Background: We have developed a winter forecasting service to predict when patients with COPD are at higher risk of an exacerbation and alert them via an automated telephone call.
WINNING ABSTRACT: Many COPD sufferers find that their symptoms become worse during colder weather, which can lead to an exacerbation resulting in hospital admission. This study investigates different measures of cold, assessing which most strongly relate to COPD admissions and whether they can be used to forecast risk of exacerbation.COPD admissions (ICD10 J40-J44) for the five Strategic Health Authorities (SHAs) in London and corresponding meteorological data were extracted for October-March 1997-2003. Correlations and regressions were used to compare the effects on admissions of: N daily mean, maximum and minimum temperature; N significant drops in temperature; N weekly average maximum temperature; N ''cumulative cold'', summing the number of degrees the daily maximum temperature was below a threshold across a week; N different windchill indices.All measures of cold showed significant negative correlations with COPD admissions. Daily relationships were weaker than weekly ones (R5 -0.19, p,0.001 for daily maximum temperature, R5 -0.36, p,0.001 for weekly average maximum temperature) but are most significant with an 8-day lag. Windchill had the strongest correlation with one-week lag (R5 -0.397, p,0.001) accounting for 20% of the variation in admissions. ''Cumulative cold'' is also significant at p,0.001, ranging from R50.28 for a 3uC threshold to R50.36 for 18uC.Cold measures explain sufficient variation in COPD hospital admissions to be used in a forecast model of risk of exacerbation. The Met Office uses such a model in a health forecasting and anticipatory care service in England.
Patients found the automated interactive calling, combined with a health risk forecast, both viable and useful, welcoming the information and tools it offered. In many cases, it added to patients' understanding of their illness and promoted better self-management. Future research should focus on the potential impact of the service in terms of health outcomes and cost-effectiveness.
BackgroundThis study reports on the process of conducting participatory research by training peer researchers to conduct interviews and analyse data collected with parents of overweight children. The methodology was chosen as a means of (a) encouraging participation among a hard-to-engage group (i.e., parents of overweight children), and (b) generating novel insights and challenging academic/health professional assumptions through the involvement of parents in the interpretation of findings.MethodsFour parents (all female) were recruited as peer researchers and trained in research processes, ethics, and interview skills over three half-day workshops. The intended interviewees were parents of children identified as obese through the National Child Measurement Programme (NCMP) at the start of primary school (age 4–5) but who had lost their excess weight by age 10–11; little is currently known about how this excess weight loss is achieved. Interviews were conducted by peer researchers, transcribed verbatim and analysed thematically by both peer- and university-based investigators.ResultsThe peer researchers felt confident to conduct interviews after three training sessions. Recruitment of interviewees was challenging, resulting in only four volunteers (all mothers) over a 5-month period; thus peer researchers were only able to conduct one interview each. All interviews were considered good quality in comparison to those conducted by Masters-level research assistants. The process of co-analysis resulted in a change in emphasis from that initially generated by the university research team; the role of health professionals in weight management was de-emphasised, and the importance of ‘not singling out’ overweight children accentuated. Given the limited number of interviews, the results of the study are only provisional but resulted in three themes: Whole Family Action, Support (and lack of support), and Protecting Childhood.ConclusionsTraining peer researchers to conduct and analyse interviews was feasible within a short period of training. Peer researchers found the experience interesting, informative and worthwhile. Two of the four volunteered to be involved in a related study 12 months later. The different perspective brought through co-analysis suggests that this approach to conducting participatory research may be a useful means of working with the public to generate new ideas to tackle intransigent issues.Electronic supplementary materialThe online version of this article (10.1186/s40900-017-0072-0) contains supplementary material, which is available to authorized users.
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