Measure (PREM) for use in NHS ambulance services’. The theme of the conference ‘impact and collaboration’ enabled me to concentrate on an element of the research process that I hadn’t previously considered in much detail. The opportunity to focus in on this within my presentation will be beneficial during those crucial thesis writing days!
The conference concluded with four finalists (at university level) of the three minute thesis competition presenting to the whole delegation. The aim of the competition is for students to effectively explain their research in ‘language appropriate to a non-specialist audience’. It draws upon their communication skills and ability to ‘cut to the chase’. The presentations were outstanding and the way in which the students drew the audience in with their engagement skills was fantastic.
Overall, I came away from the conference having made several new contacts, gained renewed confidence in my work and an optimistic view of PhD life in the East Midlands. The Graduate School here at the University of Lincoln did a great job of organising the day and ensuring that everything ran smoothly so thank you graduate school! I look forward to next year’s conference…
Dr Coral Sirdifield of CaHRU contributed to a recent report produced under the EU Health Programme (2008-2013) following completion of the HEALIT4EU project, ‘Study on sound evidence for a better understanding of health literacy in the European Union‘. Prof Niro Siriwardena, director of CaHRU, is UK coordinator of the EPHORT consortium led by the Netherlands Institute for Health Services Research which provides commissioned reports to the EU under this programme.
The authors describe health literacy as enabling “people to make judgements and take decisions in everyday life concerning healthcare, disease prevention and health promotion to maintain or improve their quality of life”, and state that it can be seen as encompassing not only an individual skill, but also an individual’s social support system and the context within which they are using basic, communicative and critical literacy skills. Health literacy is a multidimensional concept which incorporates the ability to understand, use, interact with and critically evaluate health information and services and to actively manage personal health in the context of one’s social network and the healthcare system. Poor health literacy is associated with worse health outcomes despite higher health care service use and is an important factor in health inequalities.
The report maps health literacy interventions in an EU context, and existing policies and actions aimed at improving health literacy in EU member states. The authors also developed prediction models around determining health literacy using publicly available information sources. Information around health literacy policy and practice in the UK was supplied by Prof Siriwardena and Dr Sirdifield from the University of Lincoln.
The main recommendations of the research are as follows:
- More attention should be given to the development and evaluation of health literacy interventions in a European context, using research designs which have sufficiently scientific rigour and which include cost-effectiveness in their design.
- There is a need for agreement among researchers on valid measurement tools for health literacy in a European context, and more systematic use of validated, preferably comprehensive, measurement tools in interventions.
- Health literacy research funding should give more attention to (a) the quality of the studies and (b) the need for specific kind of evidence, such as: intervention studies, effectiveness and cost-effectiveness, and international comparative research.
- Though health literacy is on the agenda in most of the EU Member States, in many countries the efforts are not coordinated through a policy at the most appropriate level. A more programmatic and evidence-based policy to health literacy in individual EU Member States and further exchanges of knowledge and best-practices at EU level could be beneficial with regard to the outcomes of these efforts.
- The concept of ‘health literacy’ can be considered a useful complement to more general health promotion and education policies, as it enables to better tailor health promotion and education approaches to individuals or populations with low literacy and increase the effectiveness of such policies.
- Policies on health literacy should also address the context in which people have to be “health literate” – this is the health care system itself, how providers deliver care, how services are organised, how health information is provided, etc. In addition, from a public health perspective health literacy policies should be implemented in other relevant contexts such as the education system and at the workplace. However, most of the current interventions and programmes do not seem to focus on the context. Instead, they seem to focus on individuals, or groups ‘at risk’, or people with low health literacy skills.”
The report recommends that more attention should be given to the development and evaluation of well-designed health literacy interventions in Europe context which include cost-effectiveness analyses and valid tools for measuring health literacy. In terms of policy the report recommends that EU Member States support evidence-based policy towards health literacy and exchange knowledge and best-practice; include health literacy to complement health promotion and education policies; and address the healthcare context for health literacy in terms of the health system, care provision, service organisation, and health information together with other relevant contexts such as the education system and the workplace.
The Community and Health Research Unit received the team award for achievement research at the University of Lincoln awards on 19 November 2014, where Despina Laparidou, Jolien Vos, Dr Jo Middlemass, Ana Godoy Caballero and Viet-Hai Phung (pictured left to right) accepted the award on behalf of CaHRU. Since the submission to the Research Excellence Framework a year ago the unit has particularly focused on developing early career researchers (ECRs), junior researchers and doctoral students, aiming to develop their research expertise, skills and outputs as future researchers and research leaders, and to increase capacity for international and world class research.
This is being done through: mentorship and support for junior staff; a monthly research writing group at which all members of the team, NHS colleagues, visiting professors and East Midlands NIHR Research Design Service staff meet to review research bids and journal papers prior to submission, and where colleagues also have an opportunity to review feedback from reviewers prior to revising bids and journal papers; a six weekly implementation science and research methods seminar at which members of the CaHRU team and external academic experts present the latest ideas on methodology.
The unit also provides opportunities for junior staff to develop their skills and expertise by working with more senior members of the team and external academic experts from the rest of the EU and internationally on projects. Our efforts have led to successful grant funding for the team and increased our outputs in high quality peer reviewed journals involving ECRs and junior researchers as lead authors and co-authors.
A new study focusing on decision making by paramedic and specialist paramedic staff and conducted in three English National Health Service (NHS) Ambulance Service Trusts was published this month. The study, entitled ‘A qualitative study of systemic influences on paramedic decision making: care transitions and patient safety‘ published in the Journal of Health Services Research and Policy was led by Dr Rachel O’Hara from ScHARR at the University of Sheffield and included Professor Niro Siriwardena, director of CaHRU, and Debbie Shaw, visiting fellow at CaHRU, and both members of the East Midlands Ambulance Research Alliance at East Midlands Ambulance Service NHS Trust.
The study involved observation and interviews, analysis of digital diaries and focus groups with paramedic staff. Different types of decision were identified, ranging from the decision to convey a patient to the emergency department, use of specialist emergency pathways or the decision to treat and leave a patient at home. Systemic influences and risk factors affecting decision making included demand, performance priorities, access to care options, risk tolerance, training, communication, feedback and resources.
The study highlighted the complexity of paramedic decision making and system factors which could worsen risk. Decision making has been studied in other settings but rarely in the prehospital environment, and the uncertainty which paramedics have to face when making decisions needs further work. The study forms part of the Prehospital Emergencies Quality and Outcomes programme at CaHRU.