The Well London program - a cluster randomized trial of community engagement for improving health behaviors and mental wellbeing: baseline survey results

Background The Well London programme used community engagement, complemented by changes to the physical and social neighbourhood environment, to improve physical activity levels, healthy eating and mental wellbeing in the most deprived communities in London. The effectiveness of Well London is being evaluated in a pair-matched cluster randomised trial (CRT). The baseline survey data are reported here. Methods The CRT involved 20 matched pairs of intervention and control communities (defined as UK census lower super output areas; ranked in the 11% most deprived LSOAs in London by Index of Multiple Deprivation) across 20 London boroughs. The primary trial outcomes, sociodemographic information and environmental neighbourhood characteristics were assessed in three quantitative components within the Well London CRT at baseline: a cross-sectional, interviewer-administered adult household survey; a self-completed, school-based adolescent questionnaire; a fieldworker completed neighbourhood environmental audit. Baseline data collection occurred in 2008. Physical activity, healthy eating and mental wellbeing were assessed using standardised, validated questionnaire tools. Multiple imputation was used to account for missing data in the outcomes and other variables in the adult and adolescent surveys. Results There were 4107 adults and 1214 adolescent respondents in the baseline surveys. The intervention and control areas were broadly comparable with respect to the primary outcomes and key sociodemographic characteristics. The environmental characteristics of the intervention and control neighbourhoods were broadly similar. There was greater between cluster variation in the primary outcomes in the adult population compared to the adolescent population. Levels of healthy eating, smoking and self-reported anxiety/depression were similar in the Well London population and the national Health Survey for England. Levels of physical activity were higher in the Well London population but this is likely to be due to the different measurement tools used in the two surveys. Conclusions Randomisation of social interventions such as Well London is acceptable and feasible and in this study the intervention and control arms are well balanced with respect to the primary outcomes and key sociodemographic characteristics. The matched design has improved the statistical efficiency of the study amongst adults but less so amongst adolescents. Follow-up data collection will be completed 2012.

The militarisation of English schools: Troops to Teaching and the implications for Initial Teacher Education and race equality

This article considers the implications of the Troops to Teaching (TtT) programme, to be introduced in England in autumn 2013, for Initial Teacher Education (ITE) and race equality. TtT will fast-track ex-armed service members to teach in schools, without necessarily the requirement of a university degree. Employing theories of white supremacy, and Althusser’s (1971) concept of Ideological and Repressive State Apparatus, I argue that this initiative both stems from, and contributes to, a system of social privilege and oppression in education. Despite appearing to be aimed at all young people, the planned TtT initiative is actually aimed at poor and racially subordinated youth. This is likely to further entrench polarisation in a system which already provides two tier educational provision: TtT will be a programme for the inner-city disadvantaged, whilst wealthier, whiter schools will mostly continue to get highly qualified teachers. Moreover, TtT contributes to a wider devaluing of current ITE; ITE itself is rendered virtually irrelevant, as it seems TtT teachers will not be subject specialists, rather will be expected to provide military-style discipline, the skills for which they will be expected to bring with them. More sinister, I argue that TtT is part of the wider militarisation of education. This military-industrial-education complex seeks to contain and police young people who are marginalised along lines of race and class, and contributes to a wider move to increase ideological support for foreign wars - both aims ultimately in the service of neoliberal objectives which will feed social inequalities.

Teacher education in the United Kingdom post devolution: convergences and divergences

This paper examines the roles of research in teacher education across the four nations of the United Kingdom. Both devolution and on-going reviews of teacher education are facilitating a greater degree of cross-national divergence. England is becoming a distinct outlier, in which the locus for teacher education is moving increasingly away from Higher Education Institutions and towards an ever-growing number of school-based providers. While the idea of teaching as a research-based profession is increasingly evident in Scotland, Northern Ireland and Wales, it seems that England, at least in respect of the political rhetoric, recent reforms and explicit definitions, is fixed on a contrastingly divergent trajectory towards the idea of teaching as a craft-based occupation, with a concomitant emphasis on a (re)turn to the practical. It is recommended that research is urgently needed to plot these divergences and to examine their consequences for teacher education, educational research and professionalism.

Conspicuous by their abstinence: the limited engagement of heroin users in English and Welsh Drug Recovery Wings

Background In recent years, an abstinence-focused, ‘recovery’ agenda has emerged in UK drug policy, largely in response to the perception that many opioid users had been ‘parked indefinitely’ on Opioid Substitution Therapy (OST). The introduction of ten pilot ‘Drug Recovery Wings’ (DRWs) in 2011 represents the application of this recovery agenda to prisons. This paper describes the DRWs’ operational models, the place of opiate dependent prisoners within them, and the challenges of delivering ‘recovery’ in prison. Methods In 2013, the implementation and operational models of all ten pilot DRWs were rapidly assessed. Up to three days were spent in each DRW, undertaking semi-structured interviews with a sample of 94 DRW staff and 102 DRW residents. Interviews were fully transcribed, and coded using grounded theory. Findings from the nine adult prisons are presented here. Results Four types of DRW were identified, distinguished by their size and selection criteria. Strikingly, no mid- or large-sized units regularly supported OST recipients through detoxification. Type A were large units whose residents were mostly on OST with long criminal records and few social or personal resources. Detoxification was rare, and medication reduction slow. Type B's mid-sized DRW was developed as a psychosocial support service for OST clients seeking detoxification. However, staff struggled to find such prisoners, and detoxification again proved rare. Type C DRWs focused on abstinence from all drugs, including OST. Though OST clients were not intentionally excluded, very few applied to these wings. Only Type D DRWs, offering intensive treatment on very small wings, regularly recruited OST recipients into abstinence-focused interventions. Conclusion Prison units wishing to support OST recipients in making greater progress towards abstinence may need to be small, intensive and take a stepped approach based on preparatory motivational work and extensive preparation for release. However, concerns about post-release deaths will remain.