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ObjectivesDuring the COVID-19 pandemic, the UK government and public health leaders advocated for community level responses to support vulnerable people. This activity could be planned and co-ordinated, however much was informal and developed organically. The effects on the individuals who were involved in providing and receiving informal support and implications for their communities have not been widely explored. The aim of this study was therefore to document and explore the nature, potential effects and longevity of community responses to the COVID-19 pandemic.ParticipantsWe asked 15 individuals in North West England to keep a diary during the first UK COVID-19 lockdown. Over 8 weeks, diaries were completed and supported with weekly calls with researchers. A community capacity building framework was used to explore reported community responses to the COVID-19 pandemic.ResultsDiarists described community characteristics that enabled and hindered helpful responses in the lockdown context. Diarists frequently described informal approaches with residents acting alone or with near neighbours, although there were examples of community networks and residents recommencing formal volunteering activities. Diarists reported communities providing practical help and social support to vulnerable people. Participants perceived a greater sense of community, increased contact between residents and new networks during the period covered.ConclusionThe diaries provided valuable insights and the framework was a useful tool to explore the COVID-19 lockdown context. The findings indicate that organic capacity building took place, primarily via individual agency, highlighting the risk of communities being ‘left behind’ if there were not individuals or community networks available with resources to plug gaps in organisational support. Recommendations to sustain helpful responses to the pandemic include further consideration of ongoing community mobilisation, empowerment and community control within the capacity building framework.

Background There is a strong national drive within the UK government and National Health Service for social prescribing. Previous research studies have mainly focused on service user perspectives and evaluating their experiences. There is limited evidence on how the general public perceive and understand what social prescribing is and how these views could influence service planning and delivery. This paper seeks to understand perceptions of social prescribing within the wider community. Methods Semi-structured focus groups were conducted with 37 members of the public in four areas in north-west England. We explored public awareness and understanding of social prescribing. Results Limited knowledge of the term social prescribing was found amongst participants as well as limited involvement in community discussions of the topic. Concerns were raised about the short-term nature of activities and the need for adequate resourcing to support continuity of service provision. The social prescribing link worker was considered to be important in supporting engagement with services and it was preferred this role was undertaken by people with local knowledge. Conclusions The findings provide evidence of public perspectives on social prescribing and highlight how wider community perceptions can supplement service user feedback to support social prescribing service planning, commissioning and delivery.

The social and economic consequences of COVID-19 have the potential to affect individuals and populations through different pathways (e.g., bereavement, loss of social interaction).This study adopted a solicited diary method to understand how mental health was affected during England's first lockdown. We also considered the experiences of diary keeping during a pandemic from the perspective of public participants.Fifteen adults older than 18 years of age were recruited from northwest England. Diarists completed semistructured online diaries for 8 weeks, which was combined with weekly calls. A focus group captured participants' experiences of diary keeping.Four key factors influenced mental health, which fluctuated over time and in relation to diarists' situations. These concerned navigating virus risk, loss of social connections and control and constrictions of the domestic space. Diarists also enacted a range of strategies to cope with the pandemic. This included support from social networks, engagement with natural environments, establishing normality, finding meaning and taking affirmative action.Use of diary methods provided insights into the lived experiences of the early months of a global pandemic. As well as contributing evidence on its mental health effects, diarists' accounts illuminated considerable resourcefulness and strategies of coping with positive effects for well-being. While diary keeping can also have therapeutic benefits during adversity, ethical and practical issues need to be considered, which include the emotional nature of diary keeping.Members of the public were involved in interpretation of data as well as critiquing the overall diary method used in the study.

Purpose: Strengthening research capacity (RC) amongst health professionals has both organisational and individual benefits. It can increase the quality of research and support the transfer of evidence into practice and policy. However there is little evidence on what works to develop and strengthen RC. This paper contributes to the evidence base by reporting findings from an evaluation of a programme that aimed to build capacity to use and do research amongst NHS and local authority organisations and their staff in a large english research partnership organisation. Methods: The evaluation used multiple qualitative methods including semi-structured interviews, focus groups and workshops (n=131 respondents including public advisers, university, NHS, and local government partners). Results: The RC building programme provided a range of development opportunities for NHS and local authority staff resulting in increased confidence and skills to undertake, participate in, and use research. Additionally, positive influences on organisational practice and collaborative working were reported. Conversely, challenges to developing research capacity were also identified as were the importance of resources, senior level buy-in, and the relevance of research topic to practice in facilitating participation in the programme. Conclusion: Collaboration for Leadership in Applied Health Research and Care North West Coast’s (CLAHRC-NWC) RC building programme differed from convential approaches giving less emphasis to formal teaching and more to experiental learning and focusing on both individual capacities and supporting organisations to integrate RC building into staff development programmes. The findings demonstrate that providing opportunities for staff in NHS and local authority organisations to develop research knowledge and skills alongside an infrastructure that supports and encourages their participation in research can have positive impacts on research capacity and organisational research culture. The potential for generalising this approach to other organisational contexts is discussed

BackgroundAction to address the structural determinants of health inequalities is prioritized in high-level initiatives such as the United Nations Sustainable Development Goals and many national health strategies. Yet, the focus of much local policy and practice is on behaviour change. Research shows that whilst lifestyle approaches can improve population health, at best they fail to reduce health inequalities because they fail to address upstream structural determinants of behaviour and health outcomes. In health research, most efforts have been directed at three streams of work: understanding causal pathways; evaluating the equity impact of national policy; and developing and evaluating lifestyle/behavioural approaches to health improvement. As a result, there is a dearth of research on effective interventions to reduce health inequalities that can be developed and implemented at a local level.ObjectiveTo describe an initiative that aimed to mainstream a focus on health equity in a large-scale research collaboration in the United Kingdom and to assess the impact on organizational culture, research processes and individual research practice.MethodsThe study used multiple qualitative methods including semi-structured interviews, focus groups and workshops (n = 131 respondents including Public Advisers, university, National Health Service (NHS), and local and document review.Resultsutilizing Extended Normalization Process Theory (ENPT) and gender mainstreaming theory, the evaluation illuminated (i) the processes developed by Collaboration for Leadership in Applied Health Research and Care North West Coast to integrate ways of thinking and acting to tackle the upstream social determinants of health inequities (i.e. to mainstream a health equity focus) and (ii) the factors that promoted or frustrated these efforts.ConclusionsFindings highlight the role of contextual factors and processes aimed at developing and implementing a robust strategy for mainstreaming health equity as building blocks for transformative change in applied health research.

Introduction There is an extensive literature on public involvement (PI) in research, but this has focused primarily on experiences for researchers and public contributors and factors enabling or restricting successful involvement in specific projects. There has been less consideration of a ‘whole system’ approach to embedding PI across an organization from governance structures through to research projects. Objective To investigate how a combination of two theoretical frameworks, one focused on mainstreaming and the other conceptualizing quality, can illuminate the embedding of positive and influential PI throughout a research organization. Methods The study used data from the evaluation of a large UK research collaboration. Primary data were collected from 131 respondents (including Public Advisers, university, NHS and local government staff) via individual and group interviews/workshops. Secondary sources included monitoring data and internal documents. Findings CLAHRC‐NWC made real progress in mainstreaming PI. An organizational vision and infrastructure to embed PI at all levels were created, and the number and range of opportunities increased; PI roles became more clearly defined and increasingly public contributors felt able to influence decisions. However, the aspiration to mainstream PI throughout the collaboration was not fully achieved: a lack of staff ‘buy‐in’ meant that in some areas, it was not experienced as positively or was absent. Conclusion The two theoretical frameworks brought a novel perspective, facilitating the investigation of the quality of PI in structures and processes across the whole organization. We propose that combining these frameworks can assist the evaluation of PI research.

Background: The supply of some injecting paraphernalia was legalized in the UK in 2003 in order to reduce harm, prevent blood born virus transmission and encourage access to services. Pharmacies comprise over three quarters of needle exchange outlets in the UK. The extent to which needle exchange pharmacists are aware of the law change or have embraced the new supply opportunities is unknown.Methods: A survey of pharmacy based needle exchanges (PBNX) in the South West of England (n = 143), undertaken using telephone interviews 6 months after the main law change.Results: Participation rate was 85% (n = 121), 66% (n = 80) of PBNX provided needles and syringes only, 34% (n = 41) supplied one or more items of paraphernalia. The most commonly supplied paraphernalia item was citric acid. Forty‐two per cent of pharmacists said they were aware of the law change. However, only 2% of these could fully describe it, 41% could partially describe it, 59% were either out of date, wrong or did not know. Most pharmacists ...