ReCITE, funded by the Arts and Humanities Research Council and led by Liverpool School of Tropical Medicine, seeks to use the power of storytelling to address fear and misinformation, and build trust in relation to health promotion and prevention measures within local communities.
At the heart of the ReCITE intervention are Community Innovation Teams, who will use local data and community insights to identify community health needs and develop local solutions using a creative health approach.
In September 2024, we announced the outcome of a funding call which resulted in collaborations with seven Community Innovation Teams (CITs) across Liverpool, Sefton and Knowsley. Since the announcement, a further two CITs have successfully applied for funding under ReCITE:
CIT 8 (Comics Youth CIC) will tackle the pressing issue of misdirected referrals to Sefton Child and Adolescent Mental Health Services, with a specific focus on neurodevelopmental conditions like autism spectrum disorder and ADHD.
CIT 9 (One Knowsley) will deploy community-based creative approaches to improve childhood diet and nutrition in areas with high rates of childhood obesity.
A grant awarded to LSTM from the UKRI Tackling Infections through Novel Technologies programme brings the total number of ReCITE CITs to 10. CIT 10 (Primary Care 24) aims to improve asylum seeker and refugee knowledge of proper antibiotic use and facilitate access to care through community-led and contextually relevant health information and promotion in Liverpool.
In this article we provide a project update from each of our CITs, who have been busy getting to grips with their data:
Cancer Screening
CIT 1 (One Knowsley) and CIT 2 (Anfield and Everton PCN (AEPCN) with lead community partner Breckfield and North Everton Neighbourhood Council (BNENC)) are both aiming to reduce low uptake of the telephone lung health check delivered by the NHS Lung Cancer Screening Programme. During the pilot phase of the programme (2021-2023), 56% of those invited (2,961 people) did not attend their telephone appointment in Anfield and Everton, and 65% (12,225 people) did not attend in Knowsley. Given the impact the programme is having on early detection of stage 1 cancer, improving uptake of the initial telephone appointment is predicted to have a significant effect on cancer related health outcomes. Over the coming months the CITs will gather insights on reasons for the low uptake of the telephone appointment, exploring knowledge, attitudes, and data quality factors.
Programme leads from the Lung Cancer Screening Programme have participated in several meetings with the CITs and are actively supporting their projects. The fact that people in the most deprived areas of Anfield, Everton and Knowsley are dying younger has not gone unheard and highlights a need to reconsider the eligibility criteria for the screening programme (ever smokers aged 55-74) in areas with high levels of deprivation. ReCITE’s Advocacy Networks will play a key role in making sure this is heard by the right people.
Immunisation
CIT 3 (Explore Partnership CIC) aims to improve MMR immunisation rates for children aged 2 to 11 years living in Knowsley. Collaborating with the South and Central Knowsley Primary Care Network (PCN) and Knowsley Public Health team, they have identified six primary healthcare facilities with relatively low uptake rates. From this information, the CIT have decided to gather insights from nurseries and primary schools that are geographically close to the targeted healthcare facilities.
In collaboration with Silly Fish Learning, a creative education resource for children aged 3-12, CIT 3 will deliver a series of creative workshops with primary school children to explore their perceptions and understanding of different health topics including immunisation. Running in parallel to this will be a survey aimed at teaching staff to gather insights on opportunities and challenges for delivering health promotion in schools.
CIT 4 (Liverpool Lighthouse (LLH)) is working in partnership with Liverpool Women’s NHS Foundation Trust, Brownlow GP surgeries, and Public Health Liverpool. Their aim is to increase uptake of the whooping cough immunisation (Pertussis immunisation) among pregnant asylum seekers, refugees, and women who need language interpreters, where uptake is around 35%, far below the national average.
The CIT includes five ethnically diverse "Creative Influencers" with personal experience as mothers in the asylum system. Through their advocacy and storytelling, they provide unique insights and advice on the best ways to reach their target population. Surveys and focus groups are underway to understand views on immunisation barriers and opportunities from midwives, other health professionals, and pregnant women.
Mental Health and Social Wellbeing
CIT 5 (The Rotunda) is addressing suicide prevention. Kirkdale and its surrounding wards are among the most deprived areas in Liverpool, with some of the highest suicide rates in the city.
The Rotunda CIT recognises that tackling such a complex and “wicked” problem requires creativity. Following a successful launch event to celebrate the ReCITE funding and support , the team has hit the ground running.
The CIT brings together representatives from healthcare, community support organisations, social housing, and the local authority. During the first official CIT meeting, there was lively discussion about the challenges of using data to measure impact around suicide risk prevention, and the potential of creative approaches to gather deep and meaningful insights. Following the meeting, the CIT has scheduled a data drilldown meeting with support from the Safer Suicide Team to refine their target population and identify appropriate change measures.
CIT 6 (The Liverpool University Hospitals NHS Foundation Trust (LUHFT)) is focusing on the interface between communities and hospitals. The team aims to find ways to better support people who frequently attend the emergency department (ED) at Aintree Hospital. Current data highlights that a quarter of high intensity users (patients with 5 ED attendances or more in a year) have no abnormality detected and just over 14% leave without being seen. These data suggest that for many of these patients, the emergency department does not offer a solution to their problems, as most of their needs are of a non-medical nature.
The CIT have been drilling down further into their data on high intensity use, looking at age, sex, ethnicity, postcode, time of attendance and diagnosis, to refine their target population and CIT membership. A Writer in Residence will join the CIT to support staff to better understand the issues that frequent attenders face and co-develop alternative pathways and solutions to support this group.
CIT 7 (Sefton Council for Voluntary Service (SCVS)) have brought together a strong partnership of professionals working across health, community support organisations, local government and arts to encourage early diagnosis of dementia and raise awareness, initially within St Oswald Ward which has been described as a ‘left behind neighbourhood’. The team are currently reviewing their practice data to refine their target population and CIT membership. They are also collating existing relevant national and local reports, studies and tools around dementia awareness (knowledge, attitudes, and practice) and early diagnosis and treatment. The CIT aims to co-produce a community narrative that supports increased diagnosis of dementia and strengthens messaging and understanding on the support available post diagnosis, aligning with the recently agreed Dementia Friendly Liverpool City Region Pledge.
Project updates from all 10 ReCITE CITs will be communicated in the new year.