Professor Louise Warwick-Booth

Evaluation overview

The Migrant Access Project operated within West and South Leeds, 2018 until March 2020. It aimed to provide support to new and existing migrant communities to better help them integrate, and thus reduce pressure on existing services, minimising low level tensions and thereby concerns from settled communities within Leeds. Our 2018 interim report focused upon the Migrant Access Plus Project (MAPP) that was running in the Armley and Holbeck areas of the city. Our 2019 report explored the extension of the project into three additional areas as part of the second year of delivery: Beeston Hill, Little London/Hyde Park/Woodhouse and New Wortley. This final report draws together all findings and overall learning from the delivery of MAPP, following a third year of extension funding.

Introduction In 2019, NHS England launched a pilot scheme of eight specialist Female Genital Mutilation (FGM) clinics for non-pregnant women. These clinics provided services and support for non-pregnant women over the age of 18 who were living with the consequences of FGM. In 2022, Starks Consulting with Ecorys and Leeds Beckett University was commissioned to complete an evaluation of the pilot clinics to help inform decisions on future service delivery. The service specification1 detailed that clinics should provide a form of tripartite support which included basic medical treatments provided by a specialist midwife or nurse; counselling for mental health concerns, and advice from a health advocate on housing or welfare needs, for example. Clinics were to be located in the community to ensure ease of access and a good local presence. Services were to be delivered independent of maternity and sexual health services and provide a sensitive and welcoming space for women. Aims of the evaluation The key aim of the evaluation was to determine whether the clinics improved the health outcomes of non-pregnant women with FGM. A key objective was to update the economic review that was carried out in 20212 . to understand whether the clinics provided opportunities for longer-term cost savings to the NHS.

BACKGROUND: Researchers may often find it challenging to gather data with underserved populations, even when using traditional qualitative methods. They may also be at risk of further entrenching the hegemony of the dominant narrative, silencing participants' experiences and further marginalising and excluding those most in need. Timelines and other creative methods are useful, sensitive tools that combine flexibility and malleability with an ethical appeal, such as feminist ethics of care. Researchers can use them to gather data from participants experiencing inequalities and trauma. AIM: To outline the value of timelines as a method in nursing research. DISCUSSION: This article considers feminist values, power dynamics and the ethics of using timelines when gathering data. It illustrates these using the example of a study involving female sex workers. CONCLUSION: Creative methods minimise the ways in which researchers control the production of data and enable participants to choose how they narrate complex and traumatic experiences. Researchers can combine them with deep, ongoing reflexivity to address some of the power imbalances inherent in research and mitigate epistemic violence. IMPLICATIONS FOR PRACTICE: There are strong and evidence-based ethical motivations for conducting research using creative methods. Having a flexible approach to their application and use in practice is key, as not everyone wants to engage with creative methods, or they may not wish to engage with that specific method at that time. Creative methods can serve as vital anchor points in your interviews with participants and are as much about the process as they are about the output.

This article reports the findings of a qualitative investigation into community based research within the Objective 1 Programme, South Yorkshire. Based upon semi-structured interviews with participants undertaking community based research and then developing action plans based upon the research findings, the study highlights the issues associated with involvement in such research from participant’s perspectives. Beginning with an examination of involvement in research and then moving on to discuss the wider issues of involvement in regeneration and partnerships, the article argues that despite the increased policy focus on bottom-up approaches, involvement is complex and conceptualised in a number of different ways and therefore requires further investigation.

This book: Looks at social divisions across societies Explores global processes and changes that are affecting inequalities Discusses social inequality in relation to class, gender and race Examines current social policy approaches to ...

This article reports the findings of a qualitative study on the impact of community-based research within the South Yorkshire Objective 1 Programme. Based upon semi-structured interviews with participants who conducted community-based research, the study highlights the social capital impacts arising from the use of such research within development practice particularly in terms of the formation of networks and the development of trust. Although community-based research can enhance social capital, the study demonstrates that this is a complex process and as such is not an easy tool to harness and use within the policy-making process.

This chapter aims a few of the key themes that partly help people understand how men’s attitudes to masculinity and mental health might be formed. Representations of women in the media have also changed, partly in response to the changes in society but also partly as a cause of those changes. In the field of men’s health people talk a lot about how a large proportion of men are trapped in a traditional masculine identity which is detrimental to their health and discourages them from addressing health problems. The reality is that a state of mental well-being is not something that we can achieve and maintain in isolation. The tendency in Western society to see outpourings of emotion as undesirable on the basis that they represent a failure in reasoning, coupled with perceptions of ‘inappropriate’ emotions related to gender roles, create a very real pressure to internalise feelings.

Occupational therapy is uniquely positioned to disrupt the hegemonic gendered and political assumptions that give rise to inequities experienced by women, owing to the discipline’s historical influences and founding philosophies. This chapter will explore the complex and nuanced phenomenon of mothering via a critical discussion of feminisms, highlighting a variety of contextual influences to present a socially constructed understanding of motherhood. Furthermore, the chapter serves to illuminate the imperative need to fight injustices of gender and raise the social consciousness of the barriers to engagement in occupation by women who experience mental illness during the perinatal period. Findings are shared from a United Kingdom (UK) doctoral research study, yet the chapter has global relevance with an overview of feminist perspectives presented, in addition to international examples of occupational injustices faced by women. Global disparities are portrayed recognizing the intersectionality of marginalized women (Crenshaw, 1993) by virtue of a patriarchy society, gendered hierarchical conceptualizations and the social construction of power relations (Hancock, 2016). Thus, broadening our understanding of mothering occupations from a feminist perspective and promoting socially relevant and inclusive occupational therapy. Recommendations for practice, policy and education will be presented, supporting the need for wider collectivist and strategic actions (Bailliard et al., 2020; Malfitano et al., 2021), to address occupational injustices.

Relative disadvantage and deprivation are significant problems for vulnerable women in urban areas in England. Despite experiencing a range of complex health needs such women do not always meet the required thresholds for statutory help or if they do, they are often unable to engage with the requirements of these service providers. Third sector (or non-governmental) organisations have often supported women in need but operate time-limited programmes due to funding restrictions. In a climate where statutory support systems are being systematically weakened, third sector organisations are playing a more significant role in supporting vulnerable women. This paper will present key findings from several evaluations of projects delivered by non-governmental organisations which are designed to make a difference to women’s lives. The findings cohere around what works providing evidence of effective approaches to supporting vulnerable women with complex needs. A transferable model of women-centred working is presented.

Researcher briefing and note taking guide for table conversations in the community

Interview schedules for CEOs, and service users. Internal outcomes monitoring tools

NHS England funded eight pilot Female Genital Mutilation (FGM) clinics for non-pregnant women across England from 2019 to 2021, with our evaluation exploring how best to meet the health and wellbeing needs of non-pregnant women who had experienced FGM. Prior to these clinics, there had been little progress in meeting the needs of non-pregnant women with FGM seeking medical help in England. Our evaluation commissioned Starks Consulting, Ecorys and Leeds Beckett to evaluate documented service delivery across the eight pilot sites. Within this we explored the importance of delivering clinics within community settings. The evaluation tested how effective/capable these clinics were in meeting the health and wellbeing needs of women accessing them. We also examined the effectiveness of various staff roles (lead clinician, health advocate and therapist) to understand the service delivery approach. We captured the views of a small number of service users through individual interviews, gathering their lived experiences of FGM and clinic attendance. The main aim of the evaluation was to determine whether the clinics improved the health outcomes of non-pregnant survivors of FGM. This paper presents findings from the qualitative component of the evaluation; interview data from 42 professionals and 12 service users. We detail the model of support (community service delivery, with trusted professionals, creating a safe space) and the learning gained from the pilot implementation. Positive outcomes include improved health and well-being for women (mental and physical health improvements). Challenges in service delivery included language barriers, how professionals reach into communities, the stigma associated with FGM as an experience, and mental health problems arising from FGM.

This report details evaluation findings associated with the NHS pilot clinics in England, which aimed to treat non-pregnant women with FGM. This report provides data on the model of service delivery, tri-partite support, clinical operations and services, the impact of the clinics, their cost effectiveness, as well as challenges and lessons learned.

This Volunteer Listeners report provides stories about older people’s experiences of social isolation as part of the evaluation Of Time to Shine, Leeds. The report details the Volunteer Listeners Approach as an idea, its development, pilot testing and full implementation during 2019. The methodology is simple, volunteers hold conversations with older people to capture their stories, and notes about these are then produced as stories. The common themes found within the stories are reported in detail here, and show that the older people telling their stories had experienced complex life circumstances, including loss, bereavement and loneliness. Their participation in Time to Shine Funded activities led to a number of individual benefits. Some also discussed being able to give back by supporting others and volunteering themselves. However, several barriers to participation were also identified.

Much attention has been given in recent years to involving community members in research within a number of fields including community development. Indeed, there is a large amount of literature outlining what this process involves and describes the benefits and problems of doing such research across a range of contexts. There has also been some discussion of the different approaches that can be applied under the umbrella of community-based research and their relationship to the outcomes associated with both successful and positive community development. Yet very little attention has been paid to the actual experiences of these lay researchers involved in community-based research in relation to their roles. The nature of the researcher's role as work thus requires critical consideration. This article examines the role of lay researchers within four different approaches to community-based research used for the development of community action plans within the Objective 1, South Yorkshire context. This article reports upon differential roles and types of work in relation to both experiences and outcomes. The article, therefore, addresses what these different researcher roles tell us about community-based research and outlines the implications in relation to community development. © 2013 Taylor & Francis.

The study aim was to examine the impacts of the theory and practice gap in UK pre-registration nursing student`s practice education, fifty percent of their undergraduate programme. Nursing student`s real- world clinical learning environments are crucial for progression to the professional register because this is where they learn to become nurses. This element of UK nursing student`s educational programmes is currently challenging, both in resources and organisational culture.This study used the Clinical Learning Environment Scale (CLES) (Saarikoski & Leino-Kilpi 2002) and lens of intelligent kindness (Ballatt & Campling 2011) to understand nursing student`s experiences in practice settings. This is a new conceptual application of this theory, examining this area of concern, and provides one element of this study`s originality. A convergent mixed methods research design with a longitudinal approach, and three-point data collection, was used. The CLES framework (Saarikoski & Leino-Kilpi 2002) provided the data collection instrument for the quantitative phase and informed the focus group questions in the subsequent qualitative phase. The integrated findings resulted in the development of an original new model, the Clinical Learning Environment Relationship Model (CLERM), which represents the main element of this study`s contribution to the knowledge for this area of concern. This study`s findings confirms the hypothesis, in the literature, that the supervisory relationship, at the micro level of influence, is pivotal for student nurse`s practice education. The CLERM, with intelligent kindness (Ballatt & Campling 2011) as the central conceptual framework, and study lens, moves the discourse to the wider organisational spheres of influence. Including the broader areas of responsibility and accountability impacting nursing student`s real-world clinical learning environments. Recognition of the influences across the micro, meso and macro levels of impact informed the recommendations for application to practice, healthcare policy makers and future research.

ObjectivesThe quantitative objectives of the study were to determine whether postnatal care satisfaction ratings predict depression scores following childbirth, as well as to consider whether the relationship varies between different birth modes and outcome. The qualitative objectives sought to hear the lived experiences and perspectives of women, acting as the mechanisms at play behind the survey insights provided. As this is an area of research that has not yet been explored, the findings of this study provide a novel contribution to the evidence base.DesignThe mixed method study examined care satisfaction and depression in postnatal women with questionnaire responses, as well as explored their voices and perspectives in semi-structured interviews. The quantitative data was then analysed using linear regression, moderator, and mediation analyses, and the qualitative data was analysed using thematic analysis. 103 women were recruited during their stay on a postnatal ward at a local NHS teaching hospital, and completed an anonymous survey, consisting of eligibility questions, the Women’s Views of Birth Postnatal Satisfaction Questionnaire (Smith, 2011), and the Edinburgh Postnatal Depression Scale (Cox et al., 1987). The interview questions were designed around the 13 dimensions of postnatal care that participants were asked about during the survey and a total of 13 interviews were conducted.Key FindingsPostnatal care satisfaction ratings were a significant predictor of depression scores. Neither birth type, tear type, or assisted vaginal delivery had a significant moderating effect on the relationship between postnatal care satisfaction ratings and depression scores. Similarly, none of the birth categories had a significant indirect effect on the relationship, which supports an overall conclusion that postnatal care satisfaction ratings predict depression scores, regardless of birth type.Qualitative data analysis identified four themes, common across multiple birth type categories, with no themes limited to any one specific birth type. This highlights that the most prevalent issues identified by women did not change based on the type of birth mode or complication. The four themes were:1. Unmet Needs and Missed Opportunities2. Expectation versus Reality – An Issue of Congruence?3. The Construction of a ‘Good’ Mother, Societal Pressures and Expectations –4. The Obvious and Less- Obvious Existence of Paternalism, Patriarchy, and MedicalisationConclusions and Implications for PracticeThe four themes may be used as a starting point for reshaping the policy that informs practice, as well as identifying some of the prevalent attitudes and cultures that exist within postnatal care, and how women feel that these must change. From the quantitative perspective, it is also worth noting that birth type does not appear to hold as much bearing on women’s evaluations of their postnatal care experiences, compared to the more personable, emotional, and individualised aspects of care and support, which women deemed as lacking. The quantitative findings emphasise the importance of providing women with postnatal care that they are satisfied with, particularly as depression was higher among women with lower care satisfaction ratings.

This paper reports on the outcomes of the Community Health Apprentices Project, an intermediate labour market (ILM) project delivered in two neighbouring areas of Bradford, England. The project was illustrative of current UK policy in its attempt to both address unemployment and health inequalities. The aim of the paper is to improve understanding of the type and range of outcomes that can result from ILM projects based in the community health sector. A qualitative evaluation was undertaken and interviews were carried out with three groups of stakeholders: the community health apprentices, key informants in the placement organisations and the delivery partners. Findings show that both anticipated and unanticipated outcomes occurred in relation to increased skills for work, improved health and well-being and improved organisational capacity. While there are contextual factors which make this project unique, the findings illustrate the potential range of outcomes that can be achieved when social and emotional support is offered in tandem with work experience. The findings further highlight the organisational benefits of investing in local people to deliver community health work. The paper concludes that in order to build an evidence base for ILM approaches, a broader understanding of outcomes needs to be developed, taking into account social and health outcomes as well as economic indicators.

The Wakefield Metropolitan District Council (MDC) Area Working programme offers a radical and innovative approach to service improvement and redesign with the aim of better meeting community needs and addressing inequalities. Community participation is a core component of the Wakefield model, which is underpinned by the wider goals of encouraging active citizenship and community empowerment. There is an acknowledged need to evidence whether the Area Working approach leads to improved services, to what extent there is meaningful community engagement and ultimately to assess whether it makes a difference to people in their neighbourhoods. This literature review addresses a range of key questions that will usefully inform the development of an evaluation framework in relation to the deployment of Area Working within Wakefield. The aims of the literature review were to scope existing models of evaluation used to assess the deployment and impact of Area Working and to identify potential evaluation frameworks and benchmark indicators. A systematic literature search was undertaken to identify published and grey literature on Area Working and similar programmes and relevant literature was reviewed. This search was supplemented by key literature identified through previous research. This brief report presents a summary of findings and makes some recommendations for the development of an evaluation framework for Wakefield Area Working Programme.

In 2021, Starks Consulting Ltd, in partnership with Leeds Beckett University, was commissioned by the West Yorkshire Health and Care Partnership (WYHCP) to report on the merits and challenges of delivering online courses for parents across West Yorkshire. This report provides the WYHCP with the findings from the research, which was conducted over four months from October 2021 to January 2022.

This chapter details a case study of a place-based model of funded feminist leadership in one city, in Northern England. Feminists recognise that traditional and historical models of leadership have often excluded women because economic, social and political power has been male dominated (Batliwala, 2021). For the purposes of this chapter feminist leadership is viewed as a transformative space where women can, and do, lead in counter-traditional ways. Using data from a 3-year qualitative longitudinal evaluation, this chapter assesses the contributions and challenges of a collective feminist partnership involving eleven organisations of varied sizes. Partners joined together to secure Big Lottery funding, from the Women and Girls Initiative. Frontline services focused upon project delivery, using specialist workers to support women with complex needs (mental health, sex workers, domestic abuse survivors, newly arrived migrant women, and women who had children removed), awareness raising in community settings via educational sessions, and spaces for women to contribute to strategic decision making via hubs. Intended outcomes were to improve and extended access for vulnerable women and girls the services and support they wanted, when they chose; to create a holistic response to ensure that women’s complex and multiple needs were better supported, and to empower women and girls to support their peers and influence service delivery, development and design across the city. A model of feminist collective, relational leadership was implemented in geographical place to deliver these gender-specific services, create evidence of gendered need, advocate for women and secure further funding. These achievements were based on local city knowledge, historical work by voluntary and community sector organisations (VCSOs), integration with the statutory sector, and feminist commitment to making gender specific improvements. This chapter discusses the model of leadership, outlines the external successful impacts arising from feminist leadership in place and, using a feminist lens, offers critical analysis of internal power dynamics within the leadership team. Positive impact masked multifaceted internal disagreements and tensions, challenging leadership spaces, and barriers to an equal collective. Attempts were made to resolve these issues with varying degrees of success. Feminist values were applied to collective leadership to support partner organisations smaller in size, with limited access to resources and mechanisms of local power. However, despite commitments from all involved to centre women’s issues in place, the internal leadership dynamics reflected wider societal power relations and hidden hierarchies, underpinned by a neo-liberal competitive funding environment. Our critical analysis shows that internally within the partnership, white, predominantly middle-class women led on everything. This book chapter discusses feminist place-based leadership in practice and its role in promoting justice and equality, considering issues of ethnicity, class, and other characteristics, and concludes by outlining lessons for the Voluntary and Community Sector as well as recommendations for partnership leaders and areas for future research.

People from the Global South, including women who migrate, have neglected experiences in research. After consultation, this project aimed to explore Global Southern migrants’ experiences with housing. Study 1 surveyed 158 migrants (75% female) revealing mixed conditions (e.g., 27% poor heating), challenges with housing providers (11% intimidation) and housemates (21% hid religion/ sexuality). Study 2 through peer-led interviews and focus groups with 25 migrant students (68% female) also highlighted mixed experiences including family accommodation support against racism, bureaucracy and isolation (e.g., “[I wish there was] a way that [I] can still like make friends”). Attending to these experiences not only challenges psychology’s colonial dominance but also emphasizes the critical importance of decent housing, especially for vulnerable groups like migrant women.

In the context of on-going high rates of domestic abuse in England, the voluntary and community sector increasingly provides specialist domestic violence and abuse (DVA) services to support women in local community settings. This paper discusses a qualitative evaluation of one programme, working to support female survivors with mental health needs. A locally based support programme worked with women in one city in England over a two-year period. 34 service users, and 8 professionals contributed to interviews and focus groups in support of the evaluation. Our framework analysis identified key themes using survivor voice in respect of the importance of trauma-informed support, adding to the evidence base about effective recovery work in the voluntary and community sector. The defining features of trauma-informed support, safety, trust, choice, collaboration and empowerment were evident in the service model, which led to positive outcomes for survivors who engaged with the programme. The model of provision discussed here is transferrable beyond the voluntary and community sector. Learning from the programme suggests that DVA services can focus on the mental health needs of survivors, using trauma-informed support to enhance recovery.

This case study discusses an evaluation research project that used mixed methods to explore the impact of a National Health Service (NHS) pilot clinics that were set up to treat non-pregnant women with Female Genital Mutilation (FGM) in England in 2019. The key aim of the evaluation was to determine whether the clinics improved the health outcomes of non-pregnant women with FGM, and this was addressed by using a mixed-methods approach to analyse internal quantitative data and generate qualitative data. Quantitative data analysed included the numbers of service users supported 2019-2021, descriptions of symptoms treated, and procedures undertaken. Qualitative data was generated through remote interview methods, using a semi-structured schedule. Interviews with professionals (n=42) involved in the delivery of the clinics, and survivors (n=12) who had accessed the pilot clinic support were included in the evaluation. Ethical approval was granted through university procedures. This case study focuses specifically upon the qualitative data collection that was undertaken remotely with survivors of FGM. 12 women were interviewed in English via telephone or video-conferencing methods (MS Teams), according to participant preference. It is the process of these remote interviews, and the advantages as well as challenges associated with them that this case study details.

Background and objective: A UK university collaborated with an NGO which provides housing and support services in a neighbouring city to conduct some participatory research. The NGO invited volunteers and the people they support through the Afghan Relocations and Assistance scheme to undertake some peer research (also called community research). Methods: Four people chose to become Community Researchers on this project: 3 Afghan men living in temporary hotel accommodation and one British woman who volunteers with the NGO. They received training and support from a university health promotion researcher; three training sessions on research, survey design, and research ethics. They chose to do some research on the mental health of Afghan people living for long periods in hotel accommodation. They designed a survey to investigate meaningful occupation that promoted good health and then spent 5 weeks collecting data. The Community and University Researchers analysed the data from the survey together. Results: The Community Researchers spoke to 14 men individually and 15 women in a group. The respondents were aged 16 to 65. Cultural norms meant that the men could not ask women questions directly, so the female volunteer spoke to a group of women with an interpreter. Respondents reported physical activity, social interaction and developing skills as the most significant factors in maintaining good health. Barriers to taking part in activities to promote health included language, caring responsibilities, and a lack of money. The Community Researchers produced recommendations regarding support which included: offering more opportunities to learn English; supporting independence through use of public transport; and facilitating connections with local people. Conclusion: Community Researchers are experts by experience and bring important community knowledge. They gained a range of skills and increased confidence through the project and provided the NGO with practical advice on how best to support their community’s health.

The Key project was set up in 2013 as a prototype approach aiming to support disadvantaged and vulnerable girls and young women, aged between 13 and 25 within the Leeds area. The project is located within Womens Health Matters, a charitable provider of gender-specific services in Leeds. This report presents the findings from an evaluation of The Key conducted by the Centre for Health Promotion Research, Leeds Beckett University. It presents evidence about the project’s journey, the outcomes for young women as a result of working with the project and overall learning from the project.

Background: Domestic abuse is a public health issue, and increasing evidence suggests that young women are more likely to suffer than older women, yet limited evidence exists in England about educational programmes and programmes for young women at risk. Study’s objectives: To evaluate a gender specific (women-only) programme aimed at educating young women aged 13-25 about abuse and staying safe in one English city. Setting: A third sector (charitable) organisation, aiming to improve women’s health across one English city delivered the programme over a three-year period, funded by the Big Lottery. Young women received both peer and one to one support, to educationally inform them, develop their skills and improve their capabilities in responding to abuse. Method: This qualitative evaluation captured the perspectives of young women accessing the programme (n=33), exploring the positive difference that it made to their lives. We also captured the views of internal stakeholders in 2018 (n=2), then followed up in 2020 (n=3), and external stakeholders referring young women to the programme (n=8). Results: The programme met its aims. Self-reported changes in young women’s lives included increased knowledge about staying safe and being happier. Some young women gained or retained custody of their children, and others exited harmful relationships. Young women identified a range of mechanisms of success including a non-judgemental approach from workers, peer support and a trusted space in which to meet and learn. The programme increased young women’s skills to stay safe whilst improving their mental wellbeing. Conclusion: The programme worked well for young women who accessed it. However, it could not reach all of those in need, was only funded in the short-term, and tended to individualise the responsibility for staying safe. Further research is needed into other community-based educational programmes to provide evidence of their effectiveness as well as transferrable models for workers in other contexts.

Small amounts of funding at a very local level were easy to apply for and processed rapidly. The funding model used as part of this project supported a tailored approach with a personal touch, so workers felt able to provide people within their communities of interest with what they needed. The model of delivery involving trusted organisations and community members working together to respond to Covid19. The model was described favourably by all evaluation participants. The peer support aspect of the model was unique and welcome. Learning about what other groups were doing improved professional practice, provided feedback and moral support, and promoted referrals/signposting as well as collaboration and partnership work. Project outputs funded by the grant scheme were described positively by professionals and included the delivery of small-scale projects and the development of resources. Evaluation participants identified important outcomes from the project as a whole such as the creation of a supportive network and capacity building; shared learning and tailored support from Forum Central and Leeds City Council as well as increased partnership working. Some participants discussed how the grant scheme had raised morale, at a time when this was much needed. Community members also described positive benefits from being involved in the grant scheme. For example, learning new skills (IT); developing skills (working professionally); delivering projects that they tailored to support their own community of interest; improving their own wellbeing and the wellbeing of others in the community; and communicating up to date Covid19 information about safety through their own local networks. Participant characteristics were intersectional.

This paper draws upon a three year longitudinal qualitative evaluation of a voluntary sector strategic partnership and delivery project involving eleven women-centred organisations. The consortium worked together to support the most vulnerable women and girls across a city in the north of England over a four year period (2017-2021), funded by the Big Lottery (charity). The partnership of 11 different women-centred and female led organisations delivered front-line services which aimed to enable women and girls to lead safer and healthier lives. Partners combined their expertise to support women with multiple needs including: mental health, domestic abuse, sexual violence and exploitation, experience of the criminal justice system, sex work and substance misuse. The project aimed to achieve 3 outcomes: 1. Improved and extended access for vulnerable women and girls across the city to the services and support they want, when they choose 2. A holistic response to ensure that the needs of women and girls with multiple and complex issues are better supported 3. Women and girls will be empowered to support their peers and influence service delivery, development and design across the city Our evaluation placed the project staff, partners, stakeholders and service users at the centre of qualitative data collection, drawing upon a co-produced Theory of Change approach to data collection. Our sample of 34 service users, 54 professionals (19 of which were repeat interviews) and monitoring data shows that the project successfully met its objectives and developed a model of practice that can be used in other contexts to support and empower women in need. This paper will describe key lessons from the evaluation focusing on the model of the project (service delivery) within the partnership setting. The service involved complex needs workers supporting women holistically for up to 9 months; an outreach community engagement service; the development of a virtual service directory; women and girls’ hubs; and peer support. Paper is of interest: This paper reports evaluation findings from examining the largest gender-specific consortia in the UK who came together specifically to support women and girls across one city, drawing upon feminist principles to empower those defined as the most vulnerable. This was a successful model of support (service) within a problematic partnership.

This case study considers moving health promotion evaluation practice online to allow the continuation of data gathering safely in Covid19 and the implications of this for all of those involved; researchers and participants alike. We outline the methods that we used to conduct a commissioned evaluation online because of the Covid19 restrictions imposed in England at the time of our study. Evaluation is an activity that remains central to health promotion practice because it is concerned with assessing whether interventions are effective (Green and South 2006). This evaluation focused upon qualitatively assessing the Third Sector and community response to Covid19 across one city in the North of England. We aimed to use a people centered approach to our data collection to explore the impacts and outcomes arising from small grants awarded to different communities (young people, ethnically diverse groups, older people, Travelers, men) by capturing the importance of service user experiences in our work. We learned to be flexible, to consider the importance of offering a variety of mechanisms to facilitate participant involvement and to expand our ethical considerations because of the implications of online data gathering.

Breathing Space was a women-centred project, funded by the Tampon Tax Fund through the Department of Digital Culture Media and Sport. It aimed to reduce distress and the harmful impact of domestic abuse on women and their children. The focus of this project was support for women who have suffered complex trauma and are experiencing difficulties in their lives as a result. WHM provided safe space for women to “stabilize”, helping women to access internal and external resources and develop stress management skills and so address the critical first stage of trauma recovery. Breathing Space ran from August 2017 until March 2020. This report documents the findings from an independent evaluation of Breathing Space, drawing upon qualitative and quantitative data collected throughout the delivery period of the project.

The Key Project receives Big Lottery funding to support disadvantaged girls and young women (aged between 13 and 25) deemed to be at high risk of abuse within the Leeds area, aiming to work with 324 individuals. The Key is hosted by a voluntary sector provider of gender-specific (women-only) health focused programmes. This paper presents the interim findings from an on-going longitudinal evaluation of The Key. The evaluation draws on data collection from creative focus group activities with young women, semi-structured interviews with project staff and referrers, as well as desk-based analysis of internal monitoring data. The Key model of delivery provides young women with peer support (weekly group sessions) and additional one to one intensive support where required, to educate them and develop their knowledge and capabilities in being better able to identify and respond appropriately to abusive relationships. The Key aims to increase young women’s skills to stay safe and to improve their mental wellbeing. In the evaluation data so far, young women report a variety of positive outcomes as a result of their engagement with The Key, including being better able to recognise abuse, increase their safety and capacity to be in control. Many reported increased self-confidence.

This case study considers the use of creative methods that have been used in evaluation research to capture and explore the views of service users receiving support in the context of two gendered interventions. We outline the use of a cake metaphor and a simple writing exercise as creative data collection tools to use with focus group scenarios. The cake metaphor enabled women to describe one thing (the way a group worked) by using the analogy of another (the baking of a cake). The writing activity was a useful tool to report the stories of some women in an exact form, with words that came directly from them. These activities were designed to give service users voice, by more actively engaging them within data-making whilst we explored serious and emotional subject matter. We applied these methods as they are in keeping with the feminist values that underpin our approach to research, and they were viewed positively by our funders. The use of creative methods described here was combined with other traditional methods, not discussed in depth in this case study. The results from the writing activity were captured in photographs as well as a slide show with accompanying narrative. The metaphor work is more traditionally presented with descriptive themes as well as a photograph. We learned to be flexible, and to consider the importance of both purpose and timing in using such tools.

The Key Project received Big Lottery funding to continue its work in 2017, aiming to work with disadvantaged girls and young women at high risk of abuse aged between 13 and 25 within the Leeds area. The project is located within Women’s Health Matters, a charitable provider of gender-specific services in Leeds. This report presents the overall evaluation findings from a longitudinal co-produced model of data collection conducted by the Centre for Health Promotion Research, Leeds Beckett University.

Background/Objectives The purpose of the paper is to explore disadvantaged young women’s talk about their experiences of trauma, struggle, structural disadvantage and behavourial risk using a salutogenic lens. Such young women are typically labelled in neoliberal policy and practice as being ‘vulnerable’ however, they often resist this label in their talk about their experiences drawing on what Antonovsky describes as a ‘Sense of Coherence’. In doing so the young women develop comprehensibility, meaningfulness and manageability and exhibiting agency and resilience. Gendered interventions provide the means to empower disadvantaged young women and it is through evaluations of such interventions that we can better understand their experiences. Methods This paper draws on evidence from several evaluations of gendered interventions designed to support ‘vulnerable’ young women. The evaluations used a range of participatory methods using multiple creative means to explore disadvantaged young women’s lived experiences. Such methods, for example, include the use of storyboards. Data from the evaluations were analysed using thematic analysis. Results Data across several evaluations reveal themes of comprehensibility, meaningfulness and manageability in the young women’s talk. Resilience and agency are also evident. Discussion Contrary to the singular portrayal in public health policy of disadvantaged young women as ‘vulnerable’, the data from the evaluations show that they construct themselves and their experiences in more agentic, salutogenic ways. This evidence shows that appropriately designed gendered interventions can have a positive impact on such young women and promoting empowering ways of being, enabling the attainment of improved health and wellbeing.

Background/Objectives This paper discusses a voluntary sector strategic partnership and delivery project involving eleven women-centred organisations who worked together to support the most vulnerable women and girls across a city in the north of England 2017-2021, aiming to 1. Improve and extend access to services and support; 2. Provide a holistic response to meet complex needs; 3. Empower women and girls. This paper details the project and partnership model and illustrate the importance of feminist health promotion as a tool for change. Methods This article draws upon a three year longitudinal qualitative evaluation, underpinned by a feminist methodology. Our evaluation placed the project staff, partners, stakeholders and service users at the centre of qualitative data collection, drawing upon a co-produced Theory of Change approach and associated framework analysis to assess the extent to which the project and partnerships aims had been met. Our sample includes 34 service users and 54 professionals (19 of which are repeat interviews) with data gathered between 2017-2020. Results Data from our evaluation shows a successful project model supporting vulnerable women in a holistic and empowering way to ensure that their complex needs were met. Our evaluation data also highlights the successes and challenges of a complex partnership aiming to advocate for women on a strategic local level. There were several positive outcomes resulting from partnership work to collectively advocate and raise awareness of the issues affecting women and girls, despite internal challenges. Discussion Feminist health promotion requires further analysis as a mechanism to achieve emancipatory innovation. Our data uncovers the hidden dichotomy between external success, such as achieving the delivery outcomes, and internal partnership politics, which are underexplored in the literature. Despite these challenges, our evidence shows that this project and partnership was a successful gendered intervention that had positive empowering impacts on many of those involved.

In recent years, particularly within the last decade there has been much policy attention paid to tackling disadvantage. Consequently, large numbers of programmes have been designed and implemented to help those who are seen as being able to benefit from intensive intervention. There have been discussions too around the need for the acknowledgement of the gendered dimensions of disadvantage. It is within this context that one specific gendered approach (The Way Forward Project), aimed at addressing the marginalization of young women with significant and unmet need has been operating since 2013, in one localised area (Calderdale, West Yorkshire). The need for gender sensitive ways of working is now recognised within the policy making process following the influential Corston Report. However, there is a lack of evidence in both the academic and policy arena related to the operation of such approaches with a gender specific remit. This paper therefore explores the way in which The Way Forward Project operates examining the projects delivery mechanisms, the complexities of the issues encompassed within its remit, the project approach (working with young women in ways that other service providers are unable to), the role of inter-agency working and local decision making processes. The paper presents a model of delivery based upon the Way Forward context, and discusses the transferable lessons for other UK localities, whilst drawing out the core issues associated with this prototype project that need to be considered within the policy-making process for effective working with vulnerable young women aged 15-25 with complex and multiple needs.

This case study will introduce the reader to threshold concepts outlining what they are and how they are defined, before moving on to discuss a qualitative research project with undergraduate students to explore perceptions of threshold concepts within health. The study aimed to establish if threshold concepts within health are identifiable from a student perspective and to explore the teaching and learning processes by which students master such concepts. Focus groups were conducted with students at level 6 of an undergraduate health related degree (health studies), and this case study will outline the data collection processes undertaken within this research. This case study provides an account of the research process, taking the reader through the methods that were used describing focus group discussions with students as a data collection mechanism to both explore and try to gain understanding of the ways in which they learn. The case sheds light upon the challenges of conducting research with students that are being taught by staff who are also researching them, as well as highlighting the findings which show how students learn using the conceptual tool of thresholds as a way to explore processes of learning from the perspective of the student.

Aim To draw on the authors’ experience of using storyboards in focus groups conducted with vulnerable young women. Background Creative methods are increasingly used in qualitative research as a means of generating richer data and of promoting more meaningful participation. This paper presents an argument for using storyboards in focus group discussions and draws on real life research with young women by way of illustration. Review Methods This is a methodology paper Discussion This paper discussed the authors’ experiences of using storyboards in participatory research. This approach has a number of advantages such as promoting participation and engagement, empowering participants and, enabling them to take more control over the research process. The theoretical and philosophical position of the authors is outlined – namely a feminist approach to research. The data collection method is then described in detail outlining each stage of the process step by step. Conclusion Using creative techniques within more traditional qualitative approaches may lead to further in-depth data as well as increased participation. Such approaches could be of value in nursing research in which patients, clients and service user perspectives are often vitally important.

Relative disadvantage and deprivation are significant problems for vulnerable women in urban areas in England. Despite experiencing a range of complex health needs such women do not always meet the required thresholds for statutory help or if they do, they are often unable to engage with the requirements of these service providers. Third sector (or non-governmental) organisations have often supported women in need but operate time-limited programmes due to funding restrictions. In a climate where statutory support systems are being systematically weakened, third sector organisations are playing a more significant role in supporting vulnerable women. This paper will present key findings from several evaluations of projects delivered by non-governmental organisations which are designed to make a difference to women’s lives. The findings cohere around what works providing evidence of effective approaches to supporting vulnerable women with complex needs. A transferable model of women-centred working is presented.

The authors of this paper reflect upon their experiences of evaluating gender specific interventions (women-focused) over the last five years, arguing that there are key lessons to be drawn from their experiences. Models of delivery place women at the centre of services, with practice discourse citing holistic, complex-needs focused work in co-production with those who choose to both engage and participate within the provision on offer. Concepts such as risk, resilience, trust and emotional labour are evident within our evaluation findings. A more critical reading of our research findings highlights the management of ‘risk’ with gendered performance used as a measurement of the success of these services. Neoliberal discourses such as self-improvement, reinvention and aspirations of self-control are evident within women’s talk. Thus, women’s discursive practices reinforce hegemonic gendered identities and neoliberal ideology. Service providers also face challenges of being feminists in practice, within funder requirements which can be constraining and challenge both the delivery of complex-needs support and co-production. In summary, gender-specific interventions create a space for the delivery of what can be understood to be ordinary kindness, for women experiencing issues rooted within broader structural inequalities. However, the delivery of potential feminism within women-centred services remains constrained by the wider neo-liberal context in which these services are located.

This report presents evaluation findings about the NOVA Menohealth project. The evaluation data includes delivery staff and stakeholder perspectives about the work, course attendee’s reflections on their experiences and a summary of internally collected data.

The Open Doors, Help Through Crisis Project (HTC) was set up in 2017 as a partnership approach between three third sector, community based organisations within Harehills and Gipton. The three partner organisations are: 1. GIPSIL (Gipton Supported Independent Living Limited), providing accommodation and housing-related support, an advice service and support to access and sustain employment, education and training, principally to young people (16-24); 2. Archway Resource Centre in Harehills (a project of Renew), providing 1-1 support, counselling, family work and mediation services as well as floating support to young people living independently; 3. Getaway Girls in Harehills, enabling vulnerable young women aged 11-25 to build confidence, develop new skills and take positive risks in an environment which offers co-operation and support. This report presents the findings from an evaluation framework review of Open Doors (HLC) conducted by the Centre for Health Promotion Research, Leeds Beckett University. It presents evidence about our methodological review and recommendations that emerge from this.

One of Shift.ms’ innovative digital interventions was our Twitter takeover: each weekend control of our account was handed to a different person from the MS community. People with MS (MSers) report that interacting with a different individual each week helped reduce feelings of isolation and reinforced a sense of community. This report presents the findings from an evaluation of The YouTube Takeover co-produced by the Centre for Health Promotion Research, Leeds Beckett University and Shift.ms.

Disadvantaged young women in England have been documented as having unmet needs. This has resulted in the growth of gender-specific intensive intervention programmes in which a more holistic women-centred service approach is still being implemented. Gender matters because structural inequalities (bias and disadvantaging societal conditions) that girls are born into influences health, their outcomes and associated inequalities. Policy-makers frequently call for the outcomes of intervention programmes to be quantified and whilst this is important it can miss opportunities for critical insights into the subjective experiences of participants as well as the context and circumstances within which change occurs. This paper reports evaluation findings from a prototype project (The Way Forward) with a remit focused upon holistic improvement, using gender specific methods and approaches to promote health for disadvantaged young women within a community setting. This paper documents the voices of young women within the project, illustrated through their creation of storyboards within focus group discussions, and interview data from their support workers (Engagement Workers). Findings illustrate the importance of the relational dimension of one to one support in achieving future positive changes in the lives of young women, as well as the complexity associated with attempts to improve their health. This paper therefore presents the young women’s perspectives and experiences as well as an accompanying narrative discussing how the service enabled them to make health-related improvements with its main contribution being in the user voices.

One You Leeds provides the maternal stop smoking service across the city of Leeds. Staff from the Centre for Health Promotion Research were commissioned to evaluate the service, between March 2018-June 2019.

Within the United Kingdom (UK) in recent years, disadvantaged young women have been documented as having unmet needs and experiencing inequalities resulting from their gender. Gendered social divisions are important because the structural inequalities that girls are born into influence their life chances. In response, UK policy-makers have funded intensive interventions for these ‘at-risk’ young women. This paper presents a post-structuralist, feminist analysis of young women’s talk about their journeys through a gendered support project. The project was specifically women-centred and aimed to promote early intervention and resilience working with relatively disadvantaged young women defined as being in risky life circumstances. The project used holistic, individually-focused, wrap-around support systems to engage vulnerable young women and meet their specific needs. Focus groups were carried out with the young women using creative methods of data collection. The young women were asked to make a storyboard illustrating their journey through the project and the impact it had had on them. They were then encouraged to reflect on, and talk about, their experiences. The young women took up various discourses in order to make sense of their life experiences and their involvement in the project. These include neoliberal discourses such as talk of self-improvement, reinvention and aspirations of self-control. The social and political implications of the analysis are discussed including a key argument that the young women’s discursive practices reinforce hegemonic gendered identities, neoliberal ideology and existing structural inequalities.

This paper presents a post-structuralist, feminist analysis of young women’s talk about their journeys through a gendered support project. The project is specifically women-centred and aims to promote early intervention and resilience working with relatively disadvantaged young women in risky life circumstances. The project uses holistic, individually-focused, wrap-around support systems to engage vulnerable young women and meet their specific needs. Several focus groups were carried out with the young women using creative methods of data collection. The young women were asked to make a storyboard illustrating their journey through the project and the impact it had had on them. They were then encouraged to reflect on, and talk about, their experiences. The young women took up various discourses in order to make sense of their life experiences and their involvement in the project. These include neoliberal discourses such as talk of self-improvement, reinvention and aspirations of self-control. There was also evidence of trauma discourse in which the young women spoke of a range of abuse and how they came to terms with and made sense of this. The social and political implications of the analysis are discussed including a key argument that the young women’s discursive practices reinforce hegemonic gendered identities and neoliberal ideology.

This presentation will share learning from two educational and support programmes relating to domestic violence delivered by a non-governmental organisation. The programme evaluations used mainly qualitative methods to explore the participants’ experiences of attending the programmes and the role education plays in recovery from and prevention of domestic abuse. What did the programmes do? They provided structured sessions in a safe women-only space for women/girls who had experienced or were at risk of domestic abuse. Education around types of abuse, staying safe and improving wellbeing were provided to prevent (further) abuse. What worked/what are the challenges? Education delivered in group settings allows the opportunity for peer support which reduces isolation and peer learning which can be more effective than learning from professionals. A youth work or ‘informal learning’ approach is taken so that the women/girls feel comfortable in a non-judgemental environment where they are supported to develop skills to stay safe. Delivering programmes through an NGO with staff who are trained in trauma-informed practice and community development/youth work approaches is a key factor in reaching women and girls who have experienced/are at risk of domestic violence. Many of the programme participants had had previous negative experiences with statutory bodies and formal education. Some of the main challenges are that these programmes don’t reach all in need, they are only funded in the short-term and they tend to individualise the responsibility for staying safe. Lessons learnt on education around violence against women and girls and evaluation of provision: More mainstream education is needed and targeted work for women who are not being reached. The independence of the NGO is important in engaging young people and those with negative experiences of statutory services. Evaluation and programme development needs to involve women/girls in the design and delivery.

Background: International evidence suggests that women experience a range of health and wellbeing challenges during menopause, and perimenopause. Current literature highlights the need for women to be educated about menopause, yet limited evidence exists in England about community-based menopause programmes that focus on educating women on this issue. Study’s objectives: The objective of this study was to evaluate a gender-specific (women-only) menopause-focused educational programme delivered in one English local authority area. Setting: A bespoke educational programme on menopause was delivered to women (n= 146) living in one geographical area, via 10 voluntary and community sector organisations, between July 2023 and March 2024. Method: This mixed methods, co-produced evaluation gathered data using pre- and post-course questionnaires (n= 51), learning logs (n= 7), observations of meetings (n= 5) and semi-structured interviews (professionals n= 11; course attendees, n= 7). Differences between pre- and post-test scores were calculated using the Wilcoxon signed rank test and effect sizes were identified. Qualitative data were analysed thematically. Results: The programme met its aims. The evaluation data show that this community-based, women-only educational programme was valued by delivery partners and course attendees alike, all of whom noted learning through their participation. Women as course attendees increased their knowledge and were able to use this education to improve their health. Conclusion: The programme worked well for the women who accessed it. However, it did not reach all the women who may have needed it, and it was only funded for a short while. Longer term, more sustainable educational provision to educate and inform women about menopause is required.

Focus  This thesis gathers data from street sex workers who work in the Managed Approach (MA) in Leeds. Current literature fails to focus on physical or mental health measures, or long-term conditions. Rather, there is a tendency in the sex worker literature to focus on harm reduction, drug use and addiction, and to consider only the risks they pose to others (Department of Health, 2014, Putnis and Burr, 2019). Street sex workers face extreme health inequalities, and without fully understanding the nature or extent of their experiences, from the women’s perspective, little can be done to address these. This thesis addresses this gap in the literature using the following research questions. • From the women’s perspectives, what are sex-working women’s patterns of engagement with health care providers? • From the women’s perspectives, what are the critical junctures at which they do and do not seek professional assistance? • What is the impact of criminalisation, stigma, bias on their health outcomes? • What are the implications of these findings for future policy and service provision?  Methods  Using Feminist Constructivism, timelines were used alongside semi structured qualitative interviews to capture the women’s critical decision-making in their health seeking behaviours. Thematic Analysis (TA) was used to analyse both the timelines and the transcribed interviews – comprising of 16 interviews and timelines from seven interviewees.  Findings and Discussion  From the TA, 3 meta narrative threads were generated: service provision; stigma and bias; and adverse childhood experiences (ACEs), trauma and experiences. A key unique contribution of this thesis is the evidence that substantiates both the need to advocate for decriminalisation of sex work, and the decriminalisation of possession of drugs for personal use, if street sex worker health inequalities are to be addressed. Additionally, the rich narrative data provided by the creative methods used that gives a first-hand account of the sex workers’ experiences in healthcare. Activist Pedagogy (Aslet, 2014) is identified as a strategic tool for development. A further contribution is methodological, and this thesis demonstrates effectively how creative methods can be used to work with underserved populations.

In this article, we reflect upon the use of duoethnography as a mechanism to explore and understand teaching practice, and as a tool for use within classroom contexts. Duoethnography is a research methodology used in the form of paired dialogue to prompt reflexivity, critical reflection and inquiry to generate data on a shared cultural context about which the two participants may have different views and experiences (Norris & Sawyer, 2012) Initiated by the Centre for Learning and Teaching at Leeds Beckett University, we used duoethnography in a project to generate insights from our four Visiting Professors, through the exploration of tensions and agreements in their conversations. In paired conversations, we explored their narrative ideas about the core nature of teaching in higher education. The Visiting Professors used their duoethnographic conversations to focus on three key themes – student agency, belonging and challenge, which are at the forefront of current higher education policy and pedagogic, scholarly debate. We discuss these in relation to existing evidence and the future of course design. Our work makes a significant contribution to the scant scholarship on Visiting Professors in higher education with broader implications for academic development and practice also outlined.

This article reports the findings of a mixed methods evaluation study on the impact of a national fund to support volunteering as a mechanism to achieve health and social goals, within the Department of Health’s Volunteering Fund Programme (HSCVF). This paper adds understanding of the mechanisms through which government organisations can build VSCE organisational capacity to support volunteers. Firstly, the programme increased capacity via resource mobilisation to enhance volunteer recruitment, secondly it strengthened voluntary, community and social enterprise (VCSE) organisations through linkages and finally the programme supported development and learning. The HSCVF impacted upon both volunteering projects and host organisations to produce a range of positive outcomes that were particularly marked in smaller organisations: ‘small project, big difference’. Successful community capacity building can result from programmes such as HSCVF, with this paper contributing to the evidence base by detailing the processes through which this occurred.

This small-scale study looked at what community members know about the role of trustees and the decision-making processes in voluntary organisations. The discussions with community members were then used to produce a short survey for trustees of voluntary or community organisations.

Existing evidence shows that many Roma communities have received little attention in relation to their health requirements. Evidence illustrates how Roma communities suffer from poorer health and unhealthier living conditions when compared to majority populations, with their poor health closely linked to wider social determinants. This study explored the health status and associated health needs of the Leeds Roma migrant community, a hard to reach and under-explored group across Europe. Questionnaires (n = 70) and focus groups (n = 43) with Roma community members as well as interviews with health professionals (n = 5) working with them were used. The study found language was a key barrier to accessing health care and understanding health messages. Furthermore, participant’s understandings of the health system were hindered by their different experiences within their countries of origin. Self-reports illustrated low mental well-being, high levels of stress and unhealthy lifestyles as common issues. The research also highlighted several wider determinants of health as key concerns within the Roma community including housing, employment opportunities and money. The findings of this study contribute to increasing understandings of this community’s health needs, their support requirements and the barriers faced by them. These need to be considered to inform strategies and ways of working as mechanisms to tackle health inequalities and promote health within this community.

This report illustrates the findings from a piece of health-related research carried out within the Roma community in Leeds in 2012. The research aimed to explore Roma community member’s health status and associated health needs. Based upon data gathered from questionnaires and focus groups with Roma community members and interview data from health professionals working with them, this report presents evidence from the data gathered. The findings reported here relate to the migrant population of Roma resident within the UK, not the indigenous Gypsy and Traveller population of the UK. UK and Irish Travellers, despite sharing common experiences to the Roma in terms of discrimination and exclusion, are a distinct community and are not of Roma origin and thus are not the focus of this report.

The Making Advice Work Project (MAW) was set up in 2013 to facilitate advice agencies in Calderdale to work together, and to improve advice and support through partnership. The project was delivered by a group of 4 organisations; Citizens Advice Calderdale Bureau (CACB), Age UK Calderdale and Kirklees, WomenCentre Calderdale and Kirklees and Calderdale Disability Advice Resource (DART). This report presents the findings from an evaluation of MAW conducted by the Centre for Health Promotion Research, Leeds Beckett University. It presents evidence about the project’s journey, the project outcomes and the overall learning from the project.

This paper presents findings from our qualitative evaluation of one Third Sector response (grants programme) to Covid19 across Leeds, funded by the local city council. This partnership between statutory services and the Third Sector involved power sharing, and a delivery model based upon trust. The response aimed to reach into communities of interest who were vulnerable and most at risk for example, older people and people from deprived areas. Our paper outlines the delivery model, the project outputs across communities of interest, as well as lessons for a new way of working between state and voluntary sector partners on inequalities.

Empowerment is core to health promotion however, there is a lack of consensus in the wider literature as to how to define it and at what level it may occur. Definitional inconsistency inevitably leads to challenges in measuring empowerment yet, if it is as important as is claimed this must be addressed. This paper discusses the complexities of measuring empowerment and puts forward a number of recommendations for researchers and policy makers as to how this can be achieved noting some of the tensions that may arise between theoretical considerations, research and practice. We argue that empowerment is a culturally and socially defined construct and that this should be taken into account in attempts to measure it. Finally we conclude that, in order to build up the evidence base for empowerment, there is a need for research clearly defining what it is and how it is being measured.

Health, a universal human value and a fundamental human right, is a contested and elusive concept. Lay meanings of health are among the different dimensions of the understanding of health, and they have been of great interest to researchers because they help people to understand themselves and their world and influence their health choices and practices. They are subject to change with changing circumstances across the lifespan. The purpose of this study was the exploration of the meanings of health among individuals living with comorbid type 2 diabetes (T2DM) and hypertension (HTN) in The Gambia which, to our knowledge, was hitherto unexplored. The study design was interpretivist and data were collected through thirty-two qualitative interviews with eighteen participants, most of whom participated in two separate interviews, from November 2018 to July 2019. Data were analysed using Braun and Clarke’s reflexive thematic analysis. Three main themes were generated to capture the meanings of health: (1) health: embodiment of corporeal experiences; (2) health: freedom; and (3) health: reward for virtue. The findings highlight the complexity of lay meanings and underscore the need for their incorporation into health promotion policy and practice to promote equality, participation and empowerment and bring the public back into public health.

Health Promotion Ethics: A Framework for Social Justice critically considers the ethical dimensions of promoting health with individuals and communities, encouraging a nuanced understanding of health promotion in the context of fairness, empowerment and social justice. The concept of social justice, indeed, is central. The book explores how health promotion should be considered in relation to moral, social and legal issues, from individual responsibility to government intervention, as well as the possibility that existing practice maintains rather than alleviates existing health inequalities by stigmatising certain groups. It also questions the 'rights' of those who promote health to use particular strategies, for example using fear to encourage behaviour change. The ethics of health promotion practice and research are considered, introducing several important debates. Case studies, international material and opportunities to reflect on practice are used throughout to bring the important issues under discussion to life, engaging both students and practitioners alike. The book provides a fascinating route to reflect on what it really means to promote health for all in a more equitable way.

The incidence and prevalence of type 2 diabetes mellitus (T2DM) and hypertension (and their comorbidity) have been increasing in sub-Saharan Africa, including The Gambia. Diet is a critical driver of these public health problems, and diet-related health education is a major strategy employed for their prevention and management. The aim of this paper is to explore the lived experiences of diet-related health education among individuals with comorbid type 2 diabetes and hypertension in Serrekunda, The Gambia, a subject hitherto unexplored in the country. The study employed a qualitative (interpretivist) methodology. Thirty-two interviews were conducted with 18 participants, with most participating in two interviews at separate time-points between November 2018 and July 2019. In addition to participant validation, the two points in time interviews elicited more depth and provided rich data. The data were analysed using Braun and Clarke’s six-phased approach to Thematic Analysis. Four main themes were generated in relation to the experiences: (i) one-off blanket dietary advice (ii) education in a vacuum (iii) diabetes-hypertension diet dichotomy and (iv) imbalanced power relationship. The study underscores the need for a reconfiguration of diet-related health education in The Gambia to include lived experiences as critical components of health promotion in tackling T2DM and hypertension. This requires an ecological approach, critical health education, regulations on unhealthy foods, and active participation of individuals as equal partners in health education.

Background Despite literature recognising the huge potential of co-production as a positive approach to evidence creation, there is a dearth of evidence about how co-production principles can problematise knowledge exchange, specifically in evaluation work. Aims To critically examine 3 evaluation projects commissioned by voluntary sector stakeholders to illustrate challenges in knowledge exchange linked to the co-production of evidence exchange. Methods We critically compare the challenges experienced in co-producing evidence across 3 evaluations, reflecting on power dynamics, co-productive ways of working and emotions, which all impact upon successful knowledge exchange. Findings In project 1, internal monitoring data required for reporting was not shared. In project 2, the commissioners’ need to evidence success resulted in limited knowledge sharing, with valuable learning about partnership issues and service delivery held internally. In project 3, evidence demonstrating the failure of a local authority model of area management for community members was partially discredited by statutory stakeholders (state actors). Discussion and conclusions Bias in evaluation reporting and academic publication can arise from current knowledge exchange processes, including co-production. Voluntary sector funding is problematic as stakeholders delivering programmes also commission evaluations. Knowledge exchange is influenced by vested interests arising from the political context in which data is gathered. Evaluators can face aggression, challenge and unfair treatment resulting in damaged relationships, and failures in knowledge exchange. The emotional elements of knowledge exchange remain under-reported. Varying and shifting power dynamics also limit knowledge exchange. Changing research practice, to support power sharing needs further exploration to facilitate improved knowledge exchange.

Gypsies and Traveller community members belong to a community that has been described as the most excluded in the UK. Furthermore, the health status of this community is considerably poorer than other English speaking ethnic minority groups. Gypsy and Traveller communities in Britain experience wide-ranging inequalities, notably in relation to health. In recognition of this, one CCG within West Yorkshire has employed a specialist outreach nurse to work with the local Traveller and Gypsy community, with a remit to improve the health of this population, initially over a one-year period, subsequently extended to two years. This work is being evaluated by Leeds Beckett University, who will present the early qualitative findings from this on-going evaluation. So far the data shows that the community members face numerous barriers to accessing services, report complex health needs and will work with the outreach nurse, whose role is perceived as acceptable. Her work is also resulting in self-reported health improvements. A key lesson from the implementation of this model of care thus far is the importance of trust in successfully implementing such an intervention.

The contribution that housing associations have made to public health in recent years is recognised within research and policy literature. This paper examines a partnership pilot intervention implemented by one housing association and one community healthcare service provider that aimed to improve the health and well-being of people with complex needs living in social housing stock in one area in England. The pilot delivered co-commissioned personalised support using a holistic model of care. This paper describes the pilot intervention and associated findings drawn from a mixed methods evaluation. The findings illustrate positive service user reports, including improved health and well-being, increased independence and reduced social isolation. The intervention was also associated with reduced use of community healthcare services; with an estimated potential local net saving of £20,818 during the year of the pilot. In conclusion, this small-scale pilot intervention supported clients with complex health needs whilst reducing demands on community health care services. Despite more research being needed in this area, particularly from larger and longer-term studies, this paper contributes to the evidence base by illustrating an effective health and housing practice-based partnership approach.

The contribution of feminist approaches to health promotion research is discussed throughout this chapter. We start by outlining the principles that underpin feminist research and discussing how such approaches distinguish themselves from more traditional and mainstream study techniques. Drawing out the links between feminist research strategies and their overlap with health promotion research, we reflect upon our own practice as feminist evaluators examining interventions that support social change and health improvement for vulnerable women in England. We highlight examples of the numerous ways in which we have drawn upon feminist principles to do data collection as part of our evaluation work, aiming to give voice to seldom heard women, and to privilege their lived experiences. Continuous reflection on our work has led us to critically analyse the ways in which feminist research remains challenged within a neoliberal context, is affected by researcher positionality and is a form of emotional labour for all involved. These challenges are relevant for other health promotion researchers, engaged in evaluation work and data collection with vulnerable groups.

CITY KNOW-HOW: Worrying trends in terms of human health and planetary health are receiving increasing global concern. City leadership, planning and development all place the constraints on urban behaviours and lifestyles, usually accelerating the problems. It is imperative that human health and environmental impacts become core foci in urban policies around the world. Changing our trajectory will require concerted action. Cities & Health aims to be part of that change; it is dedicated to supporting the flow of knowledge, in all directions, to help make this happen. We support better communication between researchers, practitioners, policy-makers, communities, and decision-makers in cities. This is the primary purpose of this City Know-how section of the journal. ‘Research for city practice’ disseminates lessons research, allowing researchers to explain new knowledge and key messages arising from their studies for city leaders, communities, and the professions involved in city policy and practice. ‘City shorts’ provide glimpses of what is being attempted or achieved ‘on the ground’ and ’case studies’ are where you will find evaluations of interventions. Lastly, ‘Commentary and debate’ extends the conversations we are having to develop and mobilise important and innovative thinking. We invite you to join these conversations. In order to strengthen communities of interest, we would like to include many and varied voices, including those from practitioners, politicians and policy-makers and researchers who are supporting health and health equity in everyday urban lives. Whether you are a just starting out on your journey, or an old hand, we would love to hear from you!

We are 3 feminist researchers, with a track record of evaluating gender-specific interventions located in the voluntary and community sector. Over the last 10 years we have evaluated 8 gender-specific health promotion interventions using feminist methods. Our evaluation data illustrates key themes underpinning successful service delivery in the sector, which works effectively to support women in a transferrable model of practice. Our most recent evaluation of Women’s Lives Leeds (project and partnership) offers unique insight into a partnership underpinned by feminist values, yet challenged by internal power differences, and external competition for funding to ensure organisational survival. We use creative, and participatory methodological approaches in our work to try and diminish the power gaps between us as researchers and the women we work with, valuing their lived experiences. However, challenges remain in terms of models of co-production, participation and the acceptability of such qualitative data as evaluation evidence.

The Institute for Sustainability Leadership at Cambridge University (CISL) is carrying out research on how supermarkets can support community health and wellbeing. The CISL researchers were keen to understand what support really looked like on the ground, and what difference it made. It was really important to them that the voice and experience of community members was included in the research and so a team from the Centre for Health Promotion Research at Leeds Beckett University supported a group of residents from a town in Cambridgeshire to do a community research project. To explore their research topic, Leeds Beckett researchers used a peer research approach. They trained community members to carry out a research project and the Community Researchers chose the topic of the research: experiences of living in the Cambridgeshire town. This report shares the findings from the research project.

The Institute for Sustainability Leadership at Cambridge University (CISL) is carrying out research on how supermarkets can support community health and wellbeing. The CISL researchers were keen to understand what support really looked like on the ground, and what difference it made. It was really important to them that the voice and experience of community members was included in the research and so a team from the Centre for Health Promotion Research at Leeds Beckett University supported a group of residents from East Leeds to do a community research project. To explore their research topic, Leeds Beckett researchers used a peer research approach. They trained community members to carry out a research project and the Community Researchers chose the topic of the research: Community Voice. This report shares the findings from the research project.

Aims: Co-production is an emerging field in public health practice. We aim to present evidence of what works well to support co-production and what can be improved based upon learning from our evaluation of a co-production project implemented by Rape Crisis England and Wales (RCEW). RCEW designed and delivered a national co-production project called Weaving the Web, to inform the development of an online support service for women who have experienced sexual violence. Methods: We qualitatively evaluated the RCEW co-production approach. The specific objectives of our evaluation were to assess the increased role and voice for women and girls in co-producing services and provide better quality of evidence for what works in empowering women and girls. The evaluation was conducted in two phases: Phase 1 was the observation of co-production events (n = 8), with findings from this used to develop an interview schedule for Phase 2, where semi-structured interviews (n = 26) were conducted with a range of stakeholders (staff, partners and service users). Results: Staff supporting the co-production project were highly committed to the work, investing time, money, and preparation, and having a good understanding of co-production. Service users were less familiar with the approach and felt alienated by some of the language used. Most service users described participation as empowering and, in some instances, important in their own recovery. They were keen to stay involved beyond the creation of the online resource. Conclusion: The data from our evaluation illustrate that co-production on a national level is challenging. While RCEW used values-based practice, and provided a supportive culture to underpin the co-production of their online service, transformative engagement and true participation were not achieved. Learning from this project is drawn out here to outline transferrable lessons for practitioners intending to use models of co-production in other public health settings.

The joint housing and health pilot project was set up in September 2015 as a prototype approach aiming to improve the health and well-being of people with complex health needs within the Batley and Spen Valley localities. The project was co-commissioned by Locala, a provider of NHS community services and Connect Housing, a charitable housing association based in the voluntary sector. This report presents the findings from an evaluation of the joint pilot project conducted by the Centre for Health Promotion Research, Leeds Beckett University. It presents evidence about the project’s background, the outcomes for service users, the Health and Support Worker role, multi-agency working, reductions in health service usage costs, and maps the evaluation evidence against Care Closer to Home Key Performance Indicators as well as overall learning from the project.

The contribution that housing associations have made to public health in recent years is recognised within research and policy literature. This paper examines a partnership pilot intervention implemented by one housing association and one community healthcare service provider that aimed to improve the health and well-being of people with complex needs living in social housing stock in one area in England. The pilot delivered co-commissioned personalised support using a holistic model of care. This paper describes the pilot intervention and associated findings drawn from a mixed methods evaluation. The findings illustrate positive service user reports, including improved health and well-being, increased independence and reduced social isolation. The intervention was also associated with reduced use of community healthcare services; with an estimated potential local net saving of £20,818 during the year of the pilot. In conclusion, this small-scale pilot intervention supported clients with complex health needs whilst reducing demands on community health care services. Despite more research being needed in this area, particularly from larger and longer-term studies, this paper contributes to the evidence base by illustrating an effective health and housing practice-based partnership approach.

The Eatwell and Livewell Programme was set up in 2014 to provide support in the malnutrition pathway for older people within two Yorkshire areas. This report presents the findings from an evaluation of the programme conducted by the Centre for Health Promotion Research, Leeds Beckett University. It presents evidence about the project’s background, its progress in relation to target outputs, the outcomes for service users, and learning from both delivery sites.

Background Women in prison have comparatively greater health needs than men, often compounded by structures and policies within the prison system. The notion of a ‘health-promoting’ prison is a concept which has been put forward to address health inequalities and health deterioration in prisons. It has, however, not been fully discussed in relation to women in prison. The paper aims to distil the learning and evidence in relation to health promotion in female prisons using prison inspection reports of women’s prisons in England and Wales. Methods Prison inspection reports are one way of ascertaining the contemporary situation in prisons. Prison inspections are often unannounced and use a myriad of methods to draw conclusions around various aspects of prison life. Thirteen prison inspection reports were analysed thematically focusing on health promotion within the institutions. Two analysts conducted the work using NVivo 12. Results Five core thematic areas were identified during the analysis of the reports. Saliently, a joined-up approach to health promotion was not a common feature in the prisons and indeed the focus tended to be on screening and ‘lifestyle issues’ rather than a concern for the underlying determinants of health. There was often an absence of a strategic approach to health promotion. There were some good examples of the democratic inclusion of women in prison in shaping services, but this was not widespread and often tokenistic. There were some examples of inequity and the inspection reports from a small number of institutions, illustrated that the health needs of some women remained unmet. Conclusions The paper suggests that there is potentially some work before conditions in women’s prisons could be described as ‘health-promoting’, although there are some examples of individual prisons demonstrating good practice. The health promoting prison movement has, implicitly at least, focused on the needs of men in prison and this has been to the exclusion of the female prison population. This does lead to several challenges and the potential for exacerbating health challenges faced by an already marginalised and vulnerable group. Greater focus on the health promotion needs of women in prison is required.

This chapter reports learning from students participating as peer researchers in a pedagogically focused study. The chapter documents the peer research model used, its challenges and its successes, to add to the evidence base about the reality of using participatory approaches (Warwick-Booth et al, 2021), specifically with and for students. The chapter also details findings from this peer research about the lived experiences of postgraduate students as they transition into learning at masters level. By exploring transition experiences qualitatively through the voices of students, the study findings enable better understanding of the wider circumstances affecting postgraduate students and their associated support needs. Morgan (2014) highlights the need for institutions to identify students experiences and expectations as a way to improve their experiences of postgraduate taught study. This chapter adds to the evidence base around postgraduate student transitions in two specific ways. Firstly, the data gathered by the peer researchers provides useful insights into lived experiences of transition, to inform teaching practice that can better enable transitions into postgraduate study. Secondly, by detailing the process of peer research the chapter outlines the ways in which participation in such work enables postgraduate transitions through joining a community of practice.

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.

Yoga offers multiple health and wellbeing benefits and is socially prescribed by clinicians in the NHS as part of health promotion measures in the United Kingdom (UK). However, socially marginalised groups are under-represented and yoga participants, or practitioners, are predominantly white, higher educated women. This research contributes to the knowledge by exploring, for the first time, the yoga access experiences of people with a broad range of marginalised identities in a UK context. It was prompted by my experiences of teaching yoga to diverse groups in a northern British city neighbourhood amongst the 10% most deprived in the country. Purposive sampling was employed to recruit 17 people from four northern UK cities who had practised, or participated in, yoga in the previous six months, but did not consider themselves to be yoga insiders, and who self-identified with one or more of seven marginalised identities, namely: Black, Brown or other people of colour; disabled; older (later life); LGBTQIA+; of a larger body type; from a religious faith or background; or on a low income. Data was collected via 1-1 teleconferencing software interviews during COVID-19 pandemic restrictions and analysed initially using thematic analysis and, subsequently, using a critical theory-based approach. Nine barriers to yoga access were initially identified using thematic analysis: cost, place, discomfort, physicality, appearance, behaviour, people, potential distress, and alien-ness. These were intersectional in impact and experienced across the range of identities studied. Additionally, nine areas of barrier effect were identified using a critical theory-based approach, these were: Inclusion and access; Whiteness/ableism; Postcolonialism and cultural/religious appropriation; Commercialisation/neoliberalism; Unaware of/don’t see; I was lucky; Belief in loveliness; and Power/challenge. These areas arose from practices and norms within the social institution of UK Yoga and could be associated with emerging criticisms in the literature. Findings were that a range of barriers to yoga access were experienced, some of which could be attributed to practices and norms within the social institution of UK Yoga. These barriers could be seen to contribute to the health inequalities faced by marginalised groups and could be associated with the social determinants of health. Recommendations are for appraisal and revision of delivery of yoga in the UK including: teacher training; pedagogy and language; tailored approaches; examination of privilege; and sharing of power. Further research is indicated with yoga ‘insiders’ with marginalised identities.

There have been concerns about the decline of health promotion as a practice and discipline and alongside this, calls for a clearer articulation of health promotion research and what, if anything, makes it distinct. This discussion paper, based on a review of the literature; the authors’ own experiences in the field; and a workshop delivered by two of the authors at the 8th Nordic Health Promotion Conference, seeks to state the reasons why health promotion research is distinctive. While by no means exhaustive, the paper suggests four distinctive features. The paper hopes to be a catalyst to enable health promotion researchers to be explicit in their practice and to begin the process of developing an agreed set of research principles.

This evidence review looks at the evidence base for empowerment and health & wellbeing. It was commissioned as part of the evaluation of the Altogether Better programme, a five-year initiative funded through the BIG Lottery that aims to empower people across the Yorkshire and Humber region to lead healthier lives. The regional programme is made up of a learning network and 16 community and workplace projects, which are working to increase physical activity, improve healthy eating and promote better mental health & well-being. Altogether Better is based on a programme empowerment model. This model is based on three elements: building confidence, building capacity and system challenge.

Welcome to the concluding final evaluation and learning report for the Women’s Lives Leeds (WLL) Project. The Women’s Lives Leeds (WLL) Project was a Big Lottery, since renamed National Lottery Community Fund (NLCF), Women and Girls Initiative Funded 4-year Project that delivered a range of opportunities including frontline services that enabled women and girls to lead safer and healthier lives and was created by a partnership of Women’s led and centred organisations in Leeds, who joined together to form the “WLL Partnership” in May 2015. The Partnership included Asha Neighbourhood Centre, Basis Yorkshire, Behind Closed Doors, Getaway Girls, Hooner Kelah, Leeds Women’s Aid, HALT (who have since merged with LWA), Nari Ekta, Shantona Women’s Centre, Together Women, Women’s Counselling and Therapy Service, and Women’s Health Matters. Between them they have a collective of over 250 years’ experience supporting the most vulnerable women and girls across the city of Leeds who experience multiple needs including; mental health, domestic abuse, sexual violence and exploitation, experience of the criminal justice system, sex work and substance misuse. The focus of the work was on providing support to the most disadvantaged communities in Leeds, with the aim of reaching greater numbers of the most vulnerable women, ensuring they receive holistic, joined-up support no matter where in the city they live. As one, they applied to the Big Lottery’s, Women’s and Girls Initiative fund, to fund the WLL Project and later that year were successful. The partnership was granted over £2.2mil over a 4-year timescale. The WLL Project focussed on Women, Young Women and Girls and identified specific target groups: young women, women with complex needs and recently arrived new migrant communities and was based on initial research completed in December 2015 that identified current needs. The Project aimed to achieve the following 3 outcomes: 1. Improved and extended access for vulnerable women and girls in Leeds to the services and support they want, when they choose 2. A holistic response to ensure that the needs of women and girls with multiple and complex issues are better supported 3. Women and Girls will be empowered to support their peers and influence service delivery, development and design across the city The Executive Summary was completed in November 2020 and has already been shared with all stakeholders, partners and commissioners including Leeds City Council, Public Health and Clinical Commissioning Groups. The purpose of this report is to detail the learning, challenges and successes taken from project delivery throughout its lifespan and its achievements with the aim for this to be shared to inform other providers in their service development. This report has been informed by views from service users, external stakeholders, ongoing external evaluation, staff and the WLL Alliance gathered over the last four years.

Summary of community views on the Managed Approach to street sex work in Holbeck, Leeds

The report shows the impact of the community project since its inception in 2017, during its early growth, through the pandemic and looking to the future. By consulting with the local community, partners and co-workers this report shows the project’s impact on local people’s health and wellbeing, the growth of strong partnership working and the solid financial footing The Old Fire Station demonstrates. The trustees intend that this report shows the clear advantages of the investment made, the return given and the power of partnership working.

Health education has changed in numerous ways since the inception of this journal, with many developments moving the discipline forward in ways that perhaps were not envisaged 75 years ago. Whilst there have been reported concerns about the decline of the discipline of health promotion and therefore associated worries about education, the contemporary evidence base has grown (Woodall et al 2017 in press), which we argue supports the delivery of quality education and the development of capable, skilled practitioners. Pedagogy has further developed too, and technology now enables health education to have a broader global reach through online teaching, social media and open-access publications. Many global challenges remain, and the UK context is one in which both health education and indeed practice faces major trials despite the traditions and approaches to health education developed by those educated and trained in this setting over a period of many years. We argue that the broader UK policy environment remains a challenge to current health promotion education, research and practice.

Health Champions are a growing component within the British public health workforce and their roles are now emphasised within the coalition’s Government’s public health strategy. However, there is the need for further exploration of the way in which Health Champions use interpersonal communication within their roles. This paper reports on the findings from a mixed method evaluation of one Health Champion programme in North East England. A key finding was the way in which Health Champions used circles of influence to communicate health knowledge and to try to achieve behaviour change, starting with themselves in the centre of their circle and then moving outwards to influence others such as family, friends and colleagues through their social networks. The paper argues that health champions act as healthy role models within their own circles of influence to successfully communicate health knowledge to those around them.

In 2012, I project managed a team of researchers who were commissioned to undertake an evaluation of the Sunderland Health Champions Programme. Evaluation is an activity that remains central to health promotion practice because it is concerned with assessing whether interventions are effective (Green and South 2006). Health Champions are a growing component within the British public health workforce and their roles are emphasised within the coalition’s Government’s public health strategy. However, there is the need for further exploration of the way in which Health Champions work and the effectiveness of programmes that use Health Champions as a mechanism to try to achieve positive health changes. Therefore Sunderland tPCT commissioned independent researchers, staff from the Centre for Health Promotion Research at Leeds Metropolitan University to evaluate their Health Champion Programme.

The Health and Social Care Volunteering Fund (HSCVF) is an innovative programme that was established in 2009 by the Department of Health (DH) to build organisational and community capacity for volunteering through a national and local grant scheme. The HSCVF has offered both funds and tailored support to health and social care projects delivered by Voluntary, Community and Social Enterprise (VCSE) organisations. The HSCVF is managed by a partnership led by Ecorys and with expertise from leading national voluntary sector organisations: Attend, Community Service Volunteers (CSV) and Primetimers. To date the HSCVF has funded a total of 157 local and national projects, of which 114 are currently live. This report presents findings from an evaluation of the HSCVF with a specific focus on the 2010/2011 national and local projects, conducted by a team from the Institute for Health & Wellbeing at Leeds Metropolitan University. It presents evidence on the extent to which, how and in what ways the HSCVF programme has built organisational and community capacity across the national and local HSCVF projects, as well as on the health and social outcomes that resulted.

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.