What are the barriers to health promotion advice delivered by staff working in urgent care and emergency departments? – promotED study
| ISRCTN | ISRCTN30288191 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN30288191 |
| IRAS number | 322930 |
| Secondary identifying numbers | IRAS 322930, CPMS 54954 |
- Submission date
- 27/03/2023
- Registration date
- 03/05/2023
- Last edited
- 25/04/2024
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Other
Plain English summary of protocol
Background and study aims
The NHS is committed to helping patients reduce their risk of disease whenever they see healthcare staff. This could reduce early deaths, years spent in ill health and costs to the health and care system. Emergency nurses and paramedics are in a unique position to communicate with a wide range of people and to use these interactions to help people improve their health, especially when patients are not critically unwell. The promotED study aims to find out if ambulance paramedics and emergency department nurses carry out health promotion activities, e.g. giving advice on diet or exercise, what affects these activities, and the views of staff and patients on possible health promotion opportunities when giving or receiving urgent and emergency care.
Who can participate?
Adult paramedic and emergency department nursing staff, and patients who have been treated in and discharged from the ED or by a paramedic at home and discharged at home in the last 12 months
What does the study involve?
The team will:
1. Send an online questionnaire to emergency nurses and paramedics to find out how they help patients to improve their health. Some of these staff will be invited to take part in one-to-one interviews to explore their answers in more detail.
2. Invite patients who have been treated in an emergency department or by a paramedic at home to a one-to-one interview to discuss their views on emergency nurses and paramedics delivering health promotion activities.
Patient and public involvement (PPI)
The team will continue to work with a diverse and dedicated PPI group with recent experience in attending the emergency department and accessing the ambulance service.
The team will work with community advocates in each of the study regions to reach out and build trust with ethnically diverse communities. Using a combination of meetings and community engagement activities, public contributors will:
1. Co-produce participant-facing documents
2. Contribute to the ethics application
3. Help to develop the interview and survey questions
4. Advise on data analysis and interpretation (training and support will be provided)
5. Advise and participate in the dissemination
Both the study steering committee and the study management committee will include two PPI members who will represent the views of the PPI group.
Dissemination
Findings will be presented at relevant events for healthcare policymakers, commissioners, researchers, and staff. The PPI group will help plan ways to communicate and share our findings with the wider public. The findings will help us design further research that will focus on interventions to support and encourage nurses and paramedics to deliver health promotion activities in a way that works for both patients and staff.
What are the possible benefits and risks of participating?
By agreeing to take part in this research study you are contributing to the improvement of health services and patient care. As a thank you for your time, you will receive a £15 gift voucher after the interview. It is not anticipated that there will be any risks to you in taking part in the study. You may however be upset during or after the interview as you will be talking about the time you were visited by a paramedic or visited the accident and emergency department. You can ask to stop the interview for a break and spend some time talking about what has made you upset. If you do need to stop the interview and wish to withdraw from the study during the interview, you may do so without explanation. You will be provided with a sheet with contact details of groups you may wish to contact after the interview if you are feeling distressed or upset by talking about your visit from the paramedic or your time in the accident and emergency department. You can also talk to the study researcher if you would find it helpful.
Where is the study run from?
University of West of England (UK)
When is the study starting and how long is it expected to run for?
February 2023 to April 2024
Who is funding the study?
National Institute for Health and Care Research (NIHR) (UK)
Who is the main contact?
Dr Behnaz Schofield, behnaz.schofield@uwe.ac.uk (UK)
Contact information
Principal Investigator
College of Health, Science and Society
School of Health and Social Wellbeing
University of West of England
Glenside Campus (1H30)
Bristol
BS16 1DD
United Kingdom
| Phone | +44 (0)117 3286369 |
|---|---|
| behnaz.schofield@uwe.ac.uk |
Study information
| Study design | Multicentre observational mixed methods - survey and qualitative interview study |
|---|---|
| Primary study design | Observational |
| Secondary study design | Cross sectional study |
| Study setting(s) | Hospital, Paramedicine |
| Study type | Prevention |
| Participant information sheet | Not available in web format, please use contact details to request a participant information sheet. |
| Scientific title | What are the barriers to health promotion advice delivered by staff working in urgent care and emergency departments? – promotED study |
| Study acronym | promotED |
| Study objectives | The COVID-19 pandemic has highlighted the importance of public health and population-level interventions and the challenges associated with health inequalities, particularly the risk of further disadvantaging members of underserved communities. These individuals will sometimes use urgent care services and have the potential to benefit most from health-promoting and prevention advice. Emergency care provides an opportunity for disease surveillance, prevention, and public health interventions. Although urgent and emergency care staff may not always identify themselves as part of the wider public health workforce, an urgent care need may create an opportunity for a ‘teachable moment’ that will promote health behaviour change. Recommendations have been made stressing the importance of evaluating all future health policy in terms of its impact on health inequalities, and health promotion policies have attempted to address these issues. |
| Ethics approval(s) | Approved 06/03/2023, East Midlands - Leicester Central Research Ethics Committee (Equinox House, City Link, Nottingham, NG2 4LA, UK; +44 (0)207 1048181; leicestercentral.rec@hra.nhs.uk), ref: 22/EM/0283 |
| Health condition(s) or problem(s) studied | Staff and patient views and experiences of health promotion in urgent and emergency care |
| Intervention | WP1: Staff survey and interviews: To investigate the views of staff on the opportunities for health promotion and what might help or hinder these. WP2: Patient interviews: To investigate the views of patients on receiving health promotion in urgent and emergency care, and to determine if they are willing to participate and engage with these conversations. The study team will: Send an online questionnaire to emergency department (ED) nurses and paramedics to find out how they help patients to improve their health. Some of these staff will be invited to take part in one-to-one interviews to explore their answers in more detail. All paramedics and ED nurses working at the Trusts participating in the study will be informed of the online survey through Trust bulletins and email. A link to the survey will be sent by the NHS Trusts. Paramedics and ED nurses will be asked through the online survey to provide their contact details and their consent to be contacted by a member of the study research team if they are interested in participating in a qualitative telephone interview. The survey will take no more than 20 minutes to complete. A member of the study team will then contact those who have provided consent to be contacted, to arrange an interview. Interviews will last approximately 30-45 minutes and will be audio recorded, transcribed verbatim and anonymised. The study team will: Invite patients who have been treated in an ED or by a paramedic at home to a one-to-one interview to discuss their views on emergency nurses and paramedics delivering health promotion activities. All patients aged 18 years and over, with capacity to consent and who have been treated in an emergency department and discharged from the ED (not admitted to hospital) or by a paramedic at home and discharged at home (not taken to hospital) during the study period will be eligible. Where patients are significantly ill or injured, or have immediate healthcare needs, health promotion is not appropriate, and we will ensure these patients are not included in the study. For this reason, we are focussing on patients who are not being conveyed to hospital by ambulance staff, or who are being discharged from the ED. We will also work to further define the groups and presentations that staff and patients feel would make it inappropriate to offer health promotion advice. In this study we will not undertake any direct health promotion activities with patients. Patients who have provided their details and a consent to be contacted will be contacted within two weeks by the researcher and asked if they are still interested in participating. The researcher will offer to explain the study again and answer further questions that may be raised by the potential participant. They will be asked if they would be willing to take part in an interview at a mutually agreed time. Those agreeing to participate will be provided with a consent form and, if required, the information sheet again. Interviews will last approximately 30-45 minutes and will be audio recorded, transcribed verbatim and anonymised. |
| Intervention type | Other |
| Primary outcome measure | Views of staff on the opportunities for health promotion and what might help or hinder these measured using qualitative surveys and interviews at baseline |
| Secondary outcome measures | Views of patients on receiving health promotion in urgent and emergency care, and to determine if they are willing to participate and engage in these conversations measured using qualitative patient interviews at baseline |
| Overall study start date | 01/02/2023 |
| Completion date | 30/04/2024 |
Eligibility
| Participant type(s) | Patient, Health professional |
|---|---|
| Age group | Adult |
| Lower age limit | 18 Years |
| Sex | Both |
| Target number of participants | All paramedics and emergency department nurses at the participating NHS sites will have access to the staff survey link. 8-12 staff interviews will be completed. |
| Total final enrolment | 366 |
| Key inclusion criteria | Staff: 1. All paramedics working in the three participating ambulance services 2. All emergency department (ED) nurses working in the three participating EDs 3. All paramedics and ED nurses will be 18 years old and over Patients: 1. Aged 18 years and over 2. A capacity to consent 3. Who has been treated in an ED and discharged from the ED (not admitted to the hospital) or by a paramedic at home and discharged at home (not taken to the hospital) in the last 12 months |
| Key exclusion criteria | 1. Younger than 18 years of age 2. Paramedics and ED nurses working outside of the six participating Trusts |
| Date of first enrolment | 15/05/2023 |
| Date of final enrolment | 31/12/2023 |
Locations
Countries of recruitment
- England
- United Kingdom
Study participating centres
Bristol
BS2 8HW
United Kingdom
Derby Road
Nottingham
NG7 2UH
United Kingdom
London
SW17 0QT
United Kingdom
Eagle Way
Exeter
EX2 7HY
United Kingdom
Waterfront Business Park
Dudley Road
Brierley Hill
DY5 1LX
United Kingdom
Nottingham
NG8 3LL
United Kingdom
Otterbourne
Winchester
SO21 2RU
United Kingdom
Sponsor information
Hospital/treatment centre
Research & Innovation
Education & Research Centre
Level 3
Upper Maudlin Street
Bristol
BS2 8AE
England
United Kingdom
| Phone | +44 (0)117 3429883 |
|---|---|
| Elinor.Griffiths@uhbw.nhs.uk | |
| Website | https://www.uhbristol.nhs.uk/research-innovation/for-researchers/contact-the-team/ |
"ROR" |
https://ror.org/04nm1cv11 |
Funders
Funder type
Government
Government organisation / National government
- Alternative name(s)
- National Institute for Health Research, NIHR Research, NIHRresearch, NIHR - National Institute for Health Research, NIHR (The National Institute for Health and Care Research), NIHR
- Location
- United Kingdom
Results and Publications
| Intention to publish date | 01/05/2025 |
|---|---|
| Individual participant data (IPD) Intention to share | Yes |
| IPD sharing plan summary | Available on request |
| Publication and dissemination plan | It is anticipated that this study will result in the publication of two academic and practice-based articles in relevant professional journals (potential publications could be Perspectives in Public Health and BMC Emergency Medicine or Emergency Nurse). Additionally, the findings will be presented at two or more national and international conferences for urgent and emergency care healthcare professionals (potential conferences could be the South West Public Health Scientific Conference and the Royal College of Emergency Medicine Annual Scientific Meeting). Reports will be provided for relevant stakeholders and the public. These briefing papers will be prepared for different stakeholder audiences including policymakers, professional organisations, patients and the public. The study outputs will be made available on the study website www.uwe.ac.uk/promoted. |
| IPD sharing plan | The datasets generated during and/or analysed during the current study will be available upon request from Dr Behnaz Schofield (behnaz.schofield@uwe.ac.uk). Ethics committee approval will be required for access to the anonymised datasets with clear publication plans in place. |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| HRA research summary | 26/07/2023 | No | No |
Editorial Notes
25/04/2024: The following changes were made to the study record:
1. Total final enrolment added.
2. Nottingham University Hospitals NHS Trust - Queen's Medical Centre Campus, St George's Hospital, Specialist Practitioner Services Swast, West Midlands Ambulance Service NHS Trust, East Midlands Ambulance Service NHS Trust (Nottingham), and South Central Ambulance Service NHS Trust were added to the study participating centres.
28/03/2023: Trial's existence confirmed by National Institute for Health and Care Research (NIHR) (UK).
