Dr Kris Southby

Introduction General Practice (GP) in socio-economically deprived communities is under pressure to address patients’ medical issues with a social dimension or arising from patients’ social situations. Many GPs are ill-equipped to address such problems, repackaging them as ‘medical’ issues and treated with pharmacological interventions. A more holistic approach to primary care, linking the resources of GPs with voluntary and community sector (VCS) organisations embedded in their communities, can yield benefits for individuals and health systems and is advocated by many clinicians and policy makers. The presentation reports on empirical research to describe factors positively and negatively affecting GP-VCS collaboration in deprived communities. Method The working relationship between pairs of GPs and VCS organisations was explored following a qualitative case-study approach. Interviews (n=18) and focus groups (n=1) were conducted with staff working across four GPs and their ‘sister’ VCS organisations. Participants were asked to describe the working relationship between organisations, important aspects to the collaboration, and areas for improvement. Analysis involved drawing out commonalities and differences regarding GP-VCS collaboration across respondents. Results A range of collaborative models between GPs and VCS organisations were described. Physical proximity, shared aims, and personal relationships are pivotal to effective collaboration. Other factors affecting collaboration include time, policy support/infrastructure, resources, leadership, working culture, and communication. Conclusions Effective and sustainable GP-VCS collaborations do not occur spontaneously but require ongoing mutual investment. The findings help identify processes contributing to successful GP-VCS collaborations to address health inequalities in deprived communities. The research was funded by Sheffield Clinical Commissioning Group.

© 2019 The Authors. British Journal of Learning Disabilities Published by John Wiley & Sons Ltd Taking part in leisure activities is beneficial, yet many adults with learning disabilities are unable to participate in their preferred activities because of cost, because not having anyone to go with or because they do not feel welcome. Befriending is where someone volunteers to act as a friend. Befriending may be a way for adults with learning disabilities to participate in leisure activities with someone who is not a paid carer or family. The author spent time with four people with learning disabilities and their befrienders to find out what things they do together and what they both get from it. Friends and family members were also interviewed. Participants enjoyed the time they spent together. However, they often did the same activities they would do with paid carers or family and the relationship was sometimes quite professional. Befriending could be a way for adults with learning disabilities to have new, beneficial experiences, but we need to know more about how relationships work. Abstract: Background Leisure time for adults with learning disabilities is often diversionary and spent doing passive, solitary or family-orientated activities. Befriending, as a hybrid “natural” support, may help adults with learning disabilities overcome the barriers to participation in nonsegregated leisure. Materials and methods Four case studies of pairs of “befrienders” and “befriendees” were recruited purposively. Participant observation was carried out with each case, followed by semi-structured interviews with participants and relevant stakeholders. Data were analysed using thematic analysis. Results Befriending activities were mostly limited to enjoyable yet “casual” leisure activities that adults with learning disabilities might already participate in with family and paid service providers. Negotiating the befriender role between friend and professional was an ongoing challenge. Conclusions Outcomes of leisure–befriending relationships for adults with learning disabilities are linked to both the nature of relationships and the types of activities undertaken. There are four proposed ideal types of leisure–befriending relationship, yet repeating familiar “casual” leisure activities means adults with learning disabilities risk missing out on novel leisure and social experiences.

Participatory research appeals to notions of community empowerment and of generating more valid data grounded in the lived experiences of communities. For research-degree students, however, implementing such an approach can complicate an already challenging endeavour. Participatory research may juxtapose the institutional mechanisms surrounding a research degree and provide practical barriers to research-degree students. Reflecting on my own experience attempting to conduct a piece of participatory research for my doctoral research, this article concludes that participation should be viewed as an expansive concept and that any meaningful attempt to progress along a continuum of participation should be recognized and encouraged

Kris Southby for the Centre for Health Promotion Research at Leeds Beckett University is working with Mencap to find out how befriending can help people with a learning disability take part in leisure activities

Social recovery is intimately linked to the re-negotiations of what it means to be an African or Caribbean man. African and Caribbean men should be able to define recovery in their own terms as part of a much more inclusive dialogue.There was some divergence in how recovery was conceptualised between men, supporters and care providers. Mental health experiences contained accounts of the role of culture in their emotional wellbeing, overly medicalised and depersonalised approaches to care and lack of discharge planning. Mental health services need to consider how they can move towards the co-production of services with African and Caribbean men. Safe spaces are required to support social recovery, and are needed before men can develop relationships of equality, authenticity and trust.

Racial disparities for African and Caribbean men are nowhere as stark as in mental health services and outcomes. Men from these communities who have been in contact with mental health services seemed to be stuck in a stalled cycle of recovery. This paper reports the findings from a study that aimed to explore how African and Caribbean men and their supporters conceptualise mental health recovery at the intersections of masculinity, racialised identities and mental distress. It illuminates the perspectives of service users,family, carers and practitioners on recovery in relation to ethnicity and culture.Owing to the exploratory nature of this study, a qualitative design using a phenomenological approach was adopted to capture the dynamics of recovery processes and outcomes for African and Caribbean men across two study sites. Interviews were conducted with African and Caribbean men, their supporters and service providers. Interpretive Phenomenology Analysis (IPA; Smith J, Flowers P, Larkin M. Interpretative phenomenological analysis: Theory method and research. London: SAGE; 2009) was used to offer insights into how recovery was understood and experienced by study participants.Seven overarching themes emerged from the data in relation to the meanings of recovery: recovering from social suffering, leading a normal life, (re)gaining control and agency, a sense of hope, (re)gaining identity, reduced medical involvement, and recovery being a healing journey. The paper concludes that recovery is an ongoing process, not merely a narrow outcome to be achieved for men. The paper advances previous understandings by conceptualising mental health recovery for African and Caribbean men as a journey towards addressing individual and collective “social suffering” that occurs at the intersections of masculinity, “race” and mental distress, and moving to a better social location.

Racial disparities for African and Caribbean men are nowhere as stark as in mental health services and outcomes. Men from these communities who have been in contact with mental health services seemed to be stuck in a stalled cycle of recovery. This paper reports the findings from a study that aimed to explore how African and Caribbean men and their supporters conceptualise mental health recovery at the intersections of masculinity, racialised identities and mental distress. It illuminates the perspectives of service users, family, carers and practitioners on recovery in relation to ethnicity and culture. Owing to the exploratory nature of this study, a qualitative design using a phenomenological approach was adopted to capture the dynamics of recovery processes and outcomes for African and Caribbean men across two study sites. Interviews were conducted with African and Caribbean men, their supporters and service providers. Interpretive Phenomenology Analysis (IPA; Smith J, Flowers P, Larkin M. Interpretative phenomenological analysis: Theory method and research. London: SAGE; 2009) was used to offer insights into how recovery was understood and experienced by study participants. Seven overarching themes emerged from the data in relation to the meanings of recovery: recovering from social suffering, leading a normal life, (re)gaining control and agency, a sense of hope, (re)gaining identity, reduced medical involvement, and recovery being a healing journey. The paper concludes that recovery is an ongoing process, not merely a narrow outcome to be achieved for men. The paper advances previous understandings by conceptualising mental health recovery for African and Caribbean men as a journey towards addressing individual and collective “social suffering” that occurs at the intersections of masculinity, “race” and mental distress, and moving to a better social location.

Despite several initiatives, notably the ‘Delivering Race Equality’ national policy, designed to reduce persistent racial disparities in mental health services, people from Black, Asian, and Minority Ethnic (BAME) communities continue to have poorer experiences and outcomes. This disparity is most significant for African and Caribbean men. Recent approaches to supporting individuals with mental health difficulties centre on the notion of recovery. African and Caribbean men, however, can often become stuck in a ‘stalled cycle of recovery’ if the services and support they receive are not tailored to their unique needs as both people of African and Caribbean heritage and as men. This symposium will draw together findings from an NIHR SSCH funder research project to explore this study has explored the extent to which a socially-orientated approach to recovery might better support the mental health of African and Caribbean men and what this support might look like. The symposium will feature two presentations of the findings of the study. The first will explore how African and Caribbean men with experience of mental health conceptualise recovery. This is important to consider in order to design services that reflect the values of service users, informed by their unique life histories at the intersection of ethnicity and gender. The second presentation will consider identified the factors that promote wellbeing for Black and Caribbean men; and explore the extent to which socially oriented approaches to recovery address the lived experience of these men. Presentations will be follow by a screening of a short film called ‘Take Control’, performed by actors from Sound Minds. Sound Minds is a user led charity and social enterprise transforming the lives of people experiencing mental ill health through participation in arts activities since 1992. 'Take Control' is designed to be performed easily in community settings and is a useful stimulus for discussion on mental health issues. Contact us if you would like the play performed for your organisation.

Coding framework with quotes from semi-structured interviews

Previous research has shown that football fandom for people with a learning disability can positively affect wellbeing, social identity, social interaction and belonging (Southby, 2013a; Southby, 2013b; Southby, 2011). However, whilst such research has been disseminated through ‘traditional’ academic routes – peer-reviewed journal articles and conferences – it has not been shared with, or had very little impact upon, the public. The ‘Being a Bantam’ project is a knowledge exchange activity to share learning about the football fandom of people with a learning disability with the ‘football community’ (i.e. fans, administrators, policy makers) and the public. The project is a co-produced photographic exhibition of images representing the experience of fans with a learning disability supporting their teams. The project aims to critically challenge public understanding of football fandom for people with a learning disability, destigmatise learning disability, and encourage greater cohesion/inclusion within the football community. The exhibition will be on display indefinitely in Bradford City Football Club’s stadium from the 9th April 2016 for those attending Bradford City FC matches to view. Upon the projects launch, fans without a learning disability viewing the images will be asked to comment on the fandom of people with a learning disability to a researcher present in the stadium (on 9th April) and via social media. The intention of this paper is to present learning from the ‘Being a Bantam’ project. It will start by outlining previous research concerning the football fandom of people with a learning disability before critically discussing the process of co-producing a knowledge exchange photography exhibition with people with a learning disability. Outcomes from the project, including areas for future research, will be presented.

Respite aims to alleviate the stress and burden of caring for someone with an intellectual disability and/or autism. Respite can take place in a number of different ways, but most commonly occurs in a residential setting. Based on survey and interview data with carers (CAs), service users and stakeholders (STs) in a northern city in England, this article explores some of the perceived or actual barriers to availing 'non-residential' respite. A number of barriers to non-residential respite are identified. Residential respite appears to be the default conceptualization of 'respite' for carers, service users and stakeholders. Persuading carers, service users and stakeholders to give up the familiarity and safety of residential respite in favour of a non-residential alternative will be challenging unless those involved are more informed. Limitations and directions for future research are suggested.

There is a growing body of evidence regarding the barriers to participation in sport for people with sight loss and for people from ethnically diverse communities. However, far less is known about the experience of people with sight loss who are also from ethnically diverse communities. Semi-structured interviews with people with lived experience and focus groups with civil society organisations that work with people with sight loss in the UK were undertaken. The aim was to explore how issues concerning ethnicity, culture, and heritage overlap with sight loss to affect sport participation. This research found that the intersecting occurrences of sight loss and ethnicity/cultural factors, as well as other socio-demographic factors like gender, compound and exacerbate the barriers to sport participation for people with sight loss from ethnically diverse communities. Further research is needed in different settings to unpack the heterogeneity related to sight loss, ethnicity, and sport.

In Britain, within the contemporary drive to use sport to tackle the isolation of socially excluded groups, football (soccer) fandom has been suggested in many policy documents as a possible site for enabling people with learning disabilities to become more socially included. Forming the basic theoretical work for my doctoral research, this paper provides a critical analysis of this so far unexamined discourse. Conclusions suggest that current policy represents a simplistic and overly romanticised view of people with learning disabilities as football fans, leaving many unanswered questions about what social inclusion targets can reasonably be met through football fandom. © 2011 World Leisure Organization.

In Britain, within the contemporary drive of using sport to tackle the isolation of socially excluded groups, association football (football) fandom has been implicated in many policy documents as a possible site for learning-disabled people to become more socially included. However, whilst there is some evidence of the benefits of playing football for learning-disabled people, there is little evidence to support these claims. Drawing on empirical data, this paper aims to provide a critical analysis of the opportunities to tackle social exclusion that football fandom provides to learning-disabled people. Evidence suggests that whilst football fandom offers social benefits to learning-disabled people - including a sense of belonging and a shared social identity - that go some way towards tackling their social exclusion, football fandom is unlikely to result in the 'social inclusion' characterized by the government. © 2013 © 2013 Taylor & Francis.

Background aims Standardised tools potentially provide a quick and reliable way for measuring wellbeing that can be used during monitoring and evaluation to understand how services are performing over time and in comparison to other services. This was a collaborative project between researchers from Leeds Beckett University, University of Liverpool, and Purple Patch Arts (a community organisation that work with adults with learning disabilities). The aim was to make a pre-existing wellbeing measurement tool more accessible for adults with learning disabilities and more useful for organisations working with adults with learning disabilities. Methods An existing standardised tool was adapted into a version that could be completed using a tablet. Adults with learning disabilities taking part in Purple Patch Arts’ sessions tested the new measure. We also asked staff at the activities what they thought about the new version. Results The accessible tablet version was found to be as reliable as two other existing standardised tools as a measure of wellbeing for adults with learning disabilities. Adults with learning disabilities and staff much preferred using the tablet version – it was more engaging, collaborative, and inclusive. However, the tablet version remained extremely resource intensive to use and relied on staff already having a relationship with adults with learning disabilities to help them complete it. Most adults with learning disabilities would still not be able to complete it independently in a service setting. Conclusion The new tablet version had strengths compared to existing wellbeing measures. However, at this stage it is not a replacement for more personalised approaches to understanding services users’ wellbeing. The accessible tablet version is a potential complementary data source in monitoring and evaluation, but more work is needed to understand its usefulness in different service settings and with more diverse groups of adults with learning disabilities.

An interdisciplinary discussion about what we know and what more we need to know about the voluntary sector, learning disabilities and autism, and tech. The webinar featured two presentations - 'Digital reversion imminent? Digital activities in Swedish day centres post pandemic' - Richard Gaddman Johansson, Stockholm University - The Click! programme - Kelly Perry & Lynne Emerson, Wynward Day Services The second part of the webinar was a facilitated discussion about research priorities and perceived important issues.

Disability sport fandom can be understood in different ways depending on whether the fans or competitors (or both) has a disability. In terms on fans of disability sport, this almost always relates to people without disabilities. It also relates mostly to those with a limited exposure to the sport they are watching/spectating rather than those with a more sustained interest. Fans of disability sport very often have the same motivations as fans of non-disabled sport, although there are also aspects unique to disability sport fandom. Disability sport fandom is thought to be a powerful mediator of popular understandings of disability that sports managers, event organisers, and policy makers have tried to harness. Watching disability sport can, in the short term, have a positive effect on people’s awareness and perceptions of disability. However, this type of representation can reinforce the value of only a limited range of disabilities. Differences between sports and the effect over time are underexplored. In terms of fans with disabilities of sport, there is relatively little evidence about their experiences of fandom. Limited studies highlight the range of experiences of fans with disabilities and the potential of sports fandom to facilitate social inclusion. Fans with disabilities of sports are very often conceptualised and discussed as ‘other’ from the traditional cultural hegemony of sports fandom. Access is a significant issue. Despite legislation and various guidance about facilitating access, sports fans with disabilities continue to face barriers preventing them enjoying the same fan experience as people without disabilities. Reasons for this include a narrow focus on the physical environment and infrastructure around sport stadia and the attitudes of managers and administrators. The dominance of a medial model of disability limits understanding of the multiple barriers to access fans with disabilities can experience. The politics of disability and the instrumental use of sport for social justice are themes that cut across both interpretations of disability sport fandom. Theories and evidence on the topic are scarce. Greater consideration is needed of the potential heterogeneity of the sport and people involved. Following social model ideals, more needs to be done with fans and competitors with disabilities on issues that are important to them and about their experience of fandom.

Collaborative working between general practice (GP) and voluntary and community sector (VCS) organisations is increasingly championed as a means of primary care doing more with less and of addressing patients' "wicked problems". This paper aims to add to the knowledge base around collaborative practice between GPs and VCS organisations by examining the factors that aid or inhibit such collaboration. A case study design was used to examine the lived-experience of GPs and VCS organisations working collaboratively. Four cases, each consisting of a GP and a VCS organisation with whom they work collaboratively, were identified. Interviews (n = 18) and a focus group (n = 1) were conducted with staff within each organisation. Transcribed data were analysed thematically. Whilet there are similarities across cases in their use of, for example, Health Trainers and social prescribing, the form and function of GP-VCS collaborations were unique to their local context. The identified factors affecting GP-VCS collaboration reflect those found in previous service evaluations and the broader literature on partnership working; shared understanding, time and resources, trust, strong leadership, operational systems and governance and the "negotiation" of professional boundaries. While the current political environment may represent an opportunity for collaborations to develop, there are issues yet to be resolved before collaboration-especially more holistic and integrated approaches-becomes systematically embedded into practice.

Background During the Covid-19 pandemic there was a significant rise in health and care services delivering services remotely, including by voluntary and community sector organisations (VCSOs) to adults with learning disabilities and/or autistic people. However, there was not enough research evidence of how different technologies are used, what works well or not well, for whom, and in what circumstances to support the diverse needs of adults with learning disabilities and/or autistic people. To address this evidence gap, Leeds Beckett University carried out a participatory realist review in partnership with 100% Digital Leeds, Pyramid and the Autism and Learning Disabilities Digital Inclusion Network (ALaDDIN) to explore how VCSOs can appropriately use digital technologies alongside or instead of in-person activity (hybrid delivery) to provide social care services to different adults with learning disabilities and/or autistic people. Methods This briefing is based on the findings of the participatory realist review. The research involved: • Five workshop and focus group discussions with people with learning disabilities and/or autistic people and representatives from VCSOs who worked with them, • A comprehensive review of relevant published research, guidance and policy, and • A deliberative hearing event to bring together findings from research and lived experience Results Everyone has the right to choose how they engage with the digital world! The workshop discussions and preliminary literature review produced 13 areas of interest that we explored in the realist review. The review included 141 articles in total and, following our discussions of the findings with service deliverers and users at the deliberative hearing event, led to six top tips for VCSOs using digital technology for delivering services to people with learning disabilities and/or autistic people.

There is a growing policy discourse and empirical evidence which suggests a need for a shift in the way that care is delivered for people with long-term conditions – moving from an expert-driven consultation to one based on collaboration and partnership. Year of Care is an approach to managing long-term conditions, focused on personalised care planning whereby patients work together with the clinician using a collaborative process of shared decision-making to agree goals, identify support needs, develop and implement action plans, and monitor progress. This paper reports the learning from implementing Year of Care in Leeds where nine ‘early adopter’ sites rolled-out the programme. Process and delivery issues are highlighted in the paper, including the challenge of navigating cultural change in General Practice and training and support issues. It is anticipated that this learning and insight will have utility beyond Leeds to other areas adopting greater patient centred care models.

There are many intellectually able autistic adults who would like to have a better quality of life but who struggle to access advice and support from traditional services. This situation leads to emotional distress and poor outcomes for these individuals and their families and society generally. So services such as the Leeds AIM (Advocacy, Information and Mentoring) service described in this paper have great potential in enhancing the lives of this group and in educating mainstream services on how advice and support might be adjusted to allow better access. In addition, creating good spaces for autistic adults offers opportunities for social contact and friendships with like-minded peers both within and outside the service

‘Low-level’ support is championed to support adults with high functioning autism spectrum disorder (HFASD) to achieve good quality health and social care, yet research in the area is sparse. Drawing on semi-structured interview data, this paper considers the efficacy of an intervention to provide low-level support to adults with HFASD with little or no funded support. The intervention led to a number of perceived positive outcomes for adults with HFASD, their families, and service providers in the city, including increased access to education, volunteering, support and information, socialising, improved health and wellbeing, and managing day-to-day. Although many of life’s difficulties still persisted, the intervention helped service users overcome barriers to availing further support, possibly leading to beneficial outcomes down the line.

Issue: Health 2020 envisions a critical role for civil society and volunteerism is an important facet of this. As well as the volunteer contribution to community health, volunteering is associated with intrinsic health benefits. This makes it a public health issue but little attention is given to the question of how volunteering intersects with health inequalities. Description of problem: This presentation reports on a UK project that is seeking to maximise the public health potential of volunteering and address barriers that result in unequal access. Because little is known about this issue beyond the variations that exist, the first stage was a rapid scoping review conducted in 2015-6. This involved reviewing key literature on health inequalities and volunteering across socio-economic status and the nine population groups protected by the UK Equality Act. Results: The scoping review identified 6,094 publications and after screening, 98 studies were reviewed; of these were 24 UK and 18 from elsewhere in Europe. Results confirmed that volunteering is associated with a social gradient, with disadvantaged groups less likely to volunteer. A web of factors were found to influence volunteering prevalence, however barriers varied between groups and across the lifecourse. The review also uncovered issues of stigma affecting people with disabilities. Lessons: The review provides a map of inequalities issues that affect volunteering, which given the focus of Europe 2020 will be of use to public health policy and practice. The next stage is to identify interventions that are able to widen participation and address social exclusion. Our conclusions are that volunteering should be recognised as a public health issue. More debate is needed on how public health systems can respond to the inequalities identified and enable those who face barriers to gain from the health and wellbeing benefits of volunteering. Main messages Volunteering needs to be considered as a public health issue, with more potential for addressing social exclusion and health inequalities Multiple factors influence inequalities in access to volunteering, with different population groups experiencing different barriers

This chapter outlines the historical development of scholarly work on masculinities and disability, paying attention to conceptual shifts in thinking on this relationship. In doing so, it challenges a view that the only gender identity options open to men with impairments are as ‘failed’, ‘spoiled’ or in need of reformulation. Through consideration of how masculinities and disability studies intersect, and using case-study examples of learning impairment and ‘cyborg bodies’, we highlight how connections of similarity and difference around disability and gender are complex and interact to support and reinforce, but also to challenge and undermine, each other.

Introduction Volunteering is acknowledged to benefit individual, community, and population health and wellbeing. However, those who have the most to gain from volunteering are often least likely to take part. There are questions about how to ensure all groups, especially those who experience social exclusion, can benefit from volunteering. This presentation reports on a rapid review of volunteering, public health and inequalities, with a focus on the barriers to volunteering experienced by population groups with characteristics protected under the Equality Act 2010 (i.e. age, disability, gender, pregnancy/maternity, ethnicity, relationship status, religion, sexual orientation). Methods A rapid review of evidence describing barriers to volunteering experienced by each of the ‘protected characteristics’ was undertaken. After searching and screening, 98 relevant papers were identified across peer-reviewed and grey literature. Data were extracted and evidence synthesised across each of the groups. Results A varied number of papers were identified for each protected characteristic. ‘Age’ (n=23) and ‘sexual orientation’ (n=0) and ‘pregnancy/maternity’ (n=0) were the most and least common respectively. The greatest number of barriers were identified for ‘age’, ‘disability’, and ‘gender’, possibly due to limited research in other areas. There were some cross cutting barriers but also distinct barriers were identified in relation to specific groups. Conclusion Barriers to volunteering are not experienced homogenously within or across protected characteristic groups. The relationship between protected characteristics and barriers to volunteering is complex. The findings help identify appropriate processes promoting social inclusion to ensure all groups can benefit from volunteering. Funding was provided by Volunteering Matters.

Key messages and summary of the research on Leeds Community Champions programme 2021-23

This research has captured learning from the Leeds Community Champions programme and appraised options for embedding a sustainable Champion model in Leeds that builds community capacity and contributes to reducing health inequalities. The Leeds Community Champions programme has been effective at engaging with, and reaching into, diverse communities at risk of experiencing significant health inequalities. In neighbourhoods and communities, Community Champions became those trusted messengers, able to have informal conversations and connect with others. Community Champions also provided flexible additional capacity to support and complement local organisations and projects. A strong partnership approach between statutory services and Voluntary, Community and Social Enterprise (VCSE) organisations at all levels has been a major factor in the success of the programme. Overall, this flexible, responsive approach has helped services reach some of those communities with the greatest needs. Going forward, learning from the programme - on inclusive volunteering, on utilising the commitment and knowledge of Community Champions, on co-design and co-delivery - can be used to shape future action on health inequalities and help strengthen volunteering in the city.

The Chiles Webster Batson Commission asked questions about the relationship between disadvantaged neighbourhoods and recreational, informal sport of the type that young people warm to because it is designed to be fun. It aimed to shine a light on the importance of such sport for many low-income young people and show the positive role that neighbourhood organisations play in supporting low income areas to become happier, better networked, enriched, more active places to live. The Commission took as a starting point the interconnectivity between life in a low-income neighbourhood and low rates of participation in sport and physical activity. Limited access to sport and physical activity is a feature of growing up poor in 21st century Britain. 72% of the demographic cohort do not attain the CMO’s physical activity guidelines of one hour a day of enhanced physical activity. Only 16% are members of a sports club and just 14% visit leisure centres. This under-representation of low-income young people in the sports system is not best explained by reference to personal choice. Rather, there is a structural inadequacy in our sports system which results in the exclusion of low-income young people. Traditional sports provision, like a tennis or rugby club, is less accessible to low income families than to more affluent families for reasons of geography, and the tendency of such clubs to market themselves to people in their own image. It is the same with gym membership where the cost is frequently prohibitive. The problem of under-representation is made more chronic by young people’s tendency to prefer sociable sports to the solo sports and activities, like jogging or walking. Such sociable activities tend to require an organiser and often require kit, indoor space or marked-up outdoor space. In other words, sociable sports need organisation and resources which the sports system does not supply. The Commission recognised that missing out on an active lifestyle increases the deficits endured by children and young people living in disadvantaged neighbourhoods. It is likely that in comparison to the lives of their more affluent peers, young people growing up in low income areas connect with fewer positive role models; enjoy fewer opportunities to take a leadership and organising role and have fewer opportunities to exercise and develop their problem-solving skills. Appropriately organised sport offers these opportunities in abundance. Disadvantaged young people miss out on the positive properties of sport in the context of lives lived with higher rates of exposure to violence, poorer mental health, higher rates of food insecurity and a lack of safe spaces. It is ironic that those neighbourhoods most in need of the benefits of well organised sport, run by wise and relatable role-models, are those which struggle most to access it. To respect the importance of the neighbourhood organisations which do provide opportunities to take part in fun-sport, and reap the associated benefits, the Commission adopted an approach which amplified their voices and combined that with hard academic evidence. Such twin-tracking allowed Commissioners to comprehensively assess the strengths, challenges and opportunities for this specialised, and generally under-appreciated, corner of the sporting landscape. This approach also embraced Asset Based Community Development theory which privileges strategies that make the target community the actor in driving change and not the recipient of external, top-down impositions – no matter how benign. To hear of the ‘lived experience’ of the neighbourhood organisations enriched the Commissions understanding of what works and why. The Commission intended to visit about 10 neighbourhood organisations to see their work in-situ and talk with the leaders and the young participants. Covid restrictions all but prevented these visits. Zoom gatherings substituted for the planned programme in a ‘make-do’ spirit. Undoubtedly, this reduced the input of the organisations’ leaders and the young participants. However, there were advantages in the Commission operating during the pandemic. It did highlight the importance of the neighbourhood organisations to their community. Driven by commitment to their patch (and operating with their lean structures and decision making powers close to the ground) these organisations rapidly became important to pandemic relief interventions. The Commission saw at first hand their flexibility and importance to neighbourhood life on a scale that reached far beyond sport.

Purpose: A proportion of the working age population in the UK experience mental health conditions, with this group often facing significant challenges to retain their employment. As part of a broader political commitment to health and well-being at work, the use of job retention services have become part of a suite of interventions designed to support both employers and employees. While rigorous assessment of job retention programmes are lacking, this paper examines the success of, and distils learning from, a job retention service in England. Design/methodology/approach A qualitative methodology was adopted for this research with semi-structured interviews considered an appropriate method to illuminate key issues. Twenty eight individuals were interviewed, including current and former service users, referrers, employers and job retention staff. Findings Without the support of the job retention service, employees with mental health conditions were reported to have been unlikely to have maintained their employment status. Additional benefits were also reported, including improved mental health outcomes and impacts on individuals’ personal life. Employers also reported positive benefits in engaging with the job retention service, including feeling better able to offer appropriate solutions that were mutually accepted to the employee and the organisation. Originality/value Job retention programmes are under researched and little is known about their effectiveness and the mechanisms that support individuals at work with mental health conditions. This study adds to the existing evidence and suggests that such interventions are promising in supporting employees and employers.

Despite volunteering being a feature of community life in the UK, differences as to who volunteers are evident. Reporting on a rapid review of the evidence on volunteering and inequalities, the aim of this paper is to provide an overview of the breadth and interconnectedness of barriers to volunteering for potentially disadvantaged groups. Sixty-seven articles were identified, to produce a map of factors affecting volunteer participation. Findings suggest that while different demographic groups experience specific barriers to volunteering, there are areas of commonality. Analysis shifts the onus of volunteering away from the level of individual choice (a dominant emphasis in policy and practical discussions around promoting volunteering) and towards the influence of structural factors related to broader exclusionary processes. Those who potentially have the most to gain from volunteering are the least likely to participate. Whilst the benefits of volunteering are increasingly documented by research and championed by policy, there are questions about the success of this approach given that the underlying social inequalities present substantive barriers to volunteering and must be address to promote greater access.

Purpose Living in an area experiencing economic and social disadvantage is a known risk factor to poor mental health and well-being. This paper aims to understand how some communities experiencing disadvantage appear to be more resilient to the enduring challenges they face and display better mental health outcomes. Design/methodology/approach A qualitative case study approach was used. Semi-structured interviews (total = 74) were undertaken remotely with residents (n = 39) and voluntary, community and social enterprise groups, community leaders and other local stakeholders (n = 35) in four case study areas. Data analysis was cross-case, thematic analysis. Community analysis workshops (n = 4) and resilience mapping workshops (n = 4) in each site corroborated emerging insights. Findings Four overlapping and interacting themes support community resilience: community hubs and local voluntary, community and social enterprise (VCSE) networks; opportunities to participate and make connections within communities; open and supportive environments to talk about mental health and well-being; and community identities and collective narratives. Differences in access to these resources was a cross-cutting theme. Originality/value Community resilience can be understood in terms of the amount of resources – articulated in terms of capital – that communities can draw on in response to challenges, and how well these resources are mobilised. A thriving VCSE sector is important for community resilience in communities experiencing disadvantage as a mechanism for both sustainably building and mobilising community resources in the face of daily and enduring challenges.

INTRODUCTION Living in an area experiencing economic and social deprivation is a known risk factor to poor mental health and wellbeing. There is considerable need to prevent poor mental health outcomes through action on the social determinants of health. This paper is concerned with how some communities experiencing disadvantage appear to be more resilient to poor mental health and wellbeing (community resilience). METHODS A qualitative case study approach was used to carry out an in-depth exploration of what factors support community resilience in four communities experiencing disadvantage in the United Kingdom. 74 semi-structured interviews were undertaken remotely with 39 residents and 35 VCSE groups, community leaders and other local stakeholders. Interviews explored resilience narratives, assets and protective factors, and local challenges. Community analysis workshops and resilience mapping workshops in each site further explored insights from interviews. Data analysis was undertaken using cross-case, thematic analysis. RESULTS Communities experiencing disadvantage encounter a range of daily and enduring challenges to good mental health and wellbeing. Four overlapping and interacting themes support community resilience: (i) Community hubs and local VCSE networks enable a community to support one another and respond effectively to challenges; (ii) Opportunities to participate and make connections within communities strengthens social connections, builds local capacity and empowers people; (iii) Open and supportive environments to talk about mental health and wellbeing help reduce stigma and gives people the tools to help one another; and (iv) Community identities and collective narratives that establish a shared sense of belonging help people to feel secure and connected. DISCUSSION & CONCLUSION Community resilience can be understood in terms of the amount of resources – articulated in terms of capital (e.g. financial, social, cultural, human, natural, physical/built) – that communities can draw on in response to challenges and how well they are mobilised. VCSE organisations and networks play a significant role both building and mobilising different capitals in communities experiencing disadvantage. However, communities experiencing disadvantage face enduring challenges (e.g. poor housing, insecure employment, Covid-19). While VCSE organisations can directly support communities at a local level, their ability to affect structural change is limited to campaigning and advocacy. Responsibility for addressing these issues lie with local and national government. A thriving VCSE sector is important for community resilience in communities experiencing disadvantage as a mechanism for both sustainably building and mobilising community resources in the face of daily and enduring challenges.

Practice-based case studies that describe learning from implementation are a useful source of evidence for policy makers, practitioners and researchers. Despite the value of narratives developed in context as a form of experiential or applied evidence, little is known about appropriate qualitative review and synthesis methods to deal with multiple practice-based case studies. This paper reports on a methodological study to develop and pilot a synthesis method using a sample of community wellbeing case studies focused on interventions to improve community infrastructure. The study was conducted in four interlinked phases: (i) literature review to scope synthesis methods (ii) piloting search and selection methods to identify a sample of relevant practice-based case studies that reported experiential learning (iii) undertaking cross case analysis and qualitative synthesis based on framework analysis methods (iv) review and reflection to produce a summative account of the method and agreed definition. The main output from the study was a staged approach to qualitative synthesis of practice-based case studies based on seven steps, which move from identification of a conceptual framework through to producing a narrative report. The potential transferability of this approach and its application in research and policy are critically discussed. Synthesis of case studies derived from community-based interventions could address knowledge gaps in the formal evidence base. While further methodological development is warranted, it is argued that study results form a credible qualitative framework for synthesising practice-based evidence.

Peer research is about academics and other professional researchers working with and training non-researchers to do research on issues that they have lived experience of and that involves collecting data from people like them—their peers. In health promotion specifically, peer research is a form of community-based participatory research and is based on a recognition that community members are experts on their own lives and so are best placed to identify and plan to solve their own health problems. Peer researchers are able to leverage their insider status within a community to improve research findings and knowledge production compared to nonparticipatory approaches. The act of involving community members as peer researchers can also support social justice and health promotion outcomes. However, there are practical, ethical, role, epistemological, and emancipatory challenges with peer research. In this chapter, strategies to support implementation of peer research in health promotion research are discussed, including involving peers as early as possible, clarifying roles and responsibilities, paying peer researchers for their contributions, and providing training and ongoing support to peer researchers. However, the relative newness of peer research as a research methodology means that a lot of questions remain about its operation and effectiveness; the majority of evidence about the method comes from informal evaluation, academic researcher observations, and feedback from peer researchers. More systematic investigation is needed to understand the utility of peer research in different health promotion contexts.

Abstract

Stakeholder engagement for the What Works Centre for Wellbeing’s (WWCW) Community Wellbeing Evidence Programme identified ‘boosting social relations’ in communities as a priority policy-related topic. A scoping review of 34 reviews identified evidence gaps relating to social relations in the following areas: community infrastructure (places and spaces); interventions to reduce or prevent social isolation in adults <60 years; community engagement and volunteering; social network analyses. We developed ‘community infrastructure (places and spaces)’ as a systematic review, as this can be addressed at a local or regional level and has potential to produce immediate practical impact. We searched 11 bibliographic databases from 1997–2017, performed reference and citation checking, searched the websites of relevant organisations, and issued a call for evidence through the WWCW. We included studies which reported: interventions to improve or make alternative use of physical places and spaces at community or neighbourhood level; outcomes of social relations, community wellbeing and related concepts; quantitative, qualitative and mixed methods studies, and process evaluations. Two reviewers undertook study selection. One reviewer undertook data extraction and validity assessment, with a random 20% checked by a second reviewer. Validity of included studies was assessed using established checklists. Following thematic synthesis of qualitative data, a narrative synthesis was produced for each of eight intervention categories. The GRADE and CERQual approaches were used to rate the overall strength of evidence for each outcome. 51 studies, mostly of poor to moderate quality, were included. The better quality evidence was qualitative, and most of the review’s findings come from the thematic synthesis of qualitative evidence There was moderate evidence that Community hubs may promote social cohesion, increase social capital and build trust between people, widen social networks and increase interaction between people, and increase people’s knowledge or skills; Changes to neighbourhood design may positively affect sense of belonging and pride in a community; Green and blue space interventions that provide the opportunity to participate in activities or meetings improve social interactions, increase social networks, bonding and bridging social capital, physical activity and healthy eating, and improve people’s skills and knowledge. There were also common themes relating to facilitators and barriers to successful interventions. The review found moderate evidence that a range of intervention approaches to community infrastructure can boost social relations and community wellbeing. Future research should prioritise high quality evaluations using repeated measures and validated tools, with robust and credible qualitative evidence.

Being a football fan can be beneficial for adults with a learning disability; it can be a social activity and a source of identify and community belonging. The Being a Bantam exhibition is a series of 25 photographs taken by fans of Bradford City Football Club with a learning disability. The photographs are intended to represent the experience of being a fan with a learning disability, the diversity of football fans, and de-stigmatise learning disability. They are on permanent display in Bradford City FC's stadium.

Background: Stakeholder engagement for the What Works Centre for Wellbeing’s (WWCW) Community Wellbeing Evidence Programme identified ‘boosting social relations’ in communities as a priority policy-related topic. A scoping review of 34 reviews identified evidence gaps relating to social relations in the following areas: community infrastructure (places and spaces); interventions to reduce or prevent social isolation in adults <60 years; community engagement and volunteering; social network analyses. We developed “community infrastructure (places and spaces)” as a systematic review, as this can be addressed at a local or regional level and has potential to produce immediate practical impact. Methods: We searched 11 bibliographic databases from 1997-2017, performed reference and citation checking, searched the websites of relevant organisations, and issued a call for evidence through the WWCW. We included studies which reported: interventions to improve or make alternative use of physical places and spaces at community or neighbourhood level; outcomes of social relations, community wellbeing and related concepts; quantitative, qualitative and mixed methods studies, and process evaluations. Two reviewers undertook study selection. One reviewer undertook data extraction and validity assessment, with a random 20% checked by a second reviewer. Validity of included studies was assessed using established checklists. Following thematic synthesis of qualitative data, a narrative synthesis was produced for each of eight intervention categories. The GRADE and CERQual approaches were used to rate the overall strength of evidence for each outcome. Results: 51 studies, mostly of poor to moderate quality, were included. The better quality evidence was qualitative, and most of the review’s findings come from the thematic synthesis of qualitative evidence There was moderate evidence that: (i) Community hubs may promote social cohesion, increase social capital and build trust between people, widen social networks and increase interaction between people, and increase people’s knowledge or skills; (ii) Changes to neighbourhood design may positively affect sense of belonging and pride in a community; (iii) Green and blue space interventions that provide the opportunity to participate in activities or meetings improve social interactions, increase social networks, bonding and bridging social capital, physical activity and healthy eating, and improve people’s skills and knowledge. There were also common themes relating to facilitators and barriers to successful interventions. Conclusions: The review found moderate evidence that a range of intervention approaches to community infrastructure can boost social relations and community wellbeing. Future research should prioritise high quality evaluations using repeated measures and validated tools, with robust and credible qualitative evidence.

This guidance provides a step by step approach to synthesising practice-based case study evidence. The rationale is the opportunity presented by combining case studies, in order to make the most of the data case studies contain, whilst also producing robust, potentially transferable findings. Findings from the synthesis of a number of individual cases may allow for translation to other settings and the generalisability of the findings from the synthesis of a number of practice-based case studies may also be increased by linking back to theory. This guide follows a full review of synthesis approaches that might be appropriate for practice-based case study evidence. The review included testing one approach, which has been used as the basis for this guide, to illustrate how synthesis can be done in practice.

This briefing presents results from a synthesis and review of practice based case studies on how community hubs and green spaces can enhance wellbeing in a place. Case study evidence provides important and rich detail on these projects and activities, and how they are delivered. This research identified community wellbeing outcomes that support the findings from systematic review evidence, as well as describing additional and unforeseen outcomes, including those that arise from the benefits of more informal spaces that may not have been the subject of formal evaluations, as well as benefits to the organisations responsible for the delivery of the interventions.

Practice-based case studies are recognised as an important source of knowledge and learning and one that is complementary to research-based evidence. There is a knowledge gap about how to synthesise this evidence. This study addressed this knowledge gap by identifying the most robust methods to collate, review and synthesise practice-based case study evidence and by carrying out a pilot synthesis on practice-based community wellbeing case studies. The pilot focused on community-based interventions (projects, initiatives, services or programmes) that aimed to improve social relations and community wellbeing through better community infrastructure (places and spaces).

As part of the Communities of Place (CoP) Evidence Programme, at the What Works Centre for Wellbeing, we are conducting a scoping review and qualitative synthesis of the methods and approaches of community-based practices in supporting community wellbeing. This ‘Community Wellbeing Case Study Synthesis’ will have two areas of focus (i) development of a method to synthesise learning and outcomes from community-based wellbeing projects (ii) collection and review of a sample of projects that are focused on promoting wellbeing through a place or neighbourhood. There is considerable interest in the knowledge and learning that can be obtained from practice-based case studies, but no consensus on how to synthesise that evidence. This study will therefore aim to provide a ‘proof of concept’, laying the foundations for synthesising learning from community wellbeing practice. This protocol sets out the process that we will use to develop the methods and then apply them with a small set of community wellbeing case studies.

Growing policymaker interest in community wellbeing puts a premium on knowledge about existing community-level challenges and possible policy responses. If evidence-based policy and practice is foregrounded in these developments, there is a risk that lived experience is seen to lack validity in policy-making decisions and that knowledge from and about underrepresented groups is underemphasised. In consequence, the best available evidence on which to make policy decisions affecting these groups might be missed, thus potentially increasing health inequalities. This paper extends debate on this dilemma in this journal by using the lens of ‘pragmatic complexity’ as an alternative view on what works as evidence for policy and practice in community wellbeing. We present an empirical analysis of two expert hearings about community wellbeing. The events used a deliberative approach, allowing participants to probe evidence and consider from multiple perspectives ideas of how to address identified issues. Two overarching themes from the hearings - a perceived gap between the rhetoric and reality of wellbeing evidence, and proposals on ‘what works’ in the (co)-production of knowledge about wellbeing – are articulated and explored. We develop specific features emerging from the hearings that have wider resonance for community wellbeing research and suggest potential responses: what counts as ‘good’ or good-enough evidence about community wellbeing; system responses requiring thinking and engaging with complexity; reflections on the collective and collaborative process of an expert hearing approach. The combination of analysis of knowledge generated deliberatively through an expert hearing approach and a pragmatic complexity lens, delimits our contribution.

During Spring/Summer 2025, the Centre for Health Promotion Research are leading a series of discussions for local and national partners about the voluntary sector, learning disabilities, and digital inequalities. These discussions are for academics, community and civil society organisations, local authorities, and service users to discuss current research and priorities for the future. The first event was a webinar on Wednesday 21st May 2025, 12:00-13:00. Kris Southby, Anne-Marie Bagnall, Danielle Varley, and Jo Trigwell will share the results of an NIHR School for Social Care study about how community organisations can effectively use digital technology to delivery services to adults with learning disabilities and/or autism. The webinar was attended by 44 people from universities, local and national government, the voluntary sector, and NHS

Community participation is a central concept for health promotion, covering a breadth of approaches, purposes and activities. This paper reports on a national knowledge translation project in England, UK, which resulted in a conceptual framework and typology of community-based approaches, published as national guidance. A key objective was to develop a conceptual framework linked to sources of evidence that could be used to support increased uptake of participatory methods across the health system. It was recognised that legitimacy of community participation was being undermined by a scattered evidence base, absence of a common terminology and low visibility of community practice. A scoping review, combined with stakeholder consultation, was undertaken and 168 review and conceptual publications were identified and a map produced. A ‘family of community-centred approaches for health and wellbeing’ was then produced as way of organising the evidence and visually representing the range of intervention types. There are four main groups, with sub-categories: (i) Strengthening communities (ii) Volunteer and peer roles (iii) Collaborations and partnerships and (iv) Access to community resources. Each group is differentiated using key concepts and theoretical justifications around increasing equity, control and social connectedness. An open access bibliography is available to accompany the framework. The paper discusses the application of the family of community-centred approaches as a flexible planning tool for health promotion practice and its potential to be used as a framework for organising and synthesising evidence from a range of participatory methods.

Volunteer engagement is crucial to the effective delivery of mega-sporting events. While evidence points to reported motivations and wellbeing benefits for individual participants during and post event, there is less evidence on how this type of civic participation relates to the social context in which it occurs and the wider social determinants of health. This qualitative study sought to understand impacts on wellbeing and the determinants of health resulting from the experience of volunteering at the Glasgow 2014 Commonwealth Games. Focus groups and interviews were conducted one-year post-Games to gather the perspectives of 46 volunteers and 7 unsuccessful applicants on their experiences. Participants provided insight into the volunteer journey, contributions and associated outcomes. Wider social impacts were also reported including a renewed sense of pride in the city. The qualitative analysis suggested an important non-linear relationship between volunteer contributions, impacts and rewards, and the outcome of enhanced social connections. The emergent ‘people and place’ framework identifies some critical factors around city life and volunteer assets that planners could consider in developing and evaluating sustainable volunteering and its wider impacts beyond a mega-event.

Background: Stakeholder engagement for the What Works Centre for Wellbeing’s (WWCW) Community Wellbeing Evidence Programme identified ‘boosting social relations’ in communities as a priority policy-related topic. A scoping review of 34 reviews identified evidence gaps relating to social relations in the following areas: community infrastructure (places and spaces); interventions to reduce or prevent social isolation in adults <60 years; community engagement and volunteering; social network analyses. We developed “community infrastructure (places and spaces)” as a systematic review, as this can be addressed at a local or regional level and has potential to produce immediate practical impact. Methods: We searched 11 bibliographic databases from 1997-2017, performed reference and citation checking, searched the websites of relevant organisations, and issued a call for evidence through the WWCW. We included studies which reported: interventions to improve or make alternative use of physical places and spaces at community or neighbourhood level; outcomes of social relations, community wellbeing and related concepts; quantitative, qualitative and mixed methods studies, and process evaluations. Two reviewers undertook study selection. One reviewer undertook data extraction and validity assessment, with a random 20% checked by a second reviewer. Validity of included studies was assessed using established checklists. Following thematic synthesis of qualitative data, a narrative synthesis was produced for each of eight intervention categories. The GRADE and CERQual approaches were used to rate the overall strength of evidence for each outcome. Results: 51 studies, mostly of poor to moderate quality, were included. The better quality evidence was qualitative, and most of the review’s findings come from the thematic synthesis of qualitative evidence There was moderate evidence that: (i) Community hubs may promote social cohesion, increase social capital and build trust between people, widen social networks and increase interaction between people, and increase people’s knowledge or skills; (ii) Changes to neighbourhood design may positively affect sense of belonging and pride in a community; (iii) Green and blue space interventions that provide the opportunity to participate in activities or meetings improve social interactions, increase social networks, bonding and bridging social capital, physical activity and healthy eating, and improve people’s skills and knowledge. There were also common themes relating to facilitators and barriers to successful interventions. Conclusions: The review found moderate evidence that a range of intervention approaches to community infrastructure can boost social relations and community wellbeing. Future research should prioritise high quality evaluations using repeated measures and validated tools, with robust and credible qualitative evidence.

The aim of this systematic review is to synthesise the available evidence, and describe the quality of that evidence, in relation to interventions that improve or create the community infrastructure that impacts on social relations and/ or community wellbeing. For this review, we are defining community infrastructure as the physical places and spaces where people can come together, formally or informally, to interact and participate in the social life of the community. We intend to produce a synthesis which is accessible and will inform practice and future research in the area.

Background Despite growing interest in understanding complex systems and public health interventions, research methodologies that take account of system-wide action are relatively underdeveloped. Community-based participatory research (CBPR) is steered and conducted by people with lived experience of the issues being researched. This paper explores the value of CBPR in complex public health intervention evaluations. The ‘Local People’ and ‘Local Conversations’ programmes use a community empowerment approach in 50 communities across the UK experiencing social disadvantage to increase social connections and collective control, improve health and wellbeing, and reduce inequalities (linked to SDG 3 and 11). Methods Evaluation of the programmes followed a mixed-methods design, including qualitative case studies, longitudinal survey, process appraisal, and CBPR. Residents from 10 communities across the programmes each undertook 2 rounds of CBPR. These projects resulted in written reports, which were analysed thematically alongside other data sources. Results There was some variation in the scope and design of the 20 completed CBPR projects. Whilst projects did not generally extend beyond the scope of the overall evaluation, peer research provided information from residents that were inaccessible to other data collection streams. Gathering community (lay) knowledge improved understanding of local priorities and actions within the programmes. However, the utility of CBPR was less consistent for community-researchers and local communities, often failing to support project development. Some community-researchers felt unprepared for the activity despite support from the academic team. Conclusions Conducted appropriately, CBPR can elicit data that would be less accessible through externally led research. This study highlights the value of CBPR in complex programme evaluations, enabling a deeper understanding of social context in which interventions occur.

Background A community empowerment programme in the UK aims to enable people to have greater collective control over area-based decision making, improved health and wellbeing and reduce health inequalities, by providing small grants to support residents of deprived neighbourhoods and communities of interest to come together to take action on issues of importance to them. Methods A survey was conducted at 4 6-month intervals as part of a mixed methods evaluation, to collect data about participant demographics, level of involvement, opinions of the project, and impacts. The survey was self-completed online or on paper, and distributed by local project leads. Outcome questions were adapted from the UK Government Community Life Survey to facilitate comparison with national statistics. Data were analysed using SPSS to produce descriptive statistics, supported by inferential statistical tests where appropriate. Regression analysis using multi-level modelling was used to estimate the conditional correlation between health outcome and Local People project participation. Results 1053 people from 29 local areas responded to the survey over the 4 time points; only 93 responded more than once. 43% took part in project activities, 36% were local project committee members and 19% were volunteers. The analysis found positive impacts on confidence, control, friendships, skills, happiness, life satisfaction, feelings of worth (p < 0.05), and that greater length and degree of involvement in the projects were associated with greater positive impacts on all of these outcomes. Conclusions The survey provides tentative evidence that participation in a community empowerment initiative may result in improved wellbeing, feelings of power and control, sense of belonging and trust. People who are involved for longer or more deeply involved are more likely to see these impacts. More community-based survey research is needed to gather people's views on neighbourhood initiatives. Key messages An evaluation of a community empowerment programme found positive impacts on control, wellbeing, belonging and trust. Greater length or degree of involvement were associated with greater impact.

Background aims Community organisations started using technology like video conferencing and social media more during the Covid-19 pandemic to keep doing activities with adults with learning disabilities and autism. They are now trying to figure out the best ways to combine technology and face-to-face activities. We wanted to find out the different ways that these community organisations combine technology and face-to-face activities and what works well. Methods We looked at published research about how community organisations use technology to provide services for adults with learning disabilities and autism. We held an event for community organisations and adults with learning disabilities and autism. We talked about what we had found out and heard peoples’ experiences of using technology. Results There is lots of research that includes community organisations using technology. Having a choice about whether to use technology is really important. Using technology can make it easier for people with learning disabilities and autism to join in if they have the right equipment, skills, and support. But there is no information about what community organisations need to use technology to delivery services for adults with learning disabilities and autism. Conclusion Supporting people with learning disabilities and autism to use technology can improve their independence and life skills. But there is not a lot of information for community groups to help them do this. We have applied for funding to do more research about this.

Background Community organisations started using technology like video conferencing and social media more during the Covid-19 pandemic to keep doing activities with adults with learning disabilities and autism. They are now trying to figure out the best ways to combine technology and face-to-face activities. We wanted to find out the different ways that these community organisations combine technology and face-to-face activities and what works well. Methods We looked at published research about how community organisations use technology to provide services for adults with learning disabilities and autism. We held an event for community organisations and adults with learning disabilities and autism. We talked about what we had found out and heard peoples’ experiences of using technology. Results There is lots of research that includes community organisations using technology. Having a choice about whether to use technology is really important. Using technology can make it easier for people with learning disabilities and autism to join in if they have the right equipment, skills, and support. But there is no information about what community organisations need to use technology to delivery services for adults with learning disabilities and autism. Conclusion Supporting people with learning disabilities and autism to use technology can improve their independence and life skills. But there is not a lot of information for community groups to help them do this. We have applied for funding to do more research about this.

Background Delivery of health and care services using a combination of remote and/or in-person channels and digital and/or traditional tools (Hybrid Service Delivery, HSD) is increasingly seen as a way of improving quality and affordability, improving access, personalisation and sustainability, and reducing inequalities. Across the voluntary, community and social enterprise sector (VCSE), using a combination of remote and/or in-person channels and digital and/or traditional tools (HSD) has enabled the essential provision of services for people who have learning disabilities and/or autistic (LDA). However, it is unclear how different tools and channels have been used, what worked well or not well, for whom, and in what circumstances. The aim of this realist review is to explore how VCSE organisations can effectively use digital technologies alongside or instead of in-person activity to provide social care services to adults with learning disabilities and/or autism. This review protocol is presented in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol (PRISMA-P). Methods We will conduct a participatory realist review. Following realist review methodology, and involving people with LDA and organisations who deliver services to them, we will define the scope of the review/theory development, search for and appraise evidence, extract and synthesise findings, and develop the narrative. Using a developed strategy, electronic databases (Academic Search Complete, CINAHL, MEDLINE, PsycInfo, SCOPUS, Social Science Citation Index and Social Policy and Practice) will be searched. A data extraction table will be used to assist in sifting, sorting and organising relevant information from identified studies. For each proposition statement, relevant data from the identified literature will be synthesised and compared with the proposed theory to develop an understanding of how, why and when hybrid delivery works in different settings with different populations. Discussion This review aims to collate and synthesise evidence relating to hybrid service delivery in VCSE organisations to provide social care services to LDA adults. By conducting a participatory realist review, we anticipate that the findings will lead to a greater understanding of contextual factors and therefore more relevant recommendations.

Background Technology is seen as a way to improve quality and reduce the cost of social care services. Voluntary and community sector organisations (VCSOs) are also becoming more involved in delivering social care services to adults with intellectual disabilities and/or autism. However, there is not enough information to help VCSOs use technology in the best way to deliver services. The aim of this research is to explore how VCSOs can appropriately use digital technologies alongside or instead of in-person activity (hybrid delivery) to provide services to different adults with intellectual disabilities and/or autism. Methods We conducted a participatory realist review. Workshops were held with service users and VCSOs to refine the scope of the review and develop preliminary theories. A systematic search of academic and grey literature was then carried out, including academic databases, website searches, and a call for evidence. Following screening, extraction, and synthesise, a deliberative hearing was held with service users and VCSOs to discuss emergent findings, refine theories, and develop conclusions. Results 141 papers were included in the review, although very few were specifically about how VCSOs use technology as part of their service delivery with people with learning disabilities and/or autism. Different technologies can have specific benefits for adults with learning disabilities and/or autism in different contexts. ‘Good’ hybrid service delivery requires co-production of services between users and VCSOs, and support that goes beyond just providing access to equipment. Conclusions VCSOs can use technology in a myriad of ways but there is limited guidance about how to do this appropriately with adults with learning disabilities and/or autism. We propose six ‘top tips’ as a starting point to help VCSOs.

Background Hybrid service delivery (HSD), involving the utilisation of both in-person and remote delivery for service provision, has been noted as a way of improving quality and affordability, increasing access and reducing inequalities. While HSD has facilitated the provision of services for people with learning disabilities and/or autism across the voluntary, community and social enterprise sector (VCSE), it is not apparent how HSD has been used, what worked well or not well, for whom, and in what circumstances. This study aimed to explore how VCSE organisations could effectively use digital technologies alongside or instead of in-person activity to provide social care services to adults with learning disabilities and/or autism. Methods A participatory realist review methodology was utilised. Programme theories and propositions about the phenomenon and related concepts were identified utilising preliminary literature searches and co-production workshops with service providers and service users. The developed statements were used to guide the database and the identification of evidence. This evidence was used to test and refine the statements. Results 141 records were used to produce 13 areas of interest. While there was strong evidence supporting the use of digital technology to improve social connections and independence, this was only the case when the technology was used correctly, implemented in a suitable setting and ‘fit’ the person using it. Evidence indicated that the development or adaptation of technology which were co-produced with adults with learning disabilities and/or autism were associated with better service delivery. Conclusions Supporting adults with learning disabilities and autism to use technology can improve their independence and life skills. However, the technology needs to be implemented in the right setting, as well as co-production being used to ensure the technology and the delivery is suitable and accessible. Key messages • There is evidence that digital technologies can be used to support people with learning disabilities and autistic people, but only if it is used correctly and in the right setting. • Utilise co-production to shape tech-enabled services. Consider language use, visuals and technology delivery. Listen to their ideas, so the technology delivers what they want and need.

Summary of outputs from the Space to Connect learning and evaluation programme

Background Peer-research is steered and conducted by people with lived experience of the issues being researched. This paper explores the value of peer-research in two complex public health intervention evaluations in the UK. Methods Reports from 18 peer research projects, completed by residents from 12 communities in the UK taking part in two community empowerment interventions, were analysed using cross-case analysis. Results Undertaking peer research helped to build the evaluation and research skills within individual projects as well as providing data on other outcomes related to the programmes Theory of Change. Some peer researchers, however, felt unprepared for the activity despite support from the academic team and were unsatisfied with project outcomes. While peer research projects provided more opportunities for local residents to engage with the overall evaluations, there was an overreliance on people closely connected to the programmes to be peer researchers. The peer research projects explored topics that were broader than the aims and objectives of the overall programme evaluations. All provided insight into the context in which projects occurred, while some also informed understanding of programme change mechanisms. Conclusions Including peer research as part of complex public health intervention evaluations can help uncover important contextual and ecological details beyond the reach of more traditional evaluation data collection. Peer research can also empower and build research/evaluation capacity within communities, which is particularly pertinent for community empowerment interventions.

Background The ‘Local People’ programme operates in 29 UK communities experiencing disadvantage and economic stressors that impact on population wellbeing. The programme uses a community empowerment approach to increase social connections, and collective control, improve health, and reduce inequalities. This links to SDGs 3 and 11. Mechanisms include a decision-making group led by residents, a project lead, funding, and support from a national charity. Methods A mixed method evaluation was conducted (2017-19) to identify processes and assess outcomes and impacts. This presentation outlines the findings from five in-depth qualitative case studies (c140 interviews) with emphasis on one post-industrial UK town suffering from the effects of industrial decline. A within case and cross case qualitative analysis was undertaken using a thematic framework. Results Priorities set by local areas focused on increasing community involvement and connections between people. A wide range of activities took place including regular classes and community events. The five case studies found strong qualitative evidence of increased social connectedness, community spirit and a sense of purpose, along with the area becoming a better place to live. People involved in project delivery gained confidence and skills, improved their wellbeing and gained a sense of control. There is, as yet, limited evidence that increased involvement has influenced the wider determinants of health. In the post-industrial town, people’s social networks expanded, enriching their lives and providing missed companionship. Participants in the programme reported improved mental and physical health, as well as increased confidence and skills. Involvement gave a voice to marginalised older people in the area. Conclusion Empowering communities and putting residents in control can lead to improvements in connectedness and some aspects of health and wellbeing, even in post-industrial towns facing considerable and complex challenges.

Community empowerment interventions, which aim to build greater individual and community control over health, are shaped by the community systems in which they are implemented. Drawing on complex systems thinking in public health research, this paper discusses the evaluation approach used for a UK community empowerment programme focused on disadvantaged neighbourhoods. It explores design choices and the tension between the overall enquiry questions, which were based on a programme theory of change, and the varied dynamic socio-cultural contexts in intervention communities. The paper concludes that the complexity of community systems needs to be accounted for through in-depth case studies that incorporate community perspectives.

The Centre for Health Promotion at Leeds Beckett University were commissioned to review existing literature on the impacts of mega-sporting event volunteering and to undertake a qualitative study to investigate the experiences of volunteers at the Glasgow 2014 Commonwealth Games (known as ‘clyde-siders’). The study also set out to explore the experiences of those who applied to be a clyde-sider but were not successful with their application (referred to as non-clyde-siders). The literature review identified process issues as significant factors in the delivery of a mega-sporting event that results in a positive experience for volunteers. The review also found that mega-sporting event volunteering yields health and social outcomes both for individual volunteers and the host community. The weight of evidence in this review suggests that the process of mega-sporting event volunteering is relatively well understood. However, gaps remain with regard to the longer-term outcomes of mega-sporting event volunteering for individual volunteers (and those who apply but do not go on to become volunteers) and for communities. Qualitative exploration with clyde-siders and non-clyde-siders identified important assets that they brought to the Glasgow 2014 Commonwealth Games. Existing skills and experiences from their professional life or other volunteering roles; a personal touch reflecting commitment and approachability; and local knowledge of the city were important attributes that were highlighted. The research highlighted that while volunteers added to the success of the Games and its delivery, they were also able to draw on the event for their own personal benefit. Positive outcomes included increased confidence and knowledge, and the development of skills for future employment. These outcomes were often more pronounced in clyde-siders than non-clyde-siders, but this was not always the case as some non-clyde-siders drew benefits from applying for the role. The development of friendships and the value that people placed on meeting new people was a particularly prominent finding for both clyde-sider and non-clyde-siders. This included ‘bridging’ with others across social and cultural boundaries. The link between place, participation and the social impacts of volunteering at the Glasgow 2014 Commonwealth Games is a distinctive finding from the research. For clyde-siders, benefits were derived from the formal volunteering role and from being part of the collective experience in the city during the Games. These benefits could not be solely attributed to being a volunteer, as non-clyde-siders also reported gaining from being part of the friendly atmosphere generated by hosting the Games. Implications for strategic planning for mega-sporting events are outlined in the report.

Issues presented by COVID-19 to community resilience are located at individual, community and system level. In this paper, we reflect on WHO Europe propositions on what makes resilient communities, and explore how communities and systems with varying capacity have responded to the pandemic by absorbing and adapting to challenges. In our research we are seeing local responses at all three levels, which challenge current assumptions about the respective roles of citizen, local voluntary sector and state. This paper presents opportunities and challenges to translating this reactive social movement into proactive resilience-transforming change in how local systems work in the future.

Issue: Strengthening community action, as proposed in the Ottawa Charter, is key to achieving public health goals within a whole-of society approach to health. Community engagement is not a simple intervention as it is shaped by community contexts and policy agendas that can either constrain or enable local action. This has implications for developing an evidence base. Description of problem: Changes in UK policy and programme funding have led to a fragmented evidence base and many participatory models not achieving sustainability. To inform an update of public heath guidance, the National Institute for Health and Care Excellence commissioned an independent, systematic scoping review to understand UK community engagement policy and practice. This paper presents findings from the documentary analysis of policy themes and concepts. Results: After systematic searching and screening, 40 policy and 30 conceptual publications were included and extracted data then mapped onto a matrix. We found that UK policy interest in community engagement in health threads through multiple sectors including health, local government and volunteering. Policy focus was not static; new concepts (eg social action) have emerged since 2000, while others (eg health inequalities) have less prominence. Local government was identified as a key policy actor. Community empowerment was a common theme but concepts were not used consistently. Lessons: Community engagement in health has policy significance but can lack visibility because it is applied across multiple policy areas and is cross referenced to different concepts. This is important for promoting intersectoral action involving communities and for building healthy public policy. Our conclusions are that community engagement is best used as a broad organising concept as it covers a range of policy areas and terms. This needs to be accounted for in building an evidence base for participatory methods within and between countries. Message 1 A mapping of UK policy since 2000 shows that community engagement in health can be promoted through a range of policy initiatives and sectors; however there is change through policy cycles Message 2 The evidence base on community engagement can appear fragmented, results from this policy analysis help identify related concepts and terms.