“It was the whole picture” a mixed methods study of successful components in an integrated wellness service in North East England

Abstract Background A growing number of Local Authorities (LAs) have introduced integrated wellness services as part of efforts to deliver cost effective, preventive services that address the social determinants of health. This study examined which elements of an integrated wellness service in the n...

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Main Authors: M. Cheetham, P. Van der Graaf, B. Khazaeli, E. Gibson, A. Wiseman, R. Rushmer
Format: Article
Language:English
Published: BMC 2018-03-01
Series:BMC Health Services Research
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12913-018-3007-z
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spelling doaj-6595096b13a64b54904e7d5611a76c212020-11-24T21:20:54ZengBMCBMC Health Services Research1472-69632018-03-0118111010.1186/s12913-018-3007-z“It was the whole picture” a mixed methods study of successful components in an integrated wellness service in North East EnglandM. Cheetham0P. Van der Graaf1B. Khazaeli2E. Gibson3A. Wiseman4R. Rushmer5Health and Social Care Institute, Constantine Building, Teesside UniversityHealth and Social Care Institute, Constantine Building, Teesside UniversityGateshead Council, Public Health TeamGateshead Council, Public Health TeamGateshead Council, Public Health TeamHealth and Social Care Institute, Constantine Building, Teesside UniversityAbstract Background A growing number of Local Authorities (LAs) have introduced integrated wellness services as part of efforts to deliver cost effective, preventive services that address the social determinants of health. This study examined which elements of an integrated wellness service in the north east of England were effective in improving health and wellbeing (HWB). Methods The study used a mixed-methods approach. In-depth semi-structured interviews (IVs) were conducted with integrated wellness service users (n = 25) and focus groups (FGs) with group based service users (n = 14) and non-service users (n = 23) to gather the views of stakeholders. Findings are presented here alongside analysis of routine monitoring data. The different data were compared to examine what each data source revealed about the effectiveness of the service. Results Findings suggest that integrated wellness services work by addressing the social determinants of health and respond to multiple complex health and social concerns rather than single issues. The paper identifies examples of ‘active ingredients’ at the heart of the programme, such as sustained relationships, peer support and confidence building, as well as the activities through which changes take place, such as sports and leisure opportunities which in turn encourage social interaction. Wider wellbeing outcomes, including reduced social isolation and increased self-efficacy are also reported. Practical and motivational support helped build community capacity by encouraging community groups to access funding, helped navigate bureaucratic systems, and promoted understanding of marginalised communities. Fully integrated wellness services could support progression opportunities through volunteering and mentoring. Conclusions An integrated wellness service that offers a holistic approach was valued by service users and allowed them to address complex issues simultaneously. Few of the reported health gains were captured in routine data. Quantitative and qualitative data each offered a partial view of how effectively services were working.http://link.springer.com/article/10.1186/s12913-018-3007-zIntegrated wellness servicesHealth and wellbeingCommissioningSocial determinantsLifestyle change
collection DOAJ
language English
format Article
sources DOAJ
author M. Cheetham
P. Van der Graaf
B. Khazaeli
E. Gibson
A. Wiseman
R. Rushmer
spellingShingle M. Cheetham
P. Van der Graaf
B. Khazaeli
E. Gibson
A. Wiseman
R. Rushmer
“It was the whole picture” a mixed methods study of successful components in an integrated wellness service in North East England
BMC Health Services Research
Integrated wellness services
Health and wellbeing
Commissioning
Social determinants
Lifestyle change
author_facet M. Cheetham
P. Van der Graaf
B. Khazaeli
E. Gibson
A. Wiseman
R. Rushmer
author_sort M. Cheetham
title “It was the whole picture” a mixed methods study of successful components in an integrated wellness service in North East England
title_short “It was the whole picture” a mixed methods study of successful components in an integrated wellness service in North East England
title_full “It was the whole picture” a mixed methods study of successful components in an integrated wellness service in North East England
title_fullStr “It was the whole picture” a mixed methods study of successful components in an integrated wellness service in North East England
title_full_unstemmed “It was the whole picture” a mixed methods study of successful components in an integrated wellness service in North East England
title_sort “it was the whole picture” a mixed methods study of successful components in an integrated wellness service in north east england
publisher BMC
series BMC Health Services Research
issn 1472-6963
publishDate 2018-03-01
description Abstract Background A growing number of Local Authorities (LAs) have introduced integrated wellness services as part of efforts to deliver cost effective, preventive services that address the social determinants of health. This study examined which elements of an integrated wellness service in the north east of England were effective in improving health and wellbeing (HWB). Methods The study used a mixed-methods approach. In-depth semi-structured interviews (IVs) were conducted with integrated wellness service users (n = 25) and focus groups (FGs) with group based service users (n = 14) and non-service users (n = 23) to gather the views of stakeholders. Findings are presented here alongside analysis of routine monitoring data. The different data were compared to examine what each data source revealed about the effectiveness of the service. Results Findings suggest that integrated wellness services work by addressing the social determinants of health and respond to multiple complex health and social concerns rather than single issues. The paper identifies examples of ‘active ingredients’ at the heart of the programme, such as sustained relationships, peer support and confidence building, as well as the activities through which changes take place, such as sports and leisure opportunities which in turn encourage social interaction. Wider wellbeing outcomes, including reduced social isolation and increased self-efficacy are also reported. Practical and motivational support helped build community capacity by encouraging community groups to access funding, helped navigate bureaucratic systems, and promoted understanding of marginalised communities. Fully integrated wellness services could support progression opportunities through volunteering and mentoring. Conclusions An integrated wellness service that offers a holistic approach was valued by service users and allowed them to address complex issues simultaneously. Few of the reported health gains were captured in routine data. Quantitative and qualitative data each offered a partial view of how effectively services were working.
topic Integrated wellness services
Health and wellbeing
Commissioning
Social determinants
Lifestyle change
url http://link.springer.com/article/10.1186/s12913-018-3007-z
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