A major healthcare reform agenda in Ireland is underway which underpins the establishment of a series of National Clinical Programmes (NCPs), which aim to take an evidence based approach to improve quality, access and value. The current study aimed to determine the enablers and barriers to implementation of the NCPs. A qualitative methodology advocated by the Medical Research Council (MRC) framework on conducting process evaluations of complex interventions guided this research. Purposive sampling techniques were used to recruit participants from seven NCPs across both acute and chronic healthcare domains, comprised of orthopaedics, rheumatology, elective surgery, emergency medicine, paediatrics, diabetes and chronic obstructive pulmonary disease. A total of 33 participants were interviewed using a semi-structured interview guide. Participants included current and previous Clinical Leads, Programme Managers, Health Service Executive management, hospital Chief Executive Officers, representatives of General Practice, and a Nursing and a Patient representative. Thematic analyses was conducted. A range of factors of different combinations and co-occurrence were highlighted across a total of six themes, including (i) positive leadership, governance and clinical networks of the NCPs, (ii) the political and social context in which the NCPs operate, (iii) constraints on resources, (iv) a passive attitudinal resistance to change borne from poor consultation and communication, (v) lack of data and information technology, (vi) forces outside of the NCPs such as the general practitioner contract thwarting change of the model of care. The MRC framework proved a useful tool to conduct this process evaluation. Results from this research provide real world experiences and insight from the people charged with implementing large-scale health system improvement initiatives. The findings highlight the need for measured responses that acknowledge both direct and non-direct challenges and opportunities for successful change. Combined, it is recommended that these elements be considered in the planning and implementation of large-scale initiatives across healthcare delivery systems, both in Ireland and internationally.

International border controls were among the earliest and most effective of measures to constrain transmission of COVID-19. However, such measures are complex when established borders are open yet politically contested, as for the border that divides the Republic of Ireland (ROI) from Northern Ireland (NI). Understanding how this border affected the everyday lives of both populations during the pandemic is important for informing the continued development of effective responses to COVID-19 and future health crises. This multi-methods study aimed to explore public perspectives on how the ROI-NI border affected experiences of and responses to the 'first wave' of the pandemic. The study collated data from focus groups (n = 8), news articles (n = 967), and Twitter posts (n = 356) on the island of Ireland, which mentioned the ROI-NI border in relation to COVID-19. Thematic analysis was used to explore the range of perspectives on the role played by the border during the early months of the pandemic. Analysis identified three themes: Cross-Border Interdependencies illustrated the complexity and challenges of living near the border; Interpretations of Cross-Border Policy Disparities showed that lay publics perceived NI and ROI policy approaches as discordant and politicised; and Responses to Cross-Border Policy Disparities revealed alternating calls to either strengthen border controls, or pursue a unified all-island approach. Results reveal clear public appetite for greater synchronisation of cross-border pandemic responses, emphasise the specific vulnerability of communities living near the border, and highlight the risk of long-term socio-political repercussions of border management decisions taken during the pandemic. Findings will inform implementation of pandemic responses and public health policies in jurisdictions that share a porous land border.

To assess the acceptability, appropriateness, and feasibility of an active break designed to disrupt prolonged sitting in university students. Participants: Students attending lectures in Trinity College Dublin, Ireland. Methods: Participants took part in an active break, which consisted of following a short exercise video lasting ∼4 min. They then completed a validated questionnaire consisting of 12 statements with two open-ended questions capturing likes/dislikes. Results: Overall 106 (response rate 96%) predominately female (83%, n = 87), health sciences students (91%, n = 96) participated. Percentage agreement ranged from 93.4% (n = 99) to 96.2% (n = 102) for acceptability, 84.9% (n = 90) to 93.4% (n = 99) for appropriateness, and 80.2% (n = 85) to 96.2% (n = 102) for feasibility. Space constraints and warm temperatures impacted negatively. Conclusion: An active break delivered during lectures is an acceptable and feasible intervention to disrupt sitting in students. Further investigation using a broader representation of the university population is needed prior to implementation.

Sedentary behaviour (SB) has been linked with detrimental effects on morbidity and mortality. This study aims to identify the individual, social and environmental correlates of total sedentary behaviour and the contexts in which sitting time accumulates in an Irish adult cohort. Cross-sectional analysis of data from 7328 adults of the nationally representative Healthy Ireland Survey. Ordinal regression analyses were used to examine participants’ socio-demographic characteristics, lifestyle factors, physical and mental health status, perceived neighbourhood environmental factors, and their association with total daily sitting times and sitting times across the domains of occupation, leisure screen-time and transportation/leisure. Overall median of sitting time per day was 450 min (7.5 h). Male gender, and living in an urban location were associated with increased total-, occupational, and screen-time sitting (p < 0.001). Younger age was associated with increased total and occupational sitting times (p < 0.001), while being older was associated with increased screen-time and transportation/leisure sitting (p < 0.001). Insufficient physical activity levels were associated with increased sitting across all domains (p < 0.001). Higher socio-economic classification and education levels were associated with increased total, occupational, and transportation/leisure SB (p < 0.001), while lower socio-economic classification and education levels were associated with increased screen-time sitting (p < 0.001). Alcohol consumption was associated with screen-time and transportation/leisure sitting (p < 0.01), while smoking was associated with increased screen-time sitting (p < 0.001). Being married was associated with less screen-time (p < 0.001) and transportation/leisure sitting (p = 0.02), while those with a caring role had less total (p = 0.04) and screen-time sitting (p = 0.01). A significant negative association between neighbourhood attributes and total (p = 0.04), and transportation/leisure sitting times (p < 0.001) was found. The results of this study provide a starting position for development of targeted interventions aimed at the most sedentary, such as males with sedentary occupations in higher socio-economic groups and education levels, those with insufficient levels of physical activity and who live in an urban location.

COVID-19 is arguably the most critical science communication challenge of a generation, yet comes in the wake of a purported populist turn against scientific expertise in western societies. This study advances understanding of science–society relations during the COVID-19 pandemic by analysing how science was represented in news and social media coverage of COVID-19 on the island of Ireland. Thematic analysis was performed on a dataset comprising 952 news articles and 603 tweets published between 1 January and 31 May 2020. Three themes characterised the range of meanings attached to science: ‘Defining science: Its subjects, practice and process’, ‘Relating to science: Between veneration and suspicion’ and ‘Using science: As solution, policy and rhetoric’. The analysis suggested that the COVID-19 pandemic represented a platform to highlight the value, philosophy, process and day-to-day activity of scientific research. However, the study also identified risks the pandemic might pose to science communication, including feeding public alienation by disparaging lay understandings, reinforcing stereotypical images of scientists, and amplifying the politicisation of scientific statements.

Professional male office employees have been identified as those most at risk of prolonged sedentary time, which is associated with many long-term adverse health conditions. The aim of the study was to assess the acceptability and feasibility of a gender-sensitive multicomponent intervention, guided by the socio-ecological model, to reduce occupational sedentary behaviour by increasing physical activity in professional men. The main elements of the intervention comprised: a Garmin watch with associated web-based platform/smartphone application, an under-desk pedal machine, and management participation and support. A cluster-randomised crossover pilot feasibility trial recruiting professional males was conducted in two workplaces. Mixed methods were used to assess the primary outcomes of recruitment, retention, and acceptability and feasibility of the intervention. Secondary outcomes included objectively measured sedentary behaviour, standing and physical activity. Focus groups were used to explore the acceptability of the intervention in a real-world setting. Twenty-two participants were recruited (mean age 42.9 years (SD 11.0)). Recruitment and retention rates were 73.3% and 95%, respectively. Overall, participants found the intervention acceptable and feasible, and expressed enjoyment of the intervention, however desk set-up issues with the pedal devices were noted. The manual recording of the pedalling bouts was overly burdensome. Preliminary data indicate that the intervention may reduce occupational sedentary behaviour and increase physical activity. This intervention should be further tested in a definitive trial following consideration of the findings of this pilot feasibility trial.