Freelance projects in 2024
1. Living with and beyond cancer – SUrvivors’ Rehabilitation Evaluation after CANcer (SURECAN)
Some two million people in the UK are living with or beyond cancer and about a third of those patients report poor quality of life. The SURECAN study is looking at developing and testing a novel psychological intervention based on Acceptance and Commitment Therapy (ACT), which has been developed especially for them. The aim is put patients’ views about what they value most in their lives at the heart of the therapy, in order to improve their quality of life. You can read about the impressive investigative team and the collaborators, who have been involved from the start of this project.
I was asked by Professors Stephanie Taylor and Damien Ridge to support the qualitative evaluation of SURECAN by coding the individual interviews conducted with patients and therapists who engaged with ACT+. The detailed coding framework I developed will help the team answer key evaluation questions, such as: what was the perceived impact on quality of life? How were each of the key components of the intervention received? Were there any contextual factors that mediated the effects of the intervention?
This was a project very close to my heart. I was diagnosed with cancer in 2011 and, though treated successfully, I have first-hand experience of what it is like to have to make many adjustments due to changes in quality of life and experiencing other losses to identity that are consequent on illness and treatment. I was so pleased to be asked to help evaluate this much needed mental health support for cancer patients.
Development of analysis is ongoing. Watch this space for our forthcoming paper that will report on findings. I really want to know if ACT+ had an overall positive impact on quality of life or not!
2. Scoping study exploring the best means of generating feedback from parents whose babies have died during pregnancy or childbirth
The Maternity Survey is currently used by a range of stakeholders to monitor and evaluate the quality of maternity care and to identify areas for improvements. The survey does not currently include experiences of baby loss. The Survey Coordinating Centre at Picker asked me to support them with a qualitative study, to explore the question: What is the most sensitive way of asking for feedback, what should we ask, and who?
Firstly, stakeholder groups were consulted about the appropriateness/feasibility of exploring experiences of baby loss through the existing survey. They were asked about alternative methods of generating feedback from people prior to, during and after the loss of their baby. I coded and analysed transcripts of these discussions and wrote up findings and recommendations.
Later in the year, I was asked to conduct in-depth interviews (and analysis and write-up) with people who experienced baby loss at different stages of pregnancy (early and late miscarriage, termination due to foetal abnormality, and stillbirth) or the loss of their new-born. I am in awe of their willingness to share these incredibly painful experiences, with the goal of helping improve the care and support others receive.
We hope that better understanding parents’ experiences will help to identify issues around the delivery of quality, safe, effective and compassionate care.
3. Police involvement in Reducing Parental Conflict
Some level of arguing and conflict between parents or carers is regarded as a normal part of family life. However, evidence suggests that frequent, intense and poorly resolved parental conflict can have a negative impact on children’s mental health and long-term life-chances.
The Department for Work and Pensions (DWP) is leading a national Reducing Parental Conflict Programme to embed evidence-based support to tackle parental conflict in local areas. The programme includes training for multi-agency practitioners, including police officers, to increase their understanding of the evidence base on parental conflict, help them identify and discuss parental conflict with parents, and refer them on for further support.
DWP commissioned a qualitative stakeholder engagement project led by me in collaboration with freelancer Joanna Apps and Foundations – What Works Centre for Children and Families to conduct a project between August 2024 – January 2025 to explore police involvement in reducing parental conflict. The project focuses on the perspectives of the police, though also explores local area lead perspectives, exploring possible reasons for lower or higher engagement with RPC and any critical issues involvement poses for policing.
Our key outputs will be a report for DWP (completed December 2024) and a briefing document (to be completed January 2025), intended for the police.
4. Progress with embedding and implementing the Reducing Parental Conflict programme – Planning tool analysis
A separate, but related, project to the above, also carried out for Foundations/ DWP as end client, involved analysis of qualitative data on RPC generated from local area RPC leads.
Local area leads were asked to use a planning tool to describe progress with embedding and implementing the RPC programme. This tool captured perceived progress over several key areas (e.g. how they were getting on with partnership working, community involvement, evaluation, etc).
I was asked to work with the Foundations/ freelance team to code data from 136 local authorities, condensing ideas and describing key themes identified in the initial coded categories and then developing analytic ideas and writing up key findings for the report to DWP.
5. Database of youth provision in England
This project was a little different for me, taking me out of my health and social care research/ qualitative comfort zone!
YFF wanted to build an extensive and complete as possible database of examples of different forms of non-statutory employment-related support for young people across England.
The YFF and freelance team used ChatGPT to search through council, charity and other programme delivery organisations’ websites to identify specific employment support programmes out there for young people/ disadvantaged young people. Once relevant programmes were identified we followed a search screening process, and information was extracted for all included. Extraction focused on programme type, groups targeted and key components of the intervention or service. We started with a list of 2, 400 organisations to search through and surfaced many hundreds more.
6. Service user experiences of community mental health services
I was also asked to help the Survey Coordinating Centre at Picker with the development of the 2024 Community Mental Health Survey. This is an annual NHS Patient Survey that has been running for 20 years, which is monitored by the Care Quality Commission.
To help with survey development, I was asked to conduct in-depth interviews, and a focus group interview that explored experiences of using community mental health services. We included a mix of participants of different ages, genders, geographical locations, ethnicities and service need (e.g., psychotic and non-psychotic) to consider different perspectives. I coded the interview transcripts, developing a framework in NVIVO that would help us answer key questions about survey design and engagement. Finally, I wrote a descriptive analysis, reporting on each of these key questions.
If you are planning a survey and think your team might benefit from using qualitative work such as this during the development and refinement phases, please do get in touch. I would love to help.
7. Rapid review on antenatal immunisations
Three vaccine-preventable diseases: COVID-19, pertussis (whooping cough) and seasonal influenza (flu) present pregnant people and their babies with significant risks. Uptake of the newer COVID-19 vaccine has been poor and uptake of the longer established vaccines for pertussis and influenza has been steadily declining. The UK Health Security Agency (UKHSA) issued a warning, in early 2024, about the rise in whooping cough and its link to a lower uptake of the vaccine, following the deaths of infants.
Complex demographic issues relating to ethnicity and high levels of social deprivation have made it a struggle to achieve high vaccination uptakes in many areas of the UK. I was asked by M.E.L to carry out a rapid review, considering uptake, reasons for vaccine hesitancy on the part of health professionals and patients, and the approaches that some areas of the UK have used to try to improve uptake of antenatal vaccinations and build public trust.
Dr Rosaleen O'Brien 