The HEALTH Passport: A Secondary School Approach
Emma Brandstatter, Natasha Bechman | University of Warwick
The nation’s health is on a steady decline with cardiovascular disease taking over as the leading cause of death in the UK. Many of the contributing risk factors are modifiable by adhering to a healthy and active lifestyle. By using the HEALTH Passport adults were able to successfully adjust their habits to improve predicted life expectancy. This research aims to investigate if imbedding the HEALTH Passport into the curriculum of secondary school students could equip them with healthy lifestyles choices, to be carried through to adulthood.
A conference of 254 trainee teachers was held to evaluate teaching on risk factors identified, alongside opinions on the new HEALTH Passport. Trainees were provided teaching on the key risk factors and workshops and questionnaires were used to evaluate the new Passport. Thematic analysis was performed on the 119 secondary specific responses in NVivo.
The response to the HEALTH Passport for Secondary schools was overall positive with recurrent additions/amendments mentioned. Participants stated it could be a “hugely valuable resource”, and highlighted noteworthy issues with the curriculum, specifically food education. It was noted that secondary students may not admit to illegal activity (if this was being monitored by teachers.
The HEALTH Passport for Secondary schools has the potential to influence the lifestyle choices of teenagers for the better. It would need to be adapted dependent on age. How data is reviewed and shared with needs to be assessed more thoroughly in order for successful and truthful student engagement.
Do Local Authorities Benchmark Fairly? Using Machine Learning to Develop a Model of Nearest Neighbours to Improve Benchmarking
Gursharun Kaur Hayer | University of Warwick
To improve services for their population, Local Authorities (LAs) require a method of comparing themselves to other, similar local authorities. A commonly used model, one used by Public Health England, is the CIPFA Nearest Neighbours (NNs) model. This research explores whether defining NNs using machine learning (ML) yields similar results to the aforementioned model; and examine selected health outcomes in Coventry, benchmarking against NNs found using the ML method, should they be different.
A dataset was curated to include eighteen variables, matched to those used in the CIPFA model, alongside proxy variables where necessary. The optimal number of clusters were determined, after which unsupervised ML by k-medoid clustering was employed to identify similar local authorities. Selected health outcomes for Coventry were then compared between clusters using Kruskal-Wallis and Bonferroni-corrected Mann-Witney tests.
Of the ten indicators compared, seven had the same results between the two models, whilst three had different results between the models. The results of this analysis demonstrate that using ML to identify NNs for LAs, compared to the CIPFA model does yield differences that are statistically significant for some of the health outcomes used in this comparison.
Given that the two models largely agree with one another provides some reassurance that there is potential for the ML method to be “trusted” and become increasingly acceptable. The significance of identifying these differences is that they encourage further research in the area of using ML methods for benchmarking purposes, in the context of public health.
How are Self-Triage and Symptom Checkers Tools Being Used During the COVID-19 pandemic?
Isobel Roberts Rajoo, Vanashree Sexton | University of Warwick
Symptom checkers tend to have lower diagnostic accuracy when compared to healthcare professionals and suggest more risk-averse triage advice. There is little evidence to suggest that symptom checkers threaten patient safety, though assessment of this is lacking.
COVID-19 symptom checker literature is still in its infancy; however, these tools have been used to avoid in-person appointments, identify new symptoms and monitor outbreaks.
Medline, Google Scholar and Google were searched between July and August 2020. The search was restricted to include studies in the last five years, studies published in English and included electronically published studies ahead of print.
31 search results were identified with 5 removed due to duplication. 26 records were screened resulting in exclusion of 4 records. Full-text articles were assessed for eligibility with a further 4 excluded. 18 articles met the eligibility criteria however, 4 were grey literature and not specifically referenced.
A summative table was synthesised with some of the digital symptom checkers (both COVID-19 or otherwise) currently available.
For a COVID-19 symptom checker to be accurate and reliable, one study suggested that both sensitivity and specificity need to be balanced. Studies show symptom checkers have been useful during lockdown – regional flare-ups monitored, novel symptoms identified and patients have accessed advice without risking exposure. Over 16 days, one COVID-19 symptom checker suggested ‘self-care’ to 240 patients, meaning that 240 appointments were potentially avoided. However, research is lacking in terms of compliance, health outcomes and patient safety.
Connecting Patients with Loved Ones During COVID-19: A Mixed-Methods Service Evaluation
Katherine Kinnear, Yau R, Dale MacLaine T, Laake JP, Griffiths F | University of Warwick
Hospital in-patients have experienced increased isolation due to restrictions to hospital visiting during the COVID-19 pandemic. Social isolation is known to have negative health impacts, especially in older adults. During the pandemic, a new service – George Eliot Hospital Patient Connect (GEH PC) – was developed at GEH to support patients to communicate with loved ones. Tablets were distributed to GEH wards to enable patients, facilitated by staff, to communicate with relatives via video calls.
This service evaluation aims to assess the quality of the GEH PC service and facilitate service improvements. There are three components to the data collection:
1. A questionnaire to investigate the views of patients and relatives regarding the quality of the service.
2. The collection of data regarding call duration, date, time and ward (this will not be linked to individual participants).
3. Interviews with staff members to explore challenges and impact.
The data will be analysed using a mixed-methods approach, incorporating qualitative and quantitative methodologies. The results will be shared internally with key stakeholders at GEH, including service and patient representatives. This work will next move to providing service development suggestions and exploring longer-term monitoring of the service. We hope to share learning from both the implementation and evaluation of the service more widely, through publications and conference presentations.
In the context of the ongoing pandemic, it is hoped that evaluating the GEH PC service will contribute towards reducing in-hospital loneliness, and improve the wellbeing of patients through the use of the service.
The HEALTH Passport: Trainee teacher Evaluation of a Primary School Approach
Natasha Bechman, Emma Brandstatter | University of Warwick
Chronic disease is still a significant burden on the global population. The HEALTH passport has previously been shown to be an effective intervention to help adults modify their chronic disease risk factors through lifestyle changes. This research aims to investigate whether this approach is feasible for primary school age children, and if so, how a newly adapted HEALTH Passport for primary would be best utilised.
A conference of 254 trainee teachers was held to evaluate teaching on risk factors identified, alongside opinions on the new HEALTH Passport. Trainees were provided teaching on the key risk factors and workshops and questionnaires were used to evaluate the new Passport. Thematic analysis was performed on the 95 primary specific responses in NVivo.
The Passport for primary was generally well received. Participants reported it was a “lovely idea” and that they “really liked this approach”. They specifically noted the emotional wellbeing section was “very useful” to “raise awareness and make it personal". However, trainees did note that it would “need to be differentiated for age groups” they expressed concerns about the mental health impact of weighing children and recording BMI at young ages.
The HEALTH Passport for primary has potential as an intervention strategy but would need to be adapted dependent on the school level and made more child friendly. References to weight/BMI should be changed or removed and emotional wellbeing strategies should be focused on where possible.
Why do Medical Students Refuse the Influenza Vaccine, and what Can be Done to Improve Vaccination Rates?
Georgia Gray | University of Warwick
The annual influenza vaccination is recommended for all frontline healthcare workers in the UK and is a crucial way of reducing mortality for vulnerable patient groups. However, to date the UK government has never explicitly monitored influenza vaccine uptake in medical students. This is important to ascertain, as students regularly move between clinical areas and are both a perfect vector for the spread of influenza and at an increased risk of contracting influenza themselves.
This service evaluation collected data about medical student uptake of influenza vaccination in one UK medical school. 251 students at different course stages completed questionnaires, answering questions on vaccination status and Likert-scale ‘belief’ questions to assess the subjective reasons behind vaccine refusal.
The results revealed a substantial difference between year group cohorts (approximately 20%), with older cohorts having a significantly lower vaccination rate than younger cohorts. Furthermore, two significant negative predictors of vaccination were found (p<0.001), related to scepticism over the effectiveness of the vaccine and lack of convenient access to the vaccination itself.
Results indicated that integrating information about the influenza vaccine into the curriculum would reduce lack of knowledge over the efficacy of the vaccine.
Furthermore, the centralisation of vaccination programmes at mandatory university-based learning events would mitigate against the problem of diversity of vaccination locations and lack of central accountability.
The results of this service evaluation provide significant predictors of vaccination status for medical students and potential occupational health interventions to improve vaccine uptake in this group.