Institute of Health & Wellbeing - Themes

Lift shaft of the Health and Wellbeing Building

The Institute of Health and Wellbeing has four main research themes which reflect our areas of expertise:  

  • Perinatal wellbeing 

  • Healthy Living

  • Long term conditions 

  • Workspace and Workforce Wellbeing


The approaches embedded within these themes include research-led practice, co-design, implementation, and translation.  

The Institute’s portfolio of research is closely aligned with the work of the Integrated Care Academy. 

Although the Institute has four distinct themes of research, there is overlap between their scope. Projects are listed under the main theme.  

Projects and Publications

Menopause and Me evaluation

Funder: Suffolk Libraries
Team lead: Valerie Gladwell
Team members: Laura Reeves, Samantha Chenery-Morris
Duration: 113 weeks

Suffolk Libraries has been awarded funding from the Department of Health and Social Care to deliver a project supporting women who are experiencing the (peri)menopause and their employers. The project will co-produce an employer pledge with the support of focus groups and surveys to be conducted with employees (predominately women but not exclusive to this gender identity) and senior staff in SME organisations (employers). The project aims to produce resources and information for employers, self-employed and women in how to support women who are experiencing the (peri)menopause.

The University of Suffolk are working with Suffolk Libraries to evaluate the effectiveness of the above project. The University of Suffolk will work in partnership with Suffolk Libraries to:

  • Collect pre- post- and follow up evaluation survey data to evaluate the pledge, lived experience and library staff training aspect of Suffolk Libraries project (see package 1)
  • Run 3 periodic workshop sessions to gather value statements around the pledge, lived experiences and library staff training provided by Suffolk Libraries (Package 2)
  • Evaluate the learning process using ripple maps and learning logs (Package 3)
  • Collect pre- and post- evaluation survey data in regard to the annual conference held by Suffolk Libraries (Package 4)

Develop a Self-report Measure to Assess Sleep Satisfaction through Community-based Participatory Research: The Suffolk Sleep Index (SuSi)

Funder: NHS Ipswich and East Suffolk CCG
Team lead: Valerie Gladwell
Team members: Colin R. Martin and Stephen Hunt
Duration: 65.1 weeks

This research is based on the protocol described in Protogerou, C., Gladwell, V., & Martin, C. (2022). Development of a self-report measure to assess sleep satisfaction: Protocol for the Suffolk Sleep Index (SuSI). Frontiers in Psychology, 13, 6803

Good sleep is essential for health but there is no consensus on how to conceptualise, define and measure sleep satisfaction. The Suffolk Sleep Index (SuSi) project was designed to develop and validate a targeted self-report measure to assess sleep satisfaction.

To date, people’s perceptions of a good night’s sleep have been, almost exclusively, conceptualized under the lens of sleep quality, which refers to objective characteristics of good sleep, such as such as ease and time needed to fall asleep, hours of sleep, and physical symptoms during sleep and upon awakening. This research focuses on sleep satisfaction, rather than sleep quality. To our knowledge, a valid and reliable sleep satisfaction self-report measure has not been developed in the United Kingdom previously.

The SuSi has been founded on principles of community-based participatory research and involved a seven-phase developmental design comprising of literature review, interviews with primary intended users (Suffolk community members), synthesis of literature review and interview findings, pre-testing, pilot-testing, scale evaluation, and refinement.

The expected outcomes and deliverables are a novel sleep satisfaction self-report measure targeted to the needs and characteristics of its primary intended users, that identifies and accounts for satisfactory sleep and which can be adapted to other populations.

Safe Suffolk Renters: Health and Housing

Funder: East Suffolk Council
Team lead: Alison Pooley
Team members: Valerie Gladwell
Duration: 104 weeks

As part of the Safe Suffolk Renters project the University research focuses on Health and Housing so we can:

  • Understand the lived experience of tenants and landlords in specific parts of Suffolk.
  • Find out what works for tenants, residents and landlords in improving each home.
  • Better understand the impacts on quality of life, health and wellbeing of living in a privately rented home in Suffolk.

Safe Suffolk Renters (SSR) aims to foster and nurture relationships between tenants, landlords, property managers, and local councils. It provides education and awareness to align everyone's understanding of responsibilities and expectations. The University of Suffolk are being funded as part of the SSR project, to examine the links between health and housing in Suffolk. This part of the SSR project, will contribute to the ongoing work being undertaken by the University into health, wellbeing, housing and resilient communities. We will focus on areas with differing needs to enable a better understanding of housing within the PRS and the impacts of various housing issues on quality of life, health and wellbeing. The Safe Suffolk Renters project is funded by the Department for

Levelling Up, Housing and Communities (DLUHC) Pathfinder Programme. The five Suffolk-wide authorities will design and implement it.

Way to Go Suffolk: Travel and Social Inclusion

Funder: UKRI Particapatory Fund
Team lead: Valerie Gladwell
Team members: Ruby Farr
Duration: 130 weeks

Rebranded as ‘Way to go Suffolk’ (October 2023) Suffolk County Council one of 11 successful bids across England (Bath and North East, Somerset, Bradford, Cornwall, Cumbria, Doncaster, Gateshead, Leeds, Nottingham, Plymouth, Suffolk, Staffordshire)

  • £12.7m total fund across 3 years
  • £1.5 award for the project in Suffolk
  • Funding from DfT, managed by Active Travel England (ATE)
  • 2 in 5 people presenting in primary care with non-medical problems or a condition where medicine cannot help

Aims and Objectives of the pilot:

  • To improve walking and cycling accessibility for underrepresented groups, to support the reduction in health inequalities
  • To create an integrated network that links transport infrastructure, link workers and VCSE work in Suffolk
  • To improve mental health and safety for underrepresented groups interested in walking and cycling
  • To increase awareness and use of existing and new active travel infrastructure
  • To facilitate increased physical activity through walking and cycling
  • To increase social inclusion, a sense of community and individual resilience though group based walking and cycling activities
  • To create a sustainable social prescribing network in Suffolk where clients repeatedly attend prescribed activities.

Types of Interventions that might be included:

  • Cycling confidence and Bikeability; Cycle Maintenance; Cycle/walk journey planning; Loaning of bikes and walking aids; Walks: hospital, buddy, green.

Special Olympics: Using co-production to explore the healthy athletes programme

Conference Poster by Ellie Rossiter (Research Assistant)

Funder: Department for Transport (via Suffolk County Council)
Team lead: Valerie Gladwell
Team members: Ellie Rossiter
Duration: 34 weeks

This is part of a wider PhD research project, that is a participatory action research study with people with learning disabilities.

Aims: The primary aims are to identify the barriers, enablers, and outcomes people with a learning disability experience when seeking to be physically active, the associated health inequalities and impact on quality of life.

Using a participatory approach, we hope to develop an understanding of how to appropriately implement the Healthy Athletes programme at a large-scale Special Olympics Suffolk event on 22/9/24.

This research will be a collaboration by University of Suffolk and a team from the University of Essex led by Ellie Rossiter (PhD student) as well as members of Special Olympics Suffolk, ACE Anglia, and an advisory group of people with a learning disability.

The data will be used for a PhD project and to inform the Special Olympics Suffolk September 2024 event.

By engaging in prior scoping exercises, potential partners and collaborators have expressed an interest in being involved within the wider project. This includes groups who provide services and physical activity opportunities for people with a learning disability, as well as engaging in conversations with people with a learning disability, including Special Olympics athletes, coaches and key support people.

This approach is an attempt to shift from research 'to' or 'about' people, towards a more participatory approach to research 'with' people. individuals with a learning disability have expressed a willingness to form an advisory group that will help to take forward the subsequent phases of this study, in a way that adheres to fundamental co-production principles and participatory methods.

Whole system approaches to embedding physical activity in healthcare.

Funder: NHS Norfolk and Waveney ICB
Team lead: Valerie Gladwell
Team members: Rob Southall-Edwards, Ellie Rossiter
Duration: 30 weeks

Aim: Generate evidence to develop a grant application for submission to NIHR, which incorporates a whole system approach (intervention) embedding PA through healthcare pathways, using a holistic, low agentic and co-ordinated approach. Our objectives are to:

  • Explore what healthcare pathways exist across the UK and internationally, which link PA and healthcare, and identify gaps in literature and practice
  • Identify how the system is working within Suffolk with specific examples
  • Identify the challenges that exist and how these may be overcome
  • Based on the above, start to develop a whole system approach that could be trialled in Suffolk
  • Produce a grant application to be submitted to the NIHR, that develops the whole system approach, by creating initiative(s) that can be trialled and implemented across Suffolk, and scaled up as appropriate.

Evaluation of the post-covid mental health fund - Suffolk.

Funder: Suffolk County Council
Team lead: Valerie Gladwell
Team members: Colin R. Martin, Rob Southall-Edwards, Abigail Webb
Duration: 56 weeks

SWAY Report - Phase 1

SWAY Report - Phase 2

SWAY Report - Phase 3

Suffolk County Council (SCC), supported by the Suffolk Covid-19 Outbreak Management Fund, have dedicated funds to a series of research themes related to wellbeing, including Emotional Needs (a Suffolk Mind project); supporting good mental health in the workplace; establishing provisions for targeted support such as physical activity, cost-of-living, and COVID memorialisation; promoting awareness of support availability, to name a few. Together, these research areas constitute the Suffolk Public Mental Health (PMH) Programme. The Evaluation will be conducted in three phases:

  • Evaluation of process used to award funding
  • Insight into process of funding from successful & unsuccessful applicants
  • Impact of funded projects on wellbeing

Continuity of care in maternity services

Funder: ESNEFT
Team lead: Colin R. Martin
Team members: Patience Pounds, Valerie Gladwell
Duration: 181.7 weeks

The importance of Midwifery Continuity of Carer (MCoC) has been acknowledged in the UK since the 1993 publication of Changing Childbirth (Department of Health, 1993) however implementation was often small scale or not sustained (McInnes et al., 2020). According to Better Births (2016), MCoC can deliver safer and more personalised maternity care. Building on the recommendations of Better Births and the commitments of the NHS Long Term Plan, the ambition for the NHS in England is for MCoC to become the default model of care for all maternity services (NHS, 2021).

MCoC is provided by midwives organised into teams of eight or fewer (headcount). Each midwife aims to provide care through pregnancy, birth and the postnatal period (NHS England, 2021). This differs from fragmented models where women receive care from different midwives depending on stage of childbearing, risk factors, their location and local services (McInnes et al., 2020).

There is good evidence that MCoC is associated with greater maternal satisfaction, and improved work experiences for midwives. Changes made to the organisation require careful implementation, with on-going evaluation to monitor progress (Hollins Martin et al., 2019); including safe staffing and supporting women from disadvantaged backgrounds. Therefore, evaluating what matters-to-midwives who provide this model of care might give us the opportunity to get this right for women and the midwifery workforce.


To explore midwives' and obstetricians' views of the introduction of MCoC in maternity services at East Suffolk and North Essex NHS Foundation Trust

Study Aim

To explore whether MCoC interventions at ESNEFT will improve women’s experience of maternity care through the views, understanding, perceptions and experiences of midwives and obstetricians working across ESNEFT.

University of West Bohemia, Czech Republic, foreign scientist award for development of international research collaboration

Funder: University of West Bohemia
Team lead: Colin R. Martin
Duration: 122 weeks

Professor Colin R. Martin holds a Czech Republic Foreign Scientist Research award at the University of West Bohemia in Pilsen, Czech Republic. The focus of the research associated with this award is on perinatal wellbeing, in particular, the research work focusses on three particular strands. The first strand is that of birth experience, in particular, what are the background, non-clinical and clinical factors that impact on birth experience. By understanding the interaction of these factors approaches to optimising and enhancing birth experience can be developed. A second strand of research relates to the measurement of psychological and psychiatric factors, for example, depression, fear of childbirth etc that may impact on maternal and neonatal outcomes. A third strand of research relates to the less researched groups of perinatal women maternal and neonatal outcomes may be deleteriously impacted by the characteristics of the group, for example, those perinatal women within the criminal justice system and/or in prison. 

Peripartum Cardiomyopathy

Funder: ESNEFT
Team lead: Colin R. Martin
Team members: Abigail Webb
Duration: 130 weeks

Peripartum cardiomyopathy (PPCM) is a very specific form of heart failure which occurs in the peripartum period. Though fortunately relatively rare, PPCM is an enigmatic presentation since recovery varies greatly from a full recovery in the months following childbirth to long-term/chronic reduction of heart function. Indeed, there are instances where the condition results in death, though fortunately, these instances are rate. A further factor complicating the issues associated with PPCM is that the cause of the condition is currently unknown and moreover, in the event of a first-time mother, virtually impossible to predict. The current programme of research is focusing on the identification of predictors of PPCM with a view to the early identification of those women who may be at elevated risk of experiencing this distressing condition.

European Union Cooperation in Science and Technology (COST) Action TREASURE

European Union COST Action CA22114 - Maternal Perinatal Stress and Adverse Outcomes in the Offspring: Maximising infants´ development (TREASURE) is an EU COST Action project examining the role of prenatal stressors on both maternal and neonatal outcomes. There are a wide range of maternal stressors, including psychological and physiological that have been established to have a deleterious impact on postpartum outcomes, both for the mother and the baby. The relationships of these factors to outcomes are in a relatively early stage of being ‘unpacked’, particularly in terms of the interactions between different factors. The TREASURE project aims to bring together an international multidisciplinary group of clinicians, researchers and clinical academics to improve understanding in this area by the provision of best evidence that can meaningfully inform both guidelines and practice. Professor Colin R. Martin is one of two United Kingdom management group representatives on this large and important International project.

Advanced Clinical Practice roles across the Suffolk and North-East Essex (SNEE) Integrated Care System..

Funder: ESNEFT
Team lead: Noreen Cushen-Brewster
Duration: 181.71 weeks

Despite the focus and investment by the department of health and social care on the workforce there remain huge challenges in furnishing the roles required across both sectors to meet the demands. Many approaches have been explored to provide the most appropriate solutions, however, there are still significant challenges to overcome to provide the appropriate workforce to deliver the care required across Integrated Care Systems (ICSs).

With the emergence of ICSs there is an increasing need to upskill and integrate services across systems rather than just individual institutions (Kline 2019). Given the unprecedented challenges facing the NHS, the system needs healthcare professionals to work differently to meet the needs of the growing number of people with complex and long-term conditions, many of whom rely on care and support from different services (Kline 2019). However, there remain challenges with appropriate numbers of a multi-professional workforce to deliver the required care.

There are noted developments in the definitions of roles and responsibilities in NHS staff groups to meet these demands. This is certainly true of the role of the Advanced Clinical Practitioner (ACP), who are critical to delivering the 21st century care set out in the NHS Long Term Plan (Department of Health 2019). Advanced Clinical Practitioners come from a variety of professional backgrounds including nursing, physiotherapy, pharmacy, paramedicine and occupational therapy. They are experienced healthcare professionals usually having completed a Masters level award or equivalent that encompasses the four pillars: clinical practice, leadership and management, education and research (Health Education England 2021). They have developed their skills and knowledge with a demonstration of core capabilities and area-specific clinical competence to take on expanded roles in the provision of patient care.

The challenge for ACPs is that they need to develop skills across patient pathways in a range of clinical areas on top of their core clinical specialty. They also need to have undertaken clinical examination skills and understand various diagnostics and treatment options to enhance the patient pathway of care. However, there has been a lack of clarity in the development of these roles and there is evidence that some members of the workforce carry the title of an ACP but do not actually have the qualifications required to function at this level. To address this inconsistency and to ensure parity across the scope of the role, HEE published a multi-professional competency framework in 2017 to improve understanding of all the aspects of the role (HEE 2017). This framework clearly outlines how individuals can work towards developing the core competencies required. This framework aligns to the Welsh, Scottish and Northern Ireland advanced clinical practice tools and frameworks. Therefore, East Suffolk and North Essex NHS Foundation Trust (ESNEFT) have commissioned the University of Suffolk to complete a programme of research to explore how the role of the ACP has been deployed across Suffolk and North East Essex (SNEE).

This research programme consists of the following three separate work streams:

  1. A scoping exercise to identify the range of ACP roles currently deployed across SNEE
  2. An action research study exploring the impact of the ACP role on patient experience
  3. A fully funded PhD to critically examine barriers and enablers to the implementation of advanced practice in the integrated care system ACP

An evaluation of a Specialist Palliative Care Service implemented in EOE

Cancer prehabilitation programme

Impaired facial emotion communication in Parkinson’s Disease: Impacts on social wellbeing and potential strategies to mitigate

Securing and retaining a local workforce: An exploration of the elements that provide an environment for growth across two integrated health systems.

Workforce study powerpoint

Inclusivity in Menopause Support

Funder: Hertfordshire and West Essex and Suffolk and Northeast Essex integrated care systems
Team lead: Samantha Chenery-Morris

Inclusivity in Menopause Transition Project. Background: The average age for menopause is 51, with many factors influencing the start of menopause, such as ethnicity, cultural beliefs, socioeconomic background, and general health issues. Therefore, the ICS wanted to explore these factors. Method: A concurrent, exploratory, mixed-method project using secondary data from the NHS Staff survey and focus group interviews with staff. Findings: Quantitative Phase: The NHS Staff survey of the two ICS included 41,353 staff. 64% of the workforce are aged 41-65, and most are female (77%). One in five staff (20%) were from an ethnic minority, and 4% identified as LGBTQ+. Qualitative phase: Four staff focus groups with a total of eight participants from mixed backgrounds were conducted. Five themes were identified and discussed. The two ICS were already undertaking a wide range of measures to support staff with the menopause transition. However, these initiatives were not always widely known, and policies to support staff were not compassionately enacted or followed. There was differential access to reasonable adjustments in the workplace.

North Essex Neighbourhood Evaluation

Funder: Northeast Health Alliance
Team lead: Valerie Gladwell
Team members: Chris Owens, Paul Freeman, Ellie Rossiter, Scott Danielsen, Oonagh Corrigan, Obinna Ejiogu
Duration: 52 weeks

Using a collaborative approach, the team developed an evaluation framework and identified an appropriate and relevant evaluation plan that reflects the motivations, principles and context of the neighbourhood model and live well domain programme. A combination of methods was used to capture early learning within the Colchester team, including focus groups, adapted ripple effects mapping (REM) workshops, and theory of change workshops. Data was analysed at different time points to allow for timely feedback and elaboration on emerging themes. An initial REM workshop took place in November 2022, after which, outputs were digitised and analysed for impact pathways and emerging themes. A follow-up workshop took place in May 2023.

How can agile working support mental wellbeing in SMEs?

Funder: NHS Norfolk and Waveney Integrated Care Board (Ipswich Borough Council)
Team lead: Valerie Gladwell
Team members: Clare Rigg, Laura Reeves, Adetola Adekunle, Warren Scott
Duration: 15 weeks

In what ways do Agile working practices impact on Mental Health & Wellbeing in Small Medium Enterprises (SME’s), and what do SME’s currently do to address this? For this grant, we had research capacity funding to explore the opportunity to bid for NIHR funding for the following project. A person’s workplace can improve their mental wellbeing, particularly when managers are supportive. However, it can be difficult to ensure that employees have good mental wellbeing when there are working arrangements that allow flexible working hours and location (known as agile working). More than half of the UK works for businesses with fewer than 250 employees (known as Small, Medium Enterprises or SMEs). Compared to big companies, SMEs tend to have fewer resources, specialists and systems in place to aid mental wellbeing. Furthermore, SMEs differ from larger companies in how they are set up, their structure and types of people. Managers are uniquely positioned to support the wellbeing of those they manage. However, they also need to look after their own well-being when trying to meet agile business objectives. In the long term, this research project was designed to improve the wellbeing of managers and employees in SMEs engaged in agile working, by designing and implementing an effective intervention with the SME managers. In the shorter term, this research investigated the impact of Agile working on Mental Wellbeing within SME’s and then went further to consider the feasibility, format and implementation of Action Learning (AL) as a way of enabling SME managers to engage effectively with Mental Wellbeing.

Securing and retaining a local workforce: An exploration of the elements that provide an environment for growth across two integrated health systems

Funder: Health Education England
Team lead: Noreen Cushen-Brewster
Team members: Philip Anyanwu, Erkan Alkan
Duration: 12 Months

This was a mixed-method study that was designed to address challenges and strategies for securing and retaining the future workforce in the Suffolk and North-East Essex regions of England. We first conducted a systematic review to ascertain what evidence already existed relating to turnover and retention of staff as well as gain a greater understanding of the organisational practice environment. Following this review, we disseminated a validated questionnaire to newly qualified nurses/allied health professionals (AHPs) and other nurses and AHPs who had been employed in the same organisation for over a year to explore individuals' personal experiences of working in high pressured environments, we then analysed the quantitative data from these questionnaires to test the relationship between turnover intention and organisational practice environment. Finally, we conducted semi-structured interviews with newly qualified staff and retained staff (over a year in employment) to ascertain an in-depth understanding of this relationship.

Informing policy for Suffolk's physical activity strategy

Funder: Research England (internal allocation)
Team lead: Valerie Gladwell
Team members: Jane Black, Chris Owens, Nafiseh Javan, Obinna Ejiogu, Robert Southall-Edwards.
Duration: 73.71 weeks

The Physical Activity Strategy project was designed to provide a high level of evidence to support and guide the development policy and strategy to make a difference in what is happening across Suffolk, especially in areas of high inequalities. The project worked with underrepresented groups and those with long-term conditions, health care professionals, coaches, and providers who provide physical activity for underrepresented groups and those with long-term conditions.

The study used the Ripple Effect mapping method, the GAPPA map (Global Action Plan on Physical Activity) and focus groups to interactively understand and explore the study aims. This qualitative research project had four workstreams. Workstream, one included providers, coaches who have provided the intervention/activity and those with lived experience who have participated in the activities/interventions. Workstream two were less heard communities with higher inequality and those with lived experience. Workstream three included two groups of health care professionals, group 1: individuals who actively promote physical activity, and group two: individuals who do not actively promote physical activity. Workstream four included coaches/ providers who provide activities for underrepresented groups. The study started in February 2023 and ended in June 2023.

Robert Southall-Edwards joined the team on the 13 March 2023

Flywheel application by Physios

Funder: Desmotec
Team lead: Marco Beato
Duration: 13 months

Flywheel (isoinertial) resistance training is a valid strength training method that has been incorporated in sport for decades, yet little is known about how therapists working in sport apply flywheel resistance training. We set out to describe and understand the current application and perception of flywheel resistance training amongst therapists working in sport. Seventy-three therapists (13.1 ± 10.0 years of experience) started part of this survey with 52 completing the entire electronic questionnaire. Nine multiple choice questions on application and perceptions of flywheel training (prerequisites, use of technology, barriers, and upper- and lower-body exercises) preceded two 6-point Likert scale statements on strength and reduction of injury likelihood.

Most therapists (47/73) either used or intended to use flywheel training with their athletes and stated familiarisation would be a priority prior to initiating training.  Although more than half suggested they were confident flywheel training could enhance strength (27/52) and muscular prehabilitation outcomes (40/52), many remained unsure. Nonetheless, it appears that therapists would mostly include flywheel training within prehabilitation (40/52) or during the later stages of rehabilitation (37/52). To monitor progress, therapists slightly prefer power (30/52) over velocity outputs, while few would not use them at all. Although therapists would prescribe most exercises - the squat, rotational exercise, and unilateral leg curl would be the most selected. Meanwhile, therapists reported remaining most unsure or would avoid prescribing the lateral squat and unilateral hip extension. The biggest perceived barriers to flywheel training are equipment cost/space, evidence, and scheduling.

Return to play after hamstring injuries

Funder: Brentford FC
Team lead: Marco Beato
Duration: 6 years

Return to Play in professional football. Football is the most played team sport in the world. Like most team sports, football is classified as a repeated sprint sport because of the repetition of high-intensity exercise bouts, followed by a shorter or longer rest period. The contact nature of the sport and the necessity to produce high forces and reach high speed expose players to several muscle, bone and joint injuries. In particular, the sprinting element exposes players to an increased risk of hamstring injuries. Thus, hamstring injury rates are particularly high in football: one-third of all muscle-related injuries, with a high recurrence rate of 12–33%. This research focussed on the Return to Play in professional football following a hamstring injury. The research looked at three aspects of this process, answering the following questions:

  • 1) Is the player ready to return to play football? What are the specific criteria to safely return to performance?
  • 2) Structure of gym-based rehabilitation. Design guidelines to prescribe the most appropriate hamstring exercises.
  • 3) On-field rehabilitation. How can hamstring rehabilitation be structured? What are the milestones and the factors to include before returning to training and playing matches?

The relationship between traffic related air pollution and airway inflammation in primary school children at school pick-up time.

Funder: UKRI Policy Support Fund
Team lead: Gavin Devereux
Team members: Scarlett Moloney
Duration: 6 months

This project investigated the relationship between traffic related air pollution and fractional exhaled nitric oxide (FeNO) in children at school pick-up time. Using a within-subject crossover design, FeNO responses to 30 minutes of walking on the roadside at school pick-up time was compared with the FeNO response to 30 minutes of walking in a tree-lined area at school pick-up time. The health benefits of exercise are well established and participating in active travel to and from school is encouraged as a flexible and accessible form of daily exercise to contribute towards meeting the World Health Organisations exercise guidelines for children. However, air pollution is the largest environmental cause of premature death and is detrimental for children’s lung development. Despite the growing focus of public policy and campaigns to reduce car idling and traffic density around schools, supporting evidence about the impact of this on children’s health is limited. Considering 99% of the world population now live in an area that exceeds the air pollution limits established by the World Health Organisation, comparing potential changes in airway inflammation following a walk along the roadside at school pick-up time to walking a tree-lined route in an urban environment is pertinent for (i) understanding how this may impact airway inflammation, and (ii) investigating realistic strategies to reduce pollution exposure and whether this could have a meaningful influence on airway inflammation.

The Tokophobia Severity Scale (TSS): measurement model, power and sample size considerations

Academics: Colin R. Martin, Catriona Jones, Chao Huang, Julie Jomeen, Laura Boubert, Claire A. Marshall.

Fear of childbirth (FoC) and tokophobia represents an area of increasing concern within perinatal mental health research and clinical practice. Existing measures of the FoC have been criticised due to either measurement inconsistencies, difficulties in scoring or practical clinical application. Attempting to address these limitations, researchers developed the Tokophobia Severity Scale (TSS).

Investigating healthcare workforce recruitment and retention: a mixed-methods study protocol

Erkan Alkan, Noreen Cushen-Brewster, Philip Anyanwu (2024)

Although the sustainability of the health workforce has been identified as essential to achieving health and wider development objectives, challenges with securing and retaining the healthcare workforce persist. In the UK, there are notable shortages across a wide range of National Health Service (NHS) staff groups, with a high staff turnover indicating retention issues in the healthcare workforce. In addition, gaps exist in understanding the root cause of individual organisation’s workforce deficiencies and how their practice environment factors interact to impact workforce recruitment and retention.

Immersive-360° Theater: User Experience in the Virtual Auditorium and Platform Efficacy for Current and Underserved Audience

Abigail Webb et al. (2024)
The present study explores the efficacy and social potential of immersive-360° theater—live-captured theater performances filmed for virtual reality (VR) viewing—as a remote platform for audiences to view theater. We obtained survey and structured interview responses from 166 and 30 participants, respectively, self-categorized as regular theatergoers, novices, or underserved audiences. We measured immersion, presence, and emotional arousal in the virtual auditorium, technology acceptance, and social perceptions including platform compatibility with traditional theater and use as a psychosocial and accessibility promotion tool. Findings show that in the immersive-360° theater auditorium ratings for presence and immersion are mixed, and the latter is likely to be influenced by external factors including hardware quality and environmental distractors. For most, immersive-360° theater is regarded as a positive tool for psychosocial aspects and accessibility, but many highlighted the absence of social aspects which are central to the traditional theater experience and cannot be replicated in remote conditions. Despite this, the experience was enjoyable for most participants, and crucially, the majority of participants do not perceive immersive-360° theater as a “threat” to its traditional counterpart. Rather, with certain improvements it is seen as a compatible and complementary offering that has potential for use as a digital pipeline for underserved audiences and recruiting new patrons. Suggestions for improving the quality of the VR theater experience and its potential as an accessibility tool included improving headset quality and resolution, additional accessibility and user controls, and the ability to share the experience with somebody else in real time.

Tackling physical inactivity and inequalities: implementing a whole systems approach to transform community provision for disabled people and people with long-term health conditions

Pettican, Anna, Southall-edwards, Rob, Reinhardt, Gina Yannitell, Gladwell, Valerie, Freeman, Paul, Low, William, Copeland, Robert and Mansfield, Louise (2024) 
Physical inactivity is a global public health priority. There are known health and well-being consequences of being inactive, and the benefits of being physically active are well established. However, there are persistent inequalities when it comes to how physically active people are, with disabled people, people living with long-term health conditions, and people residing in areas of socio-economic deprivation being particularly affected. Methods such as whole system approaches (WSAs), which are dynamic, multifaceted, and engage all relevant stakeholders, have gained momentum as an approach to address such complex public health problems. However, evidence relating to the implementation of WSAs to address physical inactivity is lacking. The aim of the Prevention and Enablement Model (PEM) was to take a whole system approach in Essex to encourage and support disabled people and/or individuals living with long-term health conditions to be more active, happier, and to live more independently.

Investigating healthcare workforce recruitment and retention: a mixed-methods study protocol

Alkan, Erkan, Cushen-Brewster, Noreen and Anyanwu, Philip (2024)
Although the sustainability of the health workforce has been identified as essential to achieving health and wider development objectives, challenges with securing and retaining the healthcare workforce persist. In the UK, there are notable shortages across a wide range of National Health Service (NHS) staff groups, with a high staff turnover indicating retention issues in the healthcare workforce. In addition, gaps exist in understanding the root cause of individual organisation’s workforce deficiencies and how their practice environment factors interact to impact workforce recruitment and retention.

Evaluating a specialist palliative care service in a community setting

Cushen-brewster, Noreen, Malloy, Ella, Black, Jane, Strudwick, Ruth, Driscoll-evans, Paul, Zeppetella, Giovambattista and Bengtson, Kelvin (2023)
In the Norfolk and Waveney Integrated Care System, a community organisation and a hospice have collaborated to develop an innovative specialist palliative care service in a community hospital. The aim of this service evaluation was to review the specialist palliative care service 2 years after implementation began across the integrated care system.

A thematic analysis of narratives about birth satisfaction and health awareness from postnatal Women who have high and low trauma scores on the Posttraumatic Stress Disorder Checklist

Emmens, Berbel, Hollins Martin, Caroline, J., Patterson, Jenny and Martin, Colin (2023)
Background: Around one third of women experience childbirth trauma, with 3-15% developing Postpartum Posttraumatic Stress Disorder (PP-PTSD).
Aim: Explore birth satisfaction and health perception across two groups of postnatal women with either high or low trauma scores.

Multidimensionality within the Edinburgh postnatal depression scale: application issues of specific structure

Ratislavová, Kateřina, Hendrych Lorenzová, Eva, Lochmannová, Alena and Martin, Colin (2023)
The 10-item Edinburgh Postnatal Depression Scale (EPDS) is a widely-used screening measure for postnatal depression. Factor analysis studies have suggested an embedded sub-scale could be used for screening for anxiety disorders. The current investigation sought to replicate and extend a recent study supporting this assertion.

Healthcare guidelines in health behaviour change interventions: quality appraisal and implementation

Cleo Protogerou, Valerie Gladwell (2023)
In this position paper, we note that appraisals of health behaviour change interventions (HBCIs) focus on identifying intervention particulars (e.g., techniques, design, theoretical underpinnings, psychological mechanisms, delivery modes) most prominently and consistently associated with desired behaviour change. However, a key aspect of interventions, the implemented healthcare guidelines, do not undergo intensive scrutiny in intervention research. We provide evidence to show that available healthcare guidelines may be flawed, and as such, may result in ineffective interventions and potential harms for guideline and intervention recipients. We therefore argue that HBCIs would benefit from investigating the accuracy and quality of the embedded guidelines, by using established guideline appraisal frameworks, and we provide examples of how this can be, systematically, done.

Development of a self-report measure to assess sleep satisfaction: protocol for the Suffolk Sleep Index (SuSI)

Cleo Protogerou, Valerie Gladwell, Colin Martin (2022)
Good sleep is essential for health but there is no consensus on how to define and measure people’s understanding of good sleep. To date, people’s perceptions of a good night’s sleep have been, almost exclusively, conceptualized under the lens of sleep quality, which refers to objective characteristics of good sleep, such as such as ease and time needed to fall asleep, hours of sleep, and physical symptoms during sleep and upon awakening. A related, yet different construct, sleep satisfaction, refers to perceived positive affect about one’s sleep experience and has, to date, received little attention. This research focuses on sleep satisfaction, rather than sleep quality, and aims to develop a self-report measure to assess sleep satisfaction in an English adult population. As the measure will be developed in Suffolk, England, and its primary intended users are Suffolk community members, it is labelled the Suffolk Sleep Index (SuSI). The SuSI will draw from principles of community-based participatory research, following a seven-phase developmental process comprising literature review, interviews with Suffolk community members, synthesis of literature review and interview findings, pre-testing, pilot-testing, scale evaluation, and refinement. The present research will also investigate indices related to sleep satisfaction, including the community’s general health status, lifestyle factors and socio-economic status. The research will add to the limited, yet emerging body of research on perceived sleep satisfaction and its measurement. To our knowledge, a valid and reliable sleep satisfaction self-report measure has not been developed in the United Kingdom previously.