Public Health Institute Journal (LJMU)
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COVID-19 and the Eating Behaviours and Emotional Wellbeing of UK Adults (CEBEW): A Cross-Sectional Observational Study
No full textBackground: This study aims to compare the differences, before and during Covid-19 restrictions, in food intake and wellbeing respectively while ascertaining the relationship between various food groups with components of wellbeing.
Methods: A cross-sectional observational study of UK adults (aged 18–65 years) was launched in March 2021 and conducted across the UK. Due to the ever-changing public health rules for the various regions of the UK, questions around food consumption, physical activity, emotional wellbeing, amount of sleep and quality of sleep, required responses from “before” and “during” lockdown restrictions, with demographic and lifestyle factors being self-reported. The study had two research questions: 1) Is there a difference between food intake and wellbeing respectively, before and during Covid-19 restrictions? 2) Are any changes in food intake and/or wellbeing linked to each other in a bidirectional manner? Participants (N = 94) were UK residents aged between 18 – 65 years and were not experiencing symptoms of Covid-19 or long Covid at the time of completion.
Results: Participants were predominantly white (87%), single (43%), female (71%), aged under 30 years (36%) and living with their spouse (43%) with no children (74%). More than a quarter of the participants (26%) lived in the 10% most deprived areas of the country and 37% were classed as obese. There were statistically significant decreases in healthy foods (p = <.001); vigorous exercise (p = .004); muscle strengthening exercise (p = <.002); feeling happy / calm (p = <.001); feeling cheerful / hopeful (p = <.001); sleeping hours (p = .003) and the quality of sleep (p = <.001). There were also statistically significant increases in participants feeling lonely / isolated (p = <.001) and the consumption of unhealthy foods (p = <.001). There were positive correlations between increased light exercise and increased lean meat consumption (p = <.001) and an increase in the frequency of light exercise and feeling happy / calm (p = <.001).
Conclusions: Covid-19 restrictions impacted negatively on nutrition and exercise behaviours, and unhealthy food was associated with loneliness
Can community approaches like social prescribing be used to tackle the problem of loneliness and social isolation in the UK?
No full textLoneliness is a global public health issue that impacts mental and physical health and is associated with a 26% increase in premature mortality (Cacioppo and Cacioppo, 2018a). The UK government has heavily invested in social prescribing as part of the 2018 Strategy for Tackling Loneliness (Department of Health and Social Care, 2019). Social prescribing is a holistic approach to improve wellbeing, that allows healthcare workers to refer participants to non-clinical services (The King\u27s Fund, 2017). This literature review aims to assess whether social prescribing can be an effective way to reduce loneliness. It compiles relevant literature on social prescribing, loneliness and social isolation, and provides an overview of the critiques of the use of social prescribing for loneliness. This review defines loneliness and social isolation and identify the impacts and at-risk groups. It also defines social prescribing and discusses its limitations and strengths in relation to loneliness. This review found that, theoretically, social prescribing could be an effective way to reduce loneliness, but there is not enough high-quality evidence to support this. Some social prescribing programmes have found a reduction in loneliness to be an outcome, but we do not yet know what does and does not work (Dayson and Leather, 2020). Since loneliness is experienced in different ways, it is important to tailor social prescribing to at risk groups and individuals’ needs. While the flexible nature of social prescribing allows link workers to do this, a greater knowledge of what is most effective is needed. To ensure that social prescribing is being used appropriately for loneliness, there needs to be more research. More knowledge is needed on what works and why for social prescribing, and specifically for loneliness. The social prescribing programmes provided must also be tailored to addressing loneliness, for example extending the time limit for service users to have access to link workers as loneliness is often a long-term issue. Link workers should also receive standardised training and support to ensure high quality services. Social prescribing programmes should also measure loneliness regularly to further understand what is effective for this issue. Programmes should target young people and other at-risk groups, as well as older people. Finally, there needs to be more investment in low-income areas to allow access to a range of community services.  
A qualitative study to explore the impact of having a hidden physical impairment whilst attending university
No full textThe term \u27hidden impairments\u27 means that you cannot tell that someone has a condition from their outward appearance. Hidden impairments are becoming more acknowledged and openly discussed in society. There is growing awareness that increased understanding is essential due to many individuals not wanting to disclose their invisible disabilities for fear of stigma. Students with hidden impairments have been found to experience barriers related to negative social attitudes and a generalised approach to disability. The aim of this research was to explore the impact that having a hidden physical impairment has on a student’s experiences during their time at university. The aim was explored by gaining an understanding of student’s academic and social life, how students feel about using accessible facilities and how they feel they are perceived by others. A small-scale qualitative study was undertaken using semi-structured interviews to explore participants’ university experiences when having a hidden physical impairment. There were five participants, all female, of varying age, with a variety of impairments. Two lived with Irritable Bowel Syndrome, one with hypermobility, one with chronic pain, and one with epilepsy. The findings show students’ academic life can be affected due to being absent as a result of their impairment, especially when universities do not provide the appropriate means to catch up. However, students do not always disclose their impairment to the university due to reasons such as embarrassment, instead, choosing to confide in a trusted staff member. Students’ social life can be affected due to their impairment including causing them difficulties consuming alcohol. Being unable to drink alcohol can cause students to feel as though they are left out or missing out on the social life at university. Students also experience negative social attitudes when using accessible facilities both at university and in everyday life. The study has shown that having a hidden physical impairment can adversely affect a student’s experience at university and, in order to achieve academically, further awareness and understanding of hidden impairments both socially and institutionally is needed. 
Experiences and engagement of users of the ‘Fresh Start’ weight management app during the Covid-19 pandemic
No full textBackground: The use of smartphone apps as a weight management intervention has continued to expand over recent years. The Covid-19 pandemic presented unique challenges to weight management services that accelerated the development of one such app ‘Fresh Start’. Limited research explores the experiences of participants using a single, new app over a standard twelve-week weight management program. This study captured those experiences as well as gaining an insight into how the Covid-19 pandemic impacted the health and wellbeing of app users.
Methods: Semi structured interviews were carried out with eight Fresh Start users. Initial interviews were carried out during April 2021, when they began using the app, and again twelve weeks later in July 2021. All interviews were carried out remotely over video-call. They were recorded, stored, and transcribed verbatim into the NVivo software package. App engagement was captured quantitatively using the volume of messages sent, through the app, by participants to their weight management advisor.
Results: Inductive thematic analysis was conducted. Initial interviews produced primary themes with several sub themes: 1) Reason for using the app and 2) Expectations of the app and of themselves. At follow-up further themes were identified: 3) Experience of using the app and its individual features, 4) behaviour change and 5) future expectations. Impact of Covid-19 was a further theme that emerged during interviews. The study found participants can engage with a weight management app when in-person services are unavailable. Participants valued tracking dietary intake, remote coaching and receiving weight management information via a smartphone. Covid-19 impacted participants significantly and presented further health and wellbeing challenges. The use of a weight management app was broadly positive in supporting participants to meet these challenges.
Conclusions: The ‘Fresh Start’ weight management app provided valued weight management support to participants whilst no in-person weight management services were operational. Dietary tracking, coaching and information content were important to participants, many of whom had only used in-person services previously. The study suggests service providers should look to support existing services with remote options, ensuring continuity of service and support during adverse events such as a pandemic
Bloody tour: exploring the perceptions and attitudes of female soldiers regarding menstrual hygiene when on tour or exercise within the British Army. A qualitative study
No full textBackground: The aim of the research was to explore the experiences and attitudes of British female soldiers managing their menstrual cycle and menstrual hygiene whilst on deployment (including on tour and on training exercise) in the UK or abroad. The research also explored any psychological and physiological impacts of managing their menstrual hygiene within a predominantly male environment and considered potential policy and practice recommendations to improve women’s health and wellbeing.
Methods: A qualitative approach was taken using semi-structured online interviews. Thematic analysis was undertaken to classify, examine, and report themes within the data. The study recruited a cohort of British army female reservist and female army veterans (n=7) from different corps across the United Kingdom (UK). All participants held noncommission officers’ ranks and the mean age was 42.3 years. The longest serving reservist had 25 years of service and the shortest three years. Among the veterans, one had served for six years and the other had completed 16 years of service.
Results: British female soldiers work and live in some austere conditions, which makes keeping clean more difficult than being based at home. Many challenges and barriers were identified by participants in the study, which showed how female soldiers had to alter their hygiene practices due to factors such as: inadequate accommodation, inadequate washing facilities, a lack of running clean water and unsuitable sanitary disposable provisions. For some female soldiers, this led to embarrassment from having to carry waste sanitary products with them, in particular when this was seen by males.
Conclusions: The findings from this qualitative study corroborate previous research by demonstrating that there has been little advancement to improve female soldiers’ experiences of menstruation on deployment and how this effects them being operationally ready
A quantitative study to investigate people\u27s awareness of plastic pollution and their preventative actions
No full textAs the world now produces 280 tons of plastics per year, plastic pollution is an ever-growing global problem. Plastic materials are constantly ending up in oceans from both land and sea-based sources, or in landfill. Although plastics are lightweight and durable once they enter the ocean or freshwater bodies, oceanic wildlife are at risk of entanglement or death from ingestion. As plastic does not biodegrade in nature, it is extremely difficult to eradicate. Plastic photodegrades naturally, causing plastic to split into smaller pieces which makes ingestion easier for aquatic animals. This study reports the findings of a small-scale survey to understand people’s awareness of plastic pollution and their preventative actions. This study used convenience sampling with 347 participants who undertook an online questionnaire, to gather data on how many of them recycled, why they recycled and any limitations they faced. In 2018, the UK rate for recycling waste from households was 45%, according to the Department for Environment Food and Rural Affairs (2020). Study findings highlighted that as age increased so did the rate of recycling, with 100% of those aged 50+ years stating they recycle every day compared to 61% of 16–18-year-olds. Both male and female’s awareness of plastic pollution was the same (85% of both were aware) which indicated there were no gender differences. This research also found that 37% of females and 31% of males strongly agreed they could recycle more which shows that although participants generally recycle there is still room for improvement. This research found that the main limitation for participants not recycling was because they were not aware of what materials could be recycled. The researcher felt that an educational approach to combat this, such as leaflets would benefit all age ranges. The study highlights the need for more research surrounding the effects plastic has on human health to fill knowledge gaps with a bigger sample, to decrease any bias. 
A qualitative study on the impact of lock down on mental health among Nepali students studying at Liverpool John Moores University (LJMU) during the Covid-19 pandemic
No full textThe aim of this study was to analyse the psychological impact of Covid-19 and lockdown on international Nepali students studying at Liverpool John Moores University (LJMU). A qualitative study was conducted using semi-structured interviews via Zoom. Eight participants (5 males and 3 females) were interviewed. The data collected were analysed using inductive thematic analysis. Themes and subthemes were developed. Three main themes are presented: 1) adapting to life during the pandemic and lockdown 2) lockdown, isolation, and mental health 3) coping strategies for stress and worry. This study argues that international students are a potentially vulnerable group and this population should not be overlooked when considering the mental impact of the Covid-19 lockdown. The study found the coronavirus pandemic had caused a wide range of changes for international students including lifestyle changes, reorganization of teaching and learning methods, economical changes and, impact on their long-term career prospects, which in turn have affected the mental health of international students. The findings of the study concluded that international students are facing various challenges associated with Covid-19 which have impacted their quality of life and mental health. International students in this study had adapted individual coping strategies and used social support to help them to deal with the fears and worries related to lockdown. However, the results establish a clear message that international student needs relevant support to address the problems they are facing, and specific intervention to help them overcome the impacts upon their mental wellbeing during this unprecedented situation. 
A systematic review into the use of social media by online weight management interventions
No full textBackground: Innovative technologies can be used as a source for delivering health related interventions. The internet has been used for delivering such interventions due to its capability in reaching large audiences and by eliminating geographical and physical barriers. This study aimed to review the use of social media online weight management interventions.
Methods: A systematic review, exploring the effectiveness of social media for delivering the online weight management intervention was conducted. Randomised Controlled Trials between 2000 to 2021 were considered for inclusion.
Results: Five studies were identified for analysis covering subject areas related to physical, behavioural, psychological, and dietary activities. In addition, the selected studies were heterogeneous in context to area, target audience as well as mode of delivery. Facebook was used in every study for delivering intervention.
Conclusions: The systematic review of study demonstrated that the Facebook was the sole method of delivering the online weight management intervention due to its capability to reach and access a large audience. Moreover, participants who use online weight management programs for more than one year saw a change in behaviour. However, the randomised control trails were not considered adequate and efficient methods for assessing the efficacy of online weight management intervention through social media
Exploring LJMU students’ perceptions of the impact of social media on body image
No full textBackground: Body image is a person’s perceptions and attitude about one’s own physical appearance. Body image can play a role in influencing our physical health and mental health. This study aimed to explore LJMU students’ perceptions of whether social media use has had an impact on their body image.
Methods: An exploratory quantitative study was conducted using an online questionnaire delivered to the Faculty of Health email lists through social media. A total of 185 participants completed the online survey.
Results: The main findings of this study revealed that 43.8% of the participants had negative and very negative feelings about their body image, while the rate of positive and very positive was 20.5%. The majority of the participants (84.8%) claimed that they usually spend 1-6 hours daily on social media. Participants aged from 18-21 years reported the highest percentage (56.8%) for using social media from 4-6 hours per day. Students aged 26 years or older received the lowest (18.1%) for using 4-6 hour and the highest (62.9%) for 1-3 hours on social media. Female participants were more likely to be affected by the impacts of social media and received higher percentages for the three options of very influential (24.2%), somewhat influential (36.2%) and slightly influential (30.2%). 53% of the participants claimed that they have attempted to use a diet from social media to lose weight, compared to 47% of them chose never. Factors that were associated with participants’ attitude towards body image include gender and current level of study. Factors that were associated with the impact of social media on body image include gender and whether they used a diet from social media to lose weight.
Conclusions: Overall, the study provided an overview of research on social media and body image. The study also identified some implications that should be taken into account for future research including the need for raising students’ awareness of supporting positive body image and good wellbeing. Helping university students to appreciate their bodies through various ways can be critical to future public health research
A quantitative research study to investigate students’ experiences while renting accommodation in the private sector
No full textThis report presents the findings of a quantitative research study to investigate students’ experiences while renting in the private sector. The study sought to address four key research objectives: 1) To explore the nature and prevalence of private rented accommodation for students, 2) To gauge the overall satisfaction students have with the quality of their rented accommodation, 3) To identify any issues students have while living in rented accommodation, and 4) To investigate the impacts of poor housing on students. This dissertation seeks to critically analyse the reasons why students may be particularly vulnerable to living in poor accommodation and suggests further action to improve the student housing experience. The introduction in this paper briefly discusses what homes mean to people, the importance of housing in terms of physical and mental health and the typical problems people face when renting accommodation. This leads to the literature review which provides an in depth look at the prevalence of housing in the private sector and the typical conditions and issues that are found in housing, using past research. It also looks at how poor housing can affect health and why this is a particular issue for students, identifying factors specific to students which may make them more vulnerable to living in poor quality accommodation. Chapter 3 describes the methodology used to carry out the study, namely questionnaires, and Chapter 4 then presents the results of the study. Chapter 5 discusses the results in the context of the research objectives and the literature review. My main findings from this research project were that there is a problem with housing conditions and lack of engagement from landlords. I also found that students as a group may be uninformed about the services available to them and they are not necessarily worried about their housing affecting their health. To conclude, this study did find that students face defects and are vulnerable to poor housing conditions; it also found that landlords are not performing regular enough checks on their properties. More research may be needed in order understand how big of a problem this is, using interviews or focus groups will give a more direct and clear understanding of the situation. 
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