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The need to foster resilience amongst young people with intellectual disabilities is increasingly recognised within policy. Critically, understanding of the actual means by which this aspiration might be most sensitively and effectively met is considered weak. This paper reports on an exploratory case-study of a social enterprise community café – The Usual Place - that through the promotion of employability, seeks to promote resilience amongst its young 'trainees' with intellectual disabilities. Two research questions were set: " how is 'resilience' conceptualized within the organisation " and " what features within the organisation are significant in fostering resilience"? We identify a range of significant features associated with being able to successfully foster resilience – the need for a foundational 'whole organisation'(settings) approach based on high levels of participation and choice; the negotiation of a constructive dynamic tension between 'support' and 'exposure'; and the embedding of these actions in embodied actions and day-to-day organisational activities. [ABSTRACT FROM AUTHOR]

Objective: The objective of this research was to explore how accessible the concept of food and physical literacy is for health and well-being professionals, and assess its potential effect on service delivery. Design: Formative research and 'concept testing' with potential deliverers of food and physical literacy. Setting: Dumfries and Galloway, a rural region in South West Scotland, UK. Method: The research was undertaken after four workshops hosted by National Health Service (NHS) public health specialists, aiming to introduce and discuss the concept. An immediate post-event focus group and a short qualitative questionnaire were used to assess professionals' initial perspectives on the concept, whether they thought the concept was applicable to their work, and what they might require by way of support if the concept was to be taken forward. Results: The findings illustrated the extent to which professionals feel that food and physical literacy is necessary, barriers to its implementation and ideal components for advancing work within this field. Conclusion: The concept of food and physical literacy has a sufficiently high level of resonance (proof of the concept) among informants to provide a foundation on which further work on its operationalisation can be based. The use of formative research and concept testing with potential service deliverers was able to identify areas to be considered during developmental stages, increasing the likelihood that the end result will be accepted by the professionals expected to utilise it. Thus, the benefits of an inclusive approach to service development were also highlighted.

The role of 'best investment' methodology in shaping priorities in many health policy areas is becoming increasingly prominent. Whilst this has traditionally been seen as a technocratic exercise, the social and political context of such practices and the constructed nature of decisions are now considered significant. In this context, this article reports on a longitudinal case study of such a process that sought to identify 'best investments' in public health interventions related to promoting physical activity. Drawing on a series of conceptual resources, we describe and reflect upon the complex and invested elements that contributed to the grounded decision-making process. In conclusion we suggest the need to adopt a multifaceted and nuanced approach to resource investment decision making, including: deploying a range of appraisal assessment resources; maintaining a long-term processual perspective; involving a variety of stakeholders; accepting and embracing fallibility; and accommodating theoretical and empirical evidence-based principles. [ABSTRACT FROM AUTHOR]

"Best practice" is currently being used to enable modernisation within the National Health Service (NHS) in the United Kingdom. One element of this is the Beacon programme where examples of hospitals that exemplify local "best practice" are supported to develop and disseminate learning across the wider NHS. The aims of this research were to map public health-related Beacon hospital initiatives and then to identify opportunities and barriers in this context. This was achieved by seeking the views of a range of relevant national and local stakeholders. The work suggests that whilst Beacon hospital projects have some potential in developing relatively innovative activity they are not perceived to be stepping-stones to wider public health action. Five possible ways forward are suggested. (Contains 1 table and 3 notes.)

Community-based palliative care services and their integration with public health systems are of considerable contemporary interest. However, the conflicts that emerge in such a complex organizational field comprising multiple stakeholders with diverse interests remain under-examined. Our analysis of community-based palliative care in Kerala identifies four 'logic conflicts' that indicate competing frames of reference in an organizational field. These conflicts shape decision-making and coordination and manifest as: 1) professional versus community logics, 2) centralized versus decentralized governance logics, 3) generalist versus specialist care logics, 4) charity versus rights-based logics. We also identify two mechanisms – forming coalitions and fostering plurality – by which actors manage these conflicting logics. We discuss contributions to public health palliative care conversations and implications for nurturing and sustaining care communities. [ABSTRACT FROM AUTHOR]

AimTo conduct a process-based evaluation of the inception and early implementation of a social prescribing initiative (Healthy Connections Stewartry) in two UK General Practices.BackgroundPrescribing a range of social, cultural, arts and educational activities to clients in primary care (known as ‘social prescribing’ or ‘community linking schemes’) as a means of addressing long-term physical health conditions and promoting mental health and well-being is becoming increasingly prominent and popular. However, concerns exist over a lack of evidence of effectiveness and formalised insights into how such initiatives may be optimally implemented.MethodsWithin a case study design and using 1–1 semi-structured interviews, three related data sets were developed over a 12-month period from 30 purposively sampled informants: the project steering group; the wider primary care team; and various community groups. Data analysis drew on various theoretical resources, particularly those pertaining to nurturing sufficient capacity for the organisational ‘normalisation’ of this practice and understanding the dynamic flows and linkages between potential clients, ‘prescribing’ primary care staff and the available community resources.FindingsThe inception and implementation of the initiative had been broadly successful and that more generally, there were grounds to suggest that these practices were becoming ‘normalised’ into the day-to-day cultures and routines of the primary care organisations. A series of procedural features are considered significant in achieving such ends. Some specific barriers to change are identified and ultimately in the context of potential ‘transferability’, a wider reflection is undertaken of the potential for such innovative practice to become established in less advantageous organisational circumstances. Fundamental difficulties are recognised and thus the need for formally implemented ‘change’ processes. Furthermore, for social prescribing to become a pervasive feature of health-care provision, the need for necessary capacity and resources is stressed. [ABSTRACT FROM PUBLISHER]