Health Professionals and Health Services

(Funded by the Public Health Research Consortium, Department of Health)

The Secretary of State for Health expressed concerns about the uptake of the seasonal flu vaccination by healthcare workers, and the Department of Health was asked to commission a study to identify factors which explained differences in uptake and to inform the development of interventions which had the potential to increase uptake. 

Therefore, the aims of this study were:

1. To explore qualitatively the interaction of staff attitudes and vaccine uptake, in a range of high and low uptake Trusts.
2. To explore and describe the key dimensions of good practice in flu programme implementation, in terms of engagement with staff attitudes and beliefs, models of delivery and organisational context.
3. To assess quantitatively and retrospectively whether good practice in implementation is associated with higher uptake of the vaccination, and what other contextual factors might explain variation in uptake.

ISM Staff: Martine Stead, Douglas Eadie, Anne Marie MacKintosh, Fiona Dobbie and Nathan Critchlow

External: NatCen

(Funded by the Chief Scientist Office)

Out-of-hospital cardiac arrest (OHCA) was a significant health problem in Scotland with approximately 3,000 resuscitation attempts each year. Survival was only 6.4%, with those in the more deprived quintile of the population (SIMD 1) twice as likely to suffer an OHCA, but 43% less likely to survive compared with those who are least deprived. The most important modifiable factor affecting survival was cardiopulmonary resuscitation (CPR) by a bystander. Bystander CPR more than doubled the likelihood of survival, but occured only around 40% of the time, and least often in the SIMD 1 quintile. In 2015 the Scottish Government launched Scotland’s OHCA strategy with a key aim to improve survival by increasing rates of bystander CPR. This study contributed to that aim by developing a strategy to ensure that communities who most need increased CPR rates were targeted. We accomplished this by designing an evidence-based intervention to improve the rate of bystander CPR in deprived areas using a social marketing framework and social network theory. Our research design included a systematic review and a range of qualitative methods with key partners and stakeholders. 

ISM Staff: Fiona Dobbie (PI), Martine Stead, Douglas Eadie, Kathryn Angus and Nathan Critchlow

External: Edward Duncan, University of Stirling; Gareth Clegg, Lisa MacInnes and Liz Hasseld, The University of Edinburgh

Publications:
Dobbie F, Angus K, Uny I, Duncan E, MacInnes L, Hasseld L and Clegg G (2018). Protocol for a systematic review to identify the barriers and facilitators to deliver bystander cardiopulmonary resuscitation (CPR) in disadvantaged communities. Systematic Reviews, 7: 143. doi:10.1186/s13643-018-0807-5

(Commissioned by the Scottish Government, through the Resuscitation Research Group, University of Edinburgh)

Survival rates from out-of-hospital cardiac arrest in Scotland were estimated at 1 in 20 (Out-of-Hospital Cardiac Arrest: A Strategy for Scotland (2015)). As most cardiac arrests happened in the home, bystander CPR was an important factor in determining survival. In March 2015 the Scottish Government launched its Out-of-Hospital Cardiac Arrest strategy (ref as above) which sought to:

“improve outcomes after out-of-hospital cardiac arrest (OHCA) and an ambition that by 2020 Scotland will be an international leader in the management of OHCA”.

The focus of this research study was to assist with the implementation of three of the strategy aims which centre on public administration of CPR (Cardio-Pulmonary Resuscitation):

• To ensure that those who witness an out-of-hospital cardiac arrest (OHCA) promptly call 999 and are enabled to carry out immediate Cardio-Pulmonary Resuscitation (CPR) and use a Public Access Defibrillator (PAD), where available, until support arrives.
• To increase the rate of bystander CPR.
• To encourage a greater public awareness of the ‘right thing to do’ and an increased willingness to help when present as a bystander at an OHCA.

We conducted a general population survey to gather baseline information on the number of people trained in CPR. The survey also explored public attitudes and behaviour toward out-of-hospital cardiac arrest (OHCA). This new learning will be used to create a social marketing strategy to address the barriers to responding to OHCA. (Note this secondary phase will be the focus of separate commission). Results are available in late 2015.

(Commissioned by NHS Health Scotland)

Scotland had one of the highest rates of childhood dental decay in Europe, and decay rates were disproportionately higher for children living in deprived communities. Childsmile was a childhood oral health service rolled out across Scotland which aspired to provide ‘universal' access to Childsmile care for every newborn, together with additional 'targeted' support intended for children seen to be most at risk of dental caries. NHS Health Scotland, in partnership with Childsmile, commissioned the Institute for Social Marketing to undertake research to inform the communication strategy and development of local social marketing campaigns designed to improve the update of the Childsmile programme as the routine dental service from birth in selected areas in Scotland 's three administrative regions. Two research exercises were completed. Firstly, a literature review examined social marketing campaigns directed at increasing parental/carers' and professional engagement with child and family health; specifically campaigns and projects related to childhood oral health, childhood vaccination and breastfeeding. Secondly, primary research was undertaken with parents/carers, health professionals and key stakeholders through qualitative group and individual interviews. This examined knowledge, understanding and perceptions of the Childsmile programme, and issues and recommendations in relation to marketing Childsmile.

ISM Staff: Ingrid Holme (left 2009), Susan MacAskill and Douglas Eadie

Publications:
Lindridge A, MacAskill S, Ginch W, Eadie D and Holme I (2013). Applying an ecological model to social marketing communications. European Journal of Marketing, 47(9): 1399-1420. Article

Holme I, MacAskill S and Eadie E (2009). Research to Develop a Communications Campaign to Promote Childsmile within Local Communities Stage 1: Literature Review. Stirling: Institute for Social Marketing, University of Stirling.

Holme I, MacAskill S and Eadie E (2009). Research to Develop a Communications Campaign to Promote Childsmile within Local Communities Stage 2: Primary Research. Stirling: Institute for Social Marketing, University of Stirling.

(In collaboration with a number of European partner organisations; funded by the European Commission and Cancer Research UK)

The PESCE project aimed to motivate increased smoking cessation interventions by GP's in Europe. As socioeconomic factors have been named in many EU countries as a deterrent to routinely practised smoking cessation interventions, an objective was to develop evidence based policy recommendations and implementation strategies to change the socioeconomic environment through political measures to motivate greater involvement of GP's in cessation interventions. The Centre for Tobacco Control Research conducted an academic literature review to provide evidence of the factors that hinder or promote GP's smoking cessation interventions, and coordinated the collection and review of grey literature from the EU member countries, Norway and Switzerland to complement this. These two reviews fed into the final European report, recommendations and strategies.

ISM Staff: Martine Stead, Gayle Tait (left 2009) and Kathryn Angus

Publications:
Stead M, Angus K, Holme I, Cohen D, Tait G and the PESCE European Research Team (2009). Factors influencing European GPs’ engagement in smoking cessation: a multi-country literature review. British Journal of General Practice, 59(566): 682-690. Article