ProjectsDepartment of Health and Social CareWork in progress
Work in progress

 These reviews are currently being conducted by the Department of Health and Social Care reviews facility:

  • Befriending, social support, and low intensity psychosocial interventions delivered remotely to reduce social isolation and loneliness among older adults

Older people are more likely to be characterised by risk factors for loneliness including having poorer health, having a long-term illness or disability, living alone, and being widowed. During the current coronavirus crisis, millions of older people (70+) across the UK and elsewhere are advised to be particularly stringent about social distancing, and to avoid contact with those outside their household. This places older people at even higher risk of social isolation and loneliness. Social isolation and loneliness adversely affect quality of life, wellbeing and mental health, and are associated with physical ill health and mortality. However, what works to prevent or mitigate loneliness is less clear. The requirement for older people to restrict their activities during the COVID-19 pandemic has identified a need to understand how to minimise the impact of loneliness and isolation, at a distance.

A number of evidence reviews have highlighted the diverse range of interventions aimed to address and alleviate loneliness (and the consequences of loneliness) amongst older people in a variety of settings. In the main, these have been face-to-face interventions, either in groups or between individuals. Given the current ‘stay at home’ instructions from Government, these face-to-face interventions are not possible. Much of our social contact now has to be conducted over the telephone, or through use of videoconferencing tools.  We are conducting a rapid review exploring what are effective befriending, social support, and low intensity psychosocial interventions delivered remotely to reduce social isolation and loneliness among older people, and are attempting to understand how they ‘work. This work is being led jointly by the EPPI-Centre and the Older People and Frailty PRU, with colleagues from the University of York/Hull York Medical School and National University of Ireland (Galway). We are conducting a review of reviews and are undertaking novel syntheses of the results including Narrative Synthesis, Intervention Component Analysis and Qualitative Comparative Analysis.

  • Adult Specialist Services for Victim-Survivors of Sexual Violence and Abuse

Prevalence of sexual violence and abuse remains largely unknown and underreported, but it is estimated that around 25% of women and 5% of men in England and Wales have experienced some type of sexual assault since the age of 16. In recent years there has been an unprecedented surge in demand for specialist support for victim-survivors of sexual violence and abuse, which may be attributable in part to the #metoo and #timesup movements which have encouraged people to speak out about their experiences of assault or abuse, sometimes dating back years or even decades. This increase in demand has come at a time when resources are severely under-resourced and when commissioning has been devolved to a local level.  

The first stage of this review will comprise a systematic map to describe the nature and extent of evidence on the effectiveness and appropriateness of specialist adult services for people who have experienced sexual violence and abuse. Once we have mapped the available evidence we will consult with stakeholders and DHSC later this summer. The consultations will help us to determine the most useful way to approach an in-depth review and synthesis with the aim of helping local and national commissioners to make informed decisions about services for victim-survivors.

[protocol not registered yet – waiting until the second stage to put this up on PROPERO]

  • Digital interventions in drug and alcohol prevention, treatment and recovery: a systematic review of research and map of service provision

Substance misuse is an important public health concern in the UK. This project aims to identify what digital drug and alcohol interventions are being used in England, what evidence exists for these and for other interventions and what research gaps exist. The review will also aim to identify what evidence exists regarding the factors associated with digital drug and alcohol interventions’ effectiveness among particular populations and contexts. Currently used interventions will be identified through an online survey of drug and alcohol providers and commissioners.

  • Precision Public Health: A Rapid Critical Review

The potential for ‘artificial intelligence’ and ‘big’ / ‘real world’ data to enable interventions to be precisely tailored to the needs of specific individuals has been gaining increasing interest. Accompanying the rise of ‘precision medicine’ there has been an active debate as to whether the same approaches can be applied in public health, and where the possible limitations may lie. This EPPI-Centre study, currently underway, is critically assessing the claims and counter-claims made about ‘precision public health’. Precision Public Health describes both the use of genomic data in public health decision-making, as well as the use of other new sources of big data, which often necessitate using analytics supported by Artificial Intelligence and Machine Learning to generate evidence. In this study, we aim to assess the challenges expressed in the literature around increasing precision in public health decision-making, and some of the underlying assumptions in this endeavour. We aim to critically evaluate the key arguments and debates published in recent literature and to situate these within long-standing debates and theories in public health. It is intended that this work will help to illuminate the feasibility and challenges of adopting this approach, as well as a critical assessment of some of the opportunities that increasing precision could bring to public health decision-making.

  • Inappropriate treatment at the end of life: a systematic review of qualitative evidence

Inappropriate treatment can occur when people are nearing the end of life. Pain and other symptoms at the end of life can be undertreated, leading to avoidable suffering for patients. Conversely, overtreatment has been found to be widespread and some evidence suggests that more aggressive treatments are associated with poorer quality of life for both patients and carers. Clinicians, patients and their family members face challenges in determining the point at which treatments focused on sustaining life should give way to treatments focused on relieving pain and other symptoms.

There is a substantial body of evidence on interventions to improve end-of-life care, particularly those focused on clarifying and communicating patient preferences. This systematic review will add to this evidence base by exploring the ways in which inappropriate treatment is understood and experienced, and illuminating the processes by which it might arise. It will search for qualitative studies focusing on under- or overtreatment, inappropriate or futile treatment for patients at or near the end of life and use thematic synthesis to identify key themes.

 

If you wish to send us your comments on our work or be notified when these reviews are published please enter your details using the form below.

 

The Department of Health and Social Care Reviews Facility is a collaboration between three centres of excellence: EPPI-Centre (Evidence for Policy and Practice Information and Co-ordinating Centre), UCL Institute of Education, University College London; CRD (Centre for Reviews and Dissemination), University of York; and PHES (Public Health, Environments and Society), London School of Hygiene and Tropical Medicine.

  
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