Amy and Nisha had a busy and exciting trip with the Royal College of Obstetrics and Gynaecology in Uganda in April. We were so impressed by how much they managed to achieve in a relatively short time. In a 2-week period, they packed in a lot of data collection methods! They made field notes, carried out focus groups, collected behavioural expectation data and coded the education for behaviour change techniques using the Behaviour Change Technique Taxonomy.
On their return, they wrote a report for RCOG, constructed in terms of capability, opportunity and motivation, provided suggestions about enhancing learning and developed some considerations for RCOG to think about on the basis of their findings.
For example, they found that there was an increase, pre to post course, in delegates’ expectations about using an ABCD approach to acutely ill patients. They coded 20 behaviour change techniques that the faculty were using, including demonstration of the behaviour, graded tasks and using a credible source.
We have received some early feedback from RCOG – they found the report interesting and helpful and are planning to implement some changes. We look forward to Nisha and Fiona’s findings.
Eleanor and Corina have landed in Beira, Mozambique, with the team from Ipswich Hospital. Eleanor and Diane have already visited the partners when the Beira partners were in Ipswich last month. With a focus on medication safety, we are looking forward to an update from them about what behavioural science can offer this partnership.
Wendy and Nimarta are about to depart for Kampala with colleagues from the Royal College of Midwives working on the MOMENTUM project with the Ugandan Private Midwives Association. The MOMENTUM project is about mentoring of student midwives and takes a mentoring approach throughout, with the UK midwifery consultants twinning with their Ugandan counterpart to bring about postive changes in mentoring in midwifery training. Taking a collaborative and action research approach, Wendy and Nim are, on a short trip, developing ideas about how behavioural science can assist these partners in meeting their aims. We look forward to their update.
University of Plymouth-Masanga Hospital, Sierra Leone
Discussions are underway with this partnership about how behavioural science evaluations can assist them in understanding the impact of their elearning on healthcare workers and community members when they suspect someone is infected with a highly infectious disease. So far, we have designed a behavioural science-based questionnaire to assess capability, opportunity and motivation for key behaviours such as hand washing, using a buddy when putting on or taking off personal protective equipment and providing oral hydration even if someone is not thirsty. An update is expected in July.
Our behaviour change consultants Amy and Nisha have now returned home from their work in Uganda:
Over the past few weeks we have been incredibly busy learning about how the RCOG obstetric skills course in Uganda works. We have: observed two skills courses and two train the trainer courses; collected pre and post course data assessing knowledge and action planning; conducted four focus groups with Ugandan doctors and midwives and a photo-elicitation focus group with RCOG faculty; and visited a number of course graduates across the Masaka region to explore how they are getting on with applying their skills in practice. We are currently in the process of producing an interim report for the RCOG detailing the evidence of the behavioural science techniques we observed and our recommendations for embedding more behavioural science within the course. Nisha is looking forward to returning to Kitovu in June to collect more data and potentially put some of our recommendations into practice.
Our volunteer, Eleanor Bull, returned from a trip to Ipswich to meet people from both sides of the Ipswich-Beira Health Partnership. Eleanor and our other volunteer, Diane Dixon, had created some great information to explain behaviour change and behavioural science to the Health Partnership leads and others. We had some great and valuable input from Portuguese speaking Health Psychologists, Vera Araujo-Soares and Angela Rodrigues, who did some ‘armchair volunteering’ and (at very short notice) translated the material prepared by Eleanor and Diane into Portuguese for the Beira team.
Eleanor reported that the trip was a great success in terms of planning how behavioural science can really add value to the work of the Ipswich-Beira Health Partnership work around medicines safety. Sarah Cavanagh, Project lead for Ipswich said “Eleanor has been absolutely brilliant and has added much already to our Partnership”.
Eleanor and a new volunteer, Corina Mason, will be travelling to Mozambique with the Ipswich team in June.
Our first volunteers will go to Uganda in a little over a week. Nisha Sharma and Amy Burton will be behaviour change consultants to the Royal College of Obstetrics and Gynaecology’s partnership with Kitovu Health District. RCOG run training and train the trainer courses to improve obstetric care and, ultimately, reduce the number of fistulas.
Regretfully, our trip to Ethiopia has had to be postponed after the Foreign Office issued an amber warning for certain parts of Ethiopia. Although the area of the project itself was not in the amber warning, travel was through the area and our insurers decided that they would not cover our volunteers in those circumstances. We are still working with University of Exeter in their partnership with Wollega Medical School but our volunteers will have to wait until October / November to visit Ethiopia.
We have developed a core monitoring and evaluation package so that we can collect and pool qualitative and quantitative data from each of the projects about behaviour, behavioural expectations and behavioural determinants. Our volunteers will be taking a bottom up approach to thinking about what is driving practice and how education and training can lead to practice change.
It is fitting that our first volunteer meeting fell on International Women’s Day because, by chance, our whole team are women. This first meeting was for the volunteers to meet each other and begin to get excited about their volunteering projects. We talked through the history and aims of The Change Exchange project. We discussed theories and methods of health psychology. We talked about data collection and gave out iPads and business cards for communication and data collection.
The volunteers are such an impressive bunch! We have professors, learning and development professionals, experts in qualitative and quantitative research, motivational interviewing etc etc. It was easy to see today that they will form a cohesive group. The future is bright!
The Change Exchange project officially began on 4th January 2016. The weeks since have seen a flurry of activity including appointment of our project manager. We had expressions of interest from 31 UK based psychologists wishing to volunteer with us. Some would have made great volunteers but didn’t have the necessary experience of behaviour change and so were not a good fit for our project. After some interviews in person and by Skype, we appointed nine volunteers to work with our five Health Partnership partners. We have started discussions with all Health Partnership partners about how our volunteers can assist them in delivering their project goals and develop their monitoring and evaluation plans to include behavioural determinants. We visited Kampala, Uganda, for three days to meet with the Royal College of Midwives and the Ugandan Private Midwives Association to discuss their exciting new midwifery mentorship project : MOMENTUM. The UK and Ugandan partners had lots of questions about the role of behavioural science in achieving their goals and we came away with a much clearer set of ideas of how our volunteers can add value.
Our volunteers will be getting together on 8th March to discuss project plans, project goals and some logistics. Our first volunteers are visiting Ethiopia in early April so have begun trips to travel clinics for vaccinations.
A large part of The Change Exchange project is to generate interest amongst health psychologists about the role that we can play in understanding and driving improvement in healthcare practice. We are beginning to see a community develop and the prospect of playing a small part in health systems strengthening in low and middle income countries is certainly inspiring.
In February, Jo and Lucie visited Porton Down in Wiltshire to speak to Public Health England about their infection prevention and control project with partners in Chennai, India. We met Prof Silman and Dr Vassan when we were asked by The Tropical Health and Education Trust to run a workshop on behaviour for their Infection prevention and control grant holders. Nigel asked if we would consider coming to see them when their Indian partners were visiting and we ended up giving an open seminar to PHE staff, discussing the IPC project and meeting their very inspirational behavioural
unit. PHE and their partners are training staff in India in responding to travellers who are suspected to have serious infectious diseases: ambulance drivers, nurses and doctors. It is a really exciting project and we are hoping to find a way to work with them. Jo saw the business end of infection prevention and control measures when, returning from Saudi Arabia, she was isolated with suspected MERS. A little bit of unexpected ethnography!