Skip to main content
Top
Published in: BMC Public Health 1/2024

Open Access 01-12-2024 | Research

Exploring the feasibility of evaluating a community alliance welfare advice programme co-located in primary care in Bradford: an uncontrolled before and after study

Authors: Sian Reece, Rachael H. Moss, Zahrah Tanveer, Mohammed Hammad, Kate E. Pickett, Josie Dickerson

Published in: BMC Public Health | Issue 1/2024

Login to get access

Abstract

Background

Welfare advice services co-located in health settings are known to improve financial security. However, little is known on how to effectively evaluate these services. This study aims to explore the feasibility of evaluating a welfare advice service co-located in a primary care setting in a deprived and ethnically diverse population. It seeks to investigate whether the proposed evaluation tools and processes are acceptable and feasible to implement and whether they are able to detect any evidence of promise for this intervention on the mental health, wellbeing and financial security of participants.

Methods

An uncontrolled before and after study design was utilised. Data on mental health, wellbeing, quality of life and financial outcomes were collected at baseline prior to receiving welfare advice and at three months follow-up. Multiple logistic and linear regression models were used to explore individual differences in self-reported financial security and changes to mental health, wellbeing and quality of life scores before and after the provision of welfare advice.

Results

Overall, the majority of key outcome measures were well completed, indicating participant acceptability of the mental health, wellbeing, quality of life and financial outcome measures used in this population. There was evidence suggestive of an improvement in participant financial security and evidence of promise for improvements in measured wellbeing and health-related quality of life for participants accessing services in a highly ethnically diverse population. Overall, the VCS Alliance welfare advice programme generated a total of £21,823.05 for all participants, with participants gaining an average of £389.70 per participant for participants with complete financial outcome data.

Conclusions

This research demonstrates the feasibility of evaluating a welfare advice service co-located in primary care in a deprived and ethnically diverse setting utilising the ascribed mental health, wellbeing and quality of life and financial outcome tools. It provides evidence of promise to support the hypothesis that the implementation of a welfare advice service co-located in a health setting can improve health and wellbeing and reduce health inequalities.
Literature
1.
go back to reference Wickham S, Anwar E, Barr B, Law C, Taylor-Robinson D. Poverty and child health in the UK: using evidence for action. Arch Dis Child. 2016;101:759–66.CrossRefPubMed Wickham S, Anwar E, Barr B, Law C, Taylor-Robinson D. Poverty and child health in the UK: using evidence for action. Arch Dis Child. 2016;101:759–66.CrossRefPubMed
2.
go back to reference Marmot M, Bell R. Fair society, healthy lives. Public Health. 2012;126(Suppl 1):4–S10.CrossRef Marmot M, Bell R. Fair society, healthy lives. Public Health. 2012;126(Suppl 1):4–S10.CrossRef
3.
go back to reference Jenkins R, Bebbington P, Brugha T, et al. Mental disorder in people with debt in the general population. Public Health Medicine. 2009;6:88–92. Jenkins R, Bebbington P, Brugha T, et al. Mental disorder in people with debt in the general population. Public Health Medicine. 2009;6:88–92.
4.
go back to reference Georgiades A, Janszky I, Blom M, Laszlo KD, Ahnve S. Financial strain predicts recurrent events among women with coronary artery disease. Int J Cardiol. 2009;135:175–83.CrossRefPubMed Georgiades A, Janszky I, Blom M, Laszlo KD, Ahnve S. Financial strain predicts recurrent events among women with coronary artery disease. Int J Cardiol. 2009;135:175–83.CrossRefPubMed
5.
go back to reference Kahn JR, Pearlin LI. Financial strain over the life course and health among older adults. J Health Soc Behav. 2006;47(1):17–31.CrossRefPubMed Kahn JR, Pearlin LI. Financial strain over the life course and health among older adults. J Health Soc Behav. 2006;47(1):17–31.CrossRefPubMed
6.
go back to reference Alliance AS. The Role of Advice Services in Health Outcomes Evidence Review and mapping study. London: The Role of Advice Services in Health; 2015. Alliance AS. The Role of Advice Services in Health Outcomes Evidence Review and mapping study. London: The Role of Advice Services in Health; 2015.
7.
go back to reference Kahn JR, Pearlin LI. Financial strain over the Life Course and Health among older adults. J Health Soc Behav; 2006. p. 17–31. Kahn JR, Pearlin LI. Financial strain over the Life Course and Health among older adults. J Health Soc Behav; 2006. p. 17–31.
8.
go back to reference Prady S, Bloor K, Bradshaw J. Does Administrative Data reflect individual experience? Comparing an index of poverty with individually Collected Data on Financial Well-being in a Multi-ethnic Community. Soc Policy Soc. 2015;15:513–35.CrossRef Prady S, Bloor K, Bradshaw J. Does Administrative Data reflect individual experience? Comparing an index of poverty with individually Collected Data on Financial Well-being in a Multi-ethnic Community. Soc Policy Soc. 2015;15:513–35.CrossRef
9.
go back to reference Allmark P, Salway S, Crisp R. R B. Ethnic minority customers of the pension, disability and Carers Service: an evidence synthesis. London: Department for Work and Pensions; 2010. Allmark P, Salway S, Crisp R. R B. Ethnic minority customers of the pension, disability and Carers Service: an evidence synthesis. London: Department for Work and Pensions; 2010.
10.
go back to reference Scharf E. Entitled to Benefit? A Review of State Benefit Take Up by Older People belonging to Black and Minority Ethnic Groups. Reinvention 2010; (2). Scharf E. Entitled to Benefit? A Review of State Benefit Take Up by Older People belonging to Black and Minority Ethnic Groups. Reinvention 2010; (2).
11.
go back to reference Hansen K, Jones E, Joshi H, Budge D. Millennium Cohort Study Fourth Survey: A User’s Guide to Initial Findings, 2010. Hansen K, Jones E, Joshi H, Budge D. Millennium Cohort Study Fourth Survey: A User’s Guide to Initial Findings, 2010.
12.
go back to reference Woodhead C, Khondoker M, Lomas R, Raine R. Impact of co-located welfare advice in healthcare settings: prospective quasi-experimental controlled study. Br J Psychiatry. 2017;211(6):388–95.CrossRefPubMedPubMedCentral Woodhead C, Khondoker M, Lomas R, Raine R. Impact of co-located welfare advice in healthcare settings: prospective quasi-experimental controlled study. Br J Psychiatry. 2017;211(6):388–95.CrossRefPubMedPubMedCentral
13.
go back to reference Krska J, Palmer S, Dalzell-Brown A, Nicholl P. Evaluation of welfare advice in primary care: effect on practice workload and prescribing for mental health. Prim Health Care Res Dev. 2013;14(3):307–14.CrossRefPubMed Krska J, Palmer S, Dalzell-Brown A, Nicholl P. Evaluation of welfare advice in primary care: effect on practice workload and prescribing for mental health. Prim Health Care Res Dev. 2013;14(3):307–14.CrossRefPubMed
14.
go back to reference Bateman N. Just what the doctor ordered: welfare benefits and advice and healthcare.; 2008; London; 2008. Bateman N. Just what the doctor ordered: welfare benefits and advice and healthcare.; 2008; London; 2008.
15.
go back to reference Pleasence P, Balmer NJ, Buck A. The Health cost of civil-law problems: further evidence of links between civil-law problems and morbidity, and the consequential use of Health services. J Empir Legal Stud. 2008;5(2):351–73.CrossRef Pleasence P, Balmer NJ, Buck A. The Health cost of civil-law problems: further evidence of links between civil-law problems and morbidity, and the consequential use of Health services. J Empir Legal Stud. 2008;5(2):351–73.CrossRef
16.
go back to reference Fairak A. The roadblock to recovery: how mental health practitioners deal with people’s practical problems in England. London: Citizens Advice; 2018. Fairak A. The roadblock to recovery: how mental health practitioners deal with people’s practical problems in England. London: Citizens Advice; 2018.
17.
go back to reference The Low Commission. Tacking the Advice Deficit: A strategy for access to advice and legal support on social welfare law in England in Wales. London, 2014. The Low Commission. Tacking the Advice Deficit: A strategy for access to advice and legal support on social welfare law in England in Wales. London, 2014.
18.
go back to reference Carrick K, Burton K, Barclay P. Forecast Social Return on Investment Analysis on the co-location of advice workers with Consensual Access to Individual Medical Records in Medical practices. Livingston: Improvement Service Scotland; 2017. Carrick K, Burton K, Barclay P. Forecast Social Return on Investment Analysis on the co-location of advice workers with Consensual Access to Individual Medical Records in Medical practices. Livingston: Improvement Service Scotland; 2017.
19.
go back to reference Wright N, Jay M, Snell S, Holden A. Great Ormond Street Hospital Citizens Advice Bureau Annual Report 2014/15. London: Citizens Advice Bureau, 2015. Wright N, Jay M, Snell S, Holden A. Great Ormond Street Hospital Citizens Advice Bureau Annual Report 2014/15. London: Citizens Advice Bureau, 2015.
20.
go back to reference Burrows J. Citizens advice in primary care: a qualitative study of the views and experiences of service users and staff. 2011. Burrows J. Citizens advice in primary care: a qualitative study of the views and experiences of service users and staff. 2011.
21.
go back to reference Adams J, White M, Moffatt S, Howel D, Mackintosh J. A systematic review of the health, social and financial impacts of welfare rights advice delivered in healthcare settings. BMC Public Health. 2006;6:81.CrossRefPubMedPubMedCentral Adams J, White M, Moffatt S, Howel D, Mackintosh J. A systematic review of the health, social and financial impacts of welfare rights advice delivered in healthcare settings. BMC Public Health. 2006;6:81.CrossRefPubMedPubMedCentral
22.
go back to reference Reece S, Sheldon TA, Dickerson J, Pickett KE. A review of the effectiveness and experiences of welfare advice services co-located in health settings: a critical narrative systematic review. Soc Sci Med. 2022;296:114746.CrossRefPubMed Reece S, Sheldon TA, Dickerson J, Pickett KE. A review of the effectiveness and experiences of welfare advice services co-located in health settings: a critical narrative systematic review. Soc Sci Med. 2022;296:114746.CrossRefPubMed
23.
go back to reference Howel D, Moffatt S, Haighton C, et al. Does domiciliary welfare rights advice improve health-related quality of life in independent-living, socio-economically disadvantaged people aged ≥ 60 years? Randomised controlled trial, economic and process evaluations in the North East of England. PLoS ONE. 2019;14(1):e0209560.CrossRefPubMedPubMedCentral Howel D, Moffatt S, Haighton C, et al. Does domiciliary welfare rights advice improve health-related quality of life in independent-living, socio-economically disadvantaged people aged ≥ 60 years? Randomised controlled trial, economic and process evaluations in the North East of England. PLoS ONE. 2019;14(1):e0209560.CrossRefPubMedPubMedCentral
24.
go back to reference Reducing Inequalities in Communities. Closing the health gap in central Bradford: Bradford District and Craven Clinical Commissioning Group, 2021. Reducing Inequalities in Communities. Closing the health gap in central Bradford: Bradford District and Craven Clinical Commissioning Group, 2021.
25.
go back to reference Bradford VCS. Alliance Ltd. The VCS Alliance. Bradford, 2023. Bradford VCS. Alliance Ltd. The VCS Alliance. Bradford, 2023.
26.
go back to reference Appreciate Ltd. Love2Shop. Merseyside, 2023. Appreciate Ltd. Love2Shop. Merseyside, 2023.
27.
go back to reference Woodhead C, Khondoker M, Lomas R, Raine R. Impact of co-located welfare advice in healthcare settings: prospective quasi-experimental controlled study. Br J Psychiatry: J Mental Sci. 2017;211:388–95.CrossRef Woodhead C, Khondoker M, Lomas R, Raine R. Impact of co-located welfare advice in healthcare settings: prospective quasi-experimental controlled study. Br J Psychiatry: J Mental Sci. 2017;211:388–95.CrossRef
28.
go back to reference Howe LD, Tilling K, Galobardes B, Lawlor DA. Loss to follow-up in cohort studies: bias in estimates of socioeconomic inequalities. Epidemiology. 2013;24(1):1–9.CrossRefPubMedPubMedCentral Howe LD, Tilling K, Galobardes B, Lawlor DA. Loss to follow-up in cohort studies: bias in estimates of socioeconomic inequalities. Epidemiology. 2013;24(1):1–9.CrossRefPubMedPubMedCentral
29.
go back to reference Bonevski B, Randell M, Paul C, et al. Reaching the hard-to-reach: a systematic review of strategies for improving health and medical research with socially disadvantaged groups. BMC Med Res Methodol. 2014;14(1):42.CrossRefPubMedPubMedCentral Bonevski B, Randell M, Paul C, et al. Reaching the hard-to-reach: a systematic review of strategies for improving health and medical research with socially disadvantaged groups. BMC Med Res Methodol. 2014;14(1):42.CrossRefPubMedPubMedCentral
30.
go back to reference Institute for Social and Economic Research. Understanding Society the UK Household Longitudinal Survey. In: University of Essex, editor.;; 2015. Institute for Social and Economic Research. Understanding Society the UK Household Longitudinal Survey. In: University of Essex, editor.;; 2015.
31.
go back to reference Kroenke K, Strine TW, Spitzer RL, Williams JBW, Berry JT, Mokdad AH. The PHQ-8 as a measure of current depression in the general population. J Affect Disord. 2009;114(1):163–73.CrossRefPubMed Kroenke K, Strine TW, Spitzer RL, Williams JBW, Berry JT, Mokdad AH. The PHQ-8 as a measure of current depression in the general population. J Affect Disord. 2009;114(1):163–73.CrossRefPubMed
32.
go back to reference Ng Fat L, Scholes S, Boniface S, Mindell J, Stewart-Brown S. Evaluating and establishing national norms for mental wellbeing using the short Warwick–Edinburgh Mental Well-being Scale (SWEMWBS): findings from the Health Survey for England. Qual Life Res. 2017;26(5):1129–44.CrossRefPubMed Ng Fat L, Scholes S, Boniface S, Mindell J, Stewart-Brown S. Evaluating and establishing national norms for mental wellbeing using the short Warwick–Edinburgh Mental Well-being Scale (SWEMWBS): findings from the Health Survey for England. Qual Life Res. 2017;26(5):1129–44.CrossRefPubMed
33.
go back to reference Brooks RG, Rabin R, De CF. The measurement and valuation of the health status using EQ-5D: a European perspective: evidence from the EuroQol BIOMED Research Programme. Dordrchet: Kluwer Academic Pub.; 2003. Brooks RG, Rabin R, De CF. The measurement and valuation of the health status using EQ-5D: a European perspective: evidence from the EuroQol BIOMED Research Programme. Dordrchet: Kluwer Academic Pub.; 2003.
34.
go back to reference Kroenke K, Spitzer RL. The PHQ-9: a new depression diagnostic and severity measure. 2002; 32: 1–7. Kroenke K, Spitzer RL. The PHQ-9: a new depression diagnostic and severity measure. 2002; 32: 1–7.
35.
go back to reference Tennant R, Hiller L, Fishwick R, et al. The Warwick-Edinburgh Mental Well-being scale (WEMWBS): development and UK validation. Health Qual Life Outcomes. 2007;5:63.CrossRefPubMedPubMedCentral Tennant R, Hiller L, Fishwick R, et al. The Warwick-Edinburgh Mental Well-being scale (WEMWBS): development and UK validation. Health Qual Life Outcomes. 2007;5:63.CrossRefPubMedPubMedCentral
36.
go back to reference The EuroQol Group. EuroQol– a new facility for the measurement of health-related quality of life. 1990; 16: 199–208. The EuroQol Group. EuroQol– a new facility for the measurement of health-related quality of life. 1990; 16: 199–208.
37.
go back to reference Devlin NJ, Shah KK, Feng Y, Mulhern B, van Hout B. Valuing health-related quality of life: an EQ-5D-5L value set for England. Health Econ. 2018;27(1):7–22.CrossRefPubMed Devlin NJ, Shah KK, Feng Y, Mulhern B, van Hout B. Valuing health-related quality of life: an EQ-5D-5L value set for England. Health Econ. 2018;27(1):7–22.CrossRefPubMed
38.
go back to reference Dickerson J, Bird PK, McEachan RRC, et al. Born in Bradford’s Better Start: an experimental birth cohort study to evaluate the impact of early life interventions. BMC Public Health; 2016. p. 711. Dickerson J, Bird PK, McEachan RRC, et al. Born in Bradford’s Better Start: an experimental birth cohort study to evaluate the impact of early life interventions. BMC Public Health; 2016. p. 711.
39.
go back to reference Wright J, Small N, Raynor P, et al. Cohort Profile: the born in Bradford multi-ethnic family cohort study. Int J Epidemiol. 2013;42(4):978–91.CrossRefPubMed Wright J, Small N, Raynor P, et al. Cohort Profile: the born in Bradford multi-ethnic family cohort study. Int J Epidemiol. 2013;42(4):978–91.CrossRefPubMed
40.
go back to reference Cook JA, Julious SA, Sones W, et al. DELTA < sup > 2 guidance on choosing the target difference and undertaking and reporting the sample size calculation for a randomised controlled trial. BMJ. 2018;363:k3750.CrossRefPubMedPubMedCentral Cook JA, Julious SA, Sones W, et al. DELTA < sup > 2 guidance on choosing the target difference and undertaking and reporting the sample size calculation for a randomised controlled trial. BMJ. 2018;363:k3750.CrossRefPubMedPubMedCentral
41.
go back to reference Feng Y, Devlin N, Bateman A, Zamora B, Parkin D. Distribution of the EQ-5D-5L profiles and values in three patient groups. Value in Health. 2019;22(3):355–61.CrossRefPubMed Feng Y, Devlin N, Bateman A, Zamora B, Parkin D. Distribution of the EQ-5D-5L profiles and values in three patient groups. Value in Health. 2019;22(3):355–61.CrossRefPubMed
42.
go back to reference Shah N, Cader M, Andrews WP, Wijesekera D, Stewart-Brown SL. Responsiveness of the Short Warwick Edinburgh Mental Well-Being Scale (SWEMWBS): evaluation a clinical sample. Health Qual Life Outcomes. 2018;16(1):239.CrossRefPubMedPubMedCentral Shah N, Cader M, Andrews WP, Wijesekera D, Stewart-Brown SL. Responsiveness of the Short Warwick Edinburgh Mental Well-Being Scale (SWEMWBS): evaluation a clinical sample. Health Qual Life Outcomes. 2018;16(1):239.CrossRefPubMedPubMedCentral
43.
go back to reference Krska J, Palmer S, Dalzell-Brown A, Nicholl P. Evaluation of welfare advice in primary care: effect on practice workload and prescribing for mental health. Primary Health Care Research & Development; 2013. pp. 307–14. Krska J, Palmer S, Dalzell-Brown A, Nicholl P. Evaluation of welfare advice in primary care: effect on practice workload and prescribing for mental health. Primary Health Care Research & Development; 2013. pp. 307–14.
44.
go back to reference Moffatt S. Done more for me in a fortnight than anybody done in all me life. How welfare rights advice can help people with cancer. 2010. Moffatt S. Done more for me in a fortnight than anybody done in all me life. How welfare rights advice can help people with cancer. 2010.
45.
go back to reference Hirst J, Minter S. Citizens advice in GP practices summary of outcomes 2013/14. Derbyshire County Council; 2014. Hirst J, Minter S. Citizens advice in GP practices summary of outcomes 2013/14. Derbyshire County Council; 2014.
46.
go back to reference Naven L, Withington R, Egan J. Maximising opportunities: final evaluation report of the Healthier, Wealthier Children (HWC) project: Glasgow Centre for Population Health, 2012. Naven L, Withington R, Egan J. Maximising opportunities: final evaluation report of the Healthier, Wealthier Children (HWC) project: Glasgow Centre for Population Health, 2012.
47.
go back to reference Withington R. NHS Greater Glasgow and Clyde financial inclusion evaluation project: literature review. 2011. Withington R. NHS Greater Glasgow and Clyde financial inclusion evaluation project: literature review. 2011.
48.
go back to reference Parsonage M. Welfare advice for people who use mental health services: developing the business case. 2013. Parsonage M. Welfare advice for people who use mental health services: developing the business case. 2013.
49.
go back to reference Gov.uk. Help with your energy bills. London, 2023. Gov.uk. Help with your energy bills. London, 2023.
50.
go back to reference Khan M. Are ROSCAs providing an alternative funding source for poor? J Econ Sustainable Dev. 2013;4(19):127–30. Khan M. Are ROSCAs providing an alternative funding source for poor? J Econ Sustainable Dev. 2013;4(19):127–30.
53.
go back to reference The COMET Initiative. Core Outcome Measures in Effectiveness Trials. London, 2023. The COMET Initiative. Core Outcome Measures in Effectiveness Trials. London, 2023.
54.
go back to reference Mansukoski L, Albert A, Vafai Y, et al. Development of Public Health Core Outcome Sets for Systems-Wide Promotion of Early Life Health and Wellbeing. Int J Environ Res Public Health. 2022;19(13):7947.CrossRefPubMedPubMedCentral Mansukoski L, Albert A, Vafai Y, et al. Development of Public Health Core Outcome Sets for Systems-Wide Promotion of Early Life Health and Wellbeing. Int J Environ Res Public Health. 2022;19(13):7947.CrossRefPubMedPubMedCentral
55.
go back to reference StataCorp. Stata Statistical Software: release 15. College Station. TX: StataCorp LLC; 2017. StataCorp. Stata Statistical Software: release 15. College Station. TX: StataCorp LLC; 2017.
Metadata
Title
Exploring the feasibility of evaluating a community alliance welfare advice programme co-located in primary care in Bradford: an uncontrolled before and after study
Authors
Sian Reece
Rachael H. Moss
Zahrah Tanveer
Mohammed Hammad
Kate E. Pickett
Josie Dickerson
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-024-17773-x

Other articles of this Issue 1/2024

BMC Public Health 1/2024 Go to the issue