Health, Care and Communities Research Group

Parents report that around 10% of infants cry a lot without an apparent reason during the first four postnatal months, a phenomenon known as ‘excessive infant crying’. In spite of many studies, however, the causes of the crying remain poorly understood. The research has begun to shift from the babies to their parents, and the question of how best to support them. Many parents find the crying stressful and seek professional help, adding to NHS costs. TheSurviving Crying (SC) programme consists of Cognitive Behavioural Therapy based sessions delivered by a specialist trained health visitor and supported by a booklet and website.  NIHR funded multi-site clinical trial is being conducted to test the clinical effectiveness and cost effectiveness of statutory health visiting (HV) services supplemented by Surviving Crying-based service compared to statutory health visiting (HV) services alone.

Contact: Emeritus Professor Jayne Brown, Dr Anne Felton

Workplace violence (WPV) presents a persistent risk within ambulance services, yet its impact on student clinicians remains under examined. This study aims to explore the extent and nature of WPV experienced by student paramedics during clinical placements, capturing verbal abuse, physical aggression, intimidation, and harassment encountered across different operational settings. Through mixed methods data collection with student cohorts and placement mentors, the project will assess the psychological, emotional, and educational consequences of WPV, including effects on confidence, clinical decision-making, and professional identity formation. Findings will also map the adequacy of existing support systems, reporting pathways, and preparatory training, with the goal of informing national guidance to enhance student safety, resilience, and wellbeing.

Contact: Dr Carl Webster

This project comprises a completed qualitative study with Nottingham University Hospitals NHS Trust explored the lived experiences of maternity and neonatal healthcare professionals under extended regulatory oversight, revealing three interconnected themes: organisational trauma, deconstructed professional identity, and a three-dimensional fracture of trust across staff–organisation, staff–families, and service–public relationships. A key finding was the concept of regulatory iatrogenesis — unintended harms generated by oversight mechanisms themselves, including fear-driven defensive practice, workforce attrition, and therapeutic relationship rupture. A follow-on bid is currently under review with Nottinghamshire Healthcare NHS Foundation Trust, extending this work into mental health settings where unique contextual factors — including therapeutic alliance as the primary intervention, use of Mental Health Act powers, and dual stigma — are expected to produce distinct but related dynamics.

Contact: Professor Gemma Stacey

Smoking among prisoner populations is up to five times more prevalent than the national average, and this exceptionally high prevalence contributes significantly to high mortality, especially from cancer and cardiovascular disease. Since 2018 the prison service in England and Wales has been smoke-free, making tobacco an illicit item within the closed prison estate. As people leaving prison have abstained from tobacco for months or even years, this offers a unique opportunity to promote lifelong cessation in this highly disadvantaged and marginalised group. This project aims to document the support provided to manage nicotine addiction during imprisonment and in the periods immediately before and after release to establish the extent to which prisoners intentionally resume or unintentionally relapse to smoking after release and obtain views on how relapse might have been prevented.  Next, using this data alongside international literature, an intervention will be designed to prevent smoking relapse after release. Finally, the developed intervention will then be piloted to establish feasibility and acceptability.

Contact: Dr Leah Jayes

Mental health recovery is shaped by cultural values, social norms, and the broader environment in which individuals live. In Romania, the mental health system has undergone significant transformation in recent decades, moving gradually from a legacy of institutionalised psychiatric care toward more community‑focused, person‑centred approaches. Within this evolving landscape, we initiated a series of interconnected studies to better understand and support recovery from the perspective of people with lived experience. Our first study explored the experiences and meanings of mental health recovery using photo‑elicitation with service users in Romania. This was followed by an arts‑based project examining the role of resilience and highlighting strengths‑based dimensions of recovery. We are currently conducting a community‑based study investigating the impact of mental health stigma on recovery through creative methodologies and participatory approaches. The findings will inform the development of an arts‑based anti‑stigma intervention led by people with lived experience of mental distress, with the long‑term aim of scaling this model to other Eastern European contexts.

Contact: Dr Lucian Milasan

This rapid evidence review will address the intergenerational transmission of gambling harms, focusing on how parental or household gambling affects children and young people, and on interventions designed to reduce or prevent these harms. Gambling harms are increasingly recognised as a public health issue that extend beyond the individual who gambles to families, communities, and society at large. Children are particularly vulnerable, with potential consequences including poorer mental health, behavioural difficulties, reduced educational attainment, family conflict, and financial insecurity. Understanding these impacts, and the mechanisms through which they arise, is critical for informing effective policy and practice responses. Evidence on how gambling harms are transmitted within families can help shape targeted prevention strategies, improve safeguarding and support services, and guide the design of interventions that reduce risks and build resilience among children and young people.

Contact: Dr Leah Jayes

An NIHR Research for Patient Benefit bid currently under review proposes developing the Person-Centred Digital Healthcare Evaluation Framework (PC-DHEF) for smartphone-based technologies. Using realist review methodology and co-production with three context expert groups — community members experiencing digital poverty, frontline NHS clinicians, and technology developers — the study will generate Context-Mechanism-Outcome configurations that explain how and why digital health technologies impact care relationships, equity, and staff wellbeing, with the aim of shifting NHS procurement beyond efficiency metrics toward a comprehensive assessment of person-centred and equity impacts.

Contact: Professor Gemma Stacey

Growing ethnic diversity across England underscores the need for culturally competent, equitable prehospital care. This study investigates how health inequalities manifest in frontline ambulance contexts by examining the cultural competence, training experiences, and perceptions of paramedics and student paramedics across multiple regions. Using qualitative interviews and survey-based assessment, the research will explore how cultural understanding influences patient communication, clinical decision-making, and trust, particularly among underserved or marginalised communities. The study aims to generate actionable insights for improving training provision, enhancing workforce confidence in cross-cultural care, and reducing disparities in emergency service outcomes through evidence based educational and organisational change.

Contact: Dr Carl Webster

Simulation-Based Education (SBE) is central to preparing paramedic students for complex clinical environments, yet its quality and implementation vary widely. This study examines paramedic educators’ perspectives on SBE design, delivery, and alignment with established quality frameworks, including ASPiH and INACSL standards. Drawing on semi-structured interviews with educators across five higher education institutions in the East Midlands, the research uses template analysis to identify key themes related to perceived quality, pedagogical value, operational challenges, and resource limitations. The findings aim to inform sector-wide strategies for enhancing SBE consistency, educator development, and curriculum integration to strengthen the preparedness and competence of future paramedics.

Contact: Dr Carl Webster