let's talk research 2015 - angela tod -creative research dissemination for maximum impact on...
TRANSCRIPT
School of Nursing, Midwifery and Social Work
Angela TodCatherine HomerAmanda Stocks
Creative Research Dissemination for
Maximum Impact on Policy and Practice
Who we are
• Angela
• Catherine
• Amanda
Overview of workshop
• Introductions• KWILLT project
– Why?– What?– Impacts?
• Putting it into action!
Cold Related Harm…why is it an issue?
• Approx. 27,000 excess winter deaths each year
• The illness caused or exacerbated by cold
• Misery and suffering
Who is vulnerable to the negative health impacts
of cold homes?people with existing health conditions such as:
• cardiovascular conditions • respiratory conditions (in particular, chronic
obstructive pulmonary disease and childhood asthma)
• mental health conditions • disabilities older people (65 and older)
https://www.nice.org.uk/guidance/ng6/resources/excess-winter-deaths-and-morbidity-and-the-health-risks-associated-with-cold-homes-51043484869
Households and other people can be at risk
too…• People or families on a low income.• Households with young children
(from new-born to school age) • Pregnant women
The impact of Winter on Health and Wellbeing
Direct effects• Heart attacks• Stroke• Respiratory
illness• Flu• Falls• Hypothermia
Indirect effects• Depression• Stress and
anxiety• Risk of Carbon
monoxide poisoning
What is KWILLT?Keeping Warm In Later Life
projecT NIHR Research for Patient Benefit
ProgrammeThe drivers were…
• Health impact of cold• High levels of fuel poverty• Costs to the NHS• Low uptake of energy efficiency interventions• Cold Weather Plan• DH Public health Outcomes Framework
(EWD/FP)
Keeping Warm In Later Life projecT
Aim: To understand the influences and decisions of vulnerable older people in relation to keeping warm in winter.
MethodologyQualitative methods• 50 older people (aged 55-95), face to face in depth
interviews,• Temperature/humidity measurements• 25 health and social care staff, face to face in depth
interviews• Six focus groups with older people and
frontline/strategic staff (n=42)• Consultation event• Framework analysis• Thematic framework
Apply Social Marketing Principles
Using research findings – develop ‘insight’
Break down the target audience into the different types of people – ‘a segmentation model’
• What are the drivers to their behaviour• What are their thoughts, fears, perceptions• What are their barriers to change
Turning insight into action…• Develop propositions or interventions
for each segment• Considering incentives and barriers
(Competition/exchange) for each segment
• Develop the marketing mix i.e. “mix” of different interventions that will change behaviour
• Develop the tools and resources
KWILLT Findings: Themes Situation or context
factorsAttitudinal drivers of behaviour Barriers to positive behaviour
Money
Age
Social connections
Housing type and tenure
Health
Making ends meeto Competing prioritieso Prideo Struggling
I can manageo Thrifto Hardiness and Stoicism
Its my businesso Mistrusto Pride and Privacy
I'm frightenedo Personal safety/vulnerability
I'll stay as I amo Like routineo Fear and mis-trust
Awarenesso Knowledgeo Informationo Experience
Technologyo Heatingo Informationo Banking
Disjointed systemso Fragmentation or serviceso Local differenceso Lack of referral systems
Visibilityo Fuelo Moneyo Information
KWILLT Findings: the segmentation model
Segmentation group DescriptionIsolated and not wanting to
cause a botherLow income and fuel poor, over 55, socially isolated and frightened, lacks information and understanding about keeping warm, private rented housing, long term mental health problems (depressions/anxiety)
Getting by cautiously Low income household and fuel poor, over 65, some social connections but not well informed about keeping warm, privately owned house, live with a partner with chronic health problems
Dependent and poorly informed Low income household and fuel poor, over 55, limited social connections with strong cultural ties, poorly informed about keeping warm, privately owned housing, poor health and mobility and very dependent on close family.
Just about managing Can pay for home heating but values thrift , over 70, some social connections but is private and trusts few people so is poorly informed about keeping warm, social housing, physical health problems and sensory impairment
Lonely and out of touch Financially secure but lives in a cold home, over 70, widowed, and socially isolated, poorly informed about keeping warm, privately owned house, physically well but bereaved.
Proud and wants to be self-sufficient
Low income but not fuel poor, over 70, regular but superficial social connections, poorly informed but values stoicism and hardiness and think they don’t need any help, social housing, good health, minor ailments.
The Pen Portraits – bringing the findings to life!
Lonely, Pearle
Proud, Fred
Dependent, Meena
Getting by, Bob and Joan
Just about managing, Enid
Isolated, Pat
http://kwillt.org/index.php/pen-portraits
Ben and Joan• Mid 60s,Low income, now
retired• Ben has chronic ill health• Joan is his carer
• Children nearby but Ben and Joan don’t like to be a bother
• Some social contact• Live in an old mid-terrace
(Right to buy)• Central heating system old,
not serviced and use supplementary heating
• Pay for fuel by direct debit but don’t understand how they work
What drives their behaviour?• Thrift• Pride and being debt
adverse• Fear of disruption in
the home• Mistrust of
organisations like energy companies banks
• Fear of technology
“Oh yes, because I was trained to be frugal, it was part of my upbringing. You didn’t have a lot so you were careful with what you did have. And with the costs rising now, I’m certainly not extravagant with the heating, I’m very wary”
(Older person participant in KWILLT)
” We changed from 'Company A' to go to 'Company B', and it was a nightmare, and I spent hours on the phone trying to get money back that they owed me. And you inform them and they say oh you can ring this number and you can get help. They did nothing! They said they would but they did nothing! I had to do it all myself and I bet that went on for over six months and I said well if that’s changing I’m never going to change again. It was a nightmare”.
(Older person participant in KWILLT)
Experiences, and those of friends, shape perception and beliefs.
This can be compounded and shaped by external influences such as media.
This can make the desire or willingness to adopt positive behaviour change a challenge
“I keep tabs on all my bills and all my doings. You’ve got
to have a programme, you know what I mean. You’ve got to be a budget, know what’s coming on… I’ve
managed to pay my bills, but I do have really expensive
bills”.
(Older person participant in KWILLT)
“I can put that heater on and that’s plenty for me in the daytime, I don’t want anything else, and therefore it can’t be as expensive as heating the whole house”.
(Older person participant in (KWILLT)
Ben and Joan are thrifty, proud and fear being in debt. They want to be in control of their life but would be reluctant to ask for help. They will cut down on other things to afford fuel
They often think it’s not worth putting the central heating system on; it doesn’t work properly it will take a while to warm up. The electric fire gets warm quicker.
A day in the life of Ben and Joan• They wake up in a cold bedroom in
a cold house. • They get up and make a cup of tea which
they drink whilst making breakfast. • They use the cooker to heat the kitchen
whilst they make breakfast. • They sit in the living room to eat their
breakfast with the electric heater on• They don’t heat the whole house;
especially the bedroom as they were brought up to believe that hot bedrooms are bad for you
• They often use the electric fir…it’s not worth putting the heating on.
• Complex Picture• Behaviour is often not logical - People
don't always do what you think they will do
• Findings challenge assumptions: policy and practice
• Need to think of strategies and solutions:• Partnership working• Networking• Recognising, identifying people at risk• Assessing and referring people in need• Neighbourhoods and communities• Government: (Department of Health (2011)
Reflections
Assumptions• People aren’t cold these days• Its only the really old who are effected• Only people who are fuel poor are cold• Other people are tackling the problems• Family will help• People know that there are health impacts of
being cold• People are aware of what healthy room
temperatures are
Assumptions cont…• People know how to use technology – heating
and banking• Vulnerable people read and act on information
from organisations such as energy companies, banks and Government bodies
• People will access interventions to help e.g. Social fuel tariffs and affordable warmth interventions e.g. Green Deal
• Vulnerable people will engage with processes to obtain help
• Interventions don’t have adverse consequences
Dissemination• Pen portraits• Policy: NICE Guidance, Cold
Weather Plan, Health and Wellbeing Board Plans etc.
• E-learning• Communication tools: Winter
warmth England• Chap books
Health and policy background
• Cold Weather Plan: Public Health England
• Fuel poverty: Hills review and Marmot Review
• NICE Guidance on excess winter deaths and illness
Dissemination Links• Winter Warmth England:
http://www.winterwarmthengland.co.uk/
• KWILLT e-learning materials: http://teaching.shu.ac.uk/hwb/AHP_resources/kwillt_resource/index.htm
• WWF pen portraits and trade off model:• http://www.shu.ac.uk/research/hsc/sites/shu.ac.uk/files/4567_1415RMBC%20BR%20About.pdf
• Book of Damp
Other spin-offs• Warm Well Families• Abacus• Foundations Warm Homes Service
evaluation• Condensation research• Learning disabilities• ESRC academic seminar series
Group work• Think about your research• Think who you want to
influence – who is your audience?
• How can you reach them?• This could be, creative or novel
dissemination approaches for each audience.