Teaching and Research Fellow in Public Health
areas of expertise
Christian Blickem is a Teaching and Research Fellow in Public Health who contributes to undergraduate and postgraduate teaching.
Christian’s research interests have focussed on health inequalities and broadening the scope of self-management support to meet the clinical and social needs for people with long-term health problems who are socially disadvantaged. One of the key aims of Christian’s work has been to explore ways of utilising local networks to improve the health and wellbeing of people who live in challenging circumstances.
Christian was recently the Chief Investigator of the BRIGHT trial which evaluated a self-care intervention to improve social networks of support. This intervention (PLANS) significantly improved blood pressure control and health-related quality of life in people with chronic kidney disease.
Christian has expertise in self-management of chronic conditions, healthcare interventions and qualitative research methods. Christian has authored a number of articles published in international journals.
- How effective, accessible and acceptable are self-management interventions for men with long-term conditions? Amount of award: £151,968.80 Awarding body: NIHR Health Services and Delivery Research Programme Date of award: December 2012 Role: Co-investigator.
- A randomised controlled trial of the clinical and cost-effectiveness of the BRIGHT (Bringing Information & Guided Help Together) intervention for the management stage 3 chronic kidney disease in primary care. Amount of award: £118,5000.00 Awarding body: NIHR Collaboration for Leadership in Applied Health Research Date of award: 01/01/2012 Role: Principal investigator.
- Feasibility and acceptability of a patient-led assessment tool linking primary care to health-relevant community resources. Amount of award: £130,371 Awarding body: NIHR Collaboration for Leadership in Applied Health Research Date of award: 01/03/2012 Role: Principal investigator
- Voluntary Organisations Community Groups And Local Networks of Support (VOCALS): A qualitative study of community networks of health. Amount of award: £234,545 Awarding body: NIHR Collaboration for Leadership in Applied Health Research Date of award: 01/05/2012 Role: Co-investigator.
Dr Christian Blickem's Papers
A scoping review to understand the effectiveness of linking schemes from healthcare providers to community resources to improve the health and well-being of people with long-term conditions
Rahena Mossabir, Rebecca Morris, Anne Kennedy, Dr Christian Blickem, Anne Rogers
Health & Social Care in the Community Volume 23, Issue 5, pages 467–484, September, 2015.
Abstract: The prevalence of people living with long-term conditions is increasing, accompanied by an increased expectation that patients will become more involved in self-management. Long-term conditions are associated with increased social isolation and poor physical and mental health. But there remains a gap in health provision between providing medical treatment and effectively addressing psychosocial well-being. One potential way of addressing this gap is by utilising social interventions which link patients from health services to community-based sources of support. However, the mechanisms involved in the delivery of interventions providing that link and their effectiveness remain unclear. This review adopted the methodological framework for conducting scoping studies, searching for both academic and grey literature on social interventions which link people from healthcare settings to a range of community and voluntary sector organisations. A literature search between May and June 2013, involving five electronic databases, hand searching of two journals and the use of Google search engine, identified seven studies relevant to the review question. In terms of key characteristics and mechanisms of the interventions, mental health conditions and social isolation were the most common reasons for referral to the interventions, and referrals were usually made through general practices. Almost all the interventions were facilitator-led, whereby the facilitator worked to identify and link participants to appropriate community-based resources. In regard to health and social outcomes and their cost-effectiveness, studies reported improvement to participants' psychological and social well-being as well as their decreased use of health services, although there were limited measures of participants' physical health outcomes. Interventions for linking patients from healthcare setting to community-based resources target and address psychosocial needs of participants. The review identified involvement of health professionals in aiding the referral of patients to the intervention and the role of the intervention facilitators as key components of the interventions.
A systematic review and metaethnography to identify how effective, cost-effective, accessible and acceptable self-management support interventions are for men with long-term conditions (SELF-MAN)
Paul Galdas, Zoe Darwin, Jennifer Fell, Lisa Kidd, Peter Bower, Dr Christian Blickem, Kerri McPherson, Kate Hunt, Simon Gilbody, Gerry Richardson
Health Services and Delivery Research Volume: 3 Issue: 34, 2015.
Abstract: Background: Self-management support interventions can improve health outcomes, but their impact is limited by the numbers of patients able or willing to access them. Men’s attendance at, and engagement with, self-management support appears suboptimal despite their increased risk of developing serious and disabling long-term conditions (LTCs). Objectives: To assess the effectiveness, cost-effectiveness, accessibility and acceptability of self-management support interventions in men with LTCs. Methods: A quantitative systematic review with meta-analysis and a qualitative review using a metaethnography approach. The findings of the two reviews were integrated in parallel synthesis. Data sources: In the quantitative review, the Cochrane Database of Systematic Reviews was searched to identify published reviews of self-management support interventions. Relevant reviews were screened to identify randomised controlled trials (RCTs) of self-management support interventions conducted in men alone, or which analysed the effects of interventions by gender. In the qualitative review, the databases Cumulative Index to Nursing and Allied Health Literature, EMBASE, Medical Literature Analysis and Retrieval System Online, PsycINFO and Social Science Citation Index (July 2013) were searched from inception to July 2013. Review methods: In the quantitative review, data on relevant outcomes, patient populations, intervention type and study quality were extracted. Quality appraisal was conducted independently by two reviewers using the Cochrane risk of bias tool. Meta-analysis was conducted to compare the effects of interventions in male, female and mixed-sex groups. In the metaethnography, study details, participant quotes (first-order constructs) and study authors’ themes/concepts (second-order constructs) were extracted. Quality appraisal was conducted independently by two reviewers using the Critical Appraisal Skills Programme tool. Data were synthesised according to a metaethnography approach. Third-order interpretations/constructs were derived from the extracted data and integrated to generate a ‘line-of-argument’ synthesis. Results: Forty RCTs of self-management support interventions in male-only samples, and 20 RCTs where an analysis by gender was reported, were included in the quantitative review. Meta-analysis suggested that interventions including physical activity, education and peer support have a positive impact on quality of life in men, and that men may derive more benefit than women from them, but there is currently insufficient evidence to draw definitive conclusions. Thirty-eight qualitative studies relevant to men’s experiences of, and perceptions of, self-management support were included in the qualitative review. The metaethnography identified four concepts: (1) need for purpose; (2) trusted environments; (3) value of peers; and (4) becoming an expert. Findings indicated that men may feel less comfortable engaging in support if it is perceived to be incongruous with valued aspects of masculine identities. Men may find support interventions more attractive when they have a clear purpose, are action-oriented and offer practical strategies that can be integrated into daily life. Support delivered in an environment that offers a sense of shared understanding can be particularly appealing to some men. Conclusions: Health professionals and those involved in designing interventions may wish to consider whether or not certain components (e.g. physical activity, education, peer support) are particularly effective in men, although more research is needed to fully determine and explore this. Interventions are most likely to be accessible and acceptable to men when working with, not against, valued aspects of masculine identities.
Connecting local support: A qualitative study exploring the role of voluntary organisations in long-term condition management
Rebecca Morris, Sue Kirk, Anne Kennedy, Ivaylo Vassilev, Amy Mathieson, Mark Jeffries, Dr Christian Blickem, Helen Brooks, Caroline Sanders, Anne Rogers
Chronic Illness, 11(2), 140-155, 2015.
Abstract: Objectives: To examine the role of community groups to support people living with long-term conditions and the organisational factors that influence this role. Methods: Thirty-three semi-structured interviews were conducted with voluntary group organisers purposefully sampled in Greater Manchester from a local database of community groups. Interviews explored the organisations role in supporting people living with a long-term condition, their social networks and the origins of the groups. Results: Respondents’ construed their role in supporting individual capacity for management either explicitly (e.g. providing exercise) or implicitly (e.g. emotional support). This role was influenced by a combination of group ideology, funding and social networks. Analysis highlights the role of the non-clinical setting, the social support provided within the group, as well as organisational processes that influenced their capacity to support people living with long-term conditions. Conclusion: By examining the organisation of voluntary groups, this study highlights the way in which they may support or constrain access to an extended range of support for people with long-term conditions. This paper has implications for commissioning of services by the health service from the third sector because of the differing ideological perspectives and limited operational capacity.