6th UK and Ireland Implementation Science Research Conference 2023
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PRESENter
Dr. Ciaran O’Neill
presenter biography
Ciaran is a junior doctor in emergency medicine in West Yorkshire. He joined the Improvement Academy as a Clinical Leadership Fellow in August 2022. His areas of interest include health inequalities and patient safety.
His work includes developing community based health checks aiming to reduce health inequalities related to cardiovascular disease. The health checks project has a strong focus on community engagement and co-production and Ciaran enjoys collaborating with organisations to understand how the projects can be more responsive to people’s needs.
background
Bradford District is one of the most deprived local authorities in England1 and the rate of Cardiovascular Disease is also higher than the national average2. This project was co-designed in response to a community expectation to implement pre-emptive actions to reduce this risk. The aim of this project is to implement a series of outreach health check events with a community centred approach for cardiovascular disease prevention, and improving community access to social prescribers and primary care.
MEthod
Community engagement and co-design are central to the implementation process. It is a mixed-methods evaluation based on Implementation Science and Participatory Action Research principles. The quantitative measures include hypertension case finding, identification of pre-diabetes and improved blood pressure and HbA1c control. The qualitative implementation evaluation uses a combination of traditional implementation science and rapid qualitative evaluation approaches using the Stanford Lightning Reports method3 to explore contextual factors that impact implementation, and assess implementation fidelity, appropriateness, and feasibility.
results
The first event was in February 2023, 61% of the 103 who attended had an abnormal blood pressure and two subsequently received a new diagnosis of Type 2 Diabetes. The event was perceived as useful by the community. Initial analysis revealed good community and stakeholder engagement, and access to funding were major implementation facilitators. Scope creep, unclear commitment from some stakeholders, system and structural challenges, and limiting beliefs of some community members about health improvement emerged as significant implementation barriers.
Conclusion
The health check event was successful in responding to community health needs, and developing and implementing a community-based, co-designed approach. Initial data demonstrated usefulness of the approach and its potential for improving engagement amongst people from deprived communities; however system level barriers remain a significant challenge to the sustainability of the intervention.
References:
1) City of Bradford Metropolitan District Council. Joint Strategic Needs Assessment, The Population of Bradford District. Bradford. 2022. Available here date accessed 18th July 2022.