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BackgroundPublic health approaches to end of life are a relatively recent development; hence research methodology in this area is also being developed.AimA workshop for practitioners and researchers describing methodologies used by an end of life public health programme to develop and test interventions and assess the needs and potential for success of further work.MethodsDuring the workshop we will describe the methodologies used in a programme which aimed to reframe death and loss as social event and additionally included participatory approaches and engaging communities. Mixed methods approaches of direct observational methods, longitudinal questionnaire surveys to determine both immediate and sustained effectiveness of interventions and also semi-structured interviews will be described. The workshop will present this work, reflect on other methodologies that could be used; discuss what worked well and not so well, and encourage discussion of other people’s research in this area and further development. The importance of retention and follow up of participants will be discussed as will issues regarding qualitative interviewing in this area and further interventions regarding how participants can be encouraged to share their thoughts and ideas re public health and palliative care thereby helping to shape the practical and research agenda. The subject and value of evaluation as opposed to research will also be discussed.ConclusionAt the end of this workshop, researchers and practitioners wishing to evaluate and research their programmes will have gained a better understanding of the theoretical and practical applications of research and evaluation.

BackgroundSocietal barriers to open discussion of personal feelings and preferences relating to death may hinder planning for end of life and supporting people who are dying or bereaved.AimTo explore views about talking about death, dying and loss.MethodSemi-structured interviews were conducted with 31 people; age range 30 to 83 years.ResultsMaking wills and communicating end of life wishes were considered very important; mostly for the sake of the family left behind. Participants also valued confidence to discuss other people’s end of life wishes and support them appropriately if they were dying or bereaved. Many participants were very comfortable talking about their own death.Identified barrier to talking about end of life wishes included not wanting to upset others; others not listening; not being about to find an appropriate moment; not knowing enough about the options available; and fear of death, especially of the unknown. Financial costs were seen as a barrier to making a will. Participants talked of the importance of raising awareness of what death and dying involves; what end of life options available; and the importance of communication. Information on the process of normal grieving and how to support somebody who has been bereaved were also suggested.ConclusionBeing able to talk about end of life wishes and know how to support people who are dying or bereaved are important to many people, and they would welcome interventions to facilitate this at a societal level.

BackgroundDeath is universal. Only 37% of adults have a will and 48% have stated their wishes regarding cremation or burial.1Planning and communication can help prevent some of the distress associated with dying and bereavement.AimTo evaluate an intervention to encourage people to plan for the end of their life and to communicate their wishes to those closest to them.MethodTwo interventions were delivered via community groups:‘Awareness’ presentations aimed to raise awareness of benefits of preparing and talking about end of life issues.‘How to’ workshops aimed to give people confidence and tools to open relevant conversations. To evaluate their impact, we conducted a 3-stage questionnaire survey; administered before, immediate after and 3 months after events.ResultsAt baseline (n = 498; 76% female) 76% had previously discussed end of life care or wishes after death. Most were comfortable talking about these subjects, giving a mean score of 8.28/10. At follow-up (n = 133); 60% indicated they had made changes following the event; 43% had talked about their own end of life wishes, 9% for the first time; and 39% reported making other changes. The change in the proportion of people who had ever talked about their own end of life wishes was statistically significant (p = 0.033).ConclusionWell designed community events can improve planning and communication of end of life preferences among general population.ReferenceDying Matters Survey http://www.comres.co.uk/polls/Dying_Matters_Public_April12.pdf

AimThe overarching aims of the Cheshire Living Well, Dying Well Programme are to improve health and well-being by supporting a change in public knowledge, attitude and behaviour towards death, dying and loss and therefore make living well and dying well the norm.BackgroundSt. Luke’s Cheshire Hospice engaged in a community consultation process which highlighted that local partner organisations supported a co-ordinated public health approach to raise awareness and change behaviours in relation to death and loss. St. Luke’s secured funding and a commitment of engagement from Macmillan Cancer Support, which included establishing a dedicated role to centrally lead and drive forward the agenda in Cheshire.MethodologyAs death, dying and loss is a cross-cutting issue, it is important that a multi-faceted approach is developed and delivered in partnership. It is also important that the work is championed and embedded at strategic, operational and community level. The programme of work provides structure and support to enable partners to work together towards achieving the shared aim.Findings and RecommendationsFollowing consultation, six strategic areas have been identified; Partnership and Strategy Development, Financial Housekeeping and Future Planning, Resource Development, Public Education, Compassionate Communities and Healthy Workplace.The work is also being championed at Health and Well-being Board Level.Highlights include:The formal launch and implementation of Cheshire Living Well, Dying Well PartnershipIdentification of Cheshire Living Well, Dying Well ChampionsDevelopment and implementation of a range of resources (including support and training sessions for the public, staff and volunteers)Development and implementation of Compassionate Community Volunteer ModelsPresentation of the Programme at a local, regional, national and international levelConclusionImproving the well-being of communities by normalising death and loss is a multi-agency issue and not singularly confined to those in the health arena.This innovative approach identifies and enables partnership activity and the collation of evidence to progress further, with a view to mainstreaming the work.