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Pen portraits: a tool to influence policy and practice
Angela TodSchool of Nursing & Midwifery
This presentation presents independent research commissioned by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference
Number PB-‐PG-‐0408-‐16041) and supported by CLAHRC-‐SY.
The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the
Department of Health.
Outline
– Focus on Kwillt – but have used Pen Portraits in other projects e.g. Warm Well Families
– Background to KWILLT– KWILLT Methodology– Social marketing– Themes and segmentation model– Pen portraits– Practice and policy impact
What was KWILLT?
• Keeping Warm In Later Life projecT (KWILLT)• NIHR Research for Patient Benefit Programme• Conducted in Roterham• Motivations
-‐ Health impact of cold-‐ High levels of fuel poverty-‐ Costs to the NHS-‐ Low uptake of energy efficiency interventions-‐ Cold Weather Plan-‐ DH Public health Outcomes Framework (EWD/FP)
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Aim
• To explore influences on older people's behaviour regarding keeping warm and well at home.
• To better understand older people's decisions regarding keeping warm at home.
• To understand how older people may or may not be able to access advances and interventions to promote keeping warm in later life e.g. technical advances, affordable warmth or fuel retail interventions.
• To use the findings to develop strategies and social marketing solutions to address/overcome issues.
KWILLT Methodology
Qualitative methods
• 50 older people (aged 55-‐95), face to face in depth interviews,• Temperature/humidity measurements• 25 health and social care staff, face to face in depth interviews• Six focus groups with older people and frontline/strategic staff
(n=42)• Consultation event• Framework analysis to identify a thematic framework• Social marketing
Why is this necessary?
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What is social marketing
• Health related social marketing involves using marketing techniques and concepts to understand why people behave in a particular way
• Aims to improve health and reduce health inequalities by helping people to change their behaviour
• Public and service providers behaviour
In KWILLT we wanted to develop interventions to help the public, service providers, policy makers and those working at strategic levels to implement policy e.g. Cold Weather Plan, Public Health Outcomes Framework
http://socialmarketing-‐toolbox.com/
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What is segmentation?
• A method of identifying and describing groups of people who behave in the same way or have similar needs (or who are at risk of certain health threats).
• For KWILLT this meant identifying groups of older people with shared characteristics who were at risk of being cold.
PEN PORTRAITS
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Moving from themes to segmentation
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Segmentation Model
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Lonely, Pearle
Proud, Fred
Dependent, Meena
Getting by, Bob and Joan
Just about managing, Enid Isolated, Pat
Pen Portraits
What are the pen portraits for?
• The six pen portraits illustrate the factors that influence older people’s ability to keep warm – Fuel poor and non-‐fuel poor.
• The pen portraits help staff and organisations to:-‐ Find people who are at risk-‐ Recognise people at risk-‐ Understand the reasons why they are cold, the context, attitude and
behaviour that contribute to this-‐ Support staff and organisations in the design and delivery of acceptable and
accessible services-‐ Identify strategies to overcome barriers-‐ Promote strategies to support self management to keep warm
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How do they do this?
• Explain a complex Picture• People don't always do what you think they will do• Findings challenge assumptions: policy and practice• Prompt people to think of strategies and solutions:
• Partnership working• Networking• Recognising, identifying people at risk• Assessing and referring people in need• Neighbourhoods and communities• Government: (Department of Health (2011)
What assumptions?
• People aren’t cold these days• Its only the really old who are effected• Only people who are fuel poor are cold• Other people are tackling the problems• Family will help• People know that there are health impacts of being cold• People are aware of what healthy room temperatures are• People know how to use technology – heating and banking• Vulnerable people read and act on information from organisations such as energy
companies, banks and Government bodies• People will access interventions to help e.g. Social fuel tariffs and affordable
warmth interventions e.g. Green Deal• Vulnerable people will engage with processes to obtain help• Interventions don’t have adverse consequences
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Dissemination and Impact
• Pen portraits: http://kwillt.org/• Policy: NICE Guidance, Cold Weather Plan, Health and Wellbeing
Board Plans etc.• E-‐learning:
http://teaching.shu.ac.uk/hwb/AHP_resources/kwillt_resource/index.htm
• Communication tools: Winter Warmth Englandhttp://www.winterwarmthengland.co.uk/
• Videos: http://www.winterwarmthengland.co.uk/ben&joan.html• Chap books: Book of Damp http://www.ianbeesley.com/?p=416
Use in practice
• Pen portraits used in staff training in NHS, Fire and rescue, home care, community organisations Making Every Contact Counts
• Warm Homes: Healthy people. Rotherham. Raise capacity of services, staff and households
• Warm Homes: Healthy people Y&H Regional collaborative resource
• Links to Winter Warmth England on the Local Government Knowledge Hub website.
• Links to KWILLT materials and videos on National Age UK website for teaching purposes.
Publications
Models
Abacus Modelhttps://www.shu.ac.uk/?sc_itemid=4D61B8D9-‐7B70-‐426A-‐B23D-‐C1CA9C8188E1
Other work
• Warm Well Families
• Foundations Warm Homes Service evaluation
• Condensation research
• Learning disabilities
• ESRC academic seminar series
Contact
Angela TodProfessor of Older People and Care
Tel: 0114 222 2057Email: a.tod@sheffield.ac.uk
School of Nursing & Midwifery
The School of Nursing and MidwiferyThe University of SheffieldBarber House Annexe, 3a Clarkehouse Road, Sheffield, S10 2LA
www.shef.ac.uk/snm
https://www.facebook.com/nursingmidwiferysheffield
https://twitter.com/ShefSNM
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