Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Health Services Research
Published in: BMC Health Services Research 1/2018

Open Access 01-12-2018 | Research article

“It was the whole picture” a mixed methods study of successful components in an integrated wellness service in North East England

Authors: M. Cheetham, P. Van der Graaf, B. Khazaeli, E. Gibson, A. Wiseman, R. Rushmer

Published in: BMC Health Services Research | Issue 1/2018

Login to get access

Abstract

Background

A growing number of Local Authorities (LAs) have introduced integrated wellness services as part of efforts to deliver cost effective, preventive services that address the social determinants of health. This study examined which elements of an integrated wellness service in the north east of England were effective in improving health and wellbeing (HWB).

Methods

The study used a mixed-methods approach. In-depth semi-structured interviews (IVs) were conducted with integrated wellness service users (n = 25) and focus groups (FGs) with group based service users (n = 14) and non-service users (n = 23) to gather the views of stakeholders. Findings are presented here alongside analysis of routine monitoring data. The different data were compared to examine what each data source revealed about the effectiveness of the service.

Results

Findings suggest that integrated wellness services work by addressing the social determinants of health and respond to multiple complex health and social concerns rather than single issues. The paper identifies examples of ‘active ingredients’ at the heart of the programme, such as sustained relationships, peer support and confidence building, as well as the activities through which changes take place, such as sports and leisure opportunities which in turn encourage social interaction. Wider wellbeing outcomes, including reduced social isolation and increased self-efficacy are also reported.
Practical and motivational support helped build community capacity by encouraging community groups to access funding, helped navigate bureaucratic systems, and promoted understanding of marginalised communities. Fully integrated wellness services could support progression opportunities through volunteering and mentoring.

Conclusions

An integrated wellness service that offers a holistic approach was valued by service users and allowed them to address complex issues simultaneously. Few of the reported health gains were captured in routine data. Quantitative and qualitative data each offered a partial view of how effectively services were working.
Literature
1.
2.
La Placa V, Knight A. Well-being: its influence and local impact on public health. Public Health. 2014;128:38–42.CrossRefPubMed
3.
4.
Dahlgren G, Whitehead M. Policies and strategies to promote social equity in health, (background document to WHO - strategy paper for Europe). 2007; 14. Copenhagen: World Health Organization.
5.
Rippon S, Hopkins T. Head, hands and heart: asset-based approaches in health care. A review of the conceptual evidence and case studies of asset-based approaches in health, care and wellbeing. London: The Health Foundation; 2015.
6.
South J, et al. A guide to community-centred approaches for health and wellbeing. London: Public Health England; 2015.
7.
Buck D, Gregory S. Improving the public’s health: a resource for local authorities. London: The King’s Fund; 2013.
8.
IDeA A glass half-full: how an asset approach can improve community health and wellbeing. 2010; Foot J. Hopkins T. London: Improvement and Development Agency.
9.
Cheetham M. Visram S. Rushmer R. Greig G. Gibson E. Khazaeli B. Wiseman A. Ít is not a quick fix’ Structural and contextual issues that affect implementation of integrated health and well-being services: a qualitative study from North East England Public Health (2017) I152:99–107.
10.
NHS Confederation Briefing: From illness to wellness. Achieving efficiencies and improving outcomes. October 2011; issue 224: London.
11.
WHO Commission on Social Determinants of Health Closing the gap in a generation. Health equity through action on the social determinants of health. Geneva: World Health Organisation; 2008.
12.
Winters L, Armitage M, Stansfield J, Scott-Samuel A, Farr A. Wellness services – evidence based review and examples of good practice, final report. 2010; observatory report series no. 76, November, Liverpool public health observatory, University of Liverpool: Liverpool.
13.
NHS England Five Year Forward View, 2014; London.
14.
15.
Friedli L, Themessl-Huber M, Butchart M. Evaluation of Dundee Equally Well Final Report. Dundee Healthy Living Initiative: Dundee; 2012.
16.
Kimberlee R, Ward R, Jones M, Powell J. Measuring the economic impact of Wellspring Healthy Living Centre's Social Prescribing Wellbeing Programme for low level mental health issues encountered by GP services. Bristol: University of the West of England; 2014.
17.
Dayson C, Bashir N. Pearson S. The social and economic impact of the Rotherham Social Prescribing Pilot evaluation report: Sheffield; Sheffield Hallam University Centre for Economic and Social Research; 2014.
18.
Buck D. and Frosini F. Clustering of unhealthy behaviours over time; Implications for policy and practice, 2012; London: The Kings Fund.
19.
Shahab L. Integrated health behaviour (lifestyle) services: a review of the evidence 2016 National Centre for Smoking Cessation and Training, Dorchester, UK.
20.
21.
22.
University of York Evidence to inform the commissioning of social prescribing. 2015; Centre for Reviews and Dissemination, York.
23.
Public Health England Health and Care Integration. Making the case from a public health perspective, 2013; London, UK.
24.
Whitehead M, et al. Due North. The report of the Inquiry on Health Equity for the North: University of Liverpool and Centre for Local Economic Strategies; 2014.
25.
26.
27.
Pawson and Tilley. Realistic Evaluation. In: Sage: London; 1997.
28.
Bagnall A, Trigwell J, White J. Health Trainers End of Year Review 1st April 2013 – 31st March 2014. 2014: Leeds: Leeds Metropolitan University.
29.
Mathers J, Taylor R, Parry J. Measuring the impact of Health Trainer Services on health and health inequalities: does the service’s data collection and reporting system provide reliable information? 2016; Journal of Public Health. January. 26:1–6.
30.
Tennant R, Hiller L, Fishwick R, Platt S. Joseph et al. The Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS): development and UK validation 2007; Health and Quality of Life Outcomes. 5:63.
31.
Ritchie J, Lewis J. Qualitative research practice: a guide for social science students and researchers. London: Sage; 2003.
32.
Ogilvie J. Review of commissioned weight management and obesity services contracted by Gateshead Public Health. Summary Report: Gateshead Primary Care Trust; 2012.
33.
Visram S, Clarke C, White M. Making and Maintaining lifestyle changes with the support of a lay health advisor: longitudinal qualitative study of health trainer services in Northern England. PLoS One. 2014;9(5):e94749.CrossRefPubMedPubMedCentral
34.
Mathers J, Taylor R, Parry J. The challenges of implementing peer-led interventions in a professionalized health service: a case study of the National Health Trainers Service in England. Millbank Quarterly. 2014;92(4):725–53.CrossRef
35.
South J, Woodward J, Lowcock D. New beginnings: stakeholder perspectives on the role of health trainers The Journal of the Royal Society for the Promotion of Health. 2007;127(5):224–30.
36.
Metadata
Title
“It was the whole picture” a mixed methods study of successful components in an integrated wellness service in North East England
Authors
M. Cheetham
P. Van der Graaf
B. Khazaeli
E. Gibson
A. Wiseman
R. Rushmer
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2018
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-018-3007-z

Other articles of this Issue 1/2018

BMC Health Services Research 1/2018 Go to the issue

Research article

Pharmacy-based hypertension care employing mHealth in Lagos, Nigeria – a mixed methods feasibility study

Research article

Effectiveness evaluation of quota payment for specific diseases under global budget: a typical provider payment system reform in rural China

Study protocol

A municipality-based vocational rehabilitation programme for occupationally marginalized citizens: a study protocol for a mixed methods study

Research article

Quality assurance for care of the dying: engaging with clinical services to facilitate a regional cross-sectional survey of bereaved relatives’ views

Research article

Health outcomes measurement and organizational readiness support quality improvement: a systematic review

Research article

Exploring the differential impact of individual and organizational factors on organizational commitment of physicians and nurses