A5073820411- Dermatology and Skin Diseases
- Antibiotic Use and Resistance
- Allergic Rhinitis and Sensitization
- Patient Satisfaction in Healthcare
- Mental Health and Patient Involvement
- Complementary and Alternative Medicine Studies
- Behavioral Health and Interventions
- Health Policy Implementation Science
- Eating Disorders and Behaviors
- Health Systems, Economic Evaluations, Quality of Life
- Digital Mental Health Interventions
- Emergency and Acute Care Studies
- Patient-Provider Communication in Healthcare
- Fibromyalgia and Chronic Fatigue Syndrome Research
- Attachment and Relationship Dynamics
- Intergenerational Family Dynamics and Caregiving
- Healthcare Decision-Making and Restraints
- Psychiatric care and mental health services
- Food Allergy and Anaphylaxis Research
- Clinical practice guidelines implementation
- Delphi Technique in Research
- Grief, Bereavement, and Mental Health
- Family Caregiving in Mental Illness
- Occupational Therapy Practice and Research
- Migration, Health and Trauma
University of Southampton
2018-2025
University of Portsmouth
2021-2022
University of Oxford
2020
To determine the effectiveness of two online behavioural interventions, one for parents and carers young people, to support eczema self-management.Two independent, pragmatic, parallel group, unmasked, randomised controlled trials.98 general practices in England.Parents children (0-12 years) with (trial 1) people (13-25 2), excluding inactive or very mild (≤5 on POEM, Patient-Oriented Eczema Measure).Participants were (1:1) using software receive usual care an (www.EczemaCareOnline.org.uk)...
Strategies to reduce antibiotic overuse in hospitals depend on prescribers taking decisions stop unnecessary use. There is scarce evidence for how support these decisions. We evaluated a multifaceted behaviour change intervention (ie, the review kit) designed use among adult acute general medical inpatients by increasing appropriate antibiotics at clinical review.We performed stepped-wedge, cluster (hospital)-randomised controlled trial using computer-generated sequence randomisation of...
Abstract Objective To estimate the cost-effectiveness of online behavioral interventions (EczemaCareOnline.org.uk) designed to support eczema self-care management for parents/carers and young people from an NHS perspective. Methods Two within-trial economic evaluations, using regression-based approaches, adjusting baseline pre-specified confounder variables, were undertaken alongside two independent, pragmatic, parallel group, unmasked randomized controlled trials, recruiting through primary...
Eczema Care Online ( www.EczemaCareOnline.org.uk/ ) is an online self-management toolkit which includes tailored content for young people (13-25 years) and parents of children that have eczema (0-12 years). Testing in two randomised controlled trials has shown it easy to use, cost effective offers a sustained improvement symptoms. Implementing outside funded research study ensuring reaches those will most benefit from now key challenge. This paper describes the lessons learnt developing...
Background Eczema is a common condition with significant impact on quality of life. The main cause treatment failure non-use prescribed treatments because are time-consuming to apply; they may sting when first applied inflamed skin; there concerns about the safety some treatments; and people often receive conflicting advice how use them. Objectives present study to: (1) explore self-care support needs children eczema their parents/carers, young eczema, (2) review current best evidence safest...
Care leavers face adversity and poor psychological outcomes, despite being a significantly under researched population. Childhood maltreatment is associated with attachment insecurity Early Maladaptive Schemas (EMS); however, there little research into the relationships between these variables, none exploring variables in care leavers. The study aimed to investigate relationship childhood maltreatment, attachment, EMS maladaptive coping leavers, hypothesising that higher levels of would be...
Hospital antimicrobial stewardship strategies, such as 'Start Smart, Then Focus' in the UK, balance need for prompt, effective antibiotic treatment with to limit overuse using 'review and revise'. However, only a minority of review decisions are stop antibiotics. Research suggests that this is due both behavioural organizational factors.To develop optimize Antibiotic Review Kit (ARK) intervention. ARK complex digital, intervention supports implementation revise' help healthcare professionals...
Abstract Objective Understanding the mechanisms of action psychological treatments is a key first step in refining and developing more effective treatments. The present study examined hypothesized mediators change enhanced cognitive behavior therapy (CBT‐E) interpersonal psychotherapy for eating disorders (IPT‐ED). Method A series mediation studies were embedded randomized controlled trial (RCT) comparing 20 weeks CBT‐E IPT‐ED transdiagnostic, non‐underweight sample patients with ( N = 130)...
Objectives To describe the development of Eczema Care Online (ECO), an online behaviour change intervention for young people with eczema (phase I); and explore optimise acceptability ECO among this target group using think-aloud interviews II). Methods Theory-based, evidence-based person-based approaches to were used. In phase I, a qualitative systematic review developed in-depth understanding needs challenges eczema. Guiding principles highlighted key design objectives features address...
Introduction Eczema care requires management of triggers and various treatments. We developed two online behavioural interventions to support eczema called ECO (Eczema Care Online) for young people families. This protocol describes randomised controlled trials (RCTs) aimed evaluate clinical cost-effectiveness the interventions. Methods analysis Design : Two independent, pragmatic, unmasked, parallel group RCTs with internal pilots nested health economic process evaluation studies. Setting...
Objectives To develop a comprehensive intervention plan for the REDUCE maintenance to support people who have had diabetic foot ulcers (DFUs) sustain behaviours that reduce reulceration risk. Methods Theory-based, evidence-based and person-based approaches development were used. In phase I of planning, evidence was collated from scoping review literature qualitative interviews with patients DFUs (n=20). This used identify psychosocial needs challenges this population barriers facilitators...
Eczema affects one in five children and can have a substantial impact on quality of life. This qualitative study aimed to explore children’s views experiences eczema what may affect treatment adherence from their perspective. We conducted semi-structured, face-to-face interviews with aged 6–12 years March July 2018. Interviews were transcribed verbatim analysed using inductive thematic analysis. found that do not typically view as long-term condition, topical treatments (predominately...
Abstract Background Deciding whether to discontinue antibiotics at early review is a cornerstone of hospital antimicrobial stewardship practice worldwide. In England, this approach described in government guidance (‘Start Smart then Focus’). However, < 10% antibiotic prescriptions are discontinued review, despite evidence that 20–30% could be safely. We aimed quantify the relative importance factors influencing prescriber decision-making review. Methods conducted an online choice...
There is a lack of well-conducted randomized controlled trials evaluating the effectiveness theory-based online interventions for eczema. To address these deficiencies, we previously developed and demonstrated two behavioural interventions: Eczema Care Online parents/carers children with eczema, young people eczema.To explore views experiences who have used to provide insights into how worked identify contextual factors that may impede users' engagement interventions.Qualitative...
Two online behavioural interventions (one website for parents/carers of children with eczema; and one young people eczema) have been shown in randomised controlled trials to facilitate a sustained improvement eczema severity. To describe intervention use examine potential mediators outcomes contextual factors that may influence delivery outcomes. Quantitative process evaluation UK primary care. Parents/carers were recruited through Intervention was recorded summarised descriptively. Logistic...
ABSTRACT Introduction Intensive psychiatric care units can be challenging environments in which to build strong staff‐patient relationships. Attachment theory may provide a useful model for strengthening relationships this setting. Aim The aim of study was explore staff perceptions the utility attachment understanding patient behaviour intensive Methods Semi‐structured interviews were conducted with 11 multi‐disciplinary members. Interviews focused on member's experience learning about and...
To ensure patients continue to get early access antibiotics at admission, while also safely reducing antibiotic use in hospitals, one needs target the continued need for as more diagnostic information becomes available. UK Department of Health guidance promotes an initiative called 'Start Smart then Focus': effective followed by active 'review and revision' 24-72 h later. However 2017, < 10% prescriptions were discontinued review, despite studies suggesting that 20-30% could be stopped...
Abstract Background Eczema can have a considerable impact on quality of life. Treatments improve this, but management is complex. Barriers to eczema self-management may be impacted upon by environmental context, such as the COVID-19 pandemic. Objectives To explore experiences eczema, self-management, and accessing healthcare advice during pandemic among young people with parents/carers children eczema. Methods Qualitative semi-structured interviews were carried out 36 participants recruited...
Abstract Background We aimed to investigate and optimise the acceptability usefulness of a patient leaflet about antibiotic prescribing decisions made during hospitalisation, explore individual experiences preferences regarding process prescription ‘review revise’ which is key strategy minimise overuse in hospitals. Methods In this qualitative study, run within feasibility study large, cluster-randomised stepped wedge trial 36 hospital organisations, series semi-structured, think-aloud...
<title>Abstract</title> Background Computerised prescribing systems, which are becoming widely adopted, have the potential to improve antimicrobial stewardship, but often lack relevant in-built components optimally facilitate good stewardship practices. Objectives To co-develop with stakeholders, a complex ePrescribing intervention (ePAMS+) comprising multiple technological and non-technological components, designed integrate commercial computerised (ePrescribing) systems work processes in...