Evaluation of an integrated care model using the RE-AIM framework: A case study of a community-based lifestyle service in rural Lincolnshire, UK
Notice bibliographique
Résumé
Introduction:?Many unhealthy behaviours such as tobacco smoking, poor diet, harmful alcohol use, and physical inactivity tend to group. In England, around a quarter of people are engaged in three or more unhealthy behaviours, contributing to a higher risk of ill health. Interventions, known as integrated lifestyle services (ILS), encourage sustained health changes and reduced costs. There is limited evidence on the effectiveness of ILSs in rural settings and factors that impact implementation. One You Lincolnshire is a non-NHS provider working with GP practices, community care services and local charities to offer online, digital lifestyle support for individuals with long-term health conditions. Methods:?This study aimed to identify the impact of addressing unhealthy behaviours for an individual through One You Lincolnshire (OYL), establish how OYL has been implemented, and highlight any potential risks and challenges that may impact the intervention in the future. This presentation will give an overview of the key findings from phase 1 of the evaluation, which used a mixed-method approach and was co-produced with a multi-stakeholder group. The study had a total of 53 participants, including Service Users (n = 24), Health Professionals (n= 9), One You Lincolnshire staff (n=17) and Stakeholders (n=3). Key Findings: Thematic analysis was used to identify key themes in service delivery and implementation. From the interviews and focus groups, the key findings were as follows:? - Online delivery model offered much greater accessibility for a wide range of clients in rural areas.?? -Once referred, an integrated service model decreased barriers for stigmatised health needs such as smoking cessation or alcohol reduction.? -A legacy of decommissioning services led to apprehension for some health professionals to adopt the model. The results from phase 1 highlight that digital service delivery during the covid pandemic may increase accessibility for individuals with long-term health conditions. Also, participating in multiple pathways suggest an increase in sustained long-term changes.? Conclusion:?Integrated lifestyle services could be an effective model to tackle co-morbidities with opportunities to work with community partners to develop robust care pathways. However, there are still challenges in adopting the model by GP practices and the need to further explore the service's health outcomes and cost-effectiveness. Implications:?These findings will be used to make real-time changes to One You Lincolnshire service delivery and contribute to a broader body of research on the implementation of ILS in rural settings. One limitation of the study was the dropout of some participants between survey and interview, resulting in fewer service users' perspectives than desired. However, phase 2 will focus on a more extensive dataset to triangulate the findings.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,028 | 0,027 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,008 | 0,005 |
| Communication savante | 0,006 | 0,003 |
| Science ouverte | 0,004 | 0,010 |
| Intégrité de la recherche | 0,003 | 0,003 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,007 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».