1
|
Wheeler AJ, Roennfeldt H, Slattery M, Krinks R, Stewart V. Codesigned recommendations for increasing engagement in structured physical activity for people with serious mental health problems in Australia. Health Soc Care Community 2018; 26:860-870. [PMID: 30047608 DOI: 10.1111/hsc.12597] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 04/22/2018] [Accepted: 05/20/2018] [Indexed: 06/08/2023]
Abstract
People with mental health problems are at higher risk of physical health comorbidities and early mortality. A key risk factor for poor health outcomes is a lack of regular physical activity. Mental health services have typically responded by focusing on screening and promoting lifestyle programmes within secondary care mental health settings. The aim of this study was to better understand the barriers and enablers for Australian mental health consumers to participate in physical activity or exercise programmes from the perspectives of consumers and exercise practitioners. Interviews with 15 consumers experiencing serious mental health problems and five exercise practitioners were undertaken, followed by two focus groups (involving eight consumers and two exercise practitioners) to gain consensus on themes from the interviews, and codesign a set of recommendations for services to support and increase the engagement of mental health consumers in regular community-based exercise. Barriers that impacted on engagement in physical activity included: lack of social support, insufficient knowledge and information, difficulties with work/life balance, impact of physical and mental health issues, fear and lack of confidence, and financial cost. Enablers or motivators assisting engagement in community-based physical activity programmes included: social support, access to person-centred individualised exercise options, connection and a sense of belonging, and access to information and education. Recommendations and a checklist were developed to assist services to increase the involvement of mental health consumers in community-based exercise and to ensure that exercise practitioners and their employing organisations are adequately equipped to work with this population.
Collapse
Affiliation(s)
- Amanda J Wheeler
- Menzies Health Institute, Griffith University, Brisbane, Queensland, Australia
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Helena Roennfeldt
- Menzies Health Institute, Griffith University, Brisbane, Queensland, Australia
| | - Maddy Slattery
- Menzies Health Institute, Griffith University, Brisbane, Queensland, Australia
| | - Rachael Krinks
- Menzies Health Institute, Griffith University, Brisbane, Queensland, Australia
| | - Victoria Stewart
- Menzies Health Institute, Griffith University, Brisbane, Queensland, Australia
| |
Collapse
|
2
|
Scuffham PA, Krinks R, Chalkidou K, Littlejohns P, Whitty JA, Wilson A, Burton P, Kendall E. Correction to: Recommendations from Two Citizens' Juries on the Surgical Management of Obesity. Obes Surg 2018; 28:1753. [PMID: 29464537 DOI: 10.1007/s11695-018-3112-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The spelling of the name of author K. Chalkidou was incorrect in the original article. It is correct here.
Collapse
Affiliation(s)
- P A Scuffham
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia. .,School of Medicine, Nathan Campus, Griffith University, Brisbane, Australia.
| | - R Krinks
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | | | | | | | - A Wilson
- Menzies Centre for Health Policy, University of Sydney, Sydney, Australia
| | - P Burton
- Cities Research Institute, Griffith University, Brisbane, Australia
| | - E Kendall
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| |
Collapse
|
3
|
Scuffham PA, Moretto N, Krinks R, Burton P, Whitty JA, Wilson A, Fitzgerald G, Littlejohns P, Kendall E. Engaging the public in healthcare decision-making: results from a Citizens' Jury on emergency care services. Emerg Med J 2016; 33:782-788. [PMID: 27323789 DOI: 10.1136/emermed-2015-205663] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 05/09/2016] [Accepted: 05/30/2016] [Indexed: 11/03/2022]
Abstract
BACKGROUND Policies addressing ED crowding have failed to incorporate the public's perspectives; engaging the public in such policies is needed. OBJECTIVE This study aimed at determining the public's recommendations related to alternative models of care intended to reduce crowding, optimising access to and provision of emergency care. METHODS A Citizens' Jury was convened in Queensland, Australia, to consider priority setting and resource allocation to address ED crowding. Twenty-two jurors were recruited from the electoral roll, who were interested and available to attend the jury from 15 to 17 June 2012. Juror feedback was collected via a survey immediately following the end of the jury. RESULTS The jury considered that all patients attending the ED should be assessed with a minority of cases diverted for assistance elsewhere. Jurors strongly supported enabling ambulance staff to treat patients in their homes without transporting them to the ED, and allowing non-medical staff to treat some patients without seeing a doctor. Jurors supported (in principle) patient choice over aspects of their treatment (when, where and type of health professional) with some support for patients paying towards treatment but unanimous opposition for patients paying to be prioritised. Most of the jurors were satisfied with their experience of the Citizens' Jury process, but some jurors perceived the time allocated for deliberations as insufficient. CONCLUSIONS These findings suggest that the general public may be open to flexible models of emergency care. The jury provided clear recommendations for direct public input to guide health policy to tackle ED crowding.
Collapse
Affiliation(s)
- P A Scuffham
- Centre for Applied Health Economics, Menzies Health Institute Queensland, Griffith University, Meadowbrook, Queensland, Australia
| | - N Moretto
- Centre for Applied Health Economics, Menzies Health Institute Queensland, Griffith University, Meadowbrook, Queensland, Australia
| | - R Krinks
- Centre of National Research on Disability and Rehabilitation, Menzies Health Institute Queensland, Griffith University, Meadowbrook, Queensland, Australia
| | - P Burton
- Urban Research Program, Griffith School of Environment, Griffith University, Southport, Queensland, Australia
| | - J A Whitty
- Centre for Applied Health Economics, Menzies Health Institute Queensland, Griffith University, Meadowbrook, Queensland, Australia.,School of Pharmacy, Faculty of Health and Behavioural Sciences, University of Queensland, St Lucia, Queensland, Australia
| | - A Wilson
- Menzies Centre for Health Policy, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - G Fitzgerald
- School of Public Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - P Littlejohns
- Division of Health and Social Care Research, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - E Kendall
- Centre of National Research on Disability and Rehabilitation, Menzies Health Institute Queensland, Griffith University, Meadowbrook, Queensland, Australia
| |
Collapse
|
4
|
Whitty JA, Ratcliffe J, Kendall E, Burton P, Wilson A, Littlejohns P, Harris P, Krinks R, Scuffham PA. Prioritising patients for bariatric surgery: building public preferences from a discrete choice experiment into public policy. BMJ Open 2015; 5:e008919. [PMID: 26474940 PMCID: PMC4611181 DOI: 10.1136/bmjopen-2015-008919] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES To derive priority weights for access to bariatric surgery for obese adults, from the perspective of the public. SETTING Australian public hospital system. PARTICIPANTS Adults (N=1994), reflecting the age and gender distribution of Queensland and South Australia. PRIMARY AND SECONDARY OUTCOME MEASURES A discrete choice experiment in which respondents indicated which of two individuals with different characteristics should be prioritised for surgery in repeated hypothetical choices. Potential surgery recipients were described by seven key characteristics or attributes: body mass index (BMI), presence of comorbid conditions, age, family history, commitment to lifestyle change, time on the surgical wait list and chance of maintaining weight loss following surgery. A multinomial logit model was used to evaluate preferences and derive priority weights (primary analysis), with a latent class model used to explore respondent characteristics that were associated with variation in preference across the sample (see online supplementary analysis). RESULTS A preference was observed to prioritise individuals who demonstrated a strong commitment to maintaining a healthy lifestyle as well as individuals categorised with very severe (BMI≥50 kg/m2) or (to a lesser extent) severe (BMI≥40 kg/m2) obesity, those who already have obesity-related comorbidity, with a family history of obesity, with a greater chance of maintaining weight loss or who had spent a longer time on the wait list. Lifestyle commitment was considered to be more than twice as important as any other criterion. There was little tendency to prioritise according to the age of the recipient. Respondent preferences were dependent on their BMI, previous experience with weight management surgery, current health state and education level. CONCLUSIONS This study extends our understanding of the publics' preferences for priority setting to the context of bariatric surgery, and derives priority weights that could be used to assist bodies responsible for commissioning bariatric services.
Collapse
Affiliation(s)
- Jennifer A Whitty
- Faculty of Health and Behavioural Sciences, School of Pharmacy, The University of Queensland, St Lucia, Queensland, Australia
| | - Julie Ratcliffe
- Flinders Health Economics Group, School of Medicine, Flinders University, Adelaide, South Australia, Australia
| | - Elizabeth Kendall
- Centre of National Research on Disability and Rehabilitation, Menzies Health Institute Queensland, Griffith University, Meadowbrook, Queensland, Australia
| | - Paul Burton
- Urban Research Program, Griffith School of Environment, Griffith University, Southport, Queensland, Australia
| | - Andrew Wilson
- Menzies Centre for Health Policy, University of Sydney, New South Wales, Australia
| | - Peter Littlejohns
- Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Paul Harris
- School of Human Services and Social Work, Menzies Health Institute Queensland, Griffith University,Meadowbrook, Queensland, Australia
| | - Rachael Krinks
- Centre of National Research on Disability and Rehabilitation, Menzies Health Institute Queensland, Griffith University, Meadowbrook, Queensland, Australia
| | - Paul A Scuffham
- Centre for Applied Health Economics, Menzies Health Institute Queensland, Griffith University, Meadowbrook, Queensland, Australia
| |
Collapse
|
5
|
Abstract
Background There is widespread agreement that the public should be engaged in health‐care decision making. One method of engagement that is gaining prominence is the citizens’ jury, which places citizens at the centre of the deliberative process. However, little is known about how the jury process works in a health‐care context. There is even less clarity about how consumer perspectives are heard within citizens’ juries and with what consequences. Objectives This paper focuses on what is known about the role of consumer voices within health‐care citizens’ juries, how these voices are heard by jurors and whether and in what ways the inclusion or exclusion of such voices may matter. Results Consumer voices are not always included in health‐care citizens’ juries. There is a dearth of research on the conditions under which consumer voices emerge (or not), from which sources and why. As a result, little is known about what stories are voiced or silenced, and how such stories are heard by jurors, with what consequences for jurors, deliberation, decision‐makers, policy and practice. Discussion and Conclusion The potential role of consumer voices in influencing deliberations and recommendations of citizens’ juries requires greater attention. Much needed knowledge about the nuances of deliberative processes will contribute to an assessment of the usefulness of citizens’ juries as a public engagement mechanism.
Collapse
Affiliation(s)
- Rachael Krinks
- School of Human Services and Social Work, Menzies Health Institute Qld, Griffith University, Logan, Qld, Australia.
| | - Elizabeth Kendall
- Centre of National Research on Disability and Rehabilitation, Menzies Health Institute Qld, Griffith University, Logan, Qld, Australia
| | - Jennifer A Whitty
- School of Pharmacy, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Qld, Australia.,Centre for Applied Health Economics, School of Medicine, Griffith University, Brisbane, Qld, Australia
| | - Paul A Scuffham
- Director of the Centre for Applied Health Economics and Director of the Population and Social Health Research Program, Menzies Health Institute Qld, Griffith University, Brisbane, Qld, Australia
| |
Collapse
|