NHS Health Scotland Knowledge Services Supporting Public Health Research

The Context NHS Health Scotland - Scotland's health improvement agency Knowledge Services: a national service supporting anyone working in public health, health improvement A new organisational focus: ‘A Fairer Healthier Scotland’ Reducing health inequalities - Introduce self & health Scotland & KS team - majority of our users (at the moment) are internal staff but we also support people working in territorial boards, local authorities, charities - A little background: - Our new corporate strategy ‘A Fairer Healthier Scotland’ focuses the organisation’s acitivity on tackling health inequalities rather than a broader population health improvement approach.

The Questions Explain the decline in inequality in heart disease mortality in Scotland over the last 10 years… Peer support and breastfeeding – review level material only What is the current evidence base relating to high risk jobs in terms of stress in the UK? Is a positive patient experience of a Keep Well health check associated with improved compliance with health behaviour change advice (or referral!)? - Although I’ve said that Health Scotland’s focus is on tackling health inequalities, this does not mean it is a narrow subject area we are dealing with - we are still looking at all the traditional public health/health improvement subjects but from an inequalities perspective – reducing smoking, healthy eating, physical activity, alcohol, sexual health, substance misuse, screening & immunisation, mental health, breastfeeding….. Our literature search questions come in many shapes and sizes…here are some recent examples How is social media used as a research method?

More Questions What models of pharmaceutical care interventions are currently recommended in the UK? What is the evidence on their effectiveness? What is the evidence of their effectiveness in relation to the older population? Benefits, outcome measures, motivation, effects & impact of exercise in the community for heart and lung diseases What is the current evidence around improving participation in Physical activity by overweight children or young people? What is the current evidence on parenting programmes specifically designed for parents who misuse substances?

Questions, questions questions… What local authority or NHS tobacco or smoking policy implementation guidance or interventions are in place for domiciliary visits to protect staff from second-hand smoke exposure (e.g. community nursing visits in which staff visit patients daily in their own homes and in which they smoke, especially when there may be repeated visits scheduled in throughout the day)? Communicable disease and the recession The impact of gambling on population health As you can see, we deal with quite a variety of topics and quite a variation in the level of detail in the questions we receive. Sometimes users are looking for a board overview of a subject and other times to answer a more specific question. Evidence for the effectiveness of social prescribing and community referrals

Resources (Potentially) ALL the usual suspects: Medline, Embase, Cinahl, PsychInfo, Web of Science, ProQuest, Emerald, HMIC, HBE Cochrane, DARE, Health Improvement Evidence portal SIGN, NICE, Scottish Govt, ISD, ScotPHO, other sources of grey literature (Google) - Because of the wide scope of the questions we get asked, we use a wide variety of databases and sources to suit the topic. - Sometimes we will be asked specifically to look for review level material so would focus on Cochrane etc and I use the SIGN review filters in medline and Embase for this too. - The HIE portal is a new area on TKn which retrieves guidelines and reviews on public health topics

Protocol Although Julie and I, who do most of the literature searches work in broadly the same way, we have a team workshop coming up soon where we will draw up a formal protocol, so it is/will be really useful to hear from the other presenters today about how things work in their services.

Documenting the search Started using this form last year - consistency/uniformity, v. useful for organsising/structure as I work through the search structure. Question, RefWorks link, databases, search strategies. This goes to requester.

Standards of Service Internal literature searches = 10 working days Future changes? External = 5 working days Internal literature searches Itend to be more complex so this is why we have a longer turnaround time. We try to be flexible if people are in a rush and equally sometimes people don’t need them for a few weeks. One of the main users of our literature search service is our Evidence for Action team who’s main role is around the synthesis and presentation of evidence – and we are in discussions with them about the possibility of establishing different timescales for different types of searches.

The Challenges The subject scope? The new focus on health inequalities The lack of evidence in some areas Evidence informed decision-making Ethical decision-making Commission new research The range of subjects can be challenge, but also for me, part of what keeps it interesting – you never know what you might get next. As I mentioned before, it does mean looking in a lot of places. The focus on health inequalities and reducing the inequalities gap is also a new challenge for the whole organisation and it can be a difficult one to search on if you don’t know to begin with what the potential inequalities. Not all of the topics we cover have a good evidence base and for us this can mean thinking that maybe you don’t have the search right and doing a lot of re-work or having to try and find whatever grey material there might be – with all the challenges that brings. For colleagues who then go on and use the material we provide, it means taking a broader evidence informed approach and where there is little or no evidence using an ethical decision making approach or commissioning new research.

Thank You