ORCID Profile
0000-0001-6029-5291
Current Organisation
University of Oxford
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Wiley
Date: 04-07-2019
DOI: 10.1111/BJHP.12379
Abstract: Although many health interventions are delivered in groups, it is unclear how group context can be best used to promote health-related behaviour change and what change processes are most helpful to participants. This study explored participants' experiences of attending type 2 diabetes prevention and management programme, and their perceptions of how group participation influenced changes in diet and physical activity. Qualitative. Semi-structured telephone interviews were conducted with 20 participants (twelve men) from nine groups in the Norfolk Diabetes Prevention Study. Interviews were audio-recorded, transcribed verbatim, and analysed using thematic analysis in NVivo. Participants benefited from in idual change processes, including information provision, structuring and prioritizing health goals, action planning, self-monitoring, and receiving feedback. They also benefited from group processes, including having a common purpose, sharing experiences, making social comparisons, monitoring and accountability, and providing and receiving social support in the groups. Participants' engagement with, and benefits from, the groups were enhanced when there was a supportive group context (i.e., group cohesion, homogeneous group composition, and a positive group atmosphere). Optimal facilitation to develop an appropriate group context and initiate effective change processes necessitated good facilitator interpersonal and professional skills, credibility and empathy, and effective group facilitation methods. Participants reported developing a sense of responsibility and making behaviour changes that resulted in improvements in health outcomes and weight loss. This study highlights the role of in idual and group processes in facilitating health-promoting behaviour change, and the importance of group context and optimal facilitation in promoting engagement with the programme. Statement of contribution What is already known on this subject? Many health interventions, including programmes to help prevent or manage diabetes and facilitate weight loss, are delivered in groups. Such group-based behaviour-change interventions are often effective in facilitating psychological and behaviour change. There is considerable research and theory on in idual change processes and techniques, but less is known about which change processes and techniques facilitate behaviour change in group settings. What does this study add? This study contributes to our understanding of how participating in group-based health programmes may enhance or impede in idual behaviour change. It identified in idual (intrapersonal) and group (interpersonal, facilitated through group interaction) change processes that were valued by group participants. The findings also show how these change processes may be affected by the group context. A diagram summarizes the identified themes helping to understand interactions between these key processes occurring in groups. The study offers an insight into participants' views on, and experiences of, attending a group-based diabetes prevention and management programme. Thus, it helps better understand how the intervention might have helped them (or not) and what processes may have influenced intervention outcomes. Key practical recommendations for designing and delivering group-based behaviour-change interventions are presented, which may be used to improve future group-based health interventions.
Publisher: Bristol University Press
Date: 11-2022
DOI: 10.1332/174426421X16388976414615
Abstract: Responses to COVID-19 have invested heavily in science. How this science was used is therefore important. Our work extends existing knowledge on the use of science in the pandemic by capturing scientific advisers’ experiences in real time. Our aim was to present generalisable messages on key qualifications or difficulties involved in speaking of ‘following the science’. Ninety-three interviews with UK scientific advisors and government officials captured their activities and perceptions during the pandemic in real time. We also examined Parliamentary Select Committee transcripts and government documents. This material was analysed for thematic content. (1) Many scientists sought guidance from policymakers about their goals, yet the COVID-19 response demonstrated the absence of a clear steer, and a tendency to change course quickly (2) many scientists did not want to offer policy advice, but rather to provide evidence and (3) a range of knowledge informed the UK’s pandemic response: we examine which kinds were privileged, and demonstrate the absence of clarity on how government synthesised the different forms of evidence being used. Understanding the reasons for a lack of clarity about policy goals would help us better understand the use of science in policy. Realisation that policy goals sometimes alter rapidly would help us better understand the logistics of scientific advice. Many scientists want their evidence to inform policy rather than determine the options selected. Since the process by which evidence leads to decisions is obscure, policy cannot be said to be evidence-based.
Publisher: Public Library of Science (PLoS)
Date: 16-03-2022
DOI: 10.1371/JOURNAL.PONE.0264906
Abstract: To identify the experiences and concerns of health workers (HWs), and how they changed, throughout the first year of the COVID-19 pandemic in the UK. Longitudinal, qualitative study with HWs involved in patient management or delivery of care related to COVID-19 in general practice, emergency departments and hospitals. Participants were identified through snowballing. Semi-structured telephone or video interviews were conducted between February 2020 and February 2021, audio-recorded, summarised, and transcribed. Data were analysed longitudinally using framework and thematic analysis. We conducted 105 interviews with 14 participants and identified three phases corresponding with shifts in HWs’ experiences and concerns. (1) Emergency and mobilisation phase (late winter-spring 2020), with significant rapid shifts in responsibilities, required skills, and training, and challenges in patient care. (2) Consolidation and preparation phase (summer-autumn 2020), involving gradual return to usual care and responsibilities, sense of professional development and improvement in care, and focus on learning and preparing for future. (3) Exhaustion and survival phase (autumn 2020-winter 2021), entailing return of changes in responsibilities, focus on balancing COVID-19 and non-COVID care (until becoming overwhelmed with COVID-19 cases), and concerns about longer-term impacts of unceasing pressure on health services. Participants’ perceptions of COVID-19 risk and patient ublic attitudes changed throughout the year, and tiredness and weariness turned into exhaustion. Results showed a long-term impact of the COVID-19 pandemic on UK HWs’ experiences and concerns related to changes in their roles, provision of care, and personal wellbeing. Despite mobilisation in the emergency phase, and trying to learn from this, HWs’ experiences seemed to be similar or worse in the second wave partly due to many COVID-19 cases. The findings highlight the importance of supporting HWs and strengthening system-level resilience (e.g., with resources, processes) to enable them to respond to current and future demands and emergencies.
Publisher: Informa UK Limited
Date: 13-06-2019
DOI: 10.1080/17437199.2019.1625282
Abstract: Group-based interventions are widely used to promote health-related behaviour change. While processes operating in groups have been extensively described, it remains unclear how behaviour change is generated in group-based health-related behaviour-change interventions. Understanding how such interventions facilitate change is important to guide intervention design and process evaluations. We employed a mixed-methods approach to identify, map and define change processes operating in group-based behaviour-change interventions. We reviewed multidisciplinary literature on group dynamics, taxonomies of change technique categories, and measures of group processes. Using weight-loss groups as an exemplar, we also reviewed qualitative studies of participants' experiences and coded transcripts of 38 group sessions from three weight-loss interventions. Finally, we consulted group participants, facilitators and researchers about our developing synthesis of findings. The resulting 'Mechanisms of Action in Group-based Interventions' (MAGI) framework comprises six overarching categories: (1) group intervention design features, (2) facilitation techniques, (3) group dynamic and development processes, (4) inter-personal change processes, (5) selective intra-personal change processes operating in groups, and (6) contextual influences. The framework provides theoretical explanations of how change occurs in group-based behaviour-change interventions and can be applied to optimise their design and delivery, and to guide evaluation, facilitator training and further research.
Publisher: Springer Science and Business Media LLC
Date: 24-06-2021
DOI: 10.1186/S12889-021-11285-8
Abstract: As COVID-19 death rates have risen and health-care systems have experienced increased demand, national testing strategies have come under scrutiny. Utilising qualitative interview data from a larger COVID-19 study, this paper provides insights into influences on and the enactment of national COVID-19 testing strategies for health care workers (HCWs) in English NHS settings during wave one of the COVID-19 pandemic (March–August 2020). Through the findings we aim to inform learning about COVID-19 testing policies and practices and to inform future pandemic diagnostic preparedness. A remote qualitative, semi-structured longitudinal interview method was employed with a purposive snowball s le of senior scientific advisors to the UK Government on COVID-19, and HCWs employed in NHS primary and secondary health care settings in England. Twenty-four interviews from 13 participants were selected from the larger project dataset using a key term search, as not all of the transcripts contained references to testing. Framework analysis was informed by the non-adoption, abandonment, scale-up, spread, and sustainability of patient-facing health and care technologies implementation framework (NASSS) and by normalisation process theory (NPT). Our account highlights tensions between the communication and implementation of national testing developments scientific advisor and HCW perceptions about infectiousness and uncertainties about the responsibility for testing and its implications at the local level. Consideration must be given to the implications of mass NHS staff testing, including the accuracy of information communicated to HCWs how HCWs interpret, manage, and act on testing guidance and the influence these have on health care organisations and services.
Publisher: Wiley
Date: 15-02-2018
DOI: 10.1111/APHW.12120
Abstract: Small groups are used to promote health, well-being, and personal change by altering members' perceptions, beliefs, expectations, and behaviour patterns. An extensive cross-disciplinary literature has articulated and tested theories explaining how such groups develop, function, and facilitate change. Yet these theoretical understandings are rarely applied in the development, description, and evaluation of health-promotion, group-based, behaviour-change interventions. Medline database, library catalogues, search engines, specific journals and reference lists were searched for relevant texts. Texts were reviewed for explanatory concepts or theories describing change processes in groups, which were integrated into the developing conceptual structure. This was designed to be a parsimonious conceptual framework that could be applied to design and delivery. Five categories of interacting processes and concepts were identified and defined: (1) group development processes, (2) dynamic group processes, (3) social change processes, (4) personal change processes, and (5) group design and operating parameters. Each of these categories encompasses a variety of theorised mechanisms explaining in idual change in small groups. The final conceptual model, together with the design issues and practical recommendations derived from it, provides a practical basis for linking research and theory explaining group functioning to optimal design of group-based, behaviour-change interventions.
Publisher: Wiley
Date: 15-02-2018
DOI: 10.1111/APHW.12121
Abstract: Many weight-loss interventions are delivered in groups but evidence on their effectiveness, and characteristics associated with effectiveness, is limited. We synthesised evidence on (1) design and delivery of group-based weight-loss interventions (2) effectiveness and (3) associations between intervention characteristics, change techniques, and effectiveness. Five online databases were searched to May 2017 for randomised controlled trials (RCTs) of group-based diet and/or physical activity interventions for overweight/obese adults (BMI ≥ 25). Intervention characteristics were synthesised narratively. Mean differences (MD) in weight loss were calculated using a random-effects meta-analysis, and sub-group analyses were conducted to identify moderators of effectiveness. Forty-seven RCTs reporting 60 evaluations of group-based interventions were included. MD in weight loss between intervention and control groups was -3.49 [95% CI -4.15, -2.84], -3.44 [-4.23, -2.85], and -2.56 kg [-3.79, -1.33] at follow-ups closest to 6, 12, and 24 months, respectively. Explicitly targeting weight loss, men-only groups providing feedback and dietary goals were significantly associated with greater effectiveness (p < .05). Diet and physical activity interventions delivered in groups are effective in promoting clinically meaningful weight loss at 12 months. Intervention design and effectiveness vary considerably between studies, and evidence on what optimises the effectiveness of group-based weight-loss interventions remains limited.
Publisher: National Institute for Health and Care Research
Date: 06-2019
DOI: 10.3310/EME06030
Abstract: Theories and meta-analyses have elucidated in idual-level mechanisms of action in behaviour change interventions. Although group-based interventions are commonly used to support health-related behaviour change, such interventions rarely consider theory and research (e.g. from social psychology) on how group-level mechanisms can also influence personal change. The aim was to enhance understanding of mechanisms of action in group-based behaviour change interventions. The objectives were to (1) develop a potentially generalisable framework of change processes in groups, (2) test the framework by analysing group session recordings to identify ex les illustrating group processes and facilitation techniques and (3) explore links between group-level mechanisms and outcomes. In this mixed-methods study, the research team reviewed literature, conducted consultations and analysed secondary data (i.e. delivery materials and 46 audio-recordings of group sessions) from three group-based weight loss interventions targeting diet and physical activity: ‘Living Well Taking Control’ (LWTC), ‘Skills for weight loss Maintenance’ and ‘Waste the Waist’. Quantitative LWTC programme data on participant characteristics, attendance and outcomes (primarily weight loss) were also used. Objectives were addressed in three stages. In stage 1, a framework of change processes in groups was developed by reviewing literature on groups (including theories, taxonomies of types of change techniques, qualitative studies and measures of group processes), analysing transcripts of 10 erse group sessions and consulting with four group participants, four facilitators and 31 researchers. In stage 2, the framework was applied in analysing 28 further group sessions. In stage 3, group-level descriptive analyses of available quantitative data from 67 groups and in-depth qualitative analyses of two groups for which comprehensive quantitative and qualitative data were available were conducted to illustrate mixed-methods approaches for exploring links between group processes and outcomes. Stage 1 resulted in development of the ‘Mechanisms of Action in Group-based Interventions’ (MAGI) framework and definitions, encompassing group intervention design features, facilitation techniques, group dynamic and development processes, interpersonal change processes, selective intrapersonal change processes operating in groups, and contextual factors. In stage 2, a coding schema was developed, refined and applied to identify ex les of framework components in group sessions, confirming the content validity of the framework for weight loss interventions. Stage 3 demonstrated considerable variability in group characteristics and outcomes and illustrated how the framework could be applied in integrating group-level qualitative and quantitative data to generate and test hypotheses about links between group mechanisms and outcomes (e.g. to identify features of more or less successful groups). The framework and ex les were primarily derived from research on weight loss interventions, and may require adaptations/additions to ensure applicability to other types of groups. The mixed-methods analyses were limited by the availability and quality of the secondary data. This study identified, defined, categorised into a framework and provided ex les of group-level mechanisms that may influence behaviour change. The framework and mixed-methods approaches developed provide a resource for designers, facilitators and evaluators to underpin future research on, and delivery of, group-based interventions. This project was funded by the Efficacy and Mechanism Evaluation programme, a Medical Research Council and National Institute for Health Research partnership.
Publisher: Springer Science and Business Media LLC
Date: 25-09-2015
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Aleksandra Borek.