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Introduction: Children exposed to parental intimate partner violence and abuse, mental illness, and substance use experience a range of problems which may persist into adulthood. These risks often co-occur and interact with structural factors such as poverty. Despite increasing evidence, it remains unclear how best to improve outcomes for children and families experiencing these adversities and address the complex issues they face. Aims and Methods: Systematic review of systematic reviews. We searched international literature databases for systematic reviews, from inception to 2021, to provide an evidence overview of the range and effectiveness of interventions to support children and families where these parental risk factors had been identified. Results: Sixty-two systematic reviews were included. The majority ( n = 59) focused on interventions designed to address single risk factors. Reviews mostly focused on parental mental health ( n = 38) and included psychological interventions or parenting-training for mothers. Only two reviews assessed interventions to address all three risk factors in combination and assessed structural interventions. Evidence indicates that families affected by parental mental health problems may be best served by integrated interventions combining therapeutic interventions for parents with parent skills training. Upstream interventions such as income supplementation and welfare reform were demonstrated to reduce the impacts of family adversity. Conclusion: Most intervention approaches focus on mitigating individual psychological harms and seek to address risk factors in isolation, which presents potentially significant gaps in intervention evidence. These interventions may not address the cumulative impacts of co-occurring risks, or social factors that may compound adversities.

The induction of robust circulating antibody titers is a key goal of HIV-1 vaccination. Probiotic supplementation is an established strategy to enhance microbiota and boost antibody responses to vaccines. A recent study tested whether oral probiotics could enhance vaccine-specific mucosal immunity by testing vaccination with and without supplementation in a Rhesus macaque Simian-Human Immunodeficiency Virus challenge model. Although supplementation was not associated with protection, the effects of probiotics on immunity after infection were not examined. To address this question, we measured antibody titers to HIV Env and commensal bacteria in plasma from the vaccination/supplementation time points as well as after SHIV acquisition. We found that a trend toward lower HIV Env-specific titers in the animals given probiotics plus vaccine became greater after SHIV infection. Significantly lower IgA titers were observed in animals vaccinated and supplemented compared to vaccine alone due to a delay in antibody kinetics at week 2 post infection. We observed no difference, however, in titers to commensal bacteria during probiotic supplementation or after SHIV infection. These results suggest that probiotic supplementation may be a strategy for reducing IgA-specific HIV antibodies in the plasma, a correlate associated with increased HIV infection in the RV144 clinical trial.

Medical records from 4 private practice veterinary dentistry specialty clinics were reviewed for a 5-year period (2013-2018) to identify dogs that had a fractured canine tooth treated by root canal therapy and returned for subsequent follow-up evaluation. Evaluation criteria included the presence of complete medical records with diagnostic quality intraoral radiographs for each procedure visit with a minimum of 6 months between visits. Forty-three dogs with a total of 55 endodontically treated canine teeth were identified and evaluated. Root canal treatment outcome was defined as successful, no evidence of failure (NEF), or failure based on radiographic findings. Patient age, time from initial treatment to follow-up, obturation material used, radiographic quality of obturation (including voids, overfill, and retention of fractured endodontic files), radiographic evidence of periapical disease and/or presence of external inflammatory root resorption (EIRR), and the presence or absence of a full coverage metal crown were evaluated. Treatment was classified as successful in 51 (92.73%) teeth, NEF in 3 (5.45%) teeth, and failure in 1 (1.82%) tooth. The results suggest that endodontic treatment of fractured canine teeth in dogs is a successful treatment option that allows for retention of this functionally important tooth.

Background Urinary incontinence affects between 25% and 45% of women. The availability and quality of services is variable and inequitable, but our understanding of the drivers is incomplete. Objectives The objectives of the study were to model patient, specialist clinician, primary and secondary care, and geographical factors associated with referral and surgery for urinary incontinence, and to explore women’s experiences of urinary incontinence and expectations of treatments. Design This was a mixed-methods study. Setting The setting was NHS England. Participants Data were collected from all women with a urinary incontinence diagnosis in primary care data, and all women undergoing mid-urethral mesh tape surgery for stress urinary incontinence were included. Interviews were also carried out with 28 women from four urogynaecology clinics who were deciding whether or not to have surgery, and surveys were completed by 245 members of the Royal College of Obstetricians and Gynaecologists with a specialist interest in urinary incontinence. Data sources The sources were patient-level data from Hospital Episode Statistics, the Clinical Practice Research Datalink and the Office for National Statistics mortality data linked to Hospital Episode Statistics. Interviews were conducted with women. An online vignette survey was conducted with members of the Royal College of Obstetricians and Gynaecologists. Main outcome measures The main outcome measures were the rates of referral from primary to secondary care and surgery after referral, the rates of stress urinary incontinence surgery by geographical area, the risk of mid-urethral mesh tape removal and reoperation after mid-urethral mesh tape insertion. Results Almost half (45.8%) of women with a new urinary incontinence diagnosis in primary care were referred to a urinary incontinence specialist: 59.5% of these referrals were within 30 days of diagnosis. In total, 14.2% of women referred to a specialist underwent a urinary incontinence procedure (94.5% of women underwent a stress urinary incontinence procedure and 5.5% underwent an urgency urinary incontinence procedure) during a follow-up period of up to 10 years. Not all women were equally likely to be referred or receive surgery. Both referral and surgery were less likely for older women, those who were obese and those from minority ethnic backgrounds. The stress urinary incontinence surgery rate was 40 procedures per 100,000 women per year, with substantial geographical variation. Among women undergoing mid-urethral mesh tape insertion for stress urinary incontinence, the 9-year mesh tape removal rate was 3.3%. Women’s decision-making about urinary incontinence surgery centred on perceptions of their urinary incontinence severity and the seriousness/risk of surgery. Women judged urinary incontinence severity in relation to their daily lives and other women’s experiences, rather than frequency or quantity of leakage, as is often recorded and used by clinicians. Five groups of UK gynaecologists could be distinguished who differed mainly in their average inclination to recommend surgery to hypothetical urinary incontinence patients. The gynaecologists’ recommendations were also influenced by urinary incontinence subtype and the patient’s history of previous surgery. Limitations The primary and secondary care data lacked information on the severity of urinary incontinence. Conclusions There was substantial variation in rates of referrals, surgery, and mesh tape removals, both geographically and between women of different ages and women from different ethnic backgrounds. The variation persisted after adjustment for factors that were likely to affect women’s preferences. Growing safety concerns over mid-urethral mesh tape surgery for stress urinary incontinence during the period from which the data are drawn are likely to have introduced more uncertainty to women’s and clinicians’ treatment decision-making. Future work Future work should capture outcomes relevant to women, including ongoing urinary incontinence and pain that is reported by women themselves, both before and after mesh and non-mesh procedures, as well as following conservative treatments. Future research should examine long-term patient-reported outcomes of treatment, including for women who do not seek further health care or surgery, and the extent to which urinary incontinence severity explains observed variation in referrals and surgery. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 9, No. 7. See the NIHR Journals Library website for further project information.

Efforts to cure HIV have focused on reactivating latent proviruses to enable elimination by CD8+ cytotoxic T-cells. Clinical studies of latency reversing agents (LRA) in individuals treated with antiretroviral therapy (ART) have shown increases in HIV transcription, but without reductions in virologic measures, or evidence that HIV-specific CD8+ T-cells were productively engaged. Here, we show that the SARS-CoV-2 mRNA vaccine BNT162b2 activates the RIG-I/TLR – TNF – NFκb axis, resulting in transcription of HIV proviruses with minimal perturbations of T-cell activation and host transcription. T-cells specific for the early gene-product HIV-Nef uniquely increased in frequency and acquired effector functon(granzyme-B) in ART-treated individuals following SARS-CoV-2 mRNA vaccination. These parameters of CD8+ T-cell induction correlated strongly with significant decreases in cell-associated HIV mRNA, suggesting killing or suppression of cells transcribing HIV. These results are, to our knowledge, the first observation of an intervention-induced reduction in a measure of HIV persistence, accompanied by precise immune correlates, in ART-suppressed individuals. However, we did not observe significant depletions of intact proviruses, underscoring challenges to achieving (or measuring) HIV reservoir reductions. Overall, our results support prioritizing the measurement of granzyme-B-producing Nef-specific responses in latency reversal studies and add impetus to developing HIV-targeted mRNA therapeutic vaccines that leverage built-in LRA activity.

This qualitative study explores the contribution of peer support to the mental health and wellbeing of police veterans. Thematic analysis of interview data with veterans ( n = 7), partners ( n = 1) and veteran peer support officers ( n = 10) captures the participant experience. Two key themes were integral to the contribution peer support makes to veteran wellbeing. First, the centrality of police identity and the importance of belonging to a supportive police community. Second, the need for hope and possibilities in transitioning from policing to civilian life. Social work services and trained peers provide veterans with a road map for re-building a life and identity away from the force.

Drawing on ethnographic fieldwork in Trinidad, this paper examines how the framing of a particular apocalyptic future provided a moral commentary and model for wellbeing in contemporary everyday life. Changing social, political, and economic circumstances and relations had brought a range of new risks and anxieties into daily life. These more recent problems originating from beyond the village (such as climate change, criminality, inequality, pollution, neglect by the State) could not be resolved through working with

Introduction and hypothesis This qualitative interview study explores aspects women with urinary incontinence(UI) reflect upon when considering whether or not to have surgery. Conducted prior to the recent mesh pause in the UK, the article provides insights for current and future approaches to shared decision-making. Methods Qualitative in-depth interviews of 28 patients referred to secondary care for stress and mixed UI who were considering UI surgery. Participants were recruited from four urogynaecology clinics in the Midlands and South England, UK. Interviews were conducted in clinics, in patient homes, and by telephone. Data analysis was based on the constant comparative method. Results Participants’ accounts comprised three key concerns: their experience of symptoms, the extent to which these impacted a variety of social roles and demands, and overcoming embarrassment. Accounts drew on individual circumstances, values, and concerns rather than objective or measurable criteria. In combination, these dimensions constituted a personal assessment of the severity of their UI and hence framed the extent to which women prioritized addressing their condition. Conclusions Acknowledging women’s personal accounts of UI shifts the concept of ‘severity’ beyond a medical definition to include what is important to patients themselves. Decision-making around elective surgery must endeavour to link medical information with women’s own experiences and personal criteria, which often change in priority over time. We propose that this research provides insight into how the controversy around the use of mesh in the UK emerged. This study also suggests ways in which facilitating shared decision-making should be conducted in future.

BackgroundManaging multimorbidity is complex for both patients and healthcare systems. Patients with multimorbidity often use a variety of primary and secondary care services. Country-specific research exploring the healthcare utilisation and cost consequences of multimorbidity may inform future interventions and payment schemes in the UK.AimTo assess the relationship between multimorbidity, healthcare costs, and healthcare utilisation; and to determine how this relationship varies by disease combinations and healthcare components.Design and settingA systematic review.MethodThis systematic review followed the bidirectional citation searching to completion method. MEDLINE and grey literature were searched for UK studies since 2004. An iterative review of references and citations was completed. Authors from all articles selected were contacted and asked to check for completeness of UK evidence. The National Institutes of Health National Heart, Lung, and Blood Institute quality assessment tool was used to assess risk of bias. Data were extracted, findings synthesised, and study heterogeneity assessed; meta-analysis was conducted when possible.ResultsSeventeen studies were identified: seven predicting healthcare costs and 10 healthcare utilisation. Multimorbidity was found to be associated with increased total costs, hospital costs, care transition costs, primary care use, dental care use, emergency department use, and hospitalisations. Several studies demonstrated the high cost of depression and of hospitalisation associated with multimorbidity.ConclusionIn the UK, multimorbidity increases healthcare utilisation and costs of primary, secondary, and dental care. Future research is needed to examine whether integrated care schemes offer efficiencies in healthcare provision for multimorbidity.

Haemodialysis patients are advised to follow multiple dietary and fluid recommendations as part of their treatment. Rebecca Lynch discusses a study that looked into how well patients were complying...

Background and objectives The INTERVAL trial aimed to find the optimum frequency of blood donation to enhance blood supplies and maintain donor health. This not only requires biological knowledge, but also an appreciation of donor perspectives, and how their experiences and beliefs might be central if any changes are ever to be made. To address this, trial participants were interviewed about their ideas of blood and the body in relation to their experiences of increased donation frequency. Materials and methods Thirty in depth face-to-face interviews conducted with blood donors participating in the trial. Results Three key themes emerged: ideas about how blood and iron reserves are replenished, and what people did to facilitate this; beliefs about physiological differences relating to age and gender; and practical issues that affected the experience of donation. Overall, participants interviewed welcomed more frequent donation, despite a range of pragmatic concerns. Conclusion Despite some practical obstacles, increased donation frequency aligned with participant's ideas about bodily replenishment, the value of donation, and their identity as enduring blood donors. They therefore supported the idea of increasing frequency of donation, independently of the biomedical evidence from the trial itself.

In line with the concept of 'nudging' people to change their behaviour, there has been increased attention on habit as a focus for psychologically-based health interventions. It is hoped that behaviours initiated by interventions not only become so regular that they are normalised into people's everyday lives, but that through repetition they may eventually become fixed and habitual. In this paper we draw on people's accounts of participating in a trial designed to encourage greater physical activity, and attend to the ways they describe their engagement with interventions within wider narratives of their everyday lives. In contrast to the idea that habit refers to automatic behaviour cued by external stimuli and governed by unconscious cognitive processes, our study describes how people identify many diverse elements that are felt to have equal significance in achieving a routine. Paradoxically, the sense of stability derives not from exact repetition, but from the ability for an assemblage of elements to be configured slightly differently each time. We consequently argue that attending to the diverse range of contextual elements bracketed off from interventions designed to be tested in trials, and the idea that continuity might emerge from variation, demands a reconceptualisation of the concept of habit adopted within many areas of current health psychology.

In recent years, medical anthropology has benefitted a great deal from debates in science studies, and in particular, the focus on knowledge practices (Pickering 1995) and epistemic cultures (Knorr...

In this special issue of Critical Public Health the papers collectively explore how certain theoretical perspectives in the social sciences, often termed ‘posthumanism’, might productively be appli...

Many studies of blood donation have looked at the motives of donors, their relationship with the wider society and corresponding values such as gift-giving, altruism and responsibility. These underpin a rhetorical representation of person-to-person donation that neglects the many technical processes that take place between donation and eventual use and the material nature of blood itself. This ethnographic study, conducted in four UK blood donation sites, describes the various practices involved in routine sessions, rather than the motives or values or donors or staff. It focuses on the procedures and equipment that not only ensures blood is collected safely and efficiently, but the extent to which they determine the nature of the collected blood itself. Taking our cue from posthuman approaches, we argue donated blood as something that is ‘made’ only when it leaves the body; in other words, it is not simply extracted, but is constructed through specific practices. We illustrate how, as blood is separated from the body, it is increasingly depersonalised and reconstituted in order to have biomedical value. In this way, rather than reproducing the essentialist claim that blood is what social scientists often described as a ‘special kind of substance’, we point to the ways in which donated blood alters as it moves in time and space. We argue that such transformations occur in both symbolic and material realms, such that the capacity of blood to have both cultural meaning and clinical value is dependent on the fact that it is never stable or singular.

Background Variation in access to joint replacement surgery has been widely reported but less attention has been given to the impact of comorbidities on the patient journey to joint replacement surgery. There is a lack of consensus amongst healthcare professionals and commissioners about how patients with comorbidities should be referred or selected for joint replacement surgery. It is therefore important to understand the views of healthcare professionals on the management, referral and selection of patients with comorbidities for joint replacement surgery. Methods An exploratory qualitative study involving semi-structured interviews with 20 healthcare professionals in England across the referral pathway to joint replacement surgery. They were asked to talk about their experiences of referring and selecting patients with comorbidities for joint replacement surgery. The interviews were audio-recorded and transcribed verbatim. Data analysis followed a thematic analysis approach based on the principles of grounded theory. Results In general, the presence of comorbidities was not seen as a barrier to being referred or selected for joint replacement but was seen as a challenge to manage the patients’ journey across the referral pathway. Each professional group, concentrated on different aspects of the patients’ condition which appeared to affect how they managed patients with comorbidities. This implied there was a disagreement about roles and responsibilities in the management of patients with comorbidities. None of the professionals believed it was their responsibility to address comorbidities in preparation for surgery. This disagreement was identified as a reason why some patients seem to ‘get lost’ in the referral system when they were considered to be unprepared for surgery. Patients were then potentially left to manage their own comorbidities before being reconsidered for joint replacement. Conclusions At the clinician-level, comorbidities were not perceived as a barrier to accessing joint replacement surgery but at the pathway-level, it may create an implicit barrier such that patients with comorbidities may get ‘lost’ to the system. Further study is needed to explore the roles and responsibilities of professionals across the current orthopaedic referral pathway which may be less suitable for patients with comorbidities. Electronic supplementary material The online version of this article (10.1186/s12913-018-3565-0) contains supplementary material, which is available to authorized users.

Background Hip and knee replacement surgery is one of the most common and effective surgical procedures. The rise in multi-morbidity world-wide is leading to increasing numbers of patients with comorbid conditions undergoing joint replacement surgery. Financially stretched commissioners of health care services in the English National Health Service (NHS) are increasingly seeking to restrict access to elective surgery, including hip and knee replacement surgery despite a lack of evidence to support these decisions. It is important to get a better understanding of the referral and selection of patients with comorbidities for joint replacement surgery. Methods An exploratory qualitative approach involving semi-structured interviews with eight orthopaedic surgeons, seven general practitioners (GPs), and five professionals working in intermediate musculoskeletal services (specific centres within the English NHS to support the referral process from primary to specialised care). Results In general, the presence of comorbidities was not seen as a barrier to being referred or selected for joint replacement. Each professional group, however, concentrated on different aspects of the patients’ condition which appeared to affect how each group managed patients with comorbidities. GPs focused on the long-term impact that comorbidities have on the patients’ everyday life. Intermediate care professionals focused on the short-term impact of comorbidities on the patients’ likelihood of being selected for surgery. Orthopaedic surgeons focused on the short-term impact of comorbidities on the surgery itself. This implied there was a disagreement about roles and responsibilities in the management of patients with comorbidities. None of the three groups believed it was their responsibility to address comorbidities in preparation for surgery. This disagreement was identified as a reason why some patients seem to ‘get lost’ in the referral system when they were considered to be unprepared for surgery. Patients were then potentially left to manage their own comorbidities before being reconsidered for joint replacement. Conclusion At the clinician-level, comorbidities were not perceived as a barrier to accessing joint replacement surgery but at the pathway-level, it may create an implicit barrier such that patients with comorbidities may get ‘lost’ to the system. The current orthopaedic clinical pathway may be less suitable for patients with comorbidities.

Enteral nutrition (EN) is recognized as a medical nutrition therapy for patients with a functional gastrointestinal tract who are unable to maintain their weight and health by oral intake alone either due to a highly catabolic medical condition or a functional limitation. EN support provides calories and protein to help improve or maintain adequate weight, lean body mass, and overall nutritional status. EN also provides nonnutritive benefits such as maintaining intestinal integrity, supporting the immune system, and preventing infection. EN support can be tailored to a patient’s nutrient needs, and there are various formulas that vary in composition of macronutrients, concentration, and electrolytes for specific disease processes or conditions that may help with tolerance and absorption. EN support complications include issues with access, diarrhea, constipation, electrolyte abnormalities, hyperglycemia, and dehydration/overhydration. Generally, EN is well tolerated. While a patient is on this type of nutrition support, it is important to closely monitor tolerance, weight, laboratory values if indicated, and overall clinical progress, with adjustment to the regimen as needed. This review contains 1 figure, 4 tables, and 48 references. Key words: enteral access, enteral formula, enteral nutrition support, gastric residuals, gastrointestinal tract, immunonutrition, malnutrition, medical nutrition therapy, tube feed formula, tube feed tolerance, tube feeding, volume-based feeding

This book raises questions about the changing relationships between technology, people and health. It examines the accelerating pace of technological development and a general shift to personalized, patient-led medicine. Such relationships are increasingly mediated through particular medical technologies, drawn together by the authors as ‘personal medical devices’ (PMDs) – devices that are attached to, worn by, interacted with, or carried by individuals for the purposes of generating biomedical data and carrying out medical interventions on the person concerned. The burgeoning PMD field is advancing rapidly across multiple domains and disciplines – so rapidly that conceptual and empirical research and thinking around PMDs, and their clinical, social and philosophical implications, often lag behind new technical developments and medical interventions. This timely and original volume explores the significant and under-researched impact of personal medical devices on contemporary understandings of health and illness. It will be a valuable read for scholars and practitioners of medicine, health, science and technology and social science.

Focusing on debates around the risk/benefits of e-cigarettes within the field of public health, this chapter argues that the for/against sides in these debates construct e-cigarettes as different objects, with implicit assumptions about what these objects ‘are’, how people will respond to them, and their comparability to tobacco cigarettes. Drawing on practice theory approaches, this chapter questions such assumptions, pointing out that objects are ‘made’ through practices and thus cannot be divided from their contexts, with different contexts enacting differing objects. The ‘riskiness’ of objects is therefore relational rather than an inherent quality in technologies themselves. Such debates tell us more about the assumptions embedded within public health itself and are themselves examples of how new technologies create new relations and material effects.

Why should we explore personal medical devices (PMDs)? Fuelled by the growth of so-called lifestyle conditions, shifts to personalised and patient-led medicine and the increasing sophistication and miniaturisation of devices themselves, PMDs have become increasingly significant in both clinical and non-clinical arenas. This chapter presents some of the intersections and new relationships, possibilities and constructions of health that the use and development of these technologies present. PMDs question existing concepts of bodily boundaries and processes (the ‘personal’), the purview of medicine and its handling of its objects of study (the ‘medical’) and wider consequences of these technologies (the ‘device’). Introducing the contributions to the book, the chapter argues that nuanced, critical and empirically grounded approaches are needed to interrogate and understand emerging issues in this field.

Reflecting on the contributions to this edited volume, this chapter draws out some of the key themes and issues raised by social science approaches to personal medical devices (PMDs). The chapters illustrate that what PMDs (and other health technologies) ‘do’ and ‘are’ may be quite different. They are variously embedded through practices, spaces, times, and relationships and so cannot be considered as stand-alone objects. Likewise, particular boundaries that PMDs bring into focus—e.g., self/other, bodily boundaries, medicine and medical boundaries, and bodily/health data—are not fixed or prescriptive but rather dynamic and changing. Investigating PMDs therefore allows exploration of dynamic and situated intersections of people, health, and technology—the quantified lives that we increasingly live and the vital data produced by these.

In recent years, health behaviour interventions have received a great deal of attention in both research and policy as a means of encouraging people to lead healthier lives. The emphasis of such interventions has varied over time, in terms of level of intervention (e.g. individual vs community) and drawing on different disciplinary perspectives. Recently, a number of critiques have focused on how health behaviour interventions sometimes sideline issues of social context, framing health as a matter of individual choice and, by implication, a personal responsibility. Part of this criticism is that health behaviour interventions often do not draw on alternative social science understandings of the structured and contextual aspects of behaviour and health. Yet to our knowledge, no study has attempted to empirically assess the extent to which, and in what ways, the health behaviour intervention field has paid attention to social context. In this article, we undertake this task using bibliometric techniques in order to map out the health behaviour intervention field. We find that the number of health behaviour interventions has grown rapidly in recent years, especially since around 2006, and that references to social science disciplines and concepts that foreground issues of social context are rare and, relatively speaking, constitute less of the field post 2006. More quantifiable concepts are used most, and those more close to the complexities of social context are mentioned least. The document co-citation analysis suggests that pre 2006, documents referring to social context were relatively diffuse in the network of key citations, but post 2006 this influence had largely diminished. The journal co-citation analysis shows less disciplinary overlap post 2006. At present, health behaviour interventions are continuing to focus on individualised approaches drawn from behavioural psychology and behavioural economics. Our findings lend empirical support to a number of recent papers that suggest more interdisciplinary collaboration is needed to advance the field.

In this paper, we describe the measures of intervention exposure used in the cluster randomised trial of the Well London programme, a public health intervention using community engagement and community-based projects to increase physical activity, healthy eating and mental health and well-being in 20 of the most deprived neighbourhoods in London.10 No earmarked resources to support the development of these measures and associated data collection were provided to either the research team or to those delivering the interventions on the ground. Instead, these were derived from contractually specified performance management information reported quarterly by partners and by inclusion of questions seeking information about participation in the follow-up questionnaires used to measure the main trial outcomes. The exposure measures are consequently considerably less sophisticated than those used in the US studies, where earmarked funding was available.

Self-monitoring, by which individuals record and appraise ongoing information about the status of their body in order to improve their health, has been a key element in the personal management of conditions such as diabetes, but it is now also increasingly used in relation to health-associated behaviours. The introduction of self-monitoring as an intervention to change behaviour is intended to provide feedback that can be used by individuals to both assess their status and provide ongoing support towards a goal that may be formally set or remains implicit. However, little attention has been paid to how individuals actually engage in the process or act upon the information they receive. This article addresses this by exploring how participants in a particular trial (‘Get Moving’) experienced the process and nature of feedback. Although the trial aimed to compare the potential efficacy of three different monitoring activities designed to encourage greater physical activity, participants did not present distinctly different accounts of each intervention and the specifics of the feedback provided. Instead, their accounts took the form of much more extended and personal narratives that included other people and features of the environment. We draw on these broader descriptions to problematise the notion of self-monitoring and conclude that self-monitoring is neither solely about ‘self’ nor is it exclusively about ‘monitoring’. We suggest that a more expansive social and material understanding of feedback can give insight into the ways information is made active and meaningful for individuals in their everyday contexts.