Karen Croucher

Public perceptions about low back pain and its management: a gap between expectations and reality?

To compare public perceptions and patient perceptions about back pain and its management with current clinical guidelines.

Meeting the challenge: developing systematic reviewing in social policy

This article uses the experience of reviewing the evidence on the financial support available for defaulting home owners to consider the opportunities and challenges systematic review methods present to social policy. It addresses concerns about examining the strength of given evidence, and perceptions of it being a purely technical method to review existing research. It argues that there is merit in utilising the method to provide research users with transparent summaries of the most robust evidence with minimum bias. The article outlines the challenges presented and suggests that social policy researchers have a valuable contribution to make to the developing methods.

Supported Housing Services for People with Mental Health Problems: A Scoping Study

This paper discusses the findings of a scoping study that aimed to explore evidence relating to models of good practice with regard to accommodation and related services for people with mental health problems in the UK. The literature reveals that there has tended to be an assumption that patients will progress from high(er) to low(er) levels of supported accommodation over time, thereby marginalising the needs of a core group of people with particularly challenging behaviour who require long-term, permanent accommodation with high levels of support. The paper concludes by examining the implications of the scoping study for current UK policies towards those with mental health problems.

Evidence for Policy Making: Some Reflections on the Application of Systematic Reviews to Housing Research

The recent turn towards evidence-based or evidence-informed policy making has generated interest in systematic literature review techniques. Systematic reviewing is increasingly being adopted to address questions in complex social policy areas, but the methodological development lags behind. Drawing on the experience of undertaking three systematic reviews of housing related topics, as part of a project designed to empirically test the transfer of systematic review methods to social policy and social care, this paper reflects on the use of the systematic review methods in housing research and considers how our experience accords with recent methodological development of reviewing in other areas. The paper first examines wider methodological developments occurring during the course of the three-year project, before considering changing review practices in housing studies. It then goes on to examine the key methodological challenges that remain unresolved, in particular: searching for literature, quality appraising studies, interpreting old research against shifting contextual factors, and providing an actual synthesis of diverse material. It calls for a more thoughtful approach to the method and more careful consideration of when systematic reviews may be appropriate.

Co-designing Urban Living Solutions to Improve Older People’s Mobility and Well-Being

Mobility is a key aspect of active ageing enabling participation and autonomy into later life. Remaining active brings multiple physical but also social benefits leading to higher levels of well-being. With globally increasing levels of urbanisation alongside demographic shifts meaning in many parts of the world this urban population will be older people, the challenge is how cities should evolve to enable so-called active ageing. This paper reports on a co-design study with 117 participants investigating the interaction of existing urban spaces and infrastructure on mobility and well-being for older residents (aged 55 + years) in three cities. A mixed method approach was trialled to identify locations beneficial to subjective well-being and participant-led solutions to urban mobility challenges. Spatial analysis was used to identify key underlying factors in locations and infrastructure that promoted or compromised mobility and well-being for participants. Co-designed solutions were assessed for acceptability or co-benefits amongst a wider cross-section of urban residents (n = 233) using online and face-to-face surveys in each conurbation. Our analysis identified three critical intersecting and interacting thematic problems for urban mobility amongst older people: The quality of physical infrastructure; issues around the delivery, governance and quality of urban systems and services; and the attitudes and behaviors of individuals that older people encounter. This identified complexity reinforces the need for policy responses that may not necessarily involve design or retrofit measures, but instead might challenge perceptions and behaviors of use and access to urban space. Our co-design results further highlight that solutions need to move beyond the generic and placeless, instead embedding specific locally relevant solutions in inherently geographical spaces, populations and processes to ensure they relate to the intricacies of place.

A Review of “Community and Ageing: Maintaining Quality of Life in Housing with Care Settings”

As we see global demographic changes play out in the 21st century, questions about where we live as we grow older, and what type of settings offer us the best opportunities to enjoy a good quality of life are becoming more pressing. This book, as the title suggests, focuses on two types of housing for later life, retirement villages and extra care housing, which have been developed in increasing numbers in the UK in the last two decades. The author also reflects on how well these models of housing meet older people’s aspirations of community, and how well they enable older people to enjoy a good quality of life. The book is organised into nine chapters. The first chapter introduces the questions that the book addresses – what does community mean to older people, how do experiences of community change across the life course, and how well do the new models of housing with care meet the aspirations for community among older people? Chapter 2 considers various concepts of community and changing theories and definitions, comparing these ideas of community with those of neighbourhood. Chapter 3 explores the changing meaning and importance of community over the life course, reflecting on the ‘baby boomer’ generation with its more consumerist ambitions for diverse life styles, noting, however, that ‘community’ is still something that is particularly valued by people as they grow older. Chapter 4 provides an overview of housing with care settings in the UK, focusing on recent developments, and how they are often marketed as offering a positive lifestyle for older people where they can age ‘successfully’. The development of housing and care options outside the UK is briefly described in Chapter 5. The following two chapters address how provider organisations are attempting to promote a sense of community in housing with care settings (for example, by the use of inclusive design and provision of spaces, services and facilities that promote social interaction), and the extent to which housing with care settings can support a diverse mix of old people with a range of experiences, expectations, needs and lifestyles. Chapter 8 reflects on the ways and the extent to which the structure of communities in Britain has changed and what these changes mean for older people in particular. In the final chapter the author concludes that by

The development of a points system to compare the potential running costs of different development options for new hospitals.

The points system provides a simple method of assessing the design aspects of health care facilities which have a significant influence on their eventual operating costs. It is intended to assist planning teams working in the early stages of designing a health care facility. The system offers a systematic form of analysis which should be used in the preparation of development proposals as an aide-memoir, and as a method of comparing and evaluating alternative design solutions. It comprises seventeen worksheets which should be used by planning teams as a checklist of Design for Reduced Operating Costs factors. The system was developed by using the ‘delphi’ methodology and has been tested in a series of repeatability tests and field trials; and it is now being used for developments within the NHS.