Implementation Our dedicated focus on implementation planning has enhanced the uptake and impact of ARC projects. Through a joint leadership role with Health Innovation Wessex, and close working with our partners, including Wessex Health Partners, our ICSs, health and care providers and our higher education partners, researchers have been supported to foster connections and networking critical to implementation success. Stakeholders (such as clinicians and commissioners) have been engaged early in the research cycle to understand the factors that will support the adoption of research. Our implementation team provided an implementation advice, co-developed implementation plans and advised on grant applications. An implementation checklist was developed to assist researchers in planning for implementation at the outset of their projects Other resources | NIHR ARC Wessex. Our partnership with Health Innovation Wessex has benefitted understanding of how to optimise the impact of ARC innovations and research findings , and has led to several joint programmes of work including research in optimising the use of medicines , the Wessex NHS Insights Prioritisation Programme (NIPP) , a review of the evidence for community based falls prevention , and development of a Workforce Evaluation Toolkit. Our medicines optimisation programme was founded on a deep understanding of system priorities, resulting in research questions that addressed system priorities and successful implementation of the findings and new resources. Our evaluations of digital remote monitoring for people with frailty in Wessex, and our joint evidence review of community based falls prevention in England with ARC South West Peninsula, provided insights into the implementation of innovation in practice and have been widely disseminated. Our policy brief on falls prevention , published in 2025, describes lessons for implementation from several ARC implementation studies of falls prevention programmes to benefit commissioners, providers and the public. Ageing, dementia & frailty priority | NIHR ARC Wessex . And in response to an expressed need from our system partners for help with evaluating change in the workplace, we produced an evaluation framework and toolkit to guide what to evaluate, how to ask evaluation questions and ways to measure change (In development). In October 2024, we launched our knowledge mobilisation programme and recruited a team of four knowledge mobilisation fellows, enabling us to develop expertise in this area and amplify awareness of the importance of knowledge mobilisation for research impact.

3163bb6a-69ec-4161-8433-72a5810416ad POST DOCTORAL PROJECT: Understanding, addressing, and meeting the complex needs of people living with long term physical and mental health conditions: a qualitative study POST DOCTORAL PROJECT: Understanding, addressing, and meeting the complex needs of people living with long term physical and mental health conditions: a qualitative study Chief Investigator: Dr Leire Ambrosio – University of Southampton Project Team Members: Professor David Baldwin – University of Southampton. Professor Mari Carmen Portillo – University of Southampton, Dr Kate Lippiett – University of Southampton, Dr Lindsey Cherry – University of Southampton, Dr Pritti Aggarwal – Living well partnership – NHS Southampton CCG, Mr Barney Williams Jones – University Hospital Southampton NHS Foundation Trust, Dr Sara Mckelvie – University of Southampton, Ms Linda Lamond – PPI co-applicant Organisations Involved: University of Southampton, Hampshire and Isle of Wight Integrated Care System, Living well Partnership – Southampton CCG. Oxfordshire Primary Care System, Anxiety UK, Mind, Oxfordshire. Background: People with long term physical conditions are 2-3 times more likely to experience mental health problems than the general population, particularly depression and anxiety. At least 30% of all adults with long term physical conditions also have mental health problems. People living with long term physical and mental conditions not only experience hardships relating to health but also have complex psychosocial, environmental, economic, and spiritual needs. Healthcare professionals find it difficult to deliver fully integrated care for these populations, partly due to systematic barriers and the fragmentation of health and social services. The advent of social prescribing link workers as a priority for the NHS provides an opportunity to address some of these hardships and needs. Social prescribing link workers aim to connect people to community local services to address their complex needs through a person- centred approach. However, approaches to social prescribing link worker implementation are variable, with potential pathway gaps, and there is unclear guidance for primary care networks about how to integrate this novel workforce into efforts to address and meet the complex needs of people living with long term physical and mental conditions.

3ace18ec-d7ab-47b5-898a-8030d0eb53f7 POST DOCTORAL PROJECT: Early detection of chronic liver disease in community settings Chief Investigator: Dr Kate Glyn-Owen – University of Southampton Project Team Members: Julie Parkes – University of Southampton, Dr Richard Aspinall – Portsmouth University Hospitals NHS Trust Organisations Involved: British Liver Trust, Portsmouth Football Club (Pompey In The Community), Portsmouth City Council public health team Background: Liver disease is the third biggest cause of early death in the UK. Two of the main causes of liver disease are drinking too much alcohol, which directly damages the liver, and being overweight, which can lead to fat building up in the liver and causing damage. If liver disease is detected early, it is possible to prevent disease progression, and in some cases to reverse damage done. This benefits patients and reduces impact on the healthcare system. The best way to detect liver disease early is not known. Tests and risk scores are available which use a simple blood test and information about the patient. These were developed in hospital settings, for people with known liver disease. They have not been used sufficiently in general population settings and we do not know how good they are at detecting liver disease in these settings. This project is investigating how these tests and scores perform in general population settings, using data from the UK Biobank, a big dataset from general population volunteers. We are exploring whether combining tests/scores with information about people’s risk factors, may improve detection of disease.We are going out to community settings, performing a risk assessment and simple scan for liver disease in populations at high risk. We are working with Portsmouth Football Club, the British Liver Trust and Portsmouth City Council public health team, to target populations at risk and to find out how effective we can be at early detection of disease in these settings.

a7ea3c51-ca08-45ba-a500-e478bca6eb43 Motivating and sustaining engagement of young people in improving their health and that of their communities Prinicpal Investigator: Professor Mary Barker Team: Kathryn Woods-Townsend, University of Southampton, James Toop, Bite Back 2030, Matthew Ryan, University of Southampton, Joanna Sofaer, University of Southampton, Pathik Pathak, University of Southampton Start Date: 1 April 2023 End Date: 30 September 2024 Background Calls by young people for increased involvement in decisions about their health and futures are echoed by WHO and UNICEF. These reflect threats to their health from inequalities and climate change, exacerbated by COVID-19. To be “architects of their own future” and have decision-making power, young people need training and opportunities to build confidence, and structures and processes that allow them to be involved in decision making. Aims We aim to explore how best to engage and maintain engagement of young people in these activities with a view to improving their health and well-being and that of their communities Our specific objectives are to: develop and test a training course for young people in skills to support participatory action research into health and well-being; test the effectiveness of arts-based approaches in engaging young people in health improvement; understand how to create a reliable, scalable and sustainable model for effective youth activism; evaluate democratic innovations to engage young people in decision making processes to influence health policy. What did we find out? Through our project we found that young people can meaningfully participate in decision making on topics that are important to them. During the year young people were engaged in two separate ways: Firstly, BiteBack 2030’s youth advocacy programme was analysed and essential components of its success extracted. Those factors included establishing open two-way channels for communication, Working to create an environment where young people’s and staff views are equally valued, Supporting staff to develop excellent facilitation skills, Investing in young people’s skills, Campaigning on issues that young people feel are important and current and Reviewing success and challenges of each campaigns and adapt activities in response. Secondly, young people were successfully trained in research skills, advocacy and democracy during a 12-week Young Researcher Training Programme. The training programme allowed young people to investigate a health topic that was important to them and collect data from their peers and community. Their projects ranged from looking at exam stress, vaping, benefits of youth participation, to women’s health issues, failures in the PSHE curriculum and vaccine hesitancy. The results from their research went towards creating a set of health recommendations that young people felt should be prioritised for the improved health and wellbeing of young people in Southampton. A Youth Jury was held in July 2024 where the recommendations were refined based on collaboration with the Hampshire and Isle of Wight Integrated Care Partnership. The 12 amended recommendations formed the basis of a manifesto for health which included the following points to be addressed by decision makers: 1.Expand Extra-Curricular Wellness Activities. 2. Improve our methods of handling young people’s mental health by creating accessible services. 3. Respond to Vaping Proactively. 4. Deliver a comprehensive digital health platform for young people. 5.Review the PSHE Curriculum. 6. Encourage the mixed teaching of Sexual and Reproductive Education (SRE) . 7. Cultural & Religious Sensitivity . 8. Information to Parents. 9.Deliver Youth Engagement. 10. Diversify and Expand Work Experience and Financial Support for Prospective Professionals. 11. Establish Panels to Honestly Inform Young People about NHS Careers. 12. Produce Youth- Led Marketing. Evaluation of the effectiveness of the training programme, Youth Jury and Assembly at engaging young people in decision making and the resultant responses from decision makers is still ongoing. Final results will be available from spring 2025. You can see Young People talking about their recommendations here What did we do with this Knowledge? • The recommendations created by the young people within the manifesto for health were presented to the Integrated Care Partnership (ICP) and wider stakeholders in health and wellbeing at the Hampshire and IoW ICP Youth Assembly on 13th November 2024. An action plan was drawn up in collaboration with decision makers to implement the recommendations in practice. These recommendations will go towards informing the delivery of health services for young people In Hampshire and the IoW. • The criteria for a successful youth advocacy/ activism programme provide BiteBack with evidence-based conclusions that they can use to replicate and grow the success of their programmes. The links between youth health and wellbeing and participation in activism programmes was highlighted The findings from this investigation also went towards informing how we run the Young Researcher Training Programme to make sure young people are getting the most out of the experience for their health, wellbeing and future quality of life. See the BiteBack poster image BiteBack poster[83] .png Download PNG • 1.08MB BiteBack visual report (PDF What Next? The learning from this project will go towards informing how future YRTP sessions will be structured and run. For example, the advocacy and links to decision making in this project will be replicated in the next iteration. The next iteration of YRTP begins in December 2025, with a focus on developing a Southampton Youth Voices service. The learnings from BiteBack’s youth activism programme will aid other youth organisations to successfully engage young people in improving their health. This work adds to the growing body of research around the importance of youth participation and its long-term health and wellbeing benefits. Talitha McCleery, 17, took part in the programme and said: "Young people want to and deserve to be, involved in decisions that impact their health and futures. We believe that the people who sit in positions of power must prioritise consulting with young people if they want their decisions to have real change and make a positive impact." Libby Tickner, 17, who also took part, added: "We must all work together - school boards, local government, local charities and national non-governmental organisations - to ensure no opportunity is left wasted." Source: Hampshire youth assembly shares health and wellbeing ideas | Daily Echo

d94081d4-7fee-46f1-acf1-61bd1a5364fc Understanding barriers and enablers of using the Living with Long Term Conditions scale as part of routine care for people from under-served groups living with type 2 diabetes Chief investigator: Dr Leire Ambrosio, Lecturer, School of Health Sciences, University of Southampton. Team: Professor Mari Carmen Portillo, School of Health Sciences, University of Southampton Dr Lindsey Cherry, School of Health Sciences, University of Southampton Dr Kinda lbrahim, Associate Professor, Faculty of Medicine. University of Southampton Dr Michelle Myall, Principle Researcher, School of Health Sciences, University of Southampton Ms Rashmi Kumar, PPI representative Partners: Ha mpshire and Isle of Wight Integrated Care Board, Hampshire and Isle of Wight NHS Foundation Trust, University of Southampton, Diabetes UK, SO:Linked (Southampton Voluntary Services). Started: 1 October 2024 End: 31 March 2026 Why is this research important? In the England over 15 million people are living with at least one long-term conditions (LTC). People from under-served groups, are at greater risk of having one or more than one LTCs. This not only affects a person’s physical health, but other aspects of their lives, such as emotional, cultural, and socio-economic wellbeing. It is key for healthcare professionals, to understand and assess how a person is living with an LTC to provide person-centred care. We recently developed the Living with Long Term Conditions (LwLTCs) scale for English-speaking populations. This is a person-centred questionnaire to evaluate how well a person lives with a long-term condition, to inform care for people based on their individual needs. What we found We found that adults with LTCS face a "daily burden" because their symptoms fluctuate unpredictably, often leading to social isolation and a feeling of being "left behind" by a fragmented healthcare system. While both Adults and Healthcare Professionals felt the LwLTC scale is a valuable "communication bridge" that can highlight hidden mental health and social struggles, some barriers remain. For the tool to work in real life, it must be flexible—offering paper and digital versions or help from a staff member—rather than being a "one-size-fits-all" tick-box exercise. Ultimately, the findings show that while the scale helps make invisible struggles visible, its success depends on building trust, ensuring cultural sensitivity, and making sure that the information gathered actually leads to obvious changes in a patient's care. What we did with the new Knowledge By discovering the deep emotional and physical challenges real people face, we are supporting patients with LTCs to have a voice in their own care. We used this new knowledge to help the healthcare system move toward truly individualised and flexible care by highlighting that the scale works best as a "communication bridge" to uncover invisible mental health and social struggles. Our findings will help NHS move away from generic digital pathways by advocating for a "digital-choice" framework that offers paper, Braille, or face-to-face assistance for those who need it. By collaborating across the SCALE project, we are discovering how to build trust with underserved communities and ensuring the care system respects the "real-life" expertise of the patient. Where next? Building on these findings, we view this not as a conclusion but as a vital first step toward transforming how the NHS handles LTC care. A major next step is addressing the "readiness gap" in current practice by developing formal guidelines for facilitated engagement, where staff are trained to help patients navigate the tool face-to-face to prevent digital exclusion. We plan to take these learnings further by advocating for the scale to be used over time to track a person's health journey, rather than relying on a single snapshot. While it remains a struggle to shift traditional clinical systems away from rigid pathways, these findings create a sense of urgency: if we do not adopt these flexible, person-centered tools, we risk leaving the most vulnerable patients with LTCs far behind.

98ea6e39-72b8-439c-baa8-0843050c271b ADOPTED: SPLENDID Social Prescribing for people to Live ENjoyably with Dementia/memory problems In Daily life Research lead: Professor George Christopher Fox, University of East Anglia ARC Wessex team: Dr Euan Sadler, University of Southampton, Dr Katherine Bradbury, University of Southampton. Partner organisations: NHS Norfolk and Waveney CCG, University of Hull, University of Nottingham, University of Exeter, King's College London, University of Newcastle upon Tyne, Meaningful Measures Ltd. Start: 01/05/2022 End: 30/04/2027 What is the problem? Nearly one million people in the UK will be living with the affects of dementia by 2030 including poor well-being and quality of life. Social prescribing is a prescription of activities for a person to use to link with others and undertake something they might enjoy, this could be a walking or singing group, flower arranging class, visit to a museum or putting them in touch with other people to help them feel better. People meet with staff called Link- Workers, who have a conversation with them to help them think about what they enjoy and might help. The Link Worker might then introduce them to a group or activity or support them to find information to make links. Family members can be involved too. Research shows social prescribing has better effects than just taking medicine and is happening more often. This study (called SPLENDID) aims to understand how we ensure social prescribing is useful and helpful to people with dementia. What we will do SPLENDID researchers will talk with people with dementia, family carers and staff working in social prescribing to understand what people want, what works well and what could be improved. We will use this to design, with people with dementia, what looks like the best way for social prescribing with people with dementia. We will create some tools (online and face-to-face) to help workers and people with dementia talk and think together about what might help them. We will test it with a small group of people to see if it helps and look at what training Link- Workers need to offer the best support for people with dementia and their families. We then decide if this should be taken forward and tested in a larger study to see if it improves peoples’ well-being and is value for money. Working with patients and carers Our team met 8 people with dementia and 8 family carers to design this study. We have 2 co-researchers (Mr Rook and Mrs Bingham) who are living with dementia. 150 people with dementia were surveyed to see what social prescribing is currently being offered and found people were doing a range of outdoor and indoor activities, some with family which they enjoyed and found helpful. People with dementia and carers will be on our Committees, and several dementia charities support this work. Dissemination Our website will offer free resources put together with people with dementia and carers. Our findings will be shared locally and nationally using links we have with universities, clinical experts, press, social media, workshops with people who commission and provide. NIHR ARC East of England study site Publications Social prescribing for people living with dementia (PLWD) and their carers: what works, for whom, under what circumstances and why – protocol for a complex intervention systematic review | BMJ Open Reimagining Dementia Care: A Complex Intervention Systematic Review on Optimising Social Prescribing (SP) for People Living With Dementia (PLWD) in the United Kingdom - Papavasiliou - 2025 - Health Expectations - Wiley Online Library Reimagining Dementia Care: A Complex Intervention Systematic Review on Optimising Social Prescribing (SP) for Carers of People Living With Dementia (PLWD) in the United Kingdom - Marshall - 2025 - Health Expectations - Wiley Online Library Social prescribing in primary care for people living with dementia: a qualitative exploration of different roles and services in England | BMC Primary Care | Springer Nature Link

5fde61a4-c4bf-4d47-8ae3-3eed94045497 ADOPTED PROJECT: Evaluating the Operation Encompass Scheme: A Qualitative Scoping Study Principal Investigator: Dr Sara Morgan Project Team: Dr Maddy Greville Harris (Bournemouth University) Start Date: 1st August 2019 End Date: 21st December 2020 Background For young people, experience of domestic violence or abuse (DVA) is associated with an increased likelihood of experiencing mental health problems, poor academic attainment and later criminal or violent behaviour. The importance of early identification and support for children experiencing DVA is therefore paramount. One safeguarding scheme that is implemented in the UK is Operation Encompass (OE). This scheme involves partnership working between police and schools, to ensure that school safeguarding leads are informed of incidents of DVA involving children from their schools by the start of the next school day. Whilst the OE scheme has been implemented nationally, there is no existing published research exploring implementation of the scheme. What we did This qualitative scoping study carried out semi-structured interviews with 13 police workers and 12 school designated safeguarding leads. Thematic analysis explored three main themes: 1) Information sharing: “the beauty of Encompass is that it’s a conversation” , describing, for example, how OE is invaluable, although seen by some as resource-intensive 2) Facilitators and barriers of the OE scheme , such as staff responsiveness, funding, and resources 3) School support and outcomes: “Now they knew about it, they could go on to help” , such as the usefulness of identifying DVA cases, providing family and wellbeing support. While the OE scheme was considered invaluable in identifying and supporting children following OE, further research into the scheme could assist in a better understanding of how to optimise support for children in schools following a notification of an incidence of DVA. What did we find out? We identified three key themes from our interviews with educators and police involved in delivering Operation Encompass (OE). These were 1. Parameters of the scheme: defining DVA; stages to police implementation; extent and scope of information sharing; expanding and tailoring the scheme. 2. Barriers and facilitators: sustainability; attitudes towards the scheme; compliance and engagement; providing useful, timely contact; systemic promotion, and funding and resources. 3. Outcomes of OE and school support making allowances; check-in and monitoring; providing a safe nurture space; family work, and prioritising wellbeing. There was overwhelming support for the OE scheme from police workers and school safeguarding leads, although several potential challenges to implementation were discussed. The parameters of the OE scheme across regions were discussed, with debate around the content of OE notifications, and how best this should be shared. Although making contact with schools was sometimes challenging, schools agreed that timely information sharing via the OE scheme was useful for providing support to children and their families. Schools discussed the types of support they offered following and OE notification, such as checking in with the child and/or family, and providing a nurture space. Several key recommendations were made, such as the potential usefulness of sharing best practice between schools and the importance of promotion and awareness of the OE scheme. What did we do with this new knowledge? • Findings from the evaluation have been cited in a recent impact report from Operation Encompass, which goes out to all areas in England and Wales delivering OE OE-impact-Report-2023.pdf • The findings on the OE scheme have implications on best practice across police, education, social care settings. • The work was presented through the Association for Children and Adolescent Mental Health Supporting children and families experiencing domestic violence: A Devon and Cornwall perspective - Recording - ACAMH • The work was also used to inform a further grant application on children experiencing domestic abuse and led to a funded UKRI ESRC-funded PhD project by Miss Rebecca Harris | University of Southampton What next? Through my work evaluating violence prevention programmes, and how to support those experiencing domestic abuse, including this evaluation of OE, I’m looking to pursue further research work that understands how to prevent the intergenerational cycle of domestic abuse and how to prevent victims being revictimized or becoming perpetrators as adults. This will involve work with the community in non NHS settings, including partnerships with the police, education, social care and the healthcare system.

55041d82-7430-4dcd-98fd-9bd97e850e1f PREDICT-NURSE – feasibility: Predicting Patient Acuity/Dependency-Based Workload from Routinely Collected Data to Assist with Nursing Staff Planning – feasibility study Prinicpal Investigator: Christina Saville Team: Paul Meredith, University of Southampton Chiara Dall'Ora, University of Southampton Tom Weeks, Portsmouth Hospitals University NHS Trust Sue Wierzbicki, Portsmouth Hospitals University NHS Trust Peter Griffiths, University of Southampton Ian Dickerson – Patient and Public Involvement Representative Start Date: 1 September 2023 End Date: 30 September 2024 Plain English Summary of Findings Using information about patients already held by hospitals (such as patient demographics, diagnostic information and movements between wards) we estimated the number of nurses needed on the ward each shift. We found that our estimates matched closely with the currently widely-used approach. For that approach, the nurse in charge records the severity of each patient's illness, and how dependent they are on nursing care, every day or shift. In contrast our approach uses a type of regression (a tool for finding patterns in data) to automatically calculate the number of nurses needed. This would potentially save nurses time in assessing patients by using information that is already recorded. What's next? We used data from one hospital so need to find out if results are similar for other hospitals. We also need to find out whether our estimates relate to patient outcomes. We have funding for another 1-year study (PREDICT-NURSE validation and extension) to explore this using existing data from another hospital. We will also investigate whether we can use similar methods in other settings outside acute care, e.g. mental health and community settings. We have also received funding for a 2.5-year study (PREDICT-NURSE) with at least 5 hospital Trusts collecting new data to develop and test algorithms using a wider range of data and outcome measures. This study will be based on user-centred design, with a national survey and workshops to gather nurses’ and other stakeholders’ views. Background Having enough nurses to care for patients on hospital wards is critical for patient safety, but it is difficult to plan for varying numbers of patients and unknown trajectories of deterioration and recovery. Tools for assessing patients’ needs to help with staff planning are an extra nursing task, thus adding further to workload. We do not know whether ward-level demand could be accurately predicted using existing assessments and data that is already recorded electronically. The overall aim of the project was to explore the feasibility of predicting acuity/dependency-based workload measures, as assessed by nurses, from routinely collected information in patients’ electronic health records. Publications Estimating Nurse Workload Using a Predictive Model From Routine Hospital Data: Algorithm Development and Validation: https://doi.org/10.2196/71666

71793130-6407-4a7a-8ebf-2af1daf96dd5 Understanding the psychosocial needs and trajectories of older adults (>64 years) with alcohol use disorder (AUD) from hospital back into community Lead applicant : Professor Julia Sinclair Co-applicants : Dr Rebecca Band, Professor Jackie Bridges Team Dr Steph Hughes – Research Fellow Zara Linssen – Medical Student Sophie Crouzet – Medical Student Stephen Lim – Implementation Champion Melinda King – PPI advisor Start: 01/01/2023 End: 01/07/2024 Partner organisations: University Hospital Southampton NHS Foundation Trust University of Southampton Background Over 200 physical and mental health conditions are caused by alcohol. In England, more people are being admitted to hospital with, and dying from, alcohol-related disease than ever before. In 2018/19, 44.7% of all alcohol related admissions were for people over the age of 65 compared with 14% in 2010/11. In 2021,1563 patients were assessed by the Alcohol Care Team (ACT) at University Hospital Southampton, 43% of whom were over the age of 60. We know that older adults can often feel more shame and stigma related to their alcohol use compared with younger people. This can create barriers to accessing help with existing community addiction services. Beyond this, very little is known about the reasons why older adults drink alcohol and how this may interact with other social factors like loneliness and social isolation. Further research is needed to understand the ways in which to best support older adults to seek help, and what interventions may best promote positive outcomes. Study Design This study will recruit older people with alcohol use disorder (AUD) admitted to hospital in Wessex. A longitudinal observational design will be used, meaning that people in the study will be asked by the research team to complete questionnaires over time following admission into hospital. This will help to understand the needs of the population. There will be four main research aims: What are the personal characteristics of older adults with AUD? How do participants make sense of themselves in relation to their alcohol use? What happens to participants in the six months following a hospital admission? What factors what might prevent or encourage people from seeking help for their alcohol use? Study Methods The study will identify potential participants through the ACT in Southampton in the first instance. Around 40% of people seen over the age of 65 years. Clinicians working in ACTs have the skills and experience to sensitively identify and assess patients with comorbid alcohol use disorders Discussion about the study and consent processes will be undertaken by the UHS clinical trials officer. Participants who are willing to be part of the study will complete a set of questionnaires in hospital. Well-established measures of alcohol use, quality of life, loneliness, collective efficacy and health service use will be collected. Participants will be asked to complete similar questionnaires again at 3 and 6 months. This will probably take place over the phone. Health service use data will be collected for the 6 months after discharge to explore resource use. Plain English summary of findings Recruitment to the study was difficult. Many patients who were identified as drinking at increasing or possibly dependent levels did not have mental capacity to take part. Of those who were eligible, a large percentage declined to participate. This resulted in a small sample size of 30, 16 of which completed their follow-up questionnaire, and 7 interviews. 20% of the sample died during the study window. Results indicated: Over 50% participants showed some level of cognitive impairment Participants had an average of 4 people in their social network; usually family members Interviews revealed links between social isolation, loneliness and drinking alcohol Those who were housebound reported drinking alcohol all day long Participants stated alcohol is not, and never has been a problem for them 50% participants met the threshold for depression Participants often provided conflicting information for the follow-up questions and in the interviews Participants had poor diets; of 32 nutrients measured 22 were not consumed in-line with the government recommendations 93% participants were taking 5 medications or more What's next? As a small preliminary study the new knowledge has been used to inform future research. Impact on patient care and population health will come from the future research. Recruitment was harder than expected. This learning point has informed recruitment and retention procedures in future research applications. Other findings, for example, the link described qualitatively between social isolation and increased alcohol consumption, has shaped ideas for intervention development. We are preparing an application to undertake the planning and developmental work for an intervention aimed at reducing alcohol consumption in a general population of adults aged 65 and over. We plan to test the feasibility of this intervention in a feasibility study.

c5ca53e9-5f1d-4394-8679-3abfad5e1fe1 WHELD: Training care home staff to improve well-being and mental health of dementia residents led by NIHR ARC Peninsula and working with NIHR ARC South London, NIHR ARC East Midlands, NIHR ARC East of England, NIHR ARC North East North Cumbria, NIHR ARC North West Coast and NIHR ARC Yorkshire and Humber Implementation of evidence-based cost-effective training for care home staff to improve Wellbeing and mental HEaLth for care home residents with Dementia and reduce unnecessary sedative medications (WHELD into Practice) Principle Investigator: Professor Clive Ballard Team members: Joanne McDermid, Jane Fossey, Barbara Woodward Carlton, John-Paul Taylor, Louise Robinson, Martin Orrell, Clare Hulme, Sube Banerjee, Esme Moniz-Cook, Dag Aarsland, Annette Boaz, Clarissa Giebel, Caroline Watkins, Jo Day Partners: NIHR ARC South West Peninsula ARC, University of Exeter, NIHR ARC Yorkshire and Humber, NIHR ARC East Midlands, NIHR ARC East of England, NIHR ACR South London, NIHR ARC North West Coast , NIHR ARC North East and North Cumbria, University of Plymouth, University of Newcastle, University of Hull, King’s College London, University of Nottingham, South West AHSN, Pendennis Care Home, Devon Partnership NHS trust, Alzheimer’s Society. Research sites: University of Exeter, University of Newcastle, University of Hull, King’s College London, University of Nottingham, University of Liverpool Starts: 1/09/2021 Ends: 31/03/2023 Lay Summary WHELD is an evidence-based person-centred training programme which, in 4 clinical trials involving 2349 care home residents with dementia, demonstrated benefits in well-being and mental health and a reduction in sedative medications across London and Buckinghamshire. No similar programme has been successfully implemented in the UK or elsewhere. Nationwide implementation would have a major impact on well-being among the most vulnerable people with dementia. Lead ARC South West Peninsula with implementation sites also in East Midlands, East of England, North East and North Cumbria, North West, and Yorkshire and Humber ARCs WHELD intervention resources have been optimized for implementation, based on the results of our recent COVID WHELD programme. WHELD will now be implemented in 75 care homes in ARC regions where WHELD has not previously been delivered. Implementation evaluation will identify implementation enablers and barriers, fidelity, reach and buy-in, and provide illustrative case studies. Engagement of PPI representatives and stakeholders to Develop Real World Implementation Plan will be integrated throughout the programme. Key stakeholder groups for this work will include commissioners, senior representatives from Integrated care system organizations, representatives from the AHSNs in the different ARC regions and care home owners/senior managers. A series of dissemination activities, including stakeholder workshops, will enable the development of a plan for scaling up the implementation to national level and any required adaptations to WHELD resources. Progress by October 2022: The digital materials for the programme have been optimized. The programme has IRAS approval and CRN adoption. We currently have 19 participating care homes, with a goal of completing recruitment by the end of March 2023. The first PPI and stakeholder workshops have been completed, with further workshops through the autumn and in the New Year.

Healthier Southampton Many of the things that affect our health also affect the environment. For example, the foods that we eat and whether we walk or drive. Some of these things also affect whether we can access good quality, nutritional food- for example, what lunches are provided by schools or colleges, and whether people can get a local allotment. It can be useful to see weight, food, and the environment as part of a complex system, a web of things that all influence each other. We are running a research exercise with local community members in Southampton on the 26th November, and we’ll share the results of that meeting here. We will run some more community gatherings on 3rd December 2025 where we will talk through the results of our research exercise and take part in a series of activities in small groups designed to explore the Southampton system in more detail. If you have any questions or comments about this research, please email j.l.barker@soton.ac.uk .

87b19b27-d8c8-4f33-9da0-73ea106dac3c Mental health Burden of Increased Living costs: Local Support (My BILLS) Principal investigators: Dr. Dianna Smith, Associate Professor, School of Geography and Environmental Science, University of Southampton and Dr Thomas Richardson, Associate Professor of Clinical Psychology, School of Psychology, University of Southampton. Co-investigator: Prof Nisreen Alwan, Associate Professor in Public Health, School of Medicine, University of Southampton. Team: Dr Monica Sood, Dr Elizabeth Taylor, Tina Lang (PPI), Beth Davies (NHS), Sarah Brightwell (Solent Mind), Sandy Bramley (Portsmouth Citizens Advice) Partners: Solent Mind, Hampshire and Isle of Wight Mental Health NHS Trust (Formerly Southern health, IOW and Solent NHS Trusts, ITalk, Talking Change), Southampton & Portsmouth city councils, Hampshire County Council, Portsmouth Citizens Advice. Start: 01/01/2023 End: 30/09/2024 What did we find out? We found that people who were more worried about the cost of living had worse symptoms of depression and anxiety. However, these worries did not cause their symptoms to get better or worse over time. Interviews with staff and service users showed that financial stress caused feelings of hopelessness and frustration. Many people found it harder to get the health care they needed because of money problems. The cost-of-living crisis also increased pressure on the NHS and its staff. Those who are having therapy for Post-Traumatic Stress Disorder don’t benefit as much if they live in a deprived neighborhood. An analysis of 86,000 NHS Talking Therapies referrals from 2021 to 2023 is ongoing. What did we do with this Knowledge? Qualitative interviews have given practical suggestions to improve the link between financial and money advice support locally. Quantitative analysis is ongoing and will be published soon. What are we doing next? Conference presentations have been completed 2 Papers published 2 papers under review. Working on submitting several other papers from the findings for publication. Feeding back results to stakeholders. Publications Neighbourhood socioeconomic deprivation associated with poorer psychological therapy outcomes for PTSD: an audit of a single NHS Talking Therapies (IAPT) service | the Cognitive Behaviour Therapist | Cambridge Core How do Mental Health Service Users and Staff Think the Cost-of-living Crisis Has Impacted Mental Health in England? A Qualitative Analysis | Community Mental Health Journal | Springer Nature Link