Skip to main content

Self Care R&D Priorities

 

With the increasing pressure on the Welfare State in the UK and other European countries, policy makers are increasingly looking to Self-Care as a means to empower individuals to live longer and healthier lives, whilst helping curb unnecessary spending and over-reliance on health systems. Yet self-care remains a broad and somewhat nebulous concept to most as it covers a wide spectrum of ideas and activities ranging from cognition and health literacy, to empowerment and evidence-based decision making and rationing of resources.  This makes self-care an exciting but also a challenging area to study.

Self-care has been extensively defined and considered by various academic groups and conceptualised from several different perspectives. Paradoxically, the academic exercise of understanding self-care as a broad concept has not as yet resulted in a definitive canon of evidence that makes the absolute case for self-care and its realised benefits in the real-world setting. It is therefore necessary to move away from self-care as a purist academic pursuit to an applied field of research.

Research into self-care necessarily implies a mixed methods approach that takes into account the study of contextual factors and microdata using a combination of qualitative and quantitative research methods, whereas the multidisciplinary nature of self-care illustrates many levers that could be used to affect change. However, pilot initiatives proposing a change in more than one variable at a time are not recommended because this confounds real scientific study, resulting in weak or non-generalizable conclusions. How, then, can we consolidate these challenges between theory and practice to advance our understanding and application of self-care in the contemporary setting?

This paradox, coupled to existing gaps in our knowledge, illustrates some R&D priorities for self-care in four broad categories:

1. Applied research that makes the absolute case for self-care. Research should advance our understanding of how self-care can benefit the wider health economy, to include health economic modelling and cost-benefit analysis as well as a means to improve tangible and intangible benefits (i.e. health spending; Quality Adjusted Life Year (QALY); improved quality of life; improved health and wellbeing overall etc.). Because self-care is a complex area of study, the body of evidence should draw from various example and initiatives across a range of different settings (i.e. community care, primary care setting etc.,) involving self-care for patients with LTCs and otherwise healthy individuals through the life span of an individual as opposed to studying one disease category for one age group in only one setting.

2. Development of a pragmatic framework to support the evaluation of Self Care interventions. There currently does not exist a validated framework that supports the objective evaluation of self-care pilots and interventions. Because self-care is multidisciplinary, a suitable framework should enable the evaluation of various categories and dimensions, including PESTLE, econometric analysis and quality of life indicators. A suitable evaluation framework could also support commissioners in the early design stages of self-care interventions by highlighting a clear requirement for meaningful data collection using suitable data collection instruments to enable objective evaluation of outcomes following implementation.
  
3. Identification of extant barriers and drivers to the widespread adoption of evidence-based self-care praxis. This could be done by investigating the role of digital health, eHealth and mobile health interventions on individual lifestyle choices and behaviours tenable to improve health literacy, and the practice of self-care for improved mental health and wellbeing for example. Dissolving extant barriers will support the folding of self-care into the culture and fabric of society such that its application becomes a legitimate and conscious lifestyle choice we feel empowered to make as active and cognizant members of the community.
  
4. Policy research and realignment of incentives to support self-care initiatives that are considered from the perspective of funding of outcomes as opposed to activities. Research streams could potentially focus on how best to consider self-care holistically to promote a ‘health in all policies’ approach by configuring and investing in the right infrastructure, including urban design factors that promote effective self-ca

Addressing these research priorities will ensure that self-care can shift away from purist academic thinking to a translational research model where it is tested as an applied concept. However, for this to happen the prevailing attitude and conceptions of health commissioners and policy makers needs to shift to enable a sustained investment into complex self-care interventions and proof of concept pilots to determine how best theoretical self-care approaches could posit in the real-world setting.

To this end, the Imperial College London Self Care Academic Research Unit (SCARU) was established in collaboration with the Self Care Forum and the International Self Care Foundation to support a progressive research agenda in the domain of self-care. SCARU aims to become a leading academic base for self-care, and will work with other national and international research partners, commissioners of health, technology leaders and patient groups to advance our understanding of self-care as an applied concept fit for 21st Century society.

Austen El-Osta is Acting Director of the Self Care Academic Research Unit (SCARU), Imperial College London School of Public Health. 
This letter was first published on the ISFglobal website:  http://isfglobal.org/self-care-rd-priorities/


Comments

Popular posts from this blog

Releasing student potential: Widening access to opportunities in community healthcare

This summer the Department of Primary Care and Public Health kicked off an exciting new programme: Widening Access to Careers in Community Healthcare (WATCCH). We hosted twenty 16-17 year olds who are aspiring to be the first in their families to go to university – at the Charing Cross campus for the inaugural WATCCH project. Our aim was to change perceptions of wider healthcare careers and provide vital work experience for their University applications. Competition was high and the team was very impressed by the number of high calibre students that applied for a place.

Year 12 Pupils from 19 London secondary schools attended an induction day in late July. During the workshop, an experienced multi-professional panel consisting of 5 professionals including an Imperial final year medical student, shared their career journeys with the pupils from their A level to postgraduate degrees. This was followed by pupils creating individual mind maps, which they thoroughly enjoyed, of where they…

Integrated Clinical Apprenticeship - FREQUENTLY ASKED QUESTIONS

WHAT ARE MY MORNING COMMITMENTS? Your Thursday morning and afternoon throughout your year 5 will be dedicated to the Integrated Clinical Apprenticeship. This has been negotiated with the Year 5 course leads and your Specialty supervisors for each firm. Attendance is mandatory for both morning and afternoon sessions.
You will attend your allocated GP surgery on a time negotiated with your GP mentor.
In the morning, you will see patients from your caseload, assessing their clinical needs and bringing yourself up to date with their secondary care contacts. You can then plan with your patient to attend any secondary care appointments in the coming weeks with your patients.
You may also see “ad hoc” patients from the surgery and, if relevant, add them to your caseload. There will be an opportunity to see other health professionals in the primary care team and assist in their daily activities.

WHAT IS MY PATIENT “CASELOAD”?
This is a group of about 12 patients (shared with your pair), recr…

Congratulations to Usama Syed

Usama Syed, a final year medical student in the Faculty of Medicine, was selected for a 2015 Imperial College London Outstanding Student Achievement Award. These awards are to recognize and commend outstanding achievement beyond the academic subject area.  Usama was nominated for his award by the Department of Primary Care and Public Health.

Usama's achievements include:
Founding a new society at the College - MedTech Imperial- designed to bring together students across the medical, engineering, and computing departments, With colleagues coding a brand new mobile phone application designed to streamline the way front-line hospital staff provide feedback and quality improvement ideas to senior medical directors. Researching and writing articles for the official Imperial College website on medical topics for public release.Editing a newsletter for a Health Centre in Clapham, London. In this role, he has written numerous articles for local residents on topics such as travel safety an…