With increased situated understanding of organizational culture and norms and greater awareness of the socio-political realities of PH, ER enables new co-produced solutions to become possible.
These findings provide useful learning in terms of the delivery and commissioning of similar IHWSs, contributing to understanding of the benefits and challenges of this model of working.
BackgroundA 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).MethodsThe 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.ResultsFindings 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.ConclusionsAn 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.
In collaboration with Fuse, the Centre for Translational Research in Public Health, a local authority public health department in North East England appointed an embedded researcher as part of a new, innovative approach to increasing research evidence in public health. There were two parts to the researcher's role: one to undertake a qualitative evaluation of an ‘integrated wellbeing model’, a preventive, asset-based approach that supports individuals, families and communities to improve their health and wellbeing. The other was to support the use of research evidence in public health more widely. The researcher was based with the public health team 3 days a week for a year until July 2016.This paper explores the reality of this methodological approach in the field of public health, drawing on the perspectives of the host organisation and the embedded researcher. We describe the assumptions underpinning the approach, how collaborative relationships were established, and what they meant. We reflect on the ways in which this research design, data interpretation and reporting were affected. Examples are used to highlight the challenges and opportunities of a University and Local Authority collaborating in this way. We review what we have learned about collaboration, with a view to sharing transferable messages. The aim is to explore the effectiveness of embedded research, and prompt debate about the pros and cons of collaborating in this way, drawing on our experiences.
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