Tim Rapley's research while affiliated with The Newcastle upon Tyne Hospitals NHS Foundation Trust and other places

Publications (202)

Preprint
BACKGROUND Internet-based Cognitive Behaviour Therapy (iCBT) services for common mental health disorders have been found to be effective. There is a need for effective strategies to improve implementation in routine practice. One-size-fits-all strategies are likely to be ineffective and tailored implementation is considered as a promising approach....
Article
Background: Normalization Process Theory (NPT) identifies mechanisms that have been demonstrated to play an important role in implementation processes. It is now widely used to inform feasibility, process evaluation, and implementation studies in healthcare and other areas of work. This qualitative synthesis of NPT studies aims to better understand...
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Children and young people with rheumatic diseases and their families are often supported by nurses who may not have had specialist training in paediatric rheumatology. The purpose of our study was to establish the core learning needs of all nurses who may encounter these children and young people in their clinical practice and use this information...
Article
Background Technology-supported self-management of long-term conditions (e.g., through the use of smartphone apps) provides easily accessible support. However, currently there are no systematically developed, evidence-based smartphone apps for Sjogren’s Syndrome. We took an agile approach to developing such an app: instead of starting “from scratch...
Article
Background Multi-disciplinary teams (MDTs) are common in paediatric rheumatology where UK standards of care state that all children/young people should have access to a paediatric rheumatologist, nurse, physiotherapist, occupational therapist and a psychologist. MDTs in paediatric rheumatology regularly meet for the broader purpose of discussing th...
Article
Background The term perinatal stroke describes focal damage to the developing brain due to cerebrovascular disease and occurring either before or shortly after birth. Aetiology, presentation and evolution differ from stroke in adults. Aims We aimed to explore early parental experiences related to having a child with perinatal stroke, including how...
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Understanding implementation-related factors and processes is key to ensuring that Internet-based interventions are embedded in practice and provide added value to the delivery of evidence-based care. The aim of this study was to evaluate the attitudes towards an Internet-based cognitive behavioural therapy (iCBT) intervention for the treatment of...
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Background Normalisation Process Theory (NPT) is frequently used to inform qualitative research that aims to explain and evaluate processes that shape late-stage translation of innovations in the organisation and delivery of healthcare. A coding manual for qualitative researchers using NPT will facilitate transparent data analysis processes and wil...
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Abstract Rationale: Translating research evidence into clinical practice to improve care involves healthcare professionals adopting new behaviours and changing or stopping their existing behaviours. However, changing healthcare professional behaviour can be difficult, particularly when it involves changing repetitive, ingrained ways of providing ca...
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With the most recent developments to the European General Data Protection Regulations (GDPR) introduced in May 2018, the resulting legislation meant a new set of considerations for study approvers and health-care researchers. Compared with previous legislation in the UK (The Data Protection Act, 1998), it introduced more extensive and directive pri...
Preprint
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Background. Qualitative studies, especially those conducted by teams of researchers, may benefit from clearly structured, parsimonious, coding manuals. The process of creating rigorous and robust coding manuals for individual studies is rarely described, and generalizable coding manuals are rare. Normalization Process Theory (NPT) provides conceptu...
Conference Paper
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Background: There is a wide recognition that the development of new innovations does not guarantee uptake in routine practice. Implementation science applies a set of methods, theories and frameworks to support the spread and normalisation of innovations. Work within the implementation literature has focused on tailoring of implementation strategie...
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The prevalence of overweight/obesity is high among Black women in England, who also face high risks of pregnancy and childbirth complications. This study explored African migrant women’s perceptions of pre- and post-migration influences on their weight-related behaviours and weight management support during pregnancy. Interviews were conducted with...
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Background Multimorbidity is common in older adults and associated with high levels of illness burden and healthcare expenditure. The evidence base for how to manage older adults with multimorbidity is weak. Yoga might be a useful intervention because it has the potential to improve health-related quality of life, physical functioning, and several...
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Background Many children and young people with juvenile idiopathic arthritis (JIA) experience delay in diagnosis and access to right care. The reasons for delay are multi-factorial and influenced by patient and family, clinician and organisational factors. Our aim was to explore the experiences of care, from initial symptoms to initial referral to...
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Context: Pre-appointment written materials, including letters and leaflets, are commonly used by healthcare organisations to deliver professional-patient interactions. The written materials potentially change patients' knowledge and behaviour as part of a healthcare intervention but have received little investigation. Objective: To describe the...
Conference Paper
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Background Each year around 1800 UK children are diagnosed with Cerebral Palsy (CP). Of these, 40–50% are deemed ‘low risk’ at birth and therefore rely on their parents and primary care health professionals (HCPs) to identify concerning features and seek early referral. Some parents report difficulties in communicating their concerns, and being fal...
Conference Paper
Background Parents of infants with conditions such as perinatal stroke (PS) often experience feelings of guilt and blame and are at risk of experiencing negative outcomes in terms of psychological wellbeing. This has the potential to adversely affect parent-infant interaction, impacting on the infant. Providing psychological support from an early s...
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Background Men who suffer recurrence of bulbar urethral stricture have to decide between endoscopic urethrotomy and open urethroplasty to manage their urinary symptoms. Evidence of relative clinical effectiveness and cost-effectiveness is lacking. Objectives To assess benefit, harms and cost-effectiveness of open urethroplasty compared with endosc...
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Objectives Musculoskeletal (MSK) presentations are common (reported prevalence of one in eight children) and a frequent cause of consultations (6% of 7-year-olds in a cohort study from the UK). Many causes are self-limiting or raised as concerns about normal development (so-called normal variants). We aimed to describe a new model of care to identi...
Article
Background Urethral stricture affects 0.9% of men. Initial treatment is urethrotomy. Approximately, half of the strictures recur within 4 yr. Options for further treatment are repeat urethrotomy or open urethroplasty. Objective To compare the effectiveness and cost-effectiveness of urethrotomy with open urethroplasty in adult men with recurrent bu...
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Background Sjögren’s syndrome (SS) is a rheumatic disease requiring self-management which may be delivered through smartphones. When developing digital interventions it is important to review what is already available (market segmentation) ¹ to identify unique selling points and aid uptake and adoption. While there are no dedicated SS apps, many ar...
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Background Sjögren’s syndrome (SS) is an autoimmune rheumatic disease with diverse symptoms including mental and physical fatigue, dryness, pain and sleep disturbances. These symptoms are interconnected and rarely occur in isolation. Improving symptoms and quality of life requires people with SS to navigate multiple interventions and engage in self...
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Background: There has been comparatively little patient information about bronchiectasis, a chronic lung disease with rising prevalence. Patients want more information, which could improve their understanding and self-management. A novel information resource meeting identified needs has been co-developed in prior work. We sought to establish the f...
Article
There is increasing global attention on the health and wellbeing needs of young people. Preventive and proactive approaches will likely lead to the clearest dividends for young people, their own children and wider society. A brief overview of the international context for young people’s health care is given. As well as influencing policy, there are...
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Objectives To investigate the practices of healthcare professionals in relation to best practice recommendations for the multidisciplinary management of people with diabetes and periodontitis, focusing on two clinical behaviours: informing patients about the links between diabetes and periodontitis, and suggesting patients with poorly controlled di...
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Background: During transition from children's to adults' healthcare, young adults with long-term conditions may show delays in psychosocial development compared to their peers without long-term conditions, and deterioration of their conditions' medical control. Methods: This paper integrates the findings, already published in 10 separate papers,...
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Aims: To explore inter-professional communication and collaboration in guideline-concordant diabetes and periodontitis care. Methods: Qualitative design using iterations of workshops to identify ways to improve multidisciplinary working attended by staff from medical and dental primary care practices, and people with diabetes (n=43). Workshops w...
Article
Background: Effective implementation of health care initiatives is of key importance for ensuring high quality clinical and health outcomes. Using Normalization Process Theory, this study investigates the implementation behaviour of dental students in relation to a novel oral health risk assessment tool. It considers the impact of advancing learni...
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Background: People with long term conditions (LTCs) make most of the daily decisions and carry out the activities which affect their health and quality of life. Only a fraction of each contact with a health care professional (HCP) is spent supporting this. This paper describes how care and support planning (CSP) and an implementation framework to...
Preprint
Background: People with long term conditions (LTCs) make most of the daily decisions and carry out the activities which affect their health and quality of life. Only a fraction of each contact with a health care professional (HCP) is spent supporting this. This paper describes how care and support planning (CSP) and an implementation framework to r...
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Objective The WHO has argued that adolescent-responsive health systems are required. Developmentally appropriate healthcare (DAH) for young people is one approach that could underpin this move. The aim of this study was to explore the potential for DAH to become normalised, to become a routine, taken-for-granted, element of clinical practice. Desi...
Preprint
Background: People with long term conditions (LTCs) make most of the daily decisions and carry out the activities which affect their health and quality of life. Only a fraction of each contact with a health care professional (HCP) is spent supporting this. This paper describes how care and support planning (CSP) and an implementation framework to r...
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Background As young people with long-term conditions move from childhood to adulthood, their health may deteriorate and their social participation may reduce. ‘Transition’ is the ‘process’ that addresses the medical, psychosocial and educational needs of young people during this time. ‘Transfer’ is the ‘event’ when medical care moves from children’...
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Patient and public involvement in research includes non‐academics working with researchers, on activities from consultative tasks, to joint working, and on user‐led initiatives. Health and social care funding bodies require involvement in research projects. A current debate focuses on a perceived lack of empirical “proof” to demonstrate the impact...
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Introduction Published guidance documents describe best practice recommendations for management of patients with diabetes and periodontitis. However, little is known about their uptake by dental professionals. Aims To explore current practice and behavioural correlates for three behaviours in the management of patients with diabetes and periodonti...
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Background Understanding and measuring implementation processes is a key challenge for implementation researchers. This study draws on Normalization Process Theory (NPT) to develop an instrument that can be applied to assess, monitor or measure factors likely to affect normalization from the perspective of implementation participants. Methods An i...
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Introduction Successful implementation and embedding of new health care practices relies on co-ordinated, collective behaviour of individuals working within the constraints of health care settings. Normalization Process Theory (NPT) provides a theory of implementation that emphasises collective action in explaining, and shaping, the embedding of ne...
Preprint
BACKGROUND The implementation of eMental health interventions (eMH) in routine healthcare constitutes a major challenge, and reliable instruments to assess implementation processes are lacking. The Normalisation MeAsure Development project (NoMAD) developed a 20-item self-report questionnaire to overcome this gap. Based on the Normalisation Process...
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Background Successfully implementing eMental health (eMH) interventions in routine mental health care constitutes a major challenge. Reliable instruments to assess implementation progress are essential. The Normalization MeAsure Development (NoMAD) study developed a brief self-report questionnaire that could be helpful in measuring implementation p...
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Dietary and physical activity behaviours during preconception and in pregnancy are important determinants of maternal and child health. This review synthesised the available evidence on dietary and physical activity behaviours in pregnant women and women of childbearing age women who have migrated from African countries to live in high income count...
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Introduction Parent‐delivered therapy interventions for children with cerebral palsy can help achieve a sufficient therapy dose, improve parental mental well‐being, and facilitate parent–child relationships creating a more relaxed familial environment. However, parent‐delivered interventions may also lead to increased parental stress, guilt if the...
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Background: Perinatal stroke (PS) affects up to 1/2300 infants and frequently leads to unilateral cerebral palsy (UCP). Preterm-born infants affected by unilateral haemorrhagic parenchymal infarction (HPI) are also at risk of UCP. To date no standardised early therapy approach exists, yet early intervention could be highly effective, by positively...
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Background: Normalization Process Theory (NPT) identifies, characterises and explains key mechanisms that promote and inhibit the implementation, embedding and integration of new health techniques, technologies and other complex interventions. A large body of literature that employs NPT to inform feasibility studies and process evaluations of comp...
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Background: Bronchiectasis is an incurable lung disease characterised by irreversible airway dilatation. It causes symptoms including chronic productive cough, dyspnoea, and recurrent respiratory infections often requiring hospital admission. Fatigue and reductions in quality of life are also reported in bronchiectasis. Patients often require mult...
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Background: For young people with long-term conditions, transition from child to adult-oriented health services is a critical period which, if not managed well, may lead to poor outcomes. There are features of transition services which guidance and research suggest improve outcomes. We studied nine such features, calling them 'proposed beneficial...
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Background Approximately 9000 new cases of head and neck squamous cell cancers (HNSCCs) are treated by the NHS each year. Chemoradiation therapy (CRT) is a commonly used treatment for advanced HNSCC. Approximately 90% of patients undergoing CRT require nutritional support via gastrostomy or nasogastric tube feeding. Long-term dysphagia following CR...