National level key informants interview topic guide. This file provides the range of topics and q... more National level key informants interview topic guide. This file provides the range of topics and questions that were covered in interviews with national participants. (PDF 219 kb)
Immunisation service providers interview topic guid. This file provides the range of topics and q... more Immunisation service providers interview topic guid. This file provides the range of topics and questions that were covered in interviews with health professionals involved in delivering immunisations in primary care and as part of community care organisations. (PDF 315 kb)
Immunisation service managers and partners interview topic guid. This file provides the range of ... more Immunisation service managers and partners interview topic guid. This file provides the range of topics and questions that were covered in interviews with people involved in commissioning, managing or assuring the immunisation programme at local level. (PDF 332 kb)
The English health system experienced a large-scale reorganisation in April 2013. A national tri-... more The English health system experienced a large-scale reorganisation in April 2013. A national tri-partite delivery framework involving the Department of Health, NHS England and Public Health England was agreed and a new local operational model applied. Evidence about how health system re-organisations affect constituent public health programmes is sparse and focused on low and middle income countries. We conducted an in-depth analysis of how the English immunisation programme adapted to the April 2013 health system reorganisation, and what facilitated or hindered the delivery of immunisation services in this context. A qualitative case study methodology involving interviews and observations at national and local level was applied. Three sites were selected to represent different localities, varying levels of immunisation coverage and a range of changes in governance. Study participants included 19 national decision-makers and 56 local implementers. Two rounds of interviews and observ...
Background Within the United Kingdom (UK), the National Institute for Health and Care Research is... more Background Within the United Kingdom (UK), the National Institute for Health and Care Research is the largest funder of health and social care research, and additionally funds research centres that support the development and delivery of research. Each year, award-holders of these research centres are required to write a report about their activities, including a summary of Patient and Public Involvement and Engagement (PPIE) activities. This study aimed to evaluate the PPIE sections of annual reports to identify best practice and challenges; this could inform future delivery of PPIE activities. Methods A framework documentary analysis informed by the six UK Standards for Public Involvement ('Inclusive opportunities' , 'Working together' , 'Support and learning' , 'Communications' , 'Impact' and 'Governance') was conducted on 112 reports. A quality improvement framework ('Insights') was used to evaluate quality as one of: 'Welcoming' , 'Listening' , 'Learning' and 'Leading'. Recommendations from this review were co-developed with stakeholders and public contributors. Results Reports documented varying levels of quality in PPIE activities which spanned across all six UK Standards. Award-holders either intended to, or were actively working towards, increasing access and inclusivity of public involvement opportunities. Methods of working with public contributors were varied, including virtual and in-person meetings. Most award-holders offered PPIE support and learning opportunities for both public contributors and staff. Some award-holders invited public contributors to co-produce communication plans relating to study materials and research findings. The impact of public involvement was described in terms of benefits to public contributors themselves, and on an organisation and project level. Many award-holders reported inviting public contributors to share decision-making within and about governance structures. Conclusions This evaluation identified that most annual reports contained evidence of good quality PPIE practice with learning from public contributors. Using the UK Standards and Insights framework enabled exploration of the breadth and quality of PPIE activities. Recommendations include the need for a platform for centres to access and share PPIE best practice and for centres to collaborate with local and national partners to build relationships with the public through inclusive community engagement.
Workplace well-being is central to tackling the social determinants of health and addressing heal... more Workplace well-being is central to tackling the social determinants of health and addressing health inequalities. Little is known about workplace health in the context of ethnic minority businesses and even less on Chinese owned businesses. Yet, the Chinese population is one of fastest growing ethnic minorities in the UK and Chinese businesses are likely to become a substantial asset to the UK economy. This study explores the views and perceptions of Chinese employees and employers as well as opinion leaders on workplace well-being in the Chinese business community in London. The specific aims were to understand the context and approach to staff well-being within Chinese owned businesses based in London and to identify any potential levers, barriers and triggers for engaging Chinese led businesses in work place well-being initiatives. In their management approach Chinese companies are not dissimilar to other ethnic minority and white owned businesses. However, working conditions in ...
Background: Decentralisation of health systems has been commonplace in many Low- and Middle-Incom... more Background: Decentralisation of health systems has been commonplace in many Low- and Middle-Income Countries (LMIC) in the last three decades. Despite several normative and theoretical arguments for decentralisation, little is known about the impact of health system reforms on vaccine systems. The contribution of vaccine systems to the reduction in childhood morbidity and mortality from vaccine-preventable diseases is significant; therefore exploring the effects of decentralisation on the vaccine systems is critical. In the 2013 policy changes in Kenya, responsibilities for vaccine systems were reconfigured. This Study explores the extent to which the quality of the vaccine systems was affected in the reconfiguration. Methods: An ethnographic approach was adopted in this qualitative Study. The researcher was partially immersed in Kilifi, Kenya, for a six-month period, obtaining an in-depth understanding of the participants’ perceptions and experiences of devolution. Thirty-eight fac...
Background A significant structural shift has taken place in both the English and Kenyan health s... more Background A significant structural shift has taken place in both the English and Kenyan health systems in recent years. In England, the National Health Service (NHS) was overhauled: new organisations were formed, existing organisations were either merged to new entities or scrapped and, some public health functions were moved to local government organisations. In Kenya, new sub-national governments were formed, health system functions were split between the national and sub-national governments. The changes were precipitated by the publication of a white paper (England) and the promulgation of a new constitution (Kenya) in 2010; both were effected in 2013. The study set out to explore and compare the impact of the structural changes on the operationalisation of the immunisation programme in both developed and developing health system settings. Methods A qualitative case-study approach was used encompassing document reviews, participant observation and semi-structured interviews hel...
Background Black Africans comprise 5.5% of the London population, but account for 1/3rd of newly ... more Background Black Africans comprise 5.5% of the London population, but account for 1/3rd of newly diagnosed HIV cases and 1/3rd of diagnosed people accessing care. Current policy encourages targeted interventions to raise HIV awareness and promote uptake of testing in this group. ‘Love Safely’ is a 10-year West London community outreach partnership promoting HIV awareness and behaviour change. It deploys outreach workers working with a toolkit to engage people. Methods The study was conducted in 2012. A mixed-methods approach involved analysis of data on 1078 clients and interviews/focus groups with 54 informants - partner organisations, outreach workers, clients, and referral services. Behaviour change was measured through three indicators: (a) recommending family members/friends for a similar visit, (b) exhibiting more careful sexual behaviour (consistent/correct condom use), and (c) accessing HIV testing. Process measures were explored to understand pathways of change. Results The...
Childhood vaccination remains a primary mechanism for reducing the burden of infectious disease. ... more Childhood vaccination remains a primary mechanism for reducing the burden of infectious disease. In the United Kingdom, as in many countries, a sustained effort is required to ensure that vaccination targets are met to afford protection to the whole population from vaccine preventable disease. The Celebrate and Protect programme is a collaborative partnership developed to improve the uptake of childhood vaccination across a number of boroughs within London through the use of a celebration card to encourage attendance for vaccination and enhance relationships between general practices and the parents/carers of children. This study was undertaken to assess the suitability, feasibility and acceptability of the Celebrate and Protect programme across nine boroughs in London. Data were collected either from telephone interviews (n = 24) or from focus groups (n = 31). A total of 55 key informants were included in the study, representing strategic, commissioning or policy leads, healthcare ...
Aim This study aimed to evaluate a pilot cross-sector initiative – bringing together public healt... more Aim This study aimed to evaluate a pilot cross-sector initiative – bringing together public health, a community group, primary mental health teams and patients – in using co-production approaches to deliver a mental health service to meet the needs of the black and minority ethnic communities. Background Black and minority ethnic communities continue to face inequalities in mental health service access and provision. They are under-represented in low-level interventions as they are less likely to be referred, and more likely to disengage from mainstream mental health services. Effective models that lead to improved access and better outcomes are yet to be established. It has long been recognised that to be effective, services need to be more culturally competent, which may be achieved through a co-production approach. Methods This study aimed to evaluate the role of co-production in the development of a novel community mental health service for black and minority ethnic service user...
National level key informants interview topic guide. This file provides the range of topics and q... more National level key informants interview topic guide. This file provides the range of topics and questions that were covered in interviews with national participants. (PDF 219 kb)
Immunisation service providers interview topic guid. This file provides the range of topics and q... more Immunisation service providers interview topic guid. This file provides the range of topics and questions that were covered in interviews with health professionals involved in delivering immunisations in primary care and as part of community care organisations. (PDF 315 kb)
Immunisation service managers and partners interview topic guid. This file provides the range of ... more Immunisation service managers and partners interview topic guid. This file provides the range of topics and questions that were covered in interviews with people involved in commissioning, managing or assuring the immunisation programme at local level. (PDF 332 kb)
The English health system experienced a large-scale reorganisation in April 2013. A national tri-... more The English health system experienced a large-scale reorganisation in April 2013. A national tri-partite delivery framework involving the Department of Health, NHS England and Public Health England was agreed and a new local operational model applied. Evidence about how health system re-organisations affect constituent public health programmes is sparse and focused on low and middle income countries. We conducted an in-depth analysis of how the English immunisation programme adapted to the April 2013 health system reorganisation, and what facilitated or hindered the delivery of immunisation services in this context. A qualitative case study methodology involving interviews and observations at national and local level was applied. Three sites were selected to represent different localities, varying levels of immunisation coverage and a range of changes in governance. Study participants included 19 national decision-makers and 56 local implementers. Two rounds of interviews and observ...
Background Within the United Kingdom (UK), the National Institute for Health and Care Research is... more Background Within the United Kingdom (UK), the National Institute for Health and Care Research is the largest funder of health and social care research, and additionally funds research centres that support the development and delivery of research. Each year, award-holders of these research centres are required to write a report about their activities, including a summary of Patient and Public Involvement and Engagement (PPIE) activities. This study aimed to evaluate the PPIE sections of annual reports to identify best practice and challenges; this could inform future delivery of PPIE activities. Methods A framework documentary analysis informed by the six UK Standards for Public Involvement ('Inclusive opportunities' , 'Working together' , 'Support and learning' , 'Communications' , 'Impact' and 'Governance') was conducted on 112 reports. A quality improvement framework ('Insights') was used to evaluate quality as one of: 'Welcoming' , 'Listening' , 'Learning' and 'Leading'. Recommendations from this review were co-developed with stakeholders and public contributors. Results Reports documented varying levels of quality in PPIE activities which spanned across all six UK Standards. Award-holders either intended to, or were actively working towards, increasing access and inclusivity of public involvement opportunities. Methods of working with public contributors were varied, including virtual and in-person meetings. Most award-holders offered PPIE support and learning opportunities for both public contributors and staff. Some award-holders invited public contributors to co-produce communication plans relating to study materials and research findings. The impact of public involvement was described in terms of benefits to public contributors themselves, and on an organisation and project level. Many award-holders reported inviting public contributors to share decision-making within and about governance structures. Conclusions This evaluation identified that most annual reports contained evidence of good quality PPIE practice with learning from public contributors. Using the UK Standards and Insights framework enabled exploration of the breadth and quality of PPIE activities. Recommendations include the need for a platform for centres to access and share PPIE best practice and for centres to collaborate with local and national partners to build relationships with the public through inclusive community engagement.
Workplace well-being is central to tackling the social determinants of health and addressing heal... more Workplace well-being is central to tackling the social determinants of health and addressing health inequalities. Little is known about workplace health in the context of ethnic minority businesses and even less on Chinese owned businesses. Yet, the Chinese population is one of fastest growing ethnic minorities in the UK and Chinese businesses are likely to become a substantial asset to the UK economy. This study explores the views and perceptions of Chinese employees and employers as well as opinion leaders on workplace well-being in the Chinese business community in London. The specific aims were to understand the context and approach to staff well-being within Chinese owned businesses based in London and to identify any potential levers, barriers and triggers for engaging Chinese led businesses in work place well-being initiatives. In their management approach Chinese companies are not dissimilar to other ethnic minority and white owned businesses. However, working conditions in ...
Background: Decentralisation of health systems has been commonplace in many Low- and Middle-Incom... more Background: Decentralisation of health systems has been commonplace in many Low- and Middle-Income Countries (LMIC) in the last three decades. Despite several normative and theoretical arguments for decentralisation, little is known about the impact of health system reforms on vaccine systems. The contribution of vaccine systems to the reduction in childhood morbidity and mortality from vaccine-preventable diseases is significant; therefore exploring the effects of decentralisation on the vaccine systems is critical. In the 2013 policy changes in Kenya, responsibilities for vaccine systems were reconfigured. This Study explores the extent to which the quality of the vaccine systems was affected in the reconfiguration. Methods: An ethnographic approach was adopted in this qualitative Study. The researcher was partially immersed in Kilifi, Kenya, for a six-month period, obtaining an in-depth understanding of the participants’ perceptions and experiences of devolution. Thirty-eight fac...
Background A significant structural shift has taken place in both the English and Kenyan health s... more Background A significant structural shift has taken place in both the English and Kenyan health systems in recent years. In England, the National Health Service (NHS) was overhauled: new organisations were formed, existing organisations were either merged to new entities or scrapped and, some public health functions were moved to local government organisations. In Kenya, new sub-national governments were formed, health system functions were split between the national and sub-national governments. The changes were precipitated by the publication of a white paper (England) and the promulgation of a new constitution (Kenya) in 2010; both were effected in 2013. The study set out to explore and compare the impact of the structural changes on the operationalisation of the immunisation programme in both developed and developing health system settings. Methods A qualitative case-study approach was used encompassing document reviews, participant observation and semi-structured interviews hel...
Background Black Africans comprise 5.5% of the London population, but account for 1/3rd of newly ... more Background Black Africans comprise 5.5% of the London population, but account for 1/3rd of newly diagnosed HIV cases and 1/3rd of diagnosed people accessing care. Current policy encourages targeted interventions to raise HIV awareness and promote uptake of testing in this group. ‘Love Safely’ is a 10-year West London community outreach partnership promoting HIV awareness and behaviour change. It deploys outreach workers working with a toolkit to engage people. Methods The study was conducted in 2012. A mixed-methods approach involved analysis of data on 1078 clients and interviews/focus groups with 54 informants - partner organisations, outreach workers, clients, and referral services. Behaviour change was measured through three indicators: (a) recommending family members/friends for a similar visit, (b) exhibiting more careful sexual behaviour (consistent/correct condom use), and (c) accessing HIV testing. Process measures were explored to understand pathways of change. Results The...
Childhood vaccination remains a primary mechanism for reducing the burden of infectious disease. ... more Childhood vaccination remains a primary mechanism for reducing the burden of infectious disease. In the United Kingdom, as in many countries, a sustained effort is required to ensure that vaccination targets are met to afford protection to the whole population from vaccine preventable disease. The Celebrate and Protect programme is a collaborative partnership developed to improve the uptake of childhood vaccination across a number of boroughs within London through the use of a celebration card to encourage attendance for vaccination and enhance relationships between general practices and the parents/carers of children. This study was undertaken to assess the suitability, feasibility and acceptability of the Celebrate and Protect programme across nine boroughs in London. Data were collected either from telephone interviews (n = 24) or from focus groups (n = 31). A total of 55 key informants were included in the study, representing strategic, commissioning or policy leads, healthcare ...
Aim This study aimed to evaluate a pilot cross-sector initiative – bringing together public healt... more Aim This study aimed to evaluate a pilot cross-sector initiative – bringing together public health, a community group, primary mental health teams and patients – in using co-production approaches to deliver a mental health service to meet the needs of the black and minority ethnic communities. Background Black and minority ethnic communities continue to face inequalities in mental health service access and provision. They are under-represented in low-level interventions as they are less likely to be referred, and more likely to disengage from mainstream mental health services. Effective models that lead to improved access and better outcomes are yet to be established. It has long been recognised that to be effective, services need to be more culturally competent, which may be achieved through a co-production approach. Methods This study aimed to evaluate the role of co-production in the development of a novel community mental health service for black and minority ethnic service user...
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Papers by Saumu Lwembe