Siobhan O'Higgins

Barriers and facilitators to attending pre‐pregnancy care services: the ATLANTIC‐DIP experience

Pre‐pregnancy care programmes can help to reduce morbidity and mortality associated with pregnancy in women with diabetes. However, uptake of a free pre‐pregnancy care programme along the Irish Atlantic seaboard was only 30%. This study sought to better understand why women with diabetes mellitus (Type 1 and Type 2) choose to attend pre‐pregnancy care services and to identify perceived barriers to attendance.

Youth Participation in Setting the Agenda: Learning Outcomes for Sex Education in Ireland.

This research set out to explore how young people could contribute to sexual health curriculum development, in order to increase the relevance of such curricula to school children. The aim was to facilitate young Irish people, through a participatory research methodology, to generate, collate and present their views on effective sex education. Developing a way to elicit youthful voices creates the possibility for those voices to be heard by those in power – without adult censure. There were 394 participants aged between 15 and 18 years. The participants made their data accessible to adults with the creation of 62 ‘Webs’. The young people stated it was vital that sex education allow them access to factual information. The issues that they wished to gain knowledge on ranged from how to establish healthy respectful, communicative relationships, knowing how babies are made, when one’s ready physically and emotionally for sex, how to put a condom on, who to go to for information and how best to talk about sexual issues. They wanted to be taught by people whom they can trust to deliver information accurately, confidentially and with confidence. The rich data reflected and respected the young peoples’ perspective without resort to adult interpretations.

The implementation of social, personal and health education in Irish schools

Purpose – Social, Personal and Health Education (SPHE) is mandated in all Irish schools. This study aims to illuminate the perceived value and quality of SPHE and to document facilitators of successful implementation.Design/methodology/approach – A case study approach was taken, where 713 pupils, 968 parents and 49 teachers and other staff across a stratified random sample of 12 schools completed questionnaires and participated in interviews and focus groups. Data were integrated at the school level and subsequently across schools.Findings – Stakeholders generally agreed on the worth of SPHE. However, its perceived value relative to other areas of the curriculum varied by school context. Facilitators for successful implementation included training for teachers, inclusion of SPHE in school planning and evaluation processes, and organisational support for SPHE via timetabling and resource management within schools.Research limitations/implications – Case studies were useful for investigating implementation ...

Health‐promoting school indicators: schematic models from students

Purpose – The purpose of this paper is to outline a three‐stage process for engaging with students to develop school level indicators of health; in sequential class groups students first generated, then categorised indicators and finally developed schematic representations of their analyses. There is a political and practical need to develop appropriate indicators for health‐promoting schools. As key stakeholders in education, students have the right to be fully engaged in this process.Design/methodology/approach – The sample in this paper comprised 164 students aged 16‐17 years in three medium‐sized Dublin schools. In the first classroom, students answered the question “If you moved to a new school, what would it need to have to be a healthy place?” on individual flashcards. In the second classroom students classified the flashcards into groups using a variation of the card game “snap”. In the third classroom, students discussed the relationships between the developed categories and determined how the ca...

Adolescents' Perceptions of the Words "Health" and "Happy".

Purpose – The shared language of youth includes understandings of concepts that can be different from those of adults. Researchers, in their efforts to explore and illuminate the health behaviours and decision‐making processes of young people, use generic terms in their data collecting protocols. This study aims to explore what adolescents understand by the words “healthy” and “happy”.Design/methodology/approach – Semi‐structured interviews were conducted in three post‐primary schools with 31 students aged 12 and 13 years. Drawing on a grounded theory approach, interviews were transcribed and subjected to thematic content analysis.Findings – The students provided a description and explanation of what health and happiness meant to them and how they intended to maintain both as they grew older. Perceptions of these two concepts were found to contain gendered nuances. This was clear in relation to descriptions of how friends were part of well‐being; the girls were more likely to talk about feeling restricted...

Comparing the clinical-effectiveness and cost-effectiveness of an internet-delivered Acceptance and Commitment Therapy (ACT) intervention with a waiting list control among adults with chronic pain: study protocol for a randomised controlled trial

Introduction Internet-delivered psychological interventions among people with chronic pain have the potential to overcome environmental and economic barriers to the provision of evidence-based psychological treatment in the Irish health service context. While the use of internet-delivered cognitive–behavioural therapy programmes has been consistently shown to have small-to-moderate effects in the management of chronic pain, there is a paucity in the research regarding the effectiveness of an internet-delivered Acceptance and Commitment Therapy (ACT) programme among people with chronic pain. The current study will compare the clinical-effectiveness and cost-effectiveness of an online ACT intervention with a waitlist control condition in terms of the management of pain-related functional interference among people with chronic pain. Methods and analysis Participants with non-malignant pain that persists for at least 3 months will be randomised to one of two study conditions. The experimental group will undergo an eight-session internet-delivered ACT programme over an 8-week period. The control group will be a waiting list group and will be offered the ACT intervention after the 3-month follow-up period. Participants will be assessed preintervention, postintervention and at a 3-month follow-up. The primary outcome will be pain-related functional interference. Secondary outcomes will include: pain intensity, depression, global impression of change, acceptance of chronic pain and quality of life. A qualitative evaluation of the perspectives of the participants regarding the ACT intervention will be completed after the trial. Ethics and dissemination The study will be performed in agreement with the Declaration of Helsinki and is approved by the National University of Ireland Galway Research Ethics Committee (12/05/05). The results of the trial will be published according to the CONSORT statement and will be presented at conferences and reported in peer-reviewed journals. Trial registration number ISRCTN18166896.

Current Practice in Meeting Child Health Needs in Family Support Services: Variation by Service Type and Perspectives on Future Developments.

The needs of all service users include those related to physical, emotional, sexual and mental health. This article documents where child health needs are recognised and being met within family support services in the west of Ireland, investigates whether there is variation across different types of family support services and presents the views of service providers as to how health needs could be more fully addressed. Four randomly selected service managers were interviewed; followed by a census survey of managers within the region. Thirty-three managers returned questionnaires (80% response) on their formal briefs in relation to health, perceived health needs being met and unmet, approaches to meeting health needs and resources required to adequately meet client health needs. Emotional and mental health needs were most frequently being met within current services, while group work, one-to-one work and referring on were all popular approaches. Systematic differences emerged by service size and client group. Access to expertise and staff training were perceived as the most popular approaches to improving service provision. These data illustrate that there is a need to develop guidelines for practice, foster links between services and provide for specialised staff training in relation to child health issues.

Prevalence, impact and cost of multimorbidity in a cohort of people with chronic pain in Ireland: a study protocol

Introduction Multimorbidity (MM) refers to the coexistence of two or more chronic conditions within one person, where no one condition is considered primary. As populations age and healthcare provision improves, MM is becoming increasingly common and poses a challenge to the single morbidity approach to illness management, usually adopted by healthcare systems. Indeed, recent research has shown that 66.2% of the people in primary care in Ireland are living with MM. Healthcare usage and cost is significantly associated with MM, and additional chronic conditions lead to exponential increases in service usage and financial costs, and decreases in physical and mental well-being. Certain conditions, for example, chronic pain, are highly correlated with MM. This study aims to assess the extent, profile, impact and cost of MM among Irish adults with chronic pain. Methods and analysis Using cluster sampling, participants aged 18 years and over will be recruited from Irish pain clinics and provided an information package and questionnaire asking them to participate in our study at three time points, 1 year apart. The questionnaire will include our specially developed checklist to assess the prevalence and impact of MM, along with validated measures of quality of life, pain, depression and anxiety, and illness perception. Economic data will also be collected, including direct and indirect costs. Ethics and dissemination Ethical approval has been granted by the Research Ethics Committee of the National University of Ireland, Galway. Dissemination of results will be via journal articles and conference presentations.

The prevalence, impact and cost of chronic non-cancer pain in Irish primary schoolchildren (PRIME-C): protocol for a longitudinal school-based survey.

Introduction Previous research has indicated that pain influences childrens daily lives, resulting in absence from school, sleep problems, poor school performance and problems with social activities. Our study aims to characterise the nature, extent, impact and cost of chronic pain among Irish children. Methods and analysis Using cluster-systematic random sampling, primary schools will be invited to participate and 6000 5–12-year-olds asked to complete questionnaires in school classrooms, at time points 1 year apart. Questionnaires will use internationally valid psychometric measures to assess a range of quality of life factors and chronic pain indicators among children, with corresponding parental/primary caregiver questions, which will be completed at home. Data will also be gathered on the cost of chronic pain. Space will be given for comments on how pain impacts on participants’ lives and possible coping mechanisms. Ethics and dissemination Ethical approval has been granted by the Research Ethics Committee, National University of Ireland, Galway. Dissemination of results will be via journal articles and conference presentations on the various aspects of the study (ie, prevalence, impact and economic cost of chronic pain among 5–12-year-olds living in Ireland).