Objective
Evidence suggests that people with a learning disability (PwLD) are less likely to attend cancer screening than the general population in the United Kingdom. The aim of this systematic review was to identify and synthesise qualitative studies reporting the attitudes and opinions of PwLD, family carers, and paid care workers towards national cancer screening programmes.
Methods
Five electronic and two grey literature databases were searched. Fourteen thousand eight hundred forty‐six papers were reviewed against predetermined inclusion criteria. Included papers were critically appraised. Findings were synthesised using meta‐aggregation.
Results
Eleven papers met the inclusion criteria, all related to cervical and breast screening. No papers were related to colorectal cancer screening. Findings were clustered into four synthesised findings: (1) supporting women with a learning disability (WwLD) to attend screening, (2) WwLD's awareness of screening and their psychophysical experiences, 3) professional practice barriers including the need for multidisciplinary working and an understanding of the needs of WwLD, and (4) approaches to improve the uptake of cervical and breast cancer screening. The synthesis highlights the significance of WwLD having support to understand the importance of screening to be able to make an informed choice about attending.
Conclusions
WwLD may not attend cancer screening due to fear, concerns over pain, and the potential influence of family carers and paid care workers. The review identified practical mechanisms which could help WwLD attend screening. Future research should focus on identifying potential barriers and facilitators as a proactive measure to promote colorectal cancer screening.
IntroductionDrinking has adverse impacts on health, well-being, education and social outcomes for adolescents. Adolescents in England are among the heaviest drinkers in Europe. Recently, the proportion of adolescents who drink alcohol has fallen, although consumption among those who do drink has actually increased. This trial seeks to investigate how effective and efficient an alcohol brief intervention is with 11–15 years olds to encourage lower alcohol consumption.Methods and analysisThis is an individually randomised two-armed trial incorporating a control arm of usual school-based practice and a leaflet on a healthy lifestyle (excl. alcohol), and an intervention arm that combines usual practice with a 30 min brief intervention delivered by school learning mentors and a leaflet on alcohol. At least 30 schools will be recruited from four regions in England (North East, North West, London, Kent and Medway) to follow-up 235 per arm. The primary outcome is total alcohol consumed in the last 28 days, using the 28 day Timeline Follow Back questionnaire measured at the 12-month follow-up. The analysis of the intervention will consider effectiveness and cost-effectiveness. A qualitative study will explore, via 1:1 in-depth interviews with (n=80) parents, young people and school staff, intervention experience, intervention fidelity and acceptability issues, using thematic narrative synthesis to report qualitative data.Ethics and disseminationEthical approval was granted by Teesside University. Dissemination plans include academic publications, conference presentations, disseminating to local and national education departments and the wider public health community, including via Fuse, and engaging with school staff and young people to comment on whether and how the project can be improved.Trial registration trialISRCTN45691494; Pre-results.
Results show that interventions in the prison setting have the potential to positively impact on alcohol use; however, because of small numbers and the use of different outcome measures we could not conduct a meta-analysis or generalise findings. Future studies are needed to standardise approaches to ensure greater rigour and efficacy.
Aims: To evaluate the effectiveness of an alcohol hospital liaison team at reducing alcohol specific hospital attendances and admissions. Methods: In a mixed method evaluation 96 patients who accessed the team were monitored using data for alcohol specific hospital attendances and accident and emergency (A&E) admissions before, during, and after engaging with the team. A feedback survey was sent to patients and a focus group was held with staff from the team to identify barriers and facilitators to the successful delivery of this service. Results: No differences were observed when looking at alcohol admissions or A&E attendances before patients engaged with the service to those after discharge. Whilst hospital admissions decreased slightly, and A&E attendances increased slightly, these differences were not significant. Hospital admissions and A&E attendances increased significantly during engagement with the service. The focus group identified confusion over who should be delivering brief interventions, and that the team were holding onto patients for too long.
Conclusions:The results of this evaluation demonstrated that this team were not effective at reducing alcohol attendances or admissions due to a number of factors. Policy makers should make note of the barriers to effectiveness highlighted in this paper before commissioning alcohol care teams in the future.
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