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Promoting Lifelong Health Group

Current or recent projects

Project Staff: Nyree Dunn, KESS PhD student;  Dr Gina Nolan, Dr Jane Davies, Professor Mark Williams

External Partner: Huntleigh Healthcare, UK

This project was conducted in collaboration with Cwm Taf Morgannwg Health Board, Aneurin Bevan Health Board and Huntleigh Healthcare.  

Lymphoedema is a debilitating and long-term condition that often leads to pooling of fluid in the lower limbs. The long-term management of swollen legs is achieved by tight  bandaging  and directed massage.  Automated compression devices, which mimic manual massage, have been developed which allow the underlying fluid accumulation to be displaced from the affected limb. These devices can be used by the patient at home, leading to improved care and the quality of life of these patients.

Little research has been conducted on the efficacy of these devices.  The aim of this project was to determine how effective home use of these automated compression devices are at reducing limb volume, restoring skin biomechanics and improving quality of life.  

The project has highlighted new avenues of investigation and provided unequivocal evidence that compression devices can be used to promote the self-management of lower limb lymphoedema.

Professor Carolyn Wallace founded and developed the Wales School for Social Prescribing Research(WSSPR)  in 2020. This virtual all-Wales school, funded by Health and Care Research Wales, has four active themes, evaluation, social value, education and wellbeing. WSSPR has received HCRW infrastructure funding to develop a social prescribing evaluation methodology, building on the work previously completed by the Wales Social Prescribing Research Network (WSPRN). 

To deliver this programme of research Professor Wallace works closely with Dr Sally Rees, WCVA, (Bangor University ), Sara Thomas (Public Health Wales), Prof David Pontin (USW), Prof Steve Smith (USW), Dr Glynne Roberts (Betsi Cadwaladr UHB)  and Megan Elliott (USW). 

In 2017, Carolyn founded the Wales Social Prescribing Research Network (WSPRN) to build the evidence base for social prescribing in Wales, with a £10k grant from Wales School for Social Care Research.

Project staff: Professor Jennifer Austin, Dr Ioannis Angelakis, Dr Patricia Gooding, University of Manchester

In the past decade, the links between core types of childhood maltreatment and suicidal acts have become an increasingly important area of investigation. However, no meta-analytic review has examined this relationship in prisoners. 

We undertook the first systematic meta-analytic review examining the link between childhood maltreatment and suicide attempts in prisoners to redress this important gap. 

Given the high rates of prison suicide deaths and suicide attempts, our findings suggest an urgent need for targeted suicide prevention priorities for prisoners, with a particular focus on ameliorating the effects of childhood traumatic experiences on suicidal prisoners.

Download the paper

Project staff: Dr Emily Groves, Professor Jennifer Austin

The Good Behavior Game (GBG) is a classroom management intervention whereby students earn points toward a particular criterion to “win” the game. Typically, students know the criterion at the start of the game. However, this approach may cause behaviour to deteriorate if, during the game, students believe that they have already won or lost. 

The study investigated the effects of known and unknown criteria in a Welsh Year 4 (ages 8–9) classroom. Participants included three students who engaged in disruptive behaviour (target students) and three who typically did not (nontarget peers). Tau-U and percentage nonoverlapping data (PND) effect size calculations indicated that both known and unknown criterion games were effective at reducing target students’ disruptions to within the range of their nontarget peers, but neither game was more effective than the other. 

Teachers reported that they preferred playing the GBG with an unknown criterion; however, the students’ preferences were mixed.

Project staff:  Gabrielle Hale, PhD student; Dr Deborah Lancastle;  Dr Nicky LewisDr Philip Tyson.

The objective of this research is to review the literature on the outreach activities of football clubs and to identify the most beneficial elements of these programmes for the mental health and psychological well-being of young participants. 

Following this, the aim is to develop and trial a novel programme which incorporates all the positive elements of successful programmes. This will incorporate both classroom and physical activity based elements. 

The research will substantially add to the literature about how physical activity may enhance the mental health and psychological well-being young people, and also clearly delineate the role of professional football clubs in this endeavour.


Two papers are currently in review:

Physical Activity Interventions for the Mental Health and Well-Being of Adolescents: A Systematic Review. Submitted to the Journal of Adolescent Health.

Physical Activity Interventions for the Mental Health and Well-Being of Children: A Systematic Review. Submitted to the Journal of Pediatric Psychology.

Project Staff: Kerry-Ann Liles (KESS PhD Student), Emma Brute (United Welsh Housing Association), Jayne Painter (Monmouthshire Housing Association) Mary Clare O’Connell, Dr Sue Faulkner, Dr Philip Tyson

The psychological disorder of hoarding is characterised by a persistent difficulty in parting with possessions irrespective of their actual value, to the extent that living areas become congested and cluttered and in some cases rooms can be unusable.  The disorder is associated with clinically significant distress, an impairment in social and occupational functioning and there are many health and safety risks associated with hoarding behaviour such as fire hazards, risk of falling, poor hygiene, poor nutrition, insect manifestations,  and medical problems resulting from bacteria, dust and dirt. 

The problem

Cases of hoarding present a challenge for housing associations because there is lack of community based support for such individuals, and there are no governmental nor local policies and procedures to help support hoarding tenants. In some instances, housing associations are faced with the prospect of having to evict tenants;  a course of action that is not ideal for either the tenant nor the housing association, and incurs considerable costs in terms of legal fees and cleaning and restoring the property to a habitable standard. There is therefore a clear need to identify and address collecting and hoarding behaviour before it results in such a drastic course of action, and at an early stage as possible to provide support to the tenant concerned.


The current project is a pilot of the use of Motivational Interview (MI) techniques as a behavioural intervention, aiming to assist tenants to curb hoarding behaviour and to generate their own insights and solutions into their situation.  MI can be defined as a person-centred method of guiding behaviour in order to elicit and strengthen personal motivation for change.  The proposed model of MI aims to work with tenants own agendas to facilitate longer-term internal changes, rather than short-term externally motivated solutions (e.g., fear of eviction). 


The onset of the Covid-19 pandemic has provided us with a unique opportunity to trial the use of distance Motivational Interviewing to address hoarding behaviour. This involves the use of a smartphone to communicate with residents and aid their behaviour change.  The project is in its second of three years.


One paper is being prepared; a systematic review of interventions for hoarding behaviour. At least one other paper is planned to report the findings on whether Motivational Interviewing can reduce hoarding behaviour.

In 2014 Professor Carolyn Wallace developed the concept of family resilience for public health nurses (health visitors) working in Wales and leads the FRAIT (Family Resilience Assessment Instrument and Tool) team at USW. 

The FRAIT comprises of the FRAIT (Family Resilience Assessment Instrument) and the FRAT (Family Resilience Assessment Tool), both of which form an evidenced based assessment for health visitors in their daily practice. 

Its purpose is to assist health visitors in decision making, care planning and planning for further interventions and resources. It is used by all health visitors in Wales to comply with the Welsh Government (2016) Healthy Child Wales Programme. 

To deliver this programme of research Professor Wallace works with Professor David Pontin (USW), Michelle Thomas (USW), Georgina Jones (SBUHB), Jane O’Kane (CTMUHB) and Liz Wilson (HDUHB).

Project staff: Dr Deborah LancastleEileen MunsonProfessor Bev JohnDr Roiyah Saltus

This work is an ongoing series of projects relating to women's reproductive health problems and the physical, psychological, and social consequences of these on women's wellbeing, work performance, and quality of life. 

It is extremely important that a full understanding of the impact of reproductive health problems on women's wellbeing is understood and that women seek help for these problems as soon as possible in order that their problems do not impact on their wellbeing and work performance across their lifespan. 

Dr Deborah Lancastle is working on a number of projects relating to women's reproductive health problems and the physical, psychological, and social consequences of these on women's wellbeing, work performance, and quality of life. 

A current project aims to establish the barriers to help-seeking for menstrual problems amongst Black, Asian, and Minority Ethnic women. 


Boivin, J., & Lancastle, D. (2010). Medical waiting periods: Imminence, emotions and coping. Women’s Health, 6, 51-59

Brain, K.E., Lifford, K.J., Fraser, L., Rosenthal, A.N., Rogers, M.T., Lancastle, D., Phelps, C., Watson, E.K., Clements, A., Menon, U. (2012). Psychological outcomes of Familial Ovarian Screening: No evidence of long-term harm. Gynecologic Oncology. 127, 556-563.

Darwiche, J., Maillard, F., Germond, M., Favez, N., Lancastle, D., de Roten, P., Guex, P., and Despland, J-N. (2013). The transition of care from fertility specialists to obstetricians: Maternal adjustment and postpartum depressive symptoms. Future Medicine: Women’s Health, 9, 109-118.

Lancastle, D., & Boivin, J. (2005). Dispositional optimism, trait anxiety and coping: Unique or shared effects on biological response to fertility treatment? Health Psychology, 24, 171 -178.

Lancastle, D & Boivin, J. (2008). Feasibility, acceptability and benefits of a self-administered positive reappraisal coping intervention (PRCI) card for medical waiting periods.Human Reproduction, 23, 2299-2307.

Lancastle, D., Brain, K., & Phelps, C. (2011). Illness representations and distress in women undergoing screening for familial ovarian cancer.Psychology and Health, 26, 1659-1677.

Roderique-Davies, G., McKnight, C., John, B., Faulkner, S., & Lancastle, D. (2017). Models of health behaviour predict intention to use long-acting reversible contraception. Women’s Health Advance Online Publication. 

Lancastle, D., Arriagada, P., & Skouby, S. (2016). Long term treatment of uterine fibroids with Ulipristal Acetate improves health-related quality of life: Findings from the PEARL-III (ext) randomised controlled trial. Poster presented at the European Society for Human Reproduction and Embryology (ESHRE), Helsinki, July 2016

Dr Deborah Lancastle

Caregiving can be a demanding and rewarding experience that can put considerable strain on caregivers' resources. Establishing ways in which caregivers' resources can be enhanced to enable them to cope with daily challenges is extremely important to help support them in their valuable efforts to care for others. 

Caring for those with additional needs can have an important impact on the wellbeing and quality of life of caregivers, and it is important that caregivers are helped to cope with any demands they experience in a way that lessens the impact on their wellbeing. 

Dr Deborah Lancastle has conducted a series of studies looking at the wellbeing of the caregivers of those with Autism Spectrum Disorder, Dementia, Down's Syndrome, and Eating Disorders, and is currently looking at the impact of carers of those with Huntington's Disease.  

A study recently completed has looked at the wellbeing of paid caregivers.

The main aim of the research is to establish the role of a particular coping strategy (Positive Reappraisal Coping) on the wellbeing of caregivers. 

Deborah has been assisted over the years by a number of MSc Health Psychology and Clinical Psychology students (Joanna Hill, Katy Pitt, Amy Stone, Catherine Wellington, Alexcia Paul, Bethanie Marsh, Chloe Hoggins, and Praises Kolawole), and an undergraduate Psychology student (Daniel Williams). 

Project staff: Gareth Parsons; Dr Juping Yu; Dr Deborah Lancastle; Dr Emma Tonkin

Nurse Education has a pivotal role to play in nurturing the qualities of care and compassion, and one way of achieving this is to utilise patient stories. We produced a short story about a real patient’s experiences of care and using QR codes built a learning resource in the form of a story walk linked to different locations around our Clinical Simulation Suite. Nursing students follow the patient’s journey from diagnosis to discharge, listening to audio recordings recounting the patient’s experience of care in her own voice. See the evaluation here.

Dr Ioannis Angelakis; Professor Jennifer Austin; Dr Patricia Gooding (University of Manchester)

This study, was published in Psychological Medicine, found that up to 68% of prisoners had previously experienced some form of childhood abuse or neglect, whereas 23% reported engaging in suicide attempts. These findings were based on 24 studies containing data from 16,586 prisoners around the world. 

Furthermore, this study demonstrated that prisoners who experienced multiple, sexual and emotional abuse were three times more likely to engage in suicide attempts than those prisoners without similar experiences, and that prisoners with experiences of physical abuse and emotional neglect were two times more likely to attempt suicide as adults. These findings suggest that early screening for experiences of childhood maltreatment in prisons may assist towards the prevention of suicidal behaviours in this highly vulnerable group.

Researcher: Dr Melody Cranbourne-Rosser (University of South Wales) 

Research Supervisors: Dr Miglena Campbell, Dr Lesley Pilkington, & Dr Nikki Carthy (Teesside University); Counselling and Psychotherapy Interventions for Children and Young People, 16 July 2020

Working with children and young people (CYP) demonstrating harmful sexual behaviour (HSB) is complex and requires understanding of the dual identity of ‘victim’ and ‘victimiser’. Working with such experiences can impact on therapeutic processes, such as ‘presence’, a phenomenon manifesting from connection and moment‐to‐moment awareness. Research into presence generally focuses on working with adults. 

This study explored presence when working with CYP demonstrating HSB. Eight practitioners were interviewed focusing on their lived experiences of presence in terms of personal perception, cultivation, and influence on practice and sustainability. Interviews were analysed using interpretative phenomenological analysis, which resulted in two main themes: ‘presence and person’ and ‘presence and place’. 

Findings suggested that in addition to presence and the therapeutic relationship enhancing each other qualitatively, presence provides a platform of connectivity from which to engage, promotes working from a whole‐person perspective and assigns deeper meaning to the work; cultivation requires opportunities to identify, enhance and embrace the phenomenon in order to promote self‐awareness and utilise presence effectively with others; practitioner well‐being and sustainability requires application of self‐care strategies and robust workplace support; and the development of a safe and productive presence‐informed service requires suitable processes and procedures to be established. These points are considered in terms of implications and future recommendations for practice and policy.

Project staff: Prof Carolyn Wallace, Dr Mark Davies, Megan Elliott, Lisa Griffiths, Prof Mark Llewellyn, Dr Nikki Lloyd Jones, Prof David Pontin, Dr Sion Tetlow, Dr Sarah Wallace

Student mental health has significantly worsened in recent years, particularly with the impact of the COVID-19 pandemic. This project aims to enhance student well-being, build resilience and promote new ways of working using a replicable model of social prescribing, co-created with partners from the local community to benefit university students as part of a whole system approach to wellbeing.

Researchers at University of South Wales and the Wales School for Social Prescribing Research are working with colleagues in Wrexham Glyndwr University and University of South Wales, funded by HEFCW on this project.  

The project employs a mixed-method approach using Group Concept Mapping (GCM) and Realist methodology in order to identify what affects student well-being, understand how the Social Prescribing model currently works in Higher Education, and evaluate the implementation of the newly developed Social Prescribing service in Wrexham Glyndwr University.

Study reports to date can be found here.

Project staff: Megan Elliott, Professor Steve Smith, Professor David Pontin, Professor Carolyn  Wallace

Many social prescribing interventions aim to improve both mental and social well-being. Existing evaluations have used validated tools to measure mental well-being, but to date there is no validated tool to measure social well-being.  

Researchers at the Wales School for Social Prescribing Research undertook an international Group Concept Mapping study between June and September 2020 to develop the concept of social well-being. 

They found that the concept of social well-being is made up of six clusters; ‘everyday life, activities and pastimes’, ‘family and friends’, ‘connecting with others and supporting needs’, ‘community involvement’, ‘engaging with and reflecting on the wider world’ and ‘self-growth and security’. For participants, the most important and accessible cluster was ‘self-growth and security’, whereas the most enjoyable cluster was ‘family and friends’. The impact of COVID-19 on access to family and friends was clear in the study. Interestingly, there were no differences in the way that people from different demographic groups rated the clusters, suggesting that the concept of social well-being is applicable to the general population.

The researchers are now using these findings to develop the South Wales Social Well-being Scale (SWSWBS), which they anticipate can be used alongside tools to measure mental well-being, to provide an overall understanding of a person’s well-being. 

The study report can be found here.

Project staff: Professor Carolyn Wallace, Megan Elliott

Even though social prescribing practice is widespread in Wales and across the United Kingdom, evaluations of social prescribing have been inconclusive and have been criticised for being methodologically flawed. Researchers have called for a coordinated approach to social prescribing evaluation to ensure that robust, systematic evaluations can be undertaken in a variety of different contexts. 

The ACCORD study is funded by Health and Care Research Wales and part of the Wales School for Social Prescribing Research (WSSPR). It employs a mixed-methods design, combining four inter-linked work packages to develop an evaluation methodology framework, reporting standards for social prescribing and training materials. 

The four work packages are as follows:

  1. Undertake a realist synthesis to identify good practice in social prescribing research, evaluation and monitoring. 
  2. Develop the evaluation methodology framework using online Group Concept mapping.
  3. Develop reporting standards for social prescribing evaluation using a world café workshop approach. 
  4. Develop training materials to enable social prescribing practitioners and researchers to undertake rigorous, high quality evaluations. 

ACCORD is a three-year study, which commenced in April 2020 and will have multiple outputs. The outputs from ACCORD can be found here.

Research partners include

United Welsh - Research Partner with Psychology Dr Philip Tyson

Tenovus logo

Mind Logo

British Red Cross

Cwm Taf UHB logo

Hywel Da University Health Board

Huntleigh Healthcare logo - USW Research Partner