Overview
I currently work within the Exeter HS&DR Evidence Synthesis Centre within the University of Exeter Medical School. We have just completed a rapid systematic review exploring experiences of the Nearest Relative provisions of the Mental Health Act. We are currently working on a large systematic review, examining the effectiveness of organisational interventions aiming to manage the length of hospital stay for older adults admitted for planned procedures.
Qualifications
2011: Doctorate in Clinical Psychology (University of Hull)
2008: Postgraduate Certificate in Mental Health (University of York)
2007: BSc Psychology (University of York)
Career
I trained as a clinical psychologist and have previously worked within Community Teams for Adults with Learning Disabilities. My thesis, carried out as part of my clinical psychology training, focused on the experience of recovery for people receiving methadone maintenance treatment.
I have previously worked on a PenCLAHRC affiliated Systematic Literature Review within the Evidence Synthesis Team, aimed at exploring the effectiveness of interventions aimed at improving the mental health of young people with long-term physical conditions. This review had three parts; a quantitative part to review the effectiveness of the interventions and their cost-effectiveness, a qualitative part to review the experiences of young people, their parents and those administering the interventions and an over-arching synthesis of the information gathered though parts 1 and 2. This review took place over 15 months
starting in January 16. I really enjoyed working alongside medical and mental health experts within the field and the young people with lived experience of LTC.
In 2015 I worked on a randomized control trial at Plymouth University to explore the effects of debt counselling on the recovery of people with money worries who were also living with depression.
Links
Research
Research interests
I have an ongoing interest in research aiming to improve mental health in vulnerable populations and enhance coordination between services to support individuals with multiple and complex needs.
Research projects
3 Systematic Reviews within the Evidence Synthesis team examining:
1) The effectiveness and cost-effectiveness of interventions targeting mental health for children and young people with LTCs and symptoms of mental distress.
2) The effects of such interventions on other key aspects of social and family functioning.
3) The factors that may enhance, or hinder, the effectiveness of the above interventions and / or the successful implementation of interventions
Publications
Key publications | Publications by category | Publications by year
Publications by category
Journal articles
Gabbay MB, Ring A, Byng R, Anderson P, Taylor RS, Matthews C, Harris T, Berry V, Byrne P, Carter E, et al (In Press). Debt Counselling for Depression in Primary Care: an adaptive randomised controlled pilot trial (DeCoDer study).
Health Technol Assess,
21(35), 1-164.
Abstract:
Debt Counselling for Depression in Primary Care: an adaptive randomised controlled pilot trial (DeCoDer study).
BACKGROUND: Depression and debt are common in the UK. Debt Counselling for Depression in Primary Care: an adaptive randomised controlled pilot trial (DeCoDer) aimed to assess the clinical effectiveness and cost-effectiveness of the addition of a primary care debt counselling advice service to usual care for patients with depression and debt. However, the study was terminated early during the internal pilot trial phase because of recruitment delays. This report describes the rationale, methods and findings of the pilot study, and implications for future research. OBJECTIVES: the overarching aim of the internal pilot was to identify and resolve problems, thereby assessing the feasibility of the main trial. The specific objectives were to confirm methods for practice recruitment and the ability to recruit patients via the proposed approaches; to determine the acceptability of the study interventions and outcome measures; to assess contamination; to confirm the randomisation method for main trial and the level of participant attrition; and to check the robustness of data collection systems. DESIGN: an adaptive, parallel, two-group multicentre randomised controlled pilot trial with a nested mixed-methods process and economic evaluation. Both individual- and cluster (general practice)-level were was used in the pilot phase to assign participants to intervention or control groups. SETTING: General practices in England and Wales. PARTICIPANTS: Individuals were included who were aged ≥ 18 years, scored ≥ 14 on the Beck Depression Inventory II and self-identified as having debt worries. The main exclusion criteria were being actively suicidal or psychotic and/or severely depressed and unresponsive to treatment; having a severe addiction to alcohol/illicit drugs; being unable/unwilling to give written informed consent; currently participating in other research including follow-up phases; having received Citizens Advice Bureau (CAB) debt advice in the past year; and not wanting debt advice via a general practice. INTERVENTIONS: the participants in the intervention group were given debt advice provided by the CAB and shared biopsychosocial assessment, in addition to treatment as usual (TAU) and two debt advice leaflets. The participants in the control group were given advice leaflets provided by the general practitioner and TAU only. MAIN OUTCOME MEASURES: (1) Outcomes of the pilot trial - the proportion of eligible patients who consented, the number of participants recruited compared with target, assessment of contamination, and assessment of patient satisfaction with intervention and outcome measures. (2) Participant outcomes - primary - Beck Depression Inventory II; secondary - psychological well-being, health and social care utilisation, service satisfaction, substance misuse, record of priority/non-priority debts, life events and difficulties, and explanatory measures. Outcomes were assessed at baseline (pre-randomisation) and at 4 months post randomisation. Other data sources - qualitative interviews were conducted with participants, clinicians and CAB advisors. RESULTS: of the 238 expressions of interest screened, 61 participants (26%) were recruited and randomised (32 in the intervention group and 29 in the control group). All participants provided baseline outcomes and 52 provided the primary outcome at 4 months' follow-up (14.7% dropout). Seventeen participants allocated to the intervention saw a CAB advisor. Descriptive statistics are reported for participants with complete outcomes at baseline and 4 months' follow-up. Our qualitative findings suggest that the relationship between debt and depression is complex, and the impact of each on the other is compounded by other psychological, social and contextual influences. CONCLUSIONS: As a result of low recruitment, this trial was terminated at the internal pilot phase and was too small for inferential statistical analysis. We recommend ways to reduce this risk when conducting complex trials among vulnerable populations recruited in community settings. These cover trial design, the design and delivery of interventions, recruitment strategies and support for sites. TRIAL REGISTRATION: Current Controlled Trials ISRCTN79705874. FUNDING: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 35. See the NIHR Journals Library website for further project information. Mark Gabbay and Adele Ring are part-funded by NIHR Collaborations for Leadership in Applied Health Research and Care (CLAHRC) North West Coast and Richard Byng and Rod S Taylor, Vashti Berry and Elizabeth Shaw part-funded by NIHR CLAHRC South West Peninsula.
Abstract.
Author URL.
Full text.
Moore D, Nunns M, Shaw L, Rogers M, Walker E, Ford T, Garside R, Ukoumunne O, Titman P, Shafran R, et al (In Press). Improving the mental health of children and young people with long term conditions: Linked evidence syntheses.
Health Technology Assessment Full text.
Finning K, Ukoumunne O, Ford T, Danielsson-Waters E, Shaw L, Romero De Jager I, Stentiford L, Moore D (In Press). The association between child and adolescent depression and poor attendance at school: a systematic review and meta-analysis.
Journal of Affective DisordersAbstract:
The association between child and adolescent depression and poor attendance at school: a systematic review and meta-analysis
Background
Depression in young people may lead to reduced school attendance through social withdrawal, loss of motivation, sleep disturbance and low energy. We systematically reviewed the evidence for an association between depression and poor school attendance.
Methods
Seven electronic databases were searched for quantitative studies with school-aged children and/or adolescents, reporting a measure of association between depression and school attendance. Articles were independently screened by two reviewers. Synthesis incorporated random-effects meta-analysis and narrative synthesis.
Results
Searches identified 4930 articles. Nineteen studies from eight countries across North America, Europe, and Asia, were included. School attendance was grouped into: 1) absenteeism (i.e. total absences), 2) excused/medical absences, 3) unexcused absences/truancy, and 4) school refusal. Meta-analyses demonstrated small-to-moderate positive cross-sectional associations between depression and absenteeism (correlation coefficient r=0.11, 95% confidence interval 0.07 to 0.15, p=0.005, I2= 63%); and depression and unexcused absences/truancy (r=0.15, 95% confidence interval 0.13 to 0.17, p
Abstract.
Full text.
Moore D, Russell A, Matthews J, Ford T, Rogers M, Ukoumunne O, Kneale D, Thompson Coon J, Sutcliffe K, Nunns M, et al (2018). Context and Implications Document for: School-based interventions for attention-deficit/hyperactivity disorder: a systematic review with multiple synthesis methods.
Review of Education,
6 Full text.
Shaw EH, Nunns MP, Briscoe S, Anderson R, Thompson Coon J (2018). Experiences of the ‘Nearest Relative’ provisions in the compulsory detention of people under the Mental Health Act: rapid systematic review.
Health Services and Delivery Research Full text.
Moore D, Russell A, Matthews J, Ford T, Rogers M, Ukoumunne O, Kneale D, Thompson Coon J, Sutcliffe K, Nunns M, et al (2018). School‐based interventions for attention-deficit/hyperactivity disorder: a systematic review with multiple synthesis methods.
Review of Education,
6 Full text.
Publications by year
In Press
Gabbay MB, Ring A, Byng R, Anderson P, Taylor RS, Matthews C, Harris T, Berry V, Byrne P, Carter E, et al (In Press). Debt Counselling for Depression in Primary Care: an adaptive randomised controlled pilot trial (DeCoDer study).
Health Technol Assess,
21(35), 1-164.
Abstract:
Debt Counselling for Depression in Primary Care: an adaptive randomised controlled pilot trial (DeCoDer study).
BACKGROUND: Depression and debt are common in the UK. Debt Counselling for Depression in Primary Care: an adaptive randomised controlled pilot trial (DeCoDer) aimed to assess the clinical effectiveness and cost-effectiveness of the addition of a primary care debt counselling advice service to usual care for patients with depression and debt. However, the study was terminated early during the internal pilot trial phase because of recruitment delays. This report describes the rationale, methods and findings of the pilot study, and implications for future research. OBJECTIVES: the overarching aim of the internal pilot was to identify and resolve problems, thereby assessing the feasibility of the main trial. The specific objectives were to confirm methods for practice recruitment and the ability to recruit patients via the proposed approaches; to determine the acceptability of the study interventions and outcome measures; to assess contamination; to confirm the randomisation method for main trial and the level of participant attrition; and to check the robustness of data collection systems. DESIGN: an adaptive, parallel, two-group multicentre randomised controlled pilot trial with a nested mixed-methods process and economic evaluation. Both individual- and cluster (general practice)-level were was used in the pilot phase to assign participants to intervention or control groups. SETTING: General practices in England and Wales. PARTICIPANTS: Individuals were included who were aged ≥ 18 years, scored ≥ 14 on the Beck Depression Inventory II and self-identified as having debt worries. The main exclusion criteria were being actively suicidal or psychotic and/or severely depressed and unresponsive to treatment; having a severe addiction to alcohol/illicit drugs; being unable/unwilling to give written informed consent; currently participating in other research including follow-up phases; having received Citizens Advice Bureau (CAB) debt advice in the past year; and not wanting debt advice via a general practice. INTERVENTIONS: the participants in the intervention group were given debt advice provided by the CAB and shared biopsychosocial assessment, in addition to treatment as usual (TAU) and two debt advice leaflets. The participants in the control group were given advice leaflets provided by the general practitioner and TAU only. MAIN OUTCOME MEASURES: (1) Outcomes of the pilot trial - the proportion of eligible patients who consented, the number of participants recruited compared with target, assessment of contamination, and assessment of patient satisfaction with intervention and outcome measures. (2) Participant outcomes - primary - Beck Depression Inventory II; secondary - psychological well-being, health and social care utilisation, service satisfaction, substance misuse, record of priority/non-priority debts, life events and difficulties, and explanatory measures. Outcomes were assessed at baseline (pre-randomisation) and at 4 months post randomisation. Other data sources - qualitative interviews were conducted with participants, clinicians and CAB advisors. RESULTS: of the 238 expressions of interest screened, 61 participants (26%) were recruited and randomised (32 in the intervention group and 29 in the control group). All participants provided baseline outcomes and 52 provided the primary outcome at 4 months' follow-up (14.7% dropout). Seventeen participants allocated to the intervention saw a CAB advisor. Descriptive statistics are reported for participants with complete outcomes at baseline and 4 months' follow-up. Our qualitative findings suggest that the relationship between debt and depression is complex, and the impact of each on the other is compounded by other psychological, social and contextual influences. CONCLUSIONS: As a result of low recruitment, this trial was terminated at the internal pilot phase and was too small for inferential statistical analysis. We recommend ways to reduce this risk when conducting complex trials among vulnerable populations recruited in community settings. These cover trial design, the design and delivery of interventions, recruitment strategies and support for sites. TRIAL REGISTRATION: Current Controlled Trials ISRCTN79705874. FUNDING: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 35. See the NIHR Journals Library website for further project information. Mark Gabbay and Adele Ring are part-funded by NIHR Collaborations for Leadership in Applied Health Research and Care (CLAHRC) North West Coast and Richard Byng and Rod S Taylor, Vashti Berry and Elizabeth Shaw part-funded by NIHR CLAHRC South West Peninsula.
Abstract.
Author URL.
Full text.
Moore D, Nunns M, Shaw L, Rogers M, Walker E, Ford T, Garside R, Ukoumunne O, Titman P, Shafran R, et al (In Press). Improving the mental health of children and young people with long term conditions: Linked evidence syntheses.
Health Technology Assessment Full text.
Finning K, Ukoumunne O, Ford T, Danielsson-Waters E, Shaw L, Romero De Jager I, Stentiford L, Moore D (In Press). The association between child and adolescent depression and poor attendance at school: a systematic review and meta-analysis.
Journal of Affective DisordersAbstract:
The association between child and adolescent depression and poor attendance at school: a systematic review and meta-analysis
Background
Depression in young people may lead to reduced school attendance through social withdrawal, loss of motivation, sleep disturbance and low energy. We systematically reviewed the evidence for an association between depression and poor school attendance.
Methods
Seven electronic databases were searched for quantitative studies with school-aged children and/or adolescents, reporting a measure of association between depression and school attendance. Articles were independently screened by two reviewers. Synthesis incorporated random-effects meta-analysis and narrative synthesis.
Results
Searches identified 4930 articles. Nineteen studies from eight countries across North America, Europe, and Asia, were included. School attendance was grouped into: 1) absenteeism (i.e. total absences), 2) excused/medical absences, 3) unexcused absences/truancy, and 4) school refusal. Meta-analyses demonstrated small-to-moderate positive cross-sectional associations between depression and absenteeism (correlation coefficient r=0.11, 95% confidence interval 0.07 to 0.15, p=0.005, I2= 63%); and depression and unexcused absences/truancy (r=0.15, 95% confidence interval 0.13 to 0.17, p
Abstract.
Full text.
2018
Moore D, Russell A, Matthews J, Ford T, Rogers M, Ukoumunne O, Kneale D, Thompson Coon J, Sutcliffe K, Nunns M, et al (2018). Context and Implications Document for: School-based interventions for attention-deficit/hyperactivity disorder: a systematic review with multiple synthesis methods.
Review of Education,
6 Full text.
Shaw EH, Nunns MP, Briscoe S, Anderson R, Thompson Coon J (2018). Experiences of the ‘Nearest Relative’ provisions in the compulsory detention of people under the Mental Health Act: rapid systematic review.
Health Services and Delivery Research Full text.
Moore D, Russell A, Matthews J, Ford T, Rogers M, Ukoumunne O, Kneale D, Thompson Coon J, Sutcliffe K, Nunns M, et al (2018). School‐based interventions for attention-deficit/hyperactivity disorder: a systematic review with multiple synthesis methods.
Review of Education,
6 Full text.
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