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This study aims to explore the experiences of living through the COVID-19 pandemic for people who faced homelessness and dealt with mental health and/or substance use challenges.

This qualitative study was comprised of 26 1:1 interviews (16 men and 10 women), conducted between February and May 2021 with people who experienced homelessness in North East England during the COVID-19 pandemic. An inductive reflexive thematic analysis was undertaken, with input from individuals with lived experience who were involved throughout the study.

Four themes were developed. The first theme, lack of support and exacerbation of mental health and substance use difficulties, highlighted how the lack of in-person support and increased isolation and loneliness led to relapses or new challenges for many people’s mental health and substance use. The second theme, uncertainty and fear during the pandemic, explored how the “surreal” experience of the pandemic led to many people feeling uncertain about the future and when things would return to normal. The third theme, isolation and impacts on social networks, discussed how isolation and changes to relationships also played a role in mental health and substance use. Finally, opportunity for reflection and self-improvement for mental health and substance use, explored how some people used the isolated time to re-evaluate their recovery journey and focus on self-improvement.

The experiences shared within this study have important implications for planning the future delivery and commissioning of health and social care services for people facing homelessness, such as sharing information accessibly through clear, consistent and simple language.

As one of the few papers to involve people with lived experience as part of the research, the findings reflect the unique narratives of this population with a focus on improving services.

This paper seeks to define a theoretical model for the urban regeneration of mass housing areas based on citizen initiative, self-management and self-financing in the form of the neighbourhood cooperative. This paper aims to identify mechanisms for economic resource generation that enable the improvement of the urban surroundings and its buildings without assuming disproportionate economic burdens by the local residents based on two principles, the economies of scale and service provision.

The research is structured in three phases: a literature review of the different trends in self-financing for urban regeneration and the conceptual framework for the definition of a cooperative model; the definition of theoretical model by analysing community ecosystem, neighbourhood-based services and the requirements for its economic equilibrium; and the discussion of the results and the conclusions.

The results show the potential of the cooperative model to generate a social economy capable of reducing costs and producing additional resources to finance the rehabilitation process. The findings show not only the extent of economic advantages but also multiple social, physical and environmental benefits. Its implementation involves the participation of multiple actors, which is one of its significant advantages.

The main contribution is to approach comprehensive urban rehabilitation from a collaborative understanding, overcoming the main financing difficulties of the current practices based on public subsidy policies. The model also allows an ethical relationship to be built with supplier companies by means of corporate social responsibility.

Background: Rising food bank usage in the UK suggests a growing prevalence of food insecurity. However, a formalised, representative measure of food insecurity was not collected in the UK until 2019, over a decade after the initial proliferation of food bank demand. In the absence of a direct measure of food insecurity, this article identifies and summarises longitudinal proxy indicators of UK food insecurity to gain insight into the growth of insecure access to food in the 21st century.

Methods: A rapid evidence synthesis of academic and grey literature (2005–present) identified candidate proxy longitudinal markers of food insecurity. These were assessed to gain insight into the prevalence of, or conditions associated with, food insecurity.

Results: Food bank data clearly demonstrates increased food insecurity. However, this data reflects an unrepresentative, fractional proportion of the food insecure population without accounting for mild/moderate insecurity, or those in need not accessing provision. Economic indicators demonstrate that a period of poor overall UK growth since 2005 has disproportionately impacted the poorest households, likely increasing vulnerability and incidence of food insecurity. This vulnerability has been exacerbated by welfare reform for some households. The COVID-19 pandemic has dramatically intensified vulnerabilities and food insecurity. Diet-related health outcomes suggest a reduction in diet quantity/quality. The causes of diet-related disease are complex and diverse; however, evidence of socio-economic inequalities in their incidence suggests poverty, and by extension, food insecurity, as key determinants.

Conclusion: Proxy measures of food insecurity suggest a significant increase since 2005, particularly for severe food insecurity. Proxy measures are inadequate to robustly assess the prevalence of food insecurity in the UK. Failure to collect standardised, representative data at the point at which food bank usage increased significantly impairs attempts to determine the full prevalence of food insecurity, understand the causes, and identify those most at risk.

This study aims to explore which outcome measures are used by occupational therapy staff in adult social care settings in the UK, and the factors affecting use of outcome measures.

A quantitative descriptive research design was used, using a cross-sectional study to explore occupational therapy staff views on the use of outcome measures. A 38-question survey was developed on Microsoft Forms. Recruitment occurred online over a three-week period in 2021 via the social media platform “Twitter”. Results were analysed using Excel using descriptive statistics and qualitative results used thematic analysis.

Participants (n = 20) used a range of outcome measures (13) in adult social care settings in the previous 12 months. Standardised measures were used by half the sample in the previous 12 months. The Therapy Outcome Measure and Barthel Index were in most use. The breadth of adult social care practice and practical factors such as caseload and lack of a meaningful tool were found to be barriers to outcome measure use. Facilitators included service improvement, accountability, use of audit and professional occupational therapy leadership.

The overall use of outcome measures can be considered low in this setting, with manager support seen to be key to the use of outcome measures. Further research is needed to investigate nationwide use.

Training, time and manager support are key to use of standardised tests and outcome measures in the adult social care settings. The use of occupational performance measures should be considered to demonstrate unique professional impact.

This contemporary study reveals use of outcome measures within occupational therapy adult social care services in the UK, which is an under researched and under published area.

In the Global North, affordable housing has evolved and thrived, and it is now gaining traction in the Global South, where governments have been vocal supporters of the concept. Therefore, this paper aims to investigate the important criteria for selecting affordable housing units in Ghana.

A quantitative research approach was used, and a survey was administered to the residents. The data was analysed using both descriptive and inferential statistics. The relative importance index technique was used to rank the important criteria, and the EFA technique was used to create a taxonomy system for the criteria.

The hierarchical ranking of the most significant criteria for selecting affordable housing includes community safety, waste management and access to good-quality education. Furthermore, the important criteria for selecting affordable housing are classified into two groups, namely, “sustainability criteria” and “housing demand and supply and social service provision”.

This study has implications for the real estate industry and construction stakeholders, as this will inform decision-making in terms of the design of affordable housing and the suitability of the location for the development.

These findings provide a baseline to support potential homeowners and tenants in their quest to select affordable housing. Furthermore, these findings will aid future longitudinal research into the indicators or criteria for selecting suitable locations for the development of low- and middle-income housing.

Integrated health and social care initiatives are increasing and health and social care systems are aiming to improve health and social outcomes in disadvantaged groups. There is a global dialogue surrounding improving services by shifting to an integrated health and social care approach. There is consensus of what is “health care”; however, the “social care” definition remains less explored. The authors describe the state of “social care” within the current integrated care literature and identify the depth of integration in current health and social care initiatives.

A narrative literature review, searching Medline, PsychINFO, CINAHL, PubMed, Scopus and Cochrane databases and grey literature (from 2016 to 2021), employing a search strategy, was conducted.

In total. 276 studies were eligible for full-text review, and 33 studies were included and categorised in types: “social care as community outreach dialogues”, “social care as addressing an ageing population”, “social care as targeting multimorbidity and corresponding social risks factors” and “social care as initiatives addressing the fragmentation of services”. Most initiatives were implemented in the United Kingdom. In total, 21 studies reported expanding integrated governance and partnerships; 27 studies reported having health and social care staff with clear integrated governance; 17 had dedicated funding and 11 used data-sharing and the integration of systems’ records.

The authors' demonstrate that social care approaches are expanding beyond the elderly, and these models have been used to respond to multimorbidity [including coronavirus disease 2019 (COVID-19)], targeting priority groups and individuals with complex presentations.

Policies on integrated care have waxed and waned over time in the English health and care sectors, culminating in the creation of 42 integrated care systems (ICSs) which were confirmed in law in July 2022. One of the four fundamental purposes of ICSs is to tackle health inequalities. This paper reports on the content of the overarching ICS plans in order to explore how they focus on health inequalities and the strategies they intend to employ to make progress. It explores how the integrated approach of ICSs may help to facilitate progress on equity.

The analysis is based on a sample of 23 ICS strategic plans using a framework to extract relevant information on health inequalities.

The place-based nature of ICSs and the focus on working across traditional health and care boundaries with non-health partners gives the potential for them to tackle not only the inequalities in access to healthcare services, but also to address health behaviours and the wider social determinants of health inequalities. The plans reveal a commitment to addressing all three of these issues, although there is variation in their approach to tackling the wider social determinants of health and inequalities.

This study adds to our knowledge of the strategic importance assigned by the new ICSs to tackling health inequalities and illustrates the ways in which features of integrated care can facilitate progress in an area of prime importance to society.

A key issue to manage sustainability is to be able to operationalise it. Relevant indicators require an appropriate definition of sustainability and sustainable development for the studied organisation. A common problem is inadequate understanding of what sustainability is from an organisational perspective. The purpose of this paper is to propose how to understand, define and measure diagnosing of sustainability from an outside-in perspective.

The building, health care, education and tourism value chains are studied. Based on interpreted stakeholder sustainability needs the stages of understanding, defining and measuring of diagnosing are reviewed, and interpretations proposed. This is with focus on identifying the vital few sustainability impacts in the studied value chains.

The resulting definitions and proposed performance indicators for the chosen areas indicate that the approach works resulting in proposed definitions and indicators for sustainability and sustainable development based on stakeholders need focus. Having clear definitions and performance indicators will support working effectively with sustainable development.

The resulting definitions and proposed performance indicators for the chosen areas indicate that the approach works. Further, proposed definitions and indicators for sustainability and sustainable development based on stakeholder needs focus is useful. Having clear definitions and performance indicators will help an organisation engage with sustainability and be sustainable within an organisational context.

The proposed approach enables using quality management for sustainable development.

Social sustainability is viewed from a poverty and affordability perspective.

Results indicate that there is a value in using an outside-in approach with focus on stakeholder needs in connection with a process-based approach. The approach is in contrast with the customary way of defining sustainability which mostly is based on an inside-out approach identifying several indicators and then adding these to a measure of sustainability.

This study aims to co-develop a Frailty, Health and Care Needs Assessment (FHCNA) questionnaire for people experiencing homelessness and explore the feasibility of its use by non-clinical staff in homeless hostels.

The FHCNA, aimed at identifying frailty and other health and care priorities for people experiencing homelessness, was co-designed in workshops (online and in person) with homelessness and inclusion health staff. Its feasibility was tested by staff and their clients in two hostels, with pre- and post-study focus groups held with hostel staff to gain input and feedback.

The FHCNA was co-developed and then used to collect 74 pairs of resident and key worker inputted data (62% of eligible hostel residents). The mean age of clients was 48 years (range 22–82 years). High levels of unmet need were identified. Over half (53%) were identified as frail. Common concerns included difficulty walking (46%), frequent falls (43%), chronic pain (36%), mental health issues (57%) and dental concerns (50%). In total, 59% of clients reported difficulty in performing at least one basic activity of daily living, while only 14% had undergone a Care Act Assessment. Hostel staff found using the FHCNA to be feasible, acceptable and potentially useful in facilitating explorations of met and unmet health and social care needs of hostel clients. By identifying unmet needs, the FHCNA has the potential to support staff to advocate for access to health and social care support.

To the best of the authors’ knowledge, this is the first study to co-develop and feasibility test a questionnaire for use by non-clinically trained staff to identify frailty and other health and care needs of people experiencing homelessness in a hostel setting.

This chapter discusses how to involve children and young people in decisions and encourage them to express their needs and participate in the decision-making process to develop a quality intervention. By describing the different aspects of projects involving a participatory approach, it shows how giving voice to children and young people unlocked new perspectives regarding the Hungarian child protection system. Participation of children in research is limited in Hungary, partly due to the challenging legislation and authorisation process. This chapter shows how research to develop child-friendly digital tools can contribute to collecting children's views on their needs related to child protection support, and how the process of listening to children can improve parenting and caregiving responses to the needs of younger and older children living with their families or in the child protection system. The chapter analyses the effect of digital applications on children's and young people's capacity to advance towards autonomy, including applications and a video campaign with short video clips created by young people. These projects gave an opportunity for children and youth in the public care system to describe their lives and wishes for the future. The analysis found: (a) for a functional child protection system and to promote development for children and young people, children's voices need to be amplified; (b) by expressing their voices, children become more autonomous; (c) children's voices contribute to decreasing social prejudices against children and young people in public care; and (d) listening to children and youth who age out of care can help professionals working in the child protection system better understand their beneficiaries.