The acceptability and impact of a randomised controlled trial of welfare rights advice accessed via primary health care: qualitative study

<p>Abstract</p> <p>Background</p> <p>Qualitative research is increasingly used alongside randomised controlled trials (RCTs) to study a range of factors including participants' experiences of a trial. The need for a sound evidence base within public health will inc...

Full description

Bibliographic Details
Main Authors: Howel Denise, White Martin, Mackintosh Joan, Moffatt Suzanne, Sandell Adam
Format: Article
Language:English
Published: BMC 2006-06-01
Series:BMC Public Health
Online Access:http://www.biomedcentral.com/1471-2458/6/163
_version_ 1811276193201127424
author Howel Denise
White Martin
Mackintosh Joan
Moffatt Suzanne
Sandell Adam
author_facet Howel Denise
White Martin
Mackintosh Joan
Moffatt Suzanne
Sandell Adam
author_sort Howel Denise
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Qualitative research is increasingly used alongside randomised controlled trials (RCTs) to study a range of factors including participants' experiences of a trial. The need for a sound evidence base within public health will increase the need for RCTs of non-clinical interventions. Welfare rights advice has been proposed as an intervention with potential to reduce health inequalities. This qualitative study, nested within an RCT of the impact of welfare rights advice, examined the acceptability of the intervention, the acceptability of the research process and the perceived impact of the intervention.</p> <p>Methods</p> <p>25 men and women aged 60 years or over were recruited from four general practices in Newcastle upon Tyne (UK), a sub-sample of those who consented to be contacted (n = 96) during the RCT baseline interview. Semi-structured interviews were undertaken and analysed using the Framework Method.</p> <p>Results</p> <p>Participants viewed the trial positively although, despite agreeing that the information leaflet was clear, some had agreed to participate without being fully aware of what was involved. Some participants were unaware of the implications of randomisation. Most thought it fair, but a few concerns were raised about the control condition. The intervention was acceptable and made participants feel confident about applying for benefit entitlements. 14 out of 25 participants received some financial award; median weekly income gain was £57 (€84, $101). The perceived impact of additional finances was considerable and included: increased affordability of necessities and occasional expenses; increased capacity to deal with emergencies; and a reduction in stress related to financial worries. Overall, perceived independence and ability to participate in society increased. Most participants perceived benefits to their mental well-being, but no-one reported an improvement in physical health. The RCT showed little or no effect on a wide range of outcome measures.</p> <p>Conclusion</p> <p>Participation in the trial and the intervention was acceptable to participants. Welfare rights advice targeted at people aged 60 years or over and accessed via primary care had a positive impact on quality of life and resulted in increased social participation. The divergence of qualitative and quantitative findings suggests that both methods make important contributions to the evaluation of complex social interventions.</p>
first_indexed 2024-04-12T23:52:06Z
format Article
id doaj.art-14c8f1b22e0d4ce387033ca7bcddda37
institution Directory Open Access Journal
issn 1471-2458
language English
last_indexed 2024-04-12T23:52:06Z
publishDate 2006-06-01
publisher BMC
record_format Article
series BMC Public Health
spelling doaj.art-14c8f1b22e0d4ce387033ca7bcddda372022-12-22T03:11:38ZengBMCBMC Public Health1471-24582006-06-016116310.1186/1471-2458-6-163The acceptability and impact of a randomised controlled trial of welfare rights advice accessed via primary health care: qualitative studyHowel DeniseWhite MartinMackintosh JoanMoffatt SuzanneSandell Adam<p>Abstract</p> <p>Background</p> <p>Qualitative research is increasingly used alongside randomised controlled trials (RCTs) to study a range of factors including participants' experiences of a trial. The need for a sound evidence base within public health will increase the need for RCTs of non-clinical interventions. Welfare rights advice has been proposed as an intervention with potential to reduce health inequalities. This qualitative study, nested within an RCT of the impact of welfare rights advice, examined the acceptability of the intervention, the acceptability of the research process and the perceived impact of the intervention.</p> <p>Methods</p> <p>25 men and women aged 60 years or over were recruited from four general practices in Newcastle upon Tyne (UK), a sub-sample of those who consented to be contacted (n = 96) during the RCT baseline interview. Semi-structured interviews were undertaken and analysed using the Framework Method.</p> <p>Results</p> <p>Participants viewed the trial positively although, despite agreeing that the information leaflet was clear, some had agreed to participate without being fully aware of what was involved. Some participants were unaware of the implications of randomisation. Most thought it fair, but a few concerns were raised about the control condition. The intervention was acceptable and made participants feel confident about applying for benefit entitlements. 14 out of 25 participants received some financial award; median weekly income gain was £57 (€84, $101). The perceived impact of additional finances was considerable and included: increased affordability of necessities and occasional expenses; increased capacity to deal with emergencies; and a reduction in stress related to financial worries. Overall, perceived independence and ability to participate in society increased. Most participants perceived benefits to their mental well-being, but no-one reported an improvement in physical health. The RCT showed little or no effect on a wide range of outcome measures.</p> <p>Conclusion</p> <p>Participation in the trial and the intervention was acceptable to participants. Welfare rights advice targeted at people aged 60 years or over and accessed via primary care had a positive impact on quality of life and resulted in increased social participation. The divergence of qualitative and quantitative findings suggests that both methods make important contributions to the evaluation of complex social interventions.</p>http://www.biomedcentral.com/1471-2458/6/163
spellingShingle Howel Denise
White Martin
Mackintosh Joan
Moffatt Suzanne
Sandell Adam
The acceptability and impact of a randomised controlled trial of welfare rights advice accessed via primary health care: qualitative study
BMC Public Health
title The acceptability and impact of a randomised controlled trial of welfare rights advice accessed via primary health care: qualitative study
title_full The acceptability and impact of a randomised controlled trial of welfare rights advice accessed via primary health care: qualitative study
title_fullStr The acceptability and impact of a randomised controlled trial of welfare rights advice accessed via primary health care: qualitative study
title_full_unstemmed The acceptability and impact of a randomised controlled trial of welfare rights advice accessed via primary health care: qualitative study
title_short The acceptability and impact of a randomised controlled trial of welfare rights advice accessed via primary health care: qualitative study
title_sort acceptability and impact of a randomised controlled trial of welfare rights advice accessed via primary health care qualitative study
url http://www.biomedcentral.com/1471-2458/6/163
work_keys_str_mv AT howeldenise theacceptabilityandimpactofarandomisedcontrolledtrialofwelfarerightsadviceaccessedviaprimaryhealthcarequalitativestudy
AT whitemartin theacceptabilityandimpactofarandomisedcontrolledtrialofwelfarerightsadviceaccessedviaprimaryhealthcarequalitativestudy
AT mackintoshjoan theacceptabilityandimpactofarandomisedcontrolledtrialofwelfarerightsadviceaccessedviaprimaryhealthcarequalitativestudy
AT moffattsuzanne theacceptabilityandimpactofarandomisedcontrolledtrialofwelfarerightsadviceaccessedviaprimaryhealthcarequalitativestudy
AT sandelladam theacceptabilityandimpactofarandomisedcontrolledtrialofwelfarerightsadviceaccessedviaprimaryhealthcarequalitativestudy
AT howeldenise acceptabilityandimpactofarandomisedcontrolledtrialofwelfarerightsadviceaccessedviaprimaryhealthcarequalitativestudy
AT whitemartin acceptabilityandimpactofarandomisedcontrolledtrialofwelfarerightsadviceaccessedviaprimaryhealthcarequalitativestudy
AT mackintoshjoan acceptabilityandimpactofarandomisedcontrolledtrialofwelfarerightsadviceaccessedviaprimaryhealthcarequalitativestudy
AT moffattsuzanne acceptabilityandimpactofarandomisedcontrolledtrialofwelfarerightsadviceaccessedviaprimaryhealthcarequalitativestudy
AT sandelladam acceptabilityandimpactofarandomisedcontrolledtrialofwelfarerightsadviceaccessedviaprimaryhealthcarequalitativestudy