SACM - United Kingdom
Permanent URI for this collectionhttps://drepo.sdl.edu.sa/handle/20.500.14154/9667
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Item Restricted Investigating opportunities to provide behaviour change conversations to promote child oral health in non-dental settings(University of Manchester, 2024) Alshammari, Dalil; Peters, Sarah; Goldthorpe, Joanna; Coupe, NiaBackground: In 2022, almost a quarter of 5-year-old children in England had at least three untreated teeth with deep tooth decay. This is partly due to limited access to dentists, suggesting a need for additional ways to support children's oral health. Therefore, this PhD project sought to investigate opportunities to provide behaviour change conversations (BCC) to reduce children's oral health problems in early years settings (EYS). Method: The thesis aim was addressed through three stages using a mixed-method approach. In the first stage, a secondary analysis was conducted of electronic records of children referred to general dental anaesthesia in northwest England for tooth extraction. In the second phase,14 parents and 11 EYS staff were interviewed to explore their views regarding delivering and receiving messages to promote children's oral health. Sampling of participants sought to include those from varied backgrounds and 8 (57%) of parent interviews were conducted in Arabic. A systematic approach was developed to ensure accurate translation of non-English data, which preserved cultural and linguistic nuances during analysis. In the final stage, the behaviour change wheel approach was used to design an intervention to address the barriers and challenges identified in the previous stages. Results: Stage one revealed that despite an increased need, there were 90% fewer referrals to general anaesthesia during lockdown than in the corresponding period in the previous year. These findings indicate the need to explore the potential for non-clinical settings to address children’s oral healthcare. Stage two revealed that parents have limited awareness of oral health activities in EYS. They acknowledged that EYS staff could influence children's oral health behaviours, but identified several limitations, such as staff credibility. EYS staff recognised the need to address child oral health yet viewed the inclusion of oral health activities as overwhelming and reported how they avoid difficult conversations about oral health with parents. In response to the challenges of translating non-English data, a framework consisting of six stages was developed to ensure accurate translation and to guide researchers through the translation process. In stage three, the ToothTalk toolkit intervention was developed to facilitate communication between EYS staff and parents regarding children's oral health. This comprised a booklet for staff with information and behaviour change techniques to support their conversations, and an accompanying parents’ interactive workbook. Conclusion: The thesis provides timely and important evidence to support the existing rollout and proposals for expanding oral health practice at EYS in England, which may have potential also for other geographical localities. It found that oral health is considered a delicate conversation where staff need training to develop the necessary communication skills and confidence to initiate and hold tooth-kind conversations. Parents need support to trust and engage more in these conversations. The ToothTalk intervention was developed to address the identified barriers, which aim to increase the frequency and quality of oral health-related discussions initiated by EYS staff with parents. Further research is necessary to evaluate its effectiveness and acceptability in the EYS context. As well as its potential to be tailored to other contexts both within the four nations of the UK, and beyond.17 0Item Restricted The Impact of Google Docs-mediated Collaborative Writing with Teacher Intervention on EFL Learners’ Writing Outcomes(University of York, 2024-07-26) Alharee, Manal; Elebyary, Khaled; Handly, ZoeSome collaborative writing studies advocate teacher intervention in online collaboration; in most, teachers’ online interventions are shown to promote student collaboration but none have examined whether such interventions improve students’ writing abilities. Therefore, this study aims to investigate the impact of GD-mediated collaborative writing (GMCW) with teacher intervention on learners’ writing outcomes. An experimental study design was used, with 46 EFL students enrolled at Level 3 in the Department of English Language at Al Qassim University, Saudi Arabia. Convenience sampling was employed to assign learners to two conditions: experimental (n=24) and control (n=22). The experimental condition involved learners participating in GMCW activities with teacher intervention while the control condition involved learners participating in GMCW activities without teacher intervention. The study was conducted for 14 weeks. Unlike previous research, a mixed-methods approach was used to evaluate learners’ writing outcomes and their collaboration process in GD, as well as their attitudes to provide a comprehensive picture. The results indicated that promoting learners’ collaboration and influencing their language-learning beliefs through teacher intervention in the experimental condition resulted in learners improving their writing outcomes significantly more than those in the control condition. In experimental conditions, learners demonstrated high levels of collaboration by engaging in collaborative, collaborative/passive, and expert/novice interaction patterns. They also viewed the activities as a means of language learning. Those in the control condition showed low collaboration levels following a cooperative/passive pattern. Furthermore, their prior language learning beliefs negatively affected their attitudes toward the activity. This thesis argues that learners’ writing outcomes and attitudes toward collaboration are related to their collaboration level. Further, this study indicates that advanced collaborative platforms such as GD cannot facilitate learners’ collaboration without teacher support. Teachers should intervene to promote students’ online collaboration, which in turn improves their writing skills.30 0Item Restricted A pragmatic cluster randomised controlled trial (cRCT) of an educational intervention to promote asthma prescription uptake in General Practitioner Practices(University of Sheffield, 2024-04-23) Alyami, Rami; Julious, Steven A.; Simpson, Rebecca M.; Oliver, PhillipBackground: Asthma exacerbation rates in school-age children peak following the return to school after the summer break. Studies have shown a decline in prescriptions collection during August, which is followed by an increase in unscheduled visits to healthcare providers. A previous study (the PLEASANT trial) found that sending reminder letters to parents of children with asthma during the summer vacation led to a 30% increase in August prescriptions being prescribed and reduced unscheduled care visits after the return to schools in the period September to December. The intervention also resulted in an estimated cost saving of £36.07 per patient per year. Objective: To determine if informing general practitioner (GP) practices about the PLEASANT trial intervention results leads to its implementation. Design: A pragmatic cluster randomised trial which utilised the Clinical Practice Research Datalink (CPRD) to send the intervention and collect data. Participants: A total of 1,326 GP practices in England, including 90,583 individuals, with 664 practices (44,708 individuals) in the intervention group and 662 practices (45,875 individuals) in the control group. Intervention: In June 2021, the intervention practices received a letter from CPRD about the PLEASANT study findings and recommendations. The letter was sent to the asthma lead and/or practice manager via postal mail and email. Control Arm: Usual care. Randomisation: GP practices were stratified by practice size (decile) and randomly allocated to either the intervention or control group. Main Outcome: The proportion of children with asthma who had a prescription for an asthma preventer medication in August and September 2021. Results: The intervention did not significantly affect the proportion of children with asthma who had a prescription in August and September 2021 compared to the control arm. In the intervention group, 15,716 out of 44,465 children (35.3%) had a prescription issued, compared to 16,001 out of 45,559 children (35.1%) in the control group (OR 1.01; 95% CI: 0.97 to 1.04). There was also no intervention effect on the number of prescriptions uptake in the same period (IRR 1.01; 95% CI: 0.98 to 1.03). Furthermore, the letter did not reduce the number of unscheduled medical contacts after returning to school from September to December 2021 (IRR 0.99; 95% CI: 0.96 to 1.02) and all medical contacts remained unchanged (IRR 1.00; 95% CI: 0.97 to 1.02). Conclusion: The study findings suggest that passive intervention of providing a letter to GPs did not achieve the intended outcomes. To bridge the gap between evidence and practice, alternative, more proactive strategies could be explored to address the identified issues.10 0