Health Professionals and Health Services

Exploring the General Public’s Knowledge, Attitudes, and Behaviour to Responding to Out-of-Hospital Cardiac Arrest
(Commissioned by the Scottish Government, through the Resuscitation Research Group, University of Edinburgh)

Survival rates from out of hospital cardiac arrest in Scotland are currently estimated at 1 in 20 (Out-of-Hospital Cardiac Arrest: A Strategy for Scotland (2015)). As most cardiac arrests happen in the home bystander CPR is an important factor in determining survival. In March 2015 the Scottish Government launched it’s Out-of-Hospital Cardiac Arrest strategy (ref as above) which seeks to:

“improve outcomes after out-of-hospital cardiac arrest (OHCA) and an ambition that by 2020 Scotland will be an international leader in the management of OHCA”.

The focus of this research study was to assist with the implementation of three of the strategy aims which centre on public administration of CPR (Cardio-Pulmonary Resuscitation):

  • To ensure that those who witness an out-of-hospital cardiac arrest (OHCA) promptly call 999 and are enabled to carry out immediate Cardio-Pulmonary Resuscitation (CPR) and use a Public Access Defibrillator (PAD), where available, until support arrives.
  • To increase the rate of bystander CPR.
  • To encourage a greater public awareness of the ‘right thing to do’ and an increased willingness to help when present as a bystander at an OHCA.

We conducted a general population survey to gather baseline information on the number of people trained in CPR. The survey also explored public attitudes and behaviour toward out-of-hospital cardiac arrest (OHCA). This new learning will be used to create a social marketing strategy to address the barriers to responding to OHCA. (Note this secondary phase will be the focus of separate commission). Results are available in late 2015.

ISM Staff: Linda Bauld and Fiona Dobbie


Research to Develop a Communications Campaign to Promote Childsmile Within Local Communities (2009)
(Commissioned by NHS Health Scotland)

Scotland has one of the highest rates of childhood dental decay in Europe, and decay rates are disproportionately higher for children living in deprived communities. Childsmile was a childhood oral health service rolled out across Scotland which aspired to provide ‘universal' access to Childsmile care for every newborn, together with additional 'targeted' support intended for children seen to be most at risk of dental caries. NHS Health Scotland, in partnership with Childsmile, commissioned the Institute for Social Marketing to undertake research to inform the communication strategy and development of local social marketing campaigns designed to improve the update of the Childsmile programme as the routine dental service from birth in selected areas in Scotland 's three administrative regions. Two research exercises were completed. Firstly, a literature review examined social marketing campaigns directed at increasing parental/carers' and professional engagement with child and family health; specifically campaigns and projects related to childhood oral health, childhood vaccination and breastfeeding. Secondly, primary research was undertaken with parents/carers, health professionals and key stakeholders through qualitative group and individual interviews. This examined current knowledge, understanding and perceptions of the Childsmile programme, and issues and recommendations in relation to marketing Childsmile .

ISM Staff: Ingrid Holme (left 2009), Susan MacAskill and Douglas Eadie

Lindridge A, MacAskill S, Ginch W, Eadie D and Holme I (2013). Applying an ecological model to social marketing communications. European Journal of Marketing, 47(9): 1399-1420. Online

Holme I, MacAskill S and Eadie E (2009). Research to Develop a Communications Campaign to Promote Childsmile within Local Communities Stage 1: Literature Review. Stirling: Institute for Social Marketing, University of Stirling. Report available from NHS Health Scotland.

Holme I, MacAskill S and Eadie E (2009). Research to Develop a Communications Campaign to Promote Childsmile within Local Communities Stage 2: Primary Research. Stirling: Institute for Social Marketing, University of Stirling. Report available from NHS Health Scotland.

(General Practitioners and Economics of Smoking Cessation in Europe) (2006-2008)
(In collaboration with a number of European partner organisations; funded by the European Commission & Cancer Research UK)

The PESCE project aimed to motivate increased smoking cessation interventions by GP's in Europe. As socioeconomic factors have been named in many EU countries as a deterrent to routinely practised smoking cessation interventions, an objective was to develop evidence based policy recommendations and implementation strategies to change the socioeconomic environment through political measures to motivate greater involvement of GP's in cessation interventions. The Centre for Tobacco Control Research conducted an academic literature review to provide evidence of the factors that hinder or promote GP's smoking cessation interventions, and coordinated the collection and review of grey literature from the EU member countries, Norway and Switzerland to complement this. These two reviews fed into the final European report, recommendations and strategies.

ISM Staff: Martine Stead, Gayle Tait (left 2009) and Kathryn Angus

Stead M, Angus K, Holme I, Cohen D, Tait G & the PESCE European Research Team (2009). Factors influencing European GPs’ engagement in smoking cessation: a multi-country literature review. British Journal of General Practice, 59(566): 682-690.

Obtaining Informed Consent: An Exploratory Study of Patient Information Sheets and Consent Form
s (2002-2003)
(Commissioned by NHS Lanarkshire Research Ethics Committee)

This two-phased project investigated public and patient understanding of written information about clinical trials and the implications for informed consent. The first phase comprised a review of the available literature on patient understanding of clinical trials and scientific method, and discussed the implications of this for effective patient communication. The findings from the review then informed a second, qualitative stage of research. Focus groups with diabetic patients not currently participating in clinical trials explored perceptions of and attitudes towards clinical trials, and used written informed consent materials from actual trials to explore how the public interpret these communications and the extent to which they might inform the decision to participate. Both the literature review and the focus groups found that understanding of the science of clinical trials - particularly of concepts such as placebo, randomisation and double-blinding - varies widely between patients, to the extent that informed consent is likely to be compromised. This variable understanding appears to reflect not simply poor understanding of the scientific method ('scientific literacy') but also an emotional unease with and resistance to concepts which undermine traditional perceptions of the doctor-patient relationship.

ISM Staff: Martine Stead and Douglas Eadie

Stead M, Eadie D, Gordon D and Angus K (2005). 'Hello, hello - it's English I speak!': A qualitative exploration of patients' understanding of the science of clinical trials. Journal of Medical Ethics, 31(11): 664-669. Article

Misuse of Over-the-Counter Medicines
(Commissioned by Lanarkshire Health Board)

It has been recognised that many over the counter medications and retail products such as analgesics, cough and cold remedies, laxatives, and hay fever preparations can be misused by consumers. Misuse takes the form of products used for excessive periods of time or used inappropriately. 'Delisted' products, or products which have recently acquired OTC status are giving particular cause for concern.

This two-stage study consisted of personal in-depth interviews with primary care professionals and a survey of all community pharmacies in the study area. The results were instrumental in guiding local health promotion policy and informing the training needs of community pharmacists and local addiction counsellors.

ISM Staff: Lynn MacFadyen and Douglas Eadie

MacFadyen L, Eadie DR and McGowan T (2001). Community pharmacists experience of over-the-counter medicine use in Scotland. The Journal of the Royal Society for the Promotion of Health, 121(3): 185-192.

Evaluation of NBS Publications
(Commissioned by the National Board for Nursing, Midwifery and Health Visiting for Scotland)

The National Board for Nursing, Midwifery and Health Visiting for Scotland (NBS) is a statutory body responsible for ensuring standards of education and training for nurses, midwives and health visitors in Scotland. Part of their remit involved the production of two series of publications ('NBS Gazette' and 'Focus on Update') designed to promote and support educational and professional development in nursing and midwifery. This study evaluated response to the specific publications and provided strategic guidance for future development initiatives. The research involved qualitative interviews with a sample drawn from key target groups. This included lecturers in post registration, practice educators, nursing staff, librarians and others in related disciplines which incorporated a preceptorship approach.

ISM Staff: Susan MacAskill and Emma Cooke (left 2002)

General Dental Practitioners' Potential Role Within Child Protection
(Commissioned by Newcastle and North Tyneside Health Authority)

This qualitative study explored the general dental practitioner's role in protecting children from abuse in North-East England. The research comprised focus groups with dental practitioners and individual interviews with key informants from other relevant disciplines. The information obtained is being used by the Health Authority to raise the profile of the issue with national professional bodies through circulation of the report and seminars and workshops. Revision of local guidelines for dentists has also been initiated.

ISM Staff: Susan MacAskill

Consumer Views of Diabetes Services
(Commissioned by Lanarkshire Health Board)

This qualitative study explored diabetes patients' perceptions of service provision and delivery (MacAskill et al 1998). It was important to identify users' views on the quality, accessibility and appropriateness of diabetes services in order to improve patient compliance and care outcomes. The research comprised focus group discussions undertaken with patients randomly selected from the Lanarks 9 October, 2009 s. The findings were used by the Health Board to inform current service delivery and future developments in the balance and level of integration of services offered in primary and secondary settings.

ISM Staff: Susan MacAskill and Douglas Eadie

MacAskill S, Eadie DR and Anderson S (1998). An exploratory study of diabetes service provision and delivery: A consumer's view - main findings. Glasgow: University of Strathclyde, Centre for Social Marketing: March.

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