呻吟之王

Mrs Jessica Turner

Job: Research Assistant

Faculty: Health and Life Sciences

School/department: School of Applied Social Sciences

Research group(s): Centre for Reproduction Research

Address: The Gateway, Leicester, LE1 9BH

T: +44 (0)116 207 8306

E: jessica.turner@dmu.ac.uk

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Personal profile

Jessica Turner is a Research Assistant within the School of Applied Social Sciences and the Centre for Reproduction Research. Jess has a MRes in Applied Health Research and a BA in Sociology. Her research interests include women's health and reproduction and chronic illness.

Her role as research assistant at the Centre for Reproduction Research includes data collection and analysis, bid-writing, organising conferences and seminars and supporting the work of the Centre for Reproduction Research.

Jess has also been involved in carryng out an ethnographic study as part of an NIHR funded research project with colleagues from the Leicester Diabetes Centre and The University of Leicester, led by Professor Melanie Davies.

Prior to her role at 呻吟之王, Jess was employed as a Research and Policy Officer at Healthwatch Derby, carrying out qualitative and quantitative research involving patients and the public around health and social care services in the city of Derby.

Research group affiliations

Centre for Reproduction Research

Publications and outputs

dc.title: Using Normalisation Process Theory (NPT) to develop an intervention to improve referral and uptake rates for self-management education for patients with type 2 diabetes in UK primary care dc.contributor.author: Turner, Jessica; Martin, Graham; Hudson, Nicky; Shaw, Liz; Huddlestone, Lisa; Weis, Christina; Northern, Alison; Schreder, Sally; Davies, Melanie; Eborall, Helen dc.description.abstract: Background Referral and uptake rates of structured self-management education (SSME) for Type 2 diabetes (T2DM) in the UK are variable and relatively low. Research has documented contributing factors at patient, practitioner and organisational levels. We report a project to develop an intervention to improve referral to and uptake of SSME, involving an integrative synthesis of existing datasets and stakeholder consultation and using Normalisation Process Theory (NPT) as a flexible framework to inform the development process. Methods A three-phase mixed-methods development process involved: (1) synthesis of existing evidence; (2) stakeholder consultation; and (3) intervention design. The first phase included a secondary analysis of data from existing studies of T2DM SSME programmes and a systematic review of the literature on application of NPT in primary care. Influences on referral and uptake of diabetes SSME were identified, along with insights into implementation processes, using NPT constructs to inform analysis. This gave rise to desirable attributes for an intervention to improve uptake of SSME. The second phase involved engaging with stakeholders to prioritise and then rank these attributes, and develop a list of associated resources needed for delivery. The third phase addressed intervention design. It involved translating the ranked attributes into essential components of a complex intervention, and then further refinement of components and associated resources. Results In phase 1, synthesised analysis of 64 transcripts and 23 articles generated a longlist of 46 attributes of an embedded SSME, mapped into four overarching domains: valued, integrated, permeable and effectively delivered. Stakeholder engagement in phase 2 progressed this to a priority ranked list of 11. In phase 3, four essential components attending to the prioritised attributes and forming the basis of the intervention were identified: 1) a clear marketing strategy for SSME; 2) a user friendly and effective referral pathway; 3) new/amended professional roles; and 4) a toolkit of resources. Conclusions NPT provides a flexible framework for synthesising evidence for the purpose of developing a complex intervention designed to increase and reduce variation in uptake to SSME programmes in primary care settings. dc.description: open access article
dc.title: Increasing uptake of structured self-management education programmes for type 2 diabetes in a primary care setting: a feasibility study dc.contributor.author: Davies, Melanie, J.; Kristunas, Caroline, A.; Huddlestone, Lisa; Abualbishr, Alshreef; Bodicoat, Danielle; Dixon, Simon; Eborall, Helen; Glab, Agnieszka; Hudson, Nicky; Khunti, Kamlesh; Martin, Graham; Patterson, Mike; Pritchard, Rebecca; Schreder, Sally; Stribling, Bernie; Turner, Jessica; Gray, Laura, J. dc.description.abstract: Background Structured self-management education (SSME) for people with type 2 diabetes mellitus (T2DM) improves biomedical and psychological outcomes, whilst being cost-effective. Yet uptake in the UK remains low. An 鈥楨mbedding Package鈥� addressing barriers and enablers to uptake at patient, health care professional and organisational levels has been developed. The aim of this study was to test the feasibility of conducting a subsequent randomised controlled trial (RCT) to evaluate the Embedding Package in primary care, using a mixed methods approach. Methods A concurrent mixed methods approach was adopted. Six general practices in the UK were recruited and received the intervention (the Embedding Package). Pseudonymised demographic, biomedical and SSME data were extracted from primary care medical records for patients recorded as having a diagnosis of T2DM. Descriptive statistics assessed quantitative data completeness and accuracy. Quantitative data were supplemented and validated by a patient questionnaire, for which two recruitment methods were trialled. Where consent was given, the questionnaire and primary care data were linked and compared. The cost of the intervention was estimated. An integrated qualitative study comprising ethnography and stakeholder and patient interviews explored the process of implementation, sustainability of change and 鈥榝it鈥� of the intervention. Qualitative data were analysed using a thematic framework guided by the Normalisation Process Theory (NPT). Results Primary care data were extracted for 2877 patients. The primary outcome for the RCT, HbA1c, was over 90% complete. Questionnaires were received from 423 (14.7%) participants, with postal invitations yielding more participants than general practitioner (GP) prompts. Ninety-one percent of questionnaire participants consented to data linkage. The mean cost per patient for the Embedding Package was 拢8.94, over a median follow-up of 162.5鈥塪ays. Removing the development cost, this reduces to 拢5.47 per patient. Adoption of ethnographic and interview methods in the collection of data was appropriate, and the use of NPT, whilst challenging, enhanced the understanding of the implementation process. The need to delay the collection of patient interview data to enable the intervention to inform patient care was highlighted. Conclusions It is feasible to collect data with reasonable completeness and accuracy for the subsequent RCT, although refinement to improve the quality of the data collected will be undertaken. Based on resource use data collected, it was feasible to produce cost estimates for each individual component of the Embedding Package. The methods chosen to generate, collect and analyse qualitative data were satisfactory, keeping participant burden low and providing insight into potential refinements of the Embedding Package and customisation of the methods for the RCT. dc.description: open access article
dc.title: Application of normalisation process theory in understanding implementation processes in primary care settings in the UK: a systematic review dc.contributor.author: Huddlestone, Lisa; Turner, Jessica; Eborall, Helen; Hudson, Nicky; Davies, Melanie J; Martin, Graham dc.description.abstract: Abstract Background: Normalisation Process Theory (NPT) provides a framework to understand how interventions are implemented, embedded, and integrated in healthcare settings. Previous reviews of published literature have examined the application of NPT across international healthcare and reports its benefits. However, given the distinctive clinical function, organisational arrangements and the increasing management of people with a wide variety of conditions in primary care settings in the United Kingdom, it is important to understand how and why authors utilise and reflect on NPT in such settings to inform and evaluate implementation processes. Methods: A systematic review of peer-reviewed literature using NPT in primary care settings in the United Kingdom (UK) was conducted. Eight electronic databases were searched using replicable methods to identify articles published between January 2012 and April 2018. Data were analysed using a framework approach. Results: Thirty-one articles met the inclusion criteria. Researchers utilised NPT to explore the implementation of interventions, targeting a wide range of health services and conditions, within primary care settings in the UK. NPT was mostly applied qualitatively; however, a small number of researchers have moved towards mixed and quantitative methods. Some variation was observed in the use of NPT constructs and sub-constructs, and whether and how researchers undertook modification to make them more relevant to the implementation process and multiple stakeholder perspectives. Conclusion: NPT provides a flexible framework for the development and evaluation of complex healthcare interventions in UK primary care settings. This review updates the literature on NPT use and indicates that its application is well suited to these environments, particularly in supporting patients with long-term conditions and co-morbidities. We recommend future research explores the receipt of interventions by multiple stakeholders and suggest that authors reflect on justifications for using NPT in their reporting. Keywords: Primary care, General practice, Normalisation process theory, NPT, United Kingdom, Complex interventions dc.description: open access article
dc.title: The impact of an intervention to increase uptake to structured self-management education for people with type 2 diabetes mellitus in primary care (the embedding package), compared to usual care, on glycaemic control: study protocol for a mixed methods study incorporating a wait-list cluster randomised controlled trial dc.contributor.author: Davies, Melanie J; Kristunas, Caroline A; Alshreef, Abualbishr; Dixon, Simon; Eborall, Helen; Glab, Agnieszka; Huddlestone, Lisa; Hudson, Nicky; Khunti, Kamlesh; Martin, Graham; Northern, Alison; Patterson, Mike; Pritchard, Rebecca; Schreder, Sally; Stribling, Bernie; Turner, Jessica; Gray, Laura J dc.description.abstract: Abstract Background Approximately 425 million people globally have diabetes, with ~鈥�90% of these having Type 2 Diabetes Mellitus (T2DM). This is a condition that leads to a poor quality of life and increased risk of serious health complications. Structured self-management education (SSME) has been shown to be effective in improving glycaemic control and patient related outcome measures and to be cost-effective. However, despite the demonstrated benefits, attendance at SSME remains low. An intervention has been developed to embed SSME called the 鈥楨mbedding Package鈥�. The intervention aims to address barriers and enhance enablers to uptake of SSME at patient, healthcare professional and organisational levels. It comprises a marketing strategy, user friendly and effective referral pathways, new roles to champion SSME and a toolkit of resources. Methods A mixed methods study incorporating a wait-list cluster randomised trial and ethnographic study, including 66 UK general practices, will be conducted with two intervention start times (at 0 and 9鈥塵onths), each followed by an active delivery phase. At 18鈥塵onths, the intervention will cease to be actively delivered and a 12鈥塵onth observational follow-up phase will begin. The intervention, the Embedding Package, aims to increase SSME uptake and subsequent improvements in health outcomes, through a clear marketing strategy, user friendly and effective referral pathways, a local clinical champion and an 鈥楨mbedder鈥� and a toolkit of resources for patients, healthcare professionals and other key stakeholders. The primary aim is, through increasing uptake to and attendance at SSME, to reduce HbA1c in people with T2DM compared with usual care. Secondary objectives include: assessing whether there is an increase in referral to and uptake of SSME and improvements in biomedical and psychosocial outcomes; an assessment of the sustainability of the Embedding Package; contextualising the process of implementation, sustainability of change and the 鈥榝it鈥� of the Embedding Package; and an assessment of the cost-effectiveness of the Embedding Package. Discussion This study will assess the effectiveness, cost-effectiveness and sustainability of the Embedding Package, an intervention which aims to improve biomedical and psychosocial outcomes of people with T2DM, through increased referral to and uptake of SSME. Trial registration International Standard Randomised Controlled Trials Number ISRCTN23474120. Assigned 05/04/2018. The study was prospectively registered. On submission of this manuscript practice recruitment is complete, participant recruitment is ongoing and expected to be completed by the end of 2019. dc.description: open access article

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Key research outputs

Turner, J. 2017. Book Review: Conceiving Masculinitiy: Male Infertility, Medicine and Identity by Liberty Walther Barnes, Men and Masculinities, 20, (1), pp. 126 - 128.

Research interests/expertise

Qualitative research
Digital sociology
Sociology of health and illness
Women's health and reproduction
Chronic illness

Qualifications

MRes in Applied Health Research (Dissertation: 'Reproducing and resisting dominant discourses of pregnancy and early motherhood on social media')

BA (Hons) Sociology

Membership of professional associations and societies

Member of the organising committee for the BSA East Midlands Medical Sociology Group.

Conference attendance

Selected Conferences

Turner, J. 'Ethical mothering on social media'. BSA Human Reproduction Study Group Annual Conference. University College London, London, 22nd June 2023.

Turner, J. 'Reproducing and resisting the dominant discourses of pregnancy and early motherhood on social media – a thematic analysis'. Society of Reproductive and Infant Psychology Annual Conference (Online), 8th-10th September, 2021.

Turner, J. 'Reproducing and resisting dominant discourses of pregnancy and early motherhood on social media'. Centre for Reproduction Research Seminar Series. 呻吟之王, Leicester, 23rd March, 2021.

Turner, J. Poster Presentation: 'Pregnancy, Social Media and Identity'. Pregnancy, Maternity, and the Self - Interdisciplinary Conference. University of Southampton, Southampton, 21st June 2019.

Turner, J. 'Pregnancy, Social Media and Identity'. BSA Human Reproduction Study Group Annual Conference. 呻吟之王, Leicester, 12th June 2019.

Eborall H, Hudson N, Martin G, Shaw E, Turner J. ‘Embedding structured education for self-management of Type 2 diabetes in primary care - an NPT informed analysis’, paper presented at the BSA Medical Sociology Conference, University of York, 13-15 September 2017.

Turner, J. 'Normalisation Process Theory: A useful framework to inform the development, implementation and evaluation of complex interventions?' Health Policy Research Unit. 呻吟之王, Leicester, UK, 8th December 2016.

Turner, J and Hudson, N. "I was secretly hoping to have twins because I knew it was my one chance": Negotiating risks around multiple births in cross border reproductive care'. BSA Human Reproduction Study Group Annual Conference. 呻吟之王, Leicester, 10th June 2016.

Turner, J. and Hudson, N. "They don't make the moral decisions for you": decision-making about embryo transfer and perceptions of multiple pregnancies amongst recipients of overseas fertility treatment'. Reproduction Research Group Seminar Series. 呻吟之王, Leicester, 6th April 2016.

Externally funded research grants information

Increasing uptake of effective self-management education programmes for type 2 diabetes in multi-ethnic primary care settings. (Research Assistant to ethnographic component). NIHR £2m. Programme Grants for Applied Research. PI: Professor Melanie Davies, University Hospitals of Leicester. Nov 2015-Oct 2020.

Internally funded research project information

'EDNA’ - Egg donation in the UK, Spain and Belgium: an interdisciplinary study. Building Impact. £3861. Higher Education Investment Fund, 呻吟之王. Hudson (PI), Culley, Herbrand, Weis, Loyal, Fearon, Turner. 2020.

Professional esteem indicators

Editor for The Centre for Reproduction Research Blog, 呻吟之王

Open Access Champion for The Centre for Reproduction Research and the School of Applied Social Sciences, 呻吟之王.