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The article focuses on a study in Scotland, United Kingdom of prioritizing protection of children from secondhand smoke exposure (SHSE) in a private space where smoke-free public places are enforced. It discusses the difficulty of political acceptability in enforcing the issue and the intervention over parental autonomy to smoke in their own home. The article also reports on the findings based on the study used called Reducing Families' Exposure to Secondhand Smoke (REFRESH) project.

This paper uses the concept of intersectionality to think about the ways people negotiate diversity on a daily basis in Glasgow, Scotland. The paper draws on ethnographic fieldwork, in‐depth interviews and focus groups carried out in semi‐formal spaces such as public libraries, community‐centres and local cafes. Discussing the ways in which people speak about their experiences of encountering others across ethnicity, age, gender, religion, and class, the paper examines situations where different positionalities interconnect to produce mundane and fleeting moments of relation. Despite tensions, misunderstandings and moments of uneasiness, the paper finds that connections and relations are built. Set in the political context of contemporary Scotland, the paper argues that being together in diversity can be a decisive act that marks the everyday as political. It contends that an openness to and through these intersectional relations can counteract notions of crisis and emergency normatively constructed around issues of immigration and multiculturalism in Scotland. [ABSTRACT FROM AUTHOR]

Online activities have spiked due to the COVID-19 pandemic, including language learning activities. As the world is aging, this affects senior citizens too. Yet, few studies have been conducted studying online (language) learning in this age-group. Moreover, no concrete pointers exist on how to go about such an online language learning course. This paper examines what should be considered when designing and implementing online language learning courses for seniors. To that end we present data from 73 senior language learners from two independent language learning contexts: the Netherlands and Scotland. The data were collected between May 2020 and August 2021. Data includes spoken and written samples from lessons, focus groups, interviews and questionnaires. Given the qualitative nature of the data and the aim of identifying patterns of meaning across the respective datasets, a reflexive thematic analysis (TA) approach was adopted. We employed an inductive approach to coding, using both semantic (explicit or overt) and latent (implicit, underlying) coding frameworks, in order to inform two overarching themes: "Navigating the digital highway" and "Camera ready for new friends." We discuss these themes and their sub-themes and arrive at concrete recommendations for the third-age language learning classroom. [ABSTRACT FROM AUTHOR]

In 2012, Bottoms and Tankebe put forward the notion that the legitimacy of criminal justice agencies is in flux and resembles an ongoing conversation between 'power-holders' and their 'audience'. However, their dialogic approach has yet to be studied in empirical research in a policing and social media context. This paper provides an original contribution to their framework and illustrates the dynamic nature of police legitimacy on social media. Extensive fieldwork was carried out in Scotland and involved observation (n=134 hours) and semi-structured interviews (n=40) with police officers and civilian staff with social media duties, and focus groups with citizens (n=22). The research findings show that police legitimacy on social media is dynamic and has four key dimensions. Firstly, police officers and civilian staff cultivate their own sense of self-legitimacy on social media in accordance with the credibility of police information and their expertise in policing. Secondly, police officers and civilian staff communicate their legitimacy to citizens on social media drawing on formal and informal styles. Thirdly, citizens make assessments about police legitimacy on social media in connection to how they understand face-to-face encounters with the police, as the police themselves internalise these judgements. Fourthly, when citizens challenge police legitimacy on social media, officers and civilian staff reconstruct and at times reassert their legitimacy. [ABSTRACT FROM AUTHOR]

Young people experience significant harm in a range of social contexts and from adults and peers unconnected to their caregivers. The recognition of this by policymakers in England, Scotland, and Wales has resulted in child protection policy frameworks increasingly requiring social work responses to the extra-familial contexts where such harm occurs, as well as to the young people affected. This paper presents results from an embedded research project in which five local children's social care departments used a Contextual Safeguarding framework to respond to this shifting policy direction. The data collected via ethnographic methods over three years included meeting and practice observations (n = 65), meeting participation (n = 334), reviews of young people's case files (n = 122), interviews (n = 27) and focus groups (n = 33) with professionals, focus groups (n = 6), interviews (n = 2) and surveys (n = 78) with parents and young people, and analysis of local policies and procedures (n = 101). At two stages in the project, the researchers used this dataset to review the progress in each participant site against the Contextual Safeguarding framework. Reporting on the progress made across the five sites, this paper identifies elements of the system change that appeared most feasible or challenging. The results demonstrate four ways in which current policy reforms fall short in creating national contexts that are conducive to the implementation of Contextual Safeguarding, despite local progress towards this goal. The implications for the policy and practices are outlined, with fundamental questions asked of the statutory systems which need to protect, but all too often criminalise, young people abused beyond their front doors. [ABSTRACT FROM AUTHOR]

Background: As digital tools are increasingly used to support COVID‐19 contact tracing, the equity implications must be considered. As part of a study to understand the public's views of digital contact tracing tools developed for the national 'Test and Protect' programme in Scotland, we aimed to explore the views of groups often excluded from such discussions. This paper reports on their views about the potential for contact tracing to exacerbate inequalities. Methods: A qualitative study was carried out; interviews were conducted with key informants from organizations supporting people in marginalized situations, followed by interviews and focus groups with people recruited from these groups. Participants included, or represented, minority ethnic groups, asylum seekers and refugees and those experiencing multiple disadvantage including severe and enduring poverty. Results: A total of 42 people participated: 13 key informants and 29 members of the public. While public participants were supportive of contact tracing, key informants raised concerns. Both sets of participants spoke about how contact tracing, and its associated digital tools, might increase inequalities. Barriers included finances (inability to afford smartphones or the data to ensure access to the internet); language (digital tools were available only in English and required a degree of literacy, even for English speakers); and trust (many marginalized groups distrusted statutory organizations and there were concerns that data may be passed to other organizations). One strength was that NHS Scotland, the data guardian, is seen as a generally trustworthy organization. Poverty was recognized as a barrier to people's ability to self‐isolate. Some participants were concerned about giving contact details of individuals who might struggle to self‐isolate for financial reasons. Conclusions: The impact of contact tracing and associated digital tools on marginalized populations needs careful monitoring. This should include the contact tracing process and the ability of people to self‐isolate. Regular clear messaging from trusted groups and community members could help maintain trust and participation in the programme. Patient and Public Contribution: Our patient and public involvement coapplicant, L. L., was involved in all aspects of the study including coauthorship. Interim results were presented to our local Public and Patient Involvement and Engagement Group, who commented on interpretation and made suggestions about further recruitment. [ABSTRACT FROM AUTHOR]

In the Spring of 2002, The SCRE Centre at the University of Glasgow was commissioned to conduct focus group research on behalf of the the Education, Culture, and Sport Committee at the Scottish Parliament. The study, which was conducted over a 3 month period, was intended to inform the Committee's inquiry into the purposes of education. Inquiries of this type are a common feature of the working practices of the Scottish Parliament. The aim of this particular one was to promote 'an in-depth discussion on key issues on the future direction of education'. The main theme of this paper is the dissonance between those who framed the inquiry and those who participated in the focus group study. The meanings of that dissonance are explored—as, briefly, are the conditions under which the research was conducted. The factors that contribute to mismatch in intention or meaning are also discussed. This study also comments on the continuing dominance of academic education in Scotland, and the consequences for those who see themselves as failures while subscribing to the centrality of education. [ABSTRACT FROM AUTHOR]

Introduction: While most countries require health warnings on cigarette packs, the Scottish and Canadian Governments are considering requiring health warnings on cigarette sticks. Methods: Twenty focus groups were conducted in Glasgow and Edinburgh (Scotland) with smokers (n = 120) segmented by age (16–17, 18–24, 25–35, 36–50, >50), gender and social grade, to explore perceptions of cigarettes displaying the warning 'Smoking kills' on the cigarette paper and any demographic differences in how smokers responded to these. Results: A warning on each cigarette was thought to prolong the health message, as it would be visible when a cigarette was taken from a pack, lit, left in an ashtray, and with each draw, and make avoidant behavior more difficult. That it would be visible to others was perceived as off-putting for some. It was felt that a warning on each cigarette would create a negative image and be embarrassing. Within several female groups they were viewed as depressing, worrying and frightening, with it suggested that people would not feel good smoking cigarettes displaying a warning. Within every group there was mention of warnings on cigarettes potentially having an impact on themselves, others or both. Some, mostly younger groups, mentioned stubbing cigarettes out early, reducing consumption or quitting. The consensus was that they would be off-putting for young people, nonsmokers and those starting to smoke. Conclusions: Including a warning on each cigarette stick is a viable policy option and one which would, for the first time, extend health messaging to the consumption experience. [ABSTRACT FROM AUTHOR]

This paper draws on UK data from an international, comparative project involving eight countries. The study examined how social workers' conceptions and definitions of family impact on the way they engage with complex families, and how social policies that frame social work context impact on the way social workers engage with families. Focus groups were held in which social workers from four service areas (child welfare, addictions, mental health and migration) were asked to discuss a case vignette. Several factors were embedded in the vignette to represent a realistic situation a social worker may come across in their day-to-day work. Social workers clearly identified the complexity of the family's situation in terms of the range of issues identified and candidate 'causes'. However, typical first responses were institutional, looking for triggers that would signify certainty about their, or other agencies' involvement. This resulted in a complicated story, through which the family was disaggregated into individual problem-service categories. This paper argues that understanding these processes and their consequences is critical for exploring the ways in which we might develop alternative, supportive professional responses with families with complex needs. It also demonstrates how organisational systems manifest themselves in everyday reasoning. [ABSTRACT FROM AUTHOR]

Citizenship is gaining currency in health and social care internationally as a way of making sense of the lived experiences of people with major life disruptions who face exclusion, marginalisation and discrimination, but the concept is often contested, poorly defined and understood. This paper charts the development of an empirical model of citizenship within Scotland, UK. A mixed‐method, community‐based participatory research approach using 10 focus groups (n = 77), concept‐mapping exercises (n = 45) and statement clarity and relevant ratings (n = 242) was used to develop a model of citizenship that is grounded in the lived experience of participants, which is absent from current conceptualisations of citizenship. Multidimensional scaling and hierarchical cluster analysis revealed five core domains emerging from our work: 'building relationships', 'autonomy and acceptance', 'access to services and supports', 'shared values and social roles' and 'civic rights and responsibilities' representing the personal meanings of citizenship for participants. We argue that the value of this model is that it is draws upon the personal understandings and experiences of participants who emphasised the 'banal ordinariness' of its core elements. We suggest that the model makes an original contribution by clearly illustrating the practical applicability of citizenship as a concept; thus, enhancing existing theories of citizenship. Our model highlights the interplay between the relational and structural aspects of citizenship and acknowledges the barriers that marginalised groups face in claiming their citizenship rights. It offers a call to action for policy makers and practitioners to set goals that contribute to the social inclusion of those who have experienced major life disruptions. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore the impact of implementing an electronic health record system on staff at a Scottish hospice. Background Electronic health records are broadly considered preferable to paper-based systems. However, changing from one system to the other is difficult. This study analysed the impact of this change in a Scottish hospice. Design Naturalistic prospective repeated-measures mixed-methods approach. Methods Data on the usability of the system, staff engagement and staff experience were obtained at four time points spanning 30 months from inception. Quantitative data were obtained from surveys, and qualitative from concurrent analysis of free-text comments and focus group. Participants were all 150 employees of a single hospice in Scotland. Results Both system usability and staff engagement scores decreased for the first two years before recovering at 30 months. Staff experience data pointed to two main challenges: (1) Technical issues, with subthemes of accessibility and usability. (2) Cultural issues, with subthemes of time, teamwork, care provision and perception of change. Conclusions It took 30 months for system usability and staff engagement scores to rise, after falling significantly for the first two years. The unintended outcomes of implementation included challenges to the way the patient story was both recorded and communicated. Nevertheless, this process of change was found to be consistent with the 'J-curve' theory of organisational change, and as such, it is both predictable and manageable for other organisations. Relevance to clinical practice It is known that implementing an electronic health record system is complex. This paper puts parameters on this complexity by defining both the nature of the complexity ('J' curve) and the time taken for the organisation to begin recovery from the challenges (two years). Understanding these parameters will help health organisations across the world plan more strategically. [ABSTRACT FROM AUTHOR]

This paper critically reflects on the Scottish Adult Support and Protection (ASP) study, a research project conducted at a time when ‘adult protection’ was understood in Scottish policies to be the professional response to ‘abuse’. During the course of analysing the ASP study data, it became apparent that practitioners themselves did not necessarily construct ‘abuse’ and ‘adult protection’ concerns as coterminous categories. Some examples are recounted to illustrate the potentially more partial, less linear relationship between these categories in practice than in policy constructions. The paper concludes with suggestions for further research into professionals' constructions of ‘adult protection’ concerns. It explains why such research would have continuing, if not greater, relevance in the context of recent Scottish policy moves to reconceptualise adult protection as a response not to ‘abuse’, but to ‘harm’. [ABSTRACT FROM PUBLISHER]

Purpose Collaborative inter-agency working is of paramount importance for the public protection agenda worldwide. The purpose of this paper is to disseminate the findings from a research study on the inter-agency working within adult support and protection (ASP) roles in the police, health and social care.Design/methodology/approach This realistic evaluation study with two inter-related phases was funded by the Scottish Institute for Policing Research. This paper reports on Phase 1 which identified existing gaps in the implementation of effective inter-agency practice by reviewing the "state of play" in inter-agency collaboration between the police and health and social care professionals. In total, 13 focus groups comprising representatives from Police Scotland (n=52), Social Care (n=31) and Health (n=18), engaged in single profession and mixed profession groups addressing issues including referral and information exchange.Findings On analysing context-mechanism-outcome (CMO), gaps in joint working were identified and attributed to the professionals' own understanding of inter-agency working and the expectations of partner agencies. It recommended the need for further research and inter-agency training on public protection.Research limitations/implications This unique Scottish study successfully identified the inter-agency practices of health, social services and police. By means of a modified realistic evaluation approach, it provides an in-depth understanding of the challenges that professionals face on a day-to-day basis when safeguarding adults and informed strategic recommendations to overcome the barriers to good practices in organisational working. The methods used to determine CMO could benefit other researchers to develop studies exploring the complexities of multi-causal effects of cross-boundary working. The use of the same case study in each focus group helped to neutralise bias. However, the voluntary nature of participation could have resulted in biased perceptions. The limited numbers of health professionals may have resulted in less representation of health sector views.Practical implications This paper reports on a Scottish study that focused on the coordinated and integrated practices amongst the police, health and social services' professionals who support and protect adult members of society at risk of harm and has implications for their practice.Social implications Whilst the focus of this study has been on ASP, the conclusions and recommendations are transferable to public protection issues in many other contexts.Originality/value Studies on the joint-working practices amongst police and health and social services' professionals who support and protect adult members of society at risk of harm are uncommon. This study investigated professionals' perceptions of gaps and concerns pertaining to integrated working by means of a realistic evaluation approach. It recommended the need for further research and inter-agency training on public protection. [ABSTRACT FROM AUTHOR]

Drawing on focus group research with social housing tenants this paper illustrates that despite the existence of a political 'will to empower' within housing stock transfer policy in Scotland, the effects of governmental strategies are only ever partial and uneven, and may be subject to challenge and contestation from below. Through a focus on 'lay' perspectives and the contested nature of contemporary governing practices, the paper argues for more attention to the messy realities of governing within specific local contexts, especially the way in which governable subjects can think and act otherwise, and forge their own alternative govern-mentalities. [ABSTRACT FROM AUTHOR]

This paper explores the emotional responses that assessment can provoke in undergraduate students. The literature on the link between emotions and learning is well established, with an emphasis on confidence and anxiety, but there is surprisingly little research on the relationship between emotions and innovative assessment practices. This article aims to make a contribution to these debates by looking at courses where students were assessed through blogging, an assessment strategy that was new and unfamiliar to all of them. Focus groups were undertaken with students on four courses at the University of Edinburgh. The data from the focus groups identified positive emotional responses to blogging with students outlining how it was a way to enhance engagement because of the enjoyment it brought them. Blogging also evoked negative emotions, with respondents detailing how a new assessment method initially engendered feelings of unease and anxiety. Our analysis indicates that it is important to pay attention to the wider emotional landscape of assessment strategies. Students compared the allure and appeal of blogging, despite its unknowns and uncertainties, with the often negative feelings they had about being assessed using more conventional means such as essays and examinations. [ABSTRACT FROM AUTHOR]

The selection, preparation and consumption of food are everyday experiences; however, the social and symbolic meaning attached to such practices varies widely. This paper presents findings from a research project which aimed to explore how such food practices were experienced, produced and maintained within residential children's homes in Scotland. Data were generated over a year-long fieldwork period during which participant observation was undertaken alongside qualitative interviews and/or focus groups with sixteen children and forty-six adults. The paper emphasises the importance of food and food practices to the ways in which children and staff living and working in residential care manage, express and contain feelings and emotions. [ABSTRACT FROM PUBLISHER]

Purpose - The purpose of this paper is to explore the role of carers as coordinators of care in their own right. It outlines how statutory and voluntary agencies can work together to support carers in this role, yet also help them work towards personal outcomes to sustain their own quality of life. It also proposes that approaches to working with carers can reveal lessons for integration. Design/methodology/approach - The research analysed data from focus groups and document analysis to examine how carers and professionals experienced two different approaches to engaging with carers: the Midlothian carer's assessment and VOCAL's outcomes focused approach. From this, several themes emerged which are relevant to the current debate on integration. Findings - Carers were found to be key co-ordinators of care who play a role in the integration of services. Approaches to working with carers can better enable personal outcomes, and integrate carers as equal partners. In addition, improved integration between services can also improve outcomes for carers. Research limitations/implications - Approaches to working with carers should be carer and outcome focused, and partnership working can mean that carers feel more empowered and included. This helps to achieve personal outcomes, as well as enhance integrated working between other services. However, differentiation between services might, in places, contribute to better outcomes for people. Originality/value - This paper shifts the focus of integration to look the role of carers as equal partners, and also illustrates how statutory and voluntary services can work better together, while preserving their distinct identities. [ABSTRACT FROM AUTHOR]

The cigarette stick, as the primary form of packaging and the object of consumption, is an increasingly important marketing tool for tobacco companies. It could, however, also be used to communicate health messaging. We therefore explore adolescents' perceptions of cigarettes designed to dissuade smoking. Eight focus groups were conducted with 16–17 year-olds in Scotland (n = 36) between November 2017 and November 2018. Groups were segmented by gender and smoking status. Participants were shown four dissuasive cigarettes; one displaying the warning 'Smoking kills'; one featuring the word 'TOXIC' and a skull and crossbones image; and two unattractively colored cigarettes (darker and lighter green). For comparison, participants were also shown a standard cigarette (white cigarette paper and imitation cork filter). All four dissuasive cigarettes were considered less attractive and more harmful than the standard cigarette, particularly among never-smokers. Some participants considered the green cigarettes to be ugly, and the on-cigarette warnings to be embarrassing and off-putting. Although reactions were mostly negative for all four dissuasive cigarettes, participants considered the on-cigarette warnings more off-putting than the green cigarettes. Participants did not generally believe that the dissuasive cigarettes would encourage cessation among established smokers, but that they may deter uptake among young people. [ABSTRACT FROM AUTHOR]

The authors of this paper discuss the use of participatory and visual research methods with older adults with daily care needs in the United Kingdom. The comments made by older adults and their caregivers in focus groups provided the narrative for this paper. The authors also discuss how to engage older adults in participatory research. Nursing research and practice both involve evaluating processes to gain a holistic understanding of patients through multiple means of data collection. In other words, how do nurses give voice to otherwise silent older adults, even in cases when their strength and recall is failing? [ABSTRACT FROM AUTHOR]

Aim To present the actions taken by the Scottish Dementia Clinical Research Network (SDCRN) to comply with Scotland's National Dementia Strategy (SNDS) on patient and public involvement (PPI). Background Tackling priorities in dementia research is paramount to success in planning and delivering effective health services. Identifying such priorities is a task that should involve patients with dementia and their carers. Aware of the potential importance that the public has in shaping the future of dementia research, the Scottish Government has launched an initiative that places PPI at its core. The SDCRN, funded by the Chief Scientist Office, has responded to this initiative and has developed a strategic PPI agenda. Data sources Experience of developing and implementing an extensive range of PPI activities with patients with dementia and their carers in Scotland. Review methods This is an informative paper. Discussion The paper discusses the strategy that the SDCRN has adopted to comply with government PPI priorities, thus supporting the strategic agenda for Scottish topic-specific research networks. Conclusion The challenges that researchers face when engaging with patients with dementia and their carers can be overcome by promoting a culture that supports dementia research. Through the development of the PPI strategy, the SDCRN has encouraged and enabled the public to become active partners in research. Implications for practice/research Involving the public in dementia research is a priority. This paper highlights how this can be achieved through extensive partnership working, collaboration and the implementation of various PPI activities to allow the public to play a major influential role in the development of future dementia services. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to examine the persistent challenges in implementing care management within the context of integration. In addition the appropriateness of the care management model will be considered within the current, personalization focused, health and social care policy landscape. The paper draws upon a recent evaluation of a care management and assessment pilot project within a health and social care partnership in Scotland. Design/methodology/approach – A multi-method approach was adopted, including interviews, vignettes and focus groups, in order to capture data around expectations in relation to the pilot as well as exploring processes and outcomes for those involved. Findings – This paper argues that whilst progress has been made with regard to care management, specific and persistent challenges remain. Professional and organizational boundaries, communication and information sharing remain key challenges. Policy imperatives have shifted the emphasis in community care services towards self-care, co-production and personalization contributing to a lack of clarity over the place of care management within the broader integration agenda. Research limitations/implications – This research was undertaken in one partnership locality in Scotland and as such the findings are related to that particular area. However, the key messages arising from this paper resonate with the broader academic literature on care management and as such are likely to be of interest to a broader audience. Originality/value – This paper brings together integrated working, care management and the developing policy framework of self-care to consider the challenges for care management in this context. [ABSTRACT FROM AUTHOR]

ABSTRACT This paper draws on the findings of a research study that examined the factors that influence local decision-making in cases where a child or young person is being considered by residential workers, social workers and senior managers for placement in a secure unit. After outlining the research problem and case study approach taken, the paper focuses on explicating the findings of the study that relate to the impact of group membership, goals, roles and norms on group performance in such cases. The paper illustrates how attending to these four areas, and the way in which power relations impact on them, may help those developing and managing groups to improve decision-making practice. [ABSTRACT FROM AUTHOR]

Despite a substantial body of research on young people's wishes about the content and delivery of sex and relationships education (SRE), studies still indicate dissatisfaction with the way lessons are provided. This discussion takes place in a public health context where young people's sexual activity is viewed negatively as a risk to health, and advice focusses on the need to prevent unwanted pregnancies and sexually transmitted infections. This focus on risk clashes with cultural representations of sexuality, and particularly male sexuality, which focus on pleasure and risk taking. In this paper, we present insights from workshops provided by a local charity to boys aged 14–15 in a school in one of the most deprived areas in Edinburgh, Scotland. We held four focus groups with a total of 20 boys and interviewed the workshop providers and the school guidance teacher. The boys valued having men from outside school talking to them about sex and relationships in ways that made them feel respected. They were keen to learn more about relationships, highlighting the need to focus on how SRE is delivered to young working class men. [ABSTRACT FROM AUTHOR]

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Aims and objectives This paper aims to explore student nurses' experiences of bioscience learning, teaching and application within the practice setting. It draws upon the social learning theory of communities of practice to consider the issues raised. Background The teaching of bioscience within many nursing curricula has shifted from traditional to more integrated approaches. Student nurses recognise bioscience as a valuable component of their studies, but many find it challenging. The focus of previous research in this area has often focussed on bioscience learning in theoretical rather than practice settings. Design A phenomenological study. Methods Data were collected via focus group or interview with a total of seven students across two campuses in a Scottish university. Participants were offered the opportunity to share their experiences at both the end of year one and year two of their studies. A thematic analysis was undertaken independently then jointly by the authors. Results The findings suggest that although participants recognise the value of bioscience within practice settings, they found that opportunities for learning were often limited. Bioscience-related learning, teaching and application was perceived to have been given less legitimacy by the practice setting than other aspects of placement activity. To enhance bioscience approaches participants expressed a desire for more structured and integrated approaches within both practice and university along with further peer learning opportunities. Conclusions Students recognise that bioscience knowledge is important in relation to the provision of safe and effective care. They request greater structure and consistency in relation to the learning, teaching and application of this topic during their placements. Relevance to clinical practice Those with a stake in educating nurses within clinical settings may find the views of student nurses on the topic of bioscience learning useful when planning and facilitating placement experiences. [ABSTRACT FROM AUTHOR]

This paper explores issues around stigmatisation and labelling as they pertain to pupils with SEBD. The paper draws upon an evaluative case study, conducted in two Scottish local authorities, of the implementation of support groups, and examines how the approach was experienced by pupils who participated within the intervention, drawing from a range of accounts. The study was implemented in upper primary (aged 10–12) and lower secondary (aged 12–14). It is principally qualitative and draws upon data generated from open questionnaires, interviews and focus group discussions. Pupil responses to intervention were largely positive, but there was evidence that a minority of children had experienced the intervention as stigmatising. Variables relating to the establishment of trusting and respectful relationships within the group, partnerships with parents, professional development for staff and the adoption of a whole-school approach emerged as key variables in determining how pupils experienced the intervention. [ABSTRACT FROM PUBLISHER]

Purpose The purpose of this paper is to review the Mental Health Foundation’s experiences designing, implementing and evaluating peer-focused self-management programmes. Through a discussion of barriers and good practice, it outlines ways to be successful in making such projects work to improve mental health and wellbeing among at-risk populations.Design/methodology/approach A total of 11 Mental Health Foundation programmes implemented over the past ten years were reviewed through reading manuals and publications and interviewing programme managers. Key data were extracted from each programme to analyse trends in aims, outcomes and recommendations.Findings Through a focus on peer-work, programmes taught individuals from a variety of societal sectors self-management skills to effectively deal with life stressors. Through sharing in non-judgmental spaces and taking ownership of programme design and content, individuals realised improvements in wellbeing and goal achievement.Practical implications Good practice, barriers and recommendations can be taken from this review and applied to future peer-focused self-management programmes. By better embedding quantitative and qualitative evaluations into programme development and implementation, programmes can add to the evidence base and effectively target needs.Originality/value This review lays out valuable experience on an innovative community service paradigm and supports the evidence on effectiveness of peer-focused self-management programmes with a variety of group populations. [ABSTRACT FROM AUTHOR]

A novel multi-location longitudinal focus group method was deployed as part of a doctoral study on the role of UK public libraries. This work was completed part-time at Edinburgh Napier University between 2013 and 2020. Over a period of three years, fifty-three participants took part in three rounds of focus group meetings in eight public library authorities in England and Scotland. The collection of data in this manner offered several advantages for the assembly of a rich data set for qualitative analysis. In particular, the revisiting of project themes on three occasions supported an increase in the level of sophistication and depth of discussion amongst the study participants. The main drawback of the approach was participant attrition. [ABSTRACT FROM AUTHOR]

Purpose – Current policy context in the UK promotes the "co-production" of health and care services – with service users and providers working in partnership. However, the assumption that all individuals and communities have the personal resources, skills and willingness to get involved in co-produced services may have implications for social and geographical equity of access to health and care services. The paper presents the results of a nine-month action research project with a remote and rural community in Scotland to discuss the implications of co-produced health and care services for remote and rural community members – particularly those with ageing populations. Design/methodology/approach – The research project worked with community members, health care providers and commissioners to develop a community social enterprise model for home care delivery. Textual resources collected during this action research process were subject to thematic analysis in order to explore community perceptions and experiences of service co-production development in the remote and rural context. Findings – The qualitative analysis showed that community members identified some positive aspects of being involved in service co-production relating to sense of community, empowerment and personal satisfaction. However, negative impacts included increased feelings of pressure, strain and frustration among those who took part in the co-production process. Overall, the community was reluctant to engage with "transformative" co-production and traditional provider-user dynamics were maintained. Originality/value – The example is used to demonstrate the types of resources that rural individuals and communities draw on in order to create social enterprises and how the potentially negative impacts of co-produced services for different types of social and geographical community may be overlooked in contemporary policy and practice. [ABSTRACT FROM AUTHOR]

Background As quality improvement (QI) programmes have become progressively larger scale, the risks of implementation having unintended consequences are increasingly recognised. More routine use of balancing measures to monitor unintended consequences has been proposed to evaluate overall effectiveness, but in practice published improvement interventions hardly ever report identification or measurement of consequences other than intended goals of improvement. Methods We conducted 15 semistructured interviews and two focus groups with 24 improvement experts to explore the current understanding of balancing measures in QI and inform a more balanced accounting of the overall impact of improvement interventions. Data were analysed iteratively using the framework approach. Results Participants described the consequences of improvement in terms of desirability/undesirability and the extent to which they were expected/ unexpected when planning improvement. Four types of consequences were defined: expected desirable consequences (goals); expected undesirable consequences (trade-offs); unexpected undesirable consequences (unpleasant surprises); and unexpected desirable consequences (pleasant surprises). Unexpected consequences were considered important but rarely measured in existing programmes, and an improvement pause to take stock after implementation would allow these to be more actively identified and managed. A balanced accounting of all consequences of improvement interventions can facilitate staff engagement and reduce resistance to change, but has to be offset against the cost of additional data collection. Conclusion Improvement measurement is usually focused on measuring intended goals, with minimal use of balancing measures which when used, typically monitor trade-offs expected before implementation. This paper proposes that improvers and leaders should seek a balanced accounting of all consequences of improvement across the life of an improvement programme, including deliberately pausing after implementation to identify and quantitatively or qualitatively evaluate any pleasant or unpleasant surprises. [ABSTRACT FROM AUTHOR]

Abstract: Health and social care integration has been a long‐term goal for successive governments in Scotland, culminating in the implementation of the recent Public Bodies (Joint Working) Scotland Act 2014. This laid down the foundations for the delegation of health and social care functions and resources to newly formed Integrated Joint Boards. It put in place demands for new ways of working and partnership planning. In this article, we explore the early implementation of this Act and how health and social care professionals and the third sector have begun to renegotiate their roles. The paper draws on new empirical data collated through focus groups and interviews with over 70 professionals from across Scotland. The data are explored through the following key themes: changing cultures, structural imbalance, governance and partnership and the role of individuals or “boundary spanners” in implementing change. We also draw on evidence from other international systems of care, which have implemented integration policies, documenting what works and what does not. We argue that under the current framework much of the potential for integration is not being fulfilled and that the evidence suggests that at this early stage of roll‐out, the structural and cultural policy changes that are required to enable this policy shift have not yet emerged. Rather, integration has been left to individual innovators or “boundary spanners” and these are acting as key drivers of change. Where change is occurring, this is happening despite the system. As it is currently structured, we argue that too much power is in the hands of health and despite the rhetoric of partnership working, there are real structural imbalances that need to be reconciled. [ABSTRACT FROM AUTHOR]

By providing a place in which children can be accessed, the school has long been a site for population-level health initiatives. Recent policy shifts towards health-promoting schools have however re-cast the school from passive host to active collaborator in public health. This paper examines secondary school teachers' views of their roles as partners in Scotland's human papilloma virus vaccination programme. Focus groups were held in seven schools across Scotland. Confusion was evident in relation to this role, with competing understandings of young women's sexuality, concerns about parental perceptions and uncertainty about professional responsibilities. Many teachers sought to distance themselves from the vaccination programme. Evidence was found of a ‘sedimentation of discourses’, as mass models of state-sanctioned health intervention persist alongside contemporary discourses of individual choice. [ABSTRACT FROM PUBLISHER]

Background: As the detection of, and treatments for cancer improve, more people are living with the disease. For many, getting back to paid work represents a return to normality and financial security. Recently there have been changes in British legislation relating to employment and equality, notably the Equality Act (2010). Content: The cancer charity, Macmillan Cancer Support and the Scottish Centre for Healthy Working Lives developed a resource, a DVD and booklet, to raise employers' awareness to issues experienced by cancer patients. This paper will look at the evaluation of this resource, and of its potential benefit to help those involved in the rehabilitation of cancer patients. The evaluators took a qualitative approach, using data from discussions with the producer of the resource, and the opinions of those who would use it. In the evaluation, 21 representatives from human resource and occupational health departments of small private companies, charity organisations, NHS and governmental departments attended one of four focus group meetings. Most participants noted that bringing the subject of 'cancer in the workplace' 'out into the public domain' was a positive attribute of both the DVD and booklet. Conclusion: This paper explores the potential benefit of an educational resource. Based on the recommendations from this evaluation, changes have been made and are widely available to the general public via the Macmillan Cancer Support website. [ABSTRACT FROM AUTHOR]

This paper reports findings from an exploratory qualitative study concerning end-of-life support for family carers in an acute ward setting. The participants included bereaved carers of patients who had died in an acute ward or hospice, as well as health professionals. Interviews and focus groups were used to collect data. The study provides insights into the perceptions and needs of carers at the end of life and the challenges these present for nursing staff in an acute ward. This paper focuses on one key theme incorporating issues around communication between family and nursing staff and the availability of practical facilities. It provides information that may be beneficial to hospital staff who work in acute areas where there is an expectation they will support carers around the time of death. [ABSTRACT FROM AUTHOR]

The objective of this article is to explore how education for innovation of our young people may help develop an innovative mindset. The article develops the theoretical justification of a skills set which, it is argued, is fundamental for the development of an innovative mindset of young people, and consequently their personal development. We focus here on the qualitative work - focus groups and interviews with teaching staff and students aged 14-19 years - that informed our understanding of the five characteristics of this mindset; leadership, creativity, self-efficacy, energy and risk-propensity. The research attempted to capture the differences in context, constraints and school types and ethos that potentially shaped behavioural expression. Case studies based on types of school revealed detailed differences in context - regional, local and personal - that shaped students' engagement and their innovative behaviour in particular. The paper also reflects on teaching style, extracurricular opportunities for skills' development and student motivation to acquire an innovation skills set. The paper reflects on practical and policy implications of this work and identifies areas for further research. [ABSTRACT FROM AUTHOR]

This paper focuses on the role of actors that operate outside formal health systems, but nevertheless have a vital, if often under-recognised, role in supporting public health. The specific example used is the ‘social enterprise’, an organisation that seeks, through trading, to maximise social returns, rather than the distribution of profits to shareholders or owners. In this paper we advance empirical and theoretical understanding of the causal pathways at work in social enterprises, by considering them as a particularly complex form of public health ‘intervention’. Data were generated through qualitative, in depth, semi-structured interviews and a focus group discussion, with a purposive, maximum variation sample of social enterprise practitioners (n = 13) in an urban setting in the west of Scotland. A method of analysis inspired by critical realism – Causation Coding – enabled the identification of a range of explanatory mechanisms and potential pathways of causation between engagement in social enterprise-led activity and various outcomes, which have been grouped into physical health, mental health and social determinants. The findings then informed the construction of an empirically-informed conceptual model to act as a platform upon which to develop a future research agenda. The results of this work are considered to not only encourage a broader and more imaginative consideration of what actually constitutes a public health intervention, but also reinforces arguments that actors within the Third Sector have an important role to play in addressing contemporary and future public health challenges. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? According to estimates more than half of adult mental health service users are parents, but their experiences are largely lacking from research literature., Parental mental illness can often be viewed from a risk perspective., Parents with mental illness and their families have unmet support needs., What this paper adds to existing knowledge? Parents with mental illness want acknowledgement that they can be able and responsible., Many parents adopt an expert by experience identity., Fathers can feel their parental role is not recognized and mothers express fears of being judged if they discuss their illness., What are the implications for practice? Adult mental health services need to recognize and support parental role of service users., Joint care planning and family oriented care should be promoted., Professionals should take advantage of the knowledge of these parents and they could be more actively engaged in service development., Abstract Introduction Parental mental illness is often viewed from a risk perspective. Despite this, being a parent can be both valuable and motivating. Research literature lacks the perspective of mothers and fathers, who have experienced mental illness. Aim This study explores how parents with mental illness construct their identities as mothers and fathers and their experiences with health and social care services. Method Three focus groups with 19 participants were conducted in Finland and Scotland. Methods of discourse analysis have been used in to analyse the interview data. Results Adult service users want their parenting role recognized and supported. Parents have knowledge and skills which can be utilized and many have adopted an expert by experience identity. Discussion Being able to see oneself as a 'good' parent can be challenging but important. Parents may require support, but want to be included in the planning of their care. Services could make more use of the knowledge and skills parents and families have, and joint working could lessen parents' anxieties. Implications for practice Mental health practitioners are in a key position in providing more family centred, resource focused care. Service user expertise should be acknowledged in clinical practice. [ABSTRACT FROM AUTHOR]

Background and aims Regulation of electronic cigarettes has moved to the top of the addiction policy agenda, as demonstrated by the recent focus across the United Kingdom on introducing age-of-sale restrictions. However, the views of those affected by such regulation remain largely unexplored. This paper presents the first detailed qualitative exploration of adolescents' perceptions of existing, and opinions about potential e-cigarette regulation. Methods Sixteen focus groups, including a total of 83 teenagers between the ages of 14 and 17 years, were conducted in deprived, mixed and affluent urban areas in Scotland and England between November 2014 and February 2015. Transcripts were imported into Nivivo 10, coded thematically and analysed. Results Participants critically considered existing evidence and competing interests in regulatory debates and demonstrated sophisticated understanding of the advantages and disadvantages of regulation. They overwhelmingly supported strong e-cigarette regulation and endorsed restrictions on sales to minors, marketing and e-cigarette use in public places. Concern about potential health harms of e-cigarette use and marketing increasing the acceptability of vaping and smoking led these adolescents to support regulation. Conclusions In focus group discussions, a sample of UK adolescents exposed to particular communications about e-cigarettes supported strict regulation of e-cigarettes, including banning sales to minors and use in indoor public areas. [ABSTRACT FROM AUTHOR]

Nonprofits are increasingly involved in collaborative governance mechanisms, on the premise that their proximity to end users and better understanding of the local contexts can lead to better policy outcomes. Although government–nonprofit relations have been theorized and explored by several studies, few studies have examined specifically collaborative governance, instead focusing on other phases of policy development or service delivery. In this article, we present a realist evaluation of data gathered from in-depth semi-structured interviews (N = 41) and four focus groups with stakeholders involved in collaborative governance arrangements within "Strategic Public Social Partnerships" in Scotland. Our findings indicate that collaborative governance processes involving nonprofits can potentially lead to improved services through mechanisms such as the development of trust and the establishment of new learning dynamics, and when knowledgeable leadership and mutuality drive collaborations. However, this is only true if the long-term sustainability of these processes translates into the mainstreaming of both the resulting services and their underlying collaborative principles. [ABSTRACT FROM AUTHOR]

The purpose of the National Dermatology Improvement Project was to identify the educational requirements of dermatology nurses and understand factors impacting the uptake of education for nurses. An educational needs analysis was performed to evaluate the strengths and weaknesses of current and future educational provision for all levels of nursing staff. Data were collected from department managers using questionnaires and interviews, and focus groups were held with nursing staff in bands 2–7. The majority of participants felt there was an overall lack of dermatology education, and that most of what was available was peer led and experiential. A number of barriers to the uptake of education were also identified, such as a lack of time, opportunity and motivation. These findings support the need for a nationally coordinated programme of dermatology education with formal and informal education provided for all levels of dermatology nursing staff. [ABSTRACT FROM AUTHOR]

Background: Our aim was to use participatory methods to investigate the feasibility and acceptability of using Bingo clubs for the design and delivery of an evidence-based physical activity and/or healthy eating intervention to socio-economically disadvantaged women. This paper describes the participatory process that has resulted in a physical activity intervention for women aged >55 years, ready for pilot-testing in a Bingo club setting.Methods: Studies using different quantitative and qualitative approaches were conducted among customers and staff of a Bingo club in a city of 85,000 inhabitants in central Scotland. These were designed to take the views of different stakeholders into account, with a view to enhancing uptake, engagement and effectiveness with any proposed intervention.Results: Sixteen relevant studies were identified in a literature review that generated ideas for intervention components. A questionnaire completed by 151 women in the Bingo club showed that almost half (47 %) aged >55 years were not meeting physical activity guidelines; evidence backed up by accelerometer data from 29 women. Discussions in six focus groups attended by 27 club members revealed different but overlapping motivations for attending the Bingo club (social benefits) and playing Bingo (cognitive benefits). There was some scepticism as to whether the Bingo club was an appropriate setting for an intervention, and a dietary intervention was not favoured. It was clear that any planned intervention needed to utilise the social motivation and habitual nature of attendance at the Bingo club, without taking women away from Bingo games. These results were taken forward to a 5-h long participative workshop with 27 stakeholders (including 19 Bingo players). Intervention design (form and content) was then finalised during two round table research team meetings.Conclusions: It was possible to access and engage with women living in areas of socio-economic disadvantage through a Bingo club setting. A physical activity intervention for women >55 years is realistic for recruitment, will address the needs of potential recipients in the Bingo club, appears to be feasible and acceptable to club members and staff, and has been designed with their input. A pilot study is underway, investigating recruitment, retention and feasibility of delivery. [ABSTRACT FROM AUTHOR]

For migrant children, moving to a new country is marked by excitement, anxiety and practical challenges in managing this significant transition. This paper draws upon the concepts of social capital and social networks to examine migrant children's access to services post‐migration. Using data from a qualitative study with Eastern European families in Scotland, we identify a range of cumulative barriers that limit children's access to services and illustrate how their experiences are shaped by ethnicity, social class and place. The study shows that migrant children are often disadvantaged post‐migration and develop their own mechanisms to mitigate the impact of migration on their lives. We argue that migrant children's own social networks are relevant and they need to be analysed through a more individualised approach. [ABSTRACT FROM AUTHOR]

This paper is based on analysis of data collected for a study, commissioned by the Scottish Government, which examined child protection work with disabled children. At a conceptual level, the paper draws on Goffman's frame analysis and on different models of disability. Focus groups were conducted with five Child Protection Committees (40 individuals) and semi-structured interviews with a further 21 practitioners from social work, education, health services, third sector organisations and the police. The findings show that, for various reasons, abuse of disabled children may go undetected. Where it is suspected, effective action does not always follow, for example, where practitioners over-empathise with parents. When child protection work is undertaken, disabled children may remain relatively invisible in terms of participation and professional focus. It is suggested that the ways in which practitioners and managers “frame” disabled children has implications for how abuse is responded to and how well these children are protected. Participants also “framed” disability in different ways, and it is suggested that a social relational model seems particularly applicable. In conclusion, in many respects disabled children experiencing abuse may remain absent from or to some extent hidden within child protection services in Scotland. While some creative work is taking place, considerable changes are required to make child protection services accessible to all disabled children, sensitive to their needs and respectful of their rights. [ABSTRACT FROM AUTHOR]

Children's perspectives literature repositions children and young people as active participants in surviving domestic abuse, protecting their family, opposing the violence and recovering from abuse. However, key tenets of safeguarding in relation to domestic abuse, both in practice and childhood research ethics, struggle to fully recognise children's agency and the need to empower children and young people as well as women. Children's right to participation now extends to national policy-making in many countries, yet has not been explored in relation to the interdependency of women and children's rights, safety and wellbeing where both have been subject to abuse. This paper challenges the current exclusion of young voices from the development of ethical praxis. It outlines a participatory ethical approach that promotes the inclusion and empowerment of young survivors in research and policy. Young expert advisors on Scottish domestic abuse policy (2009-11) co-develop the approach (participatory action research) which is informed by a wider study (2004-11) about children's help-seeking and solutions for practice. Mullender et al.' s accepted model of three Cs and Ds (consent, confidentiality, child protection: danger, distress, disclosure) are adapted to focus on children's agency. Three Es are added focusing on children's power and impact: enjoyment, empowerment and emancipation. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Messages Children and young people have a distinct, essential voice in risk assessment and management., They are competent and central decision-makers, they can consent to participation., Participation can be a powerful therapeutic tool., Enjoyment, empowerment and emancipation are intrinsic to participation, alongside recognition of children's agency in safeguarding., Access to power, equal voice and impact on children's lives are preconditions of participation to young survivors - to be worth the inherent risk of speaking out. [ABSTRACT FROM AUTHOR]

This paper presents some of the key findings of a study investigating the introduction of the Graded Care Profile (GCP) - a tool used in the assessment of child neglect - in one Scottish local authority where neglect is the primary reason for which nearly half of all children are placed on the Child Protection Register. The findings suggest that while there are some advantages to the use of the GCP there are also a number of significant questions about previous claims made about its objectivity and value-neutrality, its user-friendliness and its ability to generate good partnership working with parents, particularly where there are substantive disagreements about the quality of care. Copyright © 2013 John Wiley & Sons, Ltd. Key Practitioner Messages: The GCP is used to identify and respond to neglect., This study examined the perspectives of parents and practitioners about the GCP in one Scottish area., It found a favourable response to the way that the GCP breaks down the parenting task into more specific areas., Identified difficulties included the abstract language in the GCP and positive parental engagement where there were substantive disagreements about the quality of care. [ABSTRACT FROM AUTHOR]

Purpose:  The view of the patient is central to their care. Focus group methodology has been used in health psychology to capture patient views on health and illness. However, the process of conducting focus group research with patient groups has received scarce attention. The purpose of this paper was to highlight lessons learned from the conduct of focus groups in psychological research with chronic pain samples., Methods:  Lessons were taken from three structured focus groups containing participants recruited from General Practice. Each group contained five, four, and six chronic pain sufferers from upper, middle and lower socioeconomic areas, respectively., Results:  Nine lessons were learned about the conduct of focus group research in general, and also with chronic pain sufferers in particular. The lessons relate to (1) translating study interest into group attendance, (2) ensuring the environment maximizes the opportunity to learn from participants, (3) understanding participant motivations for attendance as well as (4) what participants take from the group, (5) ensuring adequate question specificity, accommodating the needs of particular groups in (6) moderation style and (7) discussion time scales, (8) considering the function of conflict in the group and (9) paying due attention to simultaneous dialogue. Recommendations for addressing the lessons are made., Conclusion:  Patient groups have specific requirements and the conduct of focus groups should be driven by these needs to maximize inclusion and quality contributions in the group. Time, resources, and flexibility are needed to ensure the successful transition of these groups into focus group research., (©2011 The British Psychological Society.)

Using evidence from a participatory action research process with over 100 asylum seekers and refugees in Scotland, this study explores participants’ views on mental health problems, stigma and discrimination. The study found that migration can have adverse effects on mental health and well-being, due to racism and the asylum process, and this is worsened by stigma and discrimination. This stigma is influenced by both social and cultural causal factors, including fear, past trauma, isolation, racism and the stress of the asylum process coupled with negative cultural beliefs about mental health problems. The paper considers the international relevance of this approach and the value of a model grounded in principles of community development and grassroots action. [ABSTRACT FROM AUTHOR]

Background: Complex programmes are characterised by multiple components, acting independently and interdependently, at multiple levels, within diverse and dynamic systems. High-quality evaluation of such programmes is imperative for optimising their development, implementation and effectiveness, but is often challenging. There is debate about whether the traditional outcome-focused approaches are feasible or appropriate for evaluations of large-scale, complex programmes as they often fall short of explaining how and why they do or do not work. Theory-driven approaches offer a more appropriate alternative as they attempt to uncover the black-box between the programme's inputs and the resulting complex pattern of outcomes. Aim: This paper illustrates drawing upon a realist evaluation to assess a complex programme to support normal birth. Method: Firstly, the programme theories - the ideas about how the programme would bring about change - were elicited from programme developers and key stakeholders. Secondly, these initial hypotheses were tested out by collecting data on how the programme worked in different contexts, using a multiple case study design. Thirdly, the data were analysed and interpreted to refine the programme theories in light of evidence on how the programme unfolded in practice. Findings: Described in detail are the process of conducting a realist evaluation, methods used, steps in data analyses, challenges encountered and the approach adopted to overcome them. The usefulness of this approach and some limitations are discussed. [ABSTRACT FROM AUTHOR]

Minimum Unit Pricing (MUP) is one of the Scottish Government's key policy options to reduce alcohol consumption and related harm. Although strongly evidenced for efficacy in reducing headline population level consumption, efficacy in changing the role of alcohol in Scottish culture is unknown. Questions remain as to how MUP will play across population subgroups with different sensitivities to price. In this paper we explore the views of the young adult population and situate the influence of price paid for alcohol alongside broader cultural drivers of consumption. Qualitative data from two studies investigating the role of alcohol in the transition to adulthood from 130 participants (aged 16-30) are analysed to situate the influence of price paid in shaping drinking styles and practices. Findings highlight how considerations of price paid for alcohol compete with non-financial considerations associated with choosing to drink excessively, moderately or not at all. Two broad categories of response to potential price increases were anticipated by drinkers which indicate that young adults are not a homogenous group in relation to price sensitivity. These differences highlight the potential for variation in subgroup responses to a pricing policy conceived to be effective at a population level. [ABSTRACT FROM AUTHOR]