Professor Rona Campbell

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• Professor Rona Campbell

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Applicants

• Cardiff
• Laurence Moore, Chris Butler, Gareth Williams,
  David Fone, Glyn Elwyn, Soren Holm, Simon Murphy
  SOCSI/MEDIC/CLAWS/DENTL
• Bristol
• Rona Campbell, Jenny Donovan, David Gunnell,
  Matt Hickman Social Medicine
• Swansea
• Ronan Lyons HIRU
• Director, Co Directors

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• Why UK Clinical Research Collaboration (UKCRC)
  Public Health Research Centres of Excellence?

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Limited evidence base for public health

• Much of public health policy and practice
  currently being implemented has not been
  rigorously evaluated to access its effectiveness.
  Many in the research community highlight the
  potential value of public health programmes for
  use as natural experiments, where evaluation
  should be an explicit component of the
  implementation of new interventions, programmes
  and policies and so could inform the evidence
  base for public health

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House of Commons Health Committee

• There is an ethical imperative to develop and
  use evidence-based policy. All the reforms we
  have discussed are experiments on the public and
  can be as damaging (in terms of unintended
  effects and opportunity cost) as unevaluated new
  drugs or surgical procedures. Such wanton
  large-scale experimentation is unethical, and
  needs to be superseded by a more rigorous culture
  of piloting, evaluating and using the results to
  inform policy.
• Simple changes to the design of policies and how
  they are introduced could make all the
  difference. We recommend that all future
  initiatives to tackle health inequalities
  initiatives must, prior to their introduction,
  demonstrate adherence to the basic set of
  research guidelines we have detailed in this
  chapter, which include

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Basic principles of evaluation

• importance of a counterfactual
• design should fit the specific features of the
  intervention
• randomisation prevents unknown biases
• prospective design, with baseline measures
• decide primary outcomes a priori
• measure direct and indirect impacts
• appropriate lengths of follow-up
• build in methods of measuring long-term outcomes
• objective assessment of both positive and
  negative outcomes
• non-suppression of negative findings
• explicit ideas about how the intervention is
  expected to workcollect information by gender,
  age, ethnicity and SES
• examine how the intervention is actually
  implemented
• include an economic evaluation.

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• Laurence Moore

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Mission Statement

• DECIPHer will undertake methodologically
  innovative multidisciplinary research with a
  focus on the development and evaluation of
  complex interventions and policies to achieve
  sustainable improvements in the health and
  well-being of children and young people

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• Why focus on developing and evaluating complex
  interventions and only to do with children and
  young people?

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Obesity prevention

• Its not rocket science. People just need to
  eat less and be more active
• Caroline Flint, Minister for Public Health,
  England

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• Public health issues are complex so simplistic
  interventions are unlikely to suffice

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7 major subsystems
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SOCIO-ECOLOGICAL FRAMEWORK (McLeroy et al 1989)
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Ottawa Charter (1986)

• Action areas to improve health wellbeing
• build healthy public policy
• create supportive environments
• strengthen community action
• develop personal skills
• reorient the health service (to health from
  medicine)
• Not alternatives, multiple actions at multiple
  levels required

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What do the funds cover?

• NOT project funding
• Infrastructural funding
• M5 over 5 years (_at_70 FEC)
• Expectation that Centres self-sustaining
• New posts, PhD studentships
• Capacity development
• Engagement with policy, practice, public

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Mission of UKCRC Public Health Research Centres

• Research
• Policy and practice engagement
• Research capacity development

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Strategic Research Programmes

• Multiple risk behaviours in young people and
  their underlying causes
• Developing innovative and sustainable child and
  youth centred interventions
• Health promoting schools and other youth settings
• Sustainable health improvement in communities,
  households and families
• Environmental determinants of health and the
  evaluation of environmental and policy
  interventions

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DECIPHer relevance to policy and practice

• Bid DECIPHer willmaximise impact on, and
  engagement with, policy and practice in the UK
  and beyond
• Research which engages needs to be
• Relevant
• Timely
• Findings capable of being implemented at the
  level of engagement

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Experience in policy relevant trials

• ASSIST A Stop Smoking in Schools Trial (MRC)
• Advocacy in Action Study (DH PRP, DfT)
• National Exercise Referral Scheme (WAG)
• Free School Breakfast Initiative (WAG)

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Current work - DECIPHer

• Trial of hand washing education (NIHR- RFPB
  (Collaboration with HPA HS))
• AHEAD Activity and Healthy Eating in
  Adolescence (DH PRP)
• RCT of intervention to increase Chlamydia
  Screening in Primary Care (HPA C McNulty)
• Modelling childhood obesity interventions
  (Bristol PCT)

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Levels of engagement

• Different levels require different approaches
• Government ministers
• National and local politicians
• Senior policy makers
• Practitioners
• Public
• Philip Daniels DECIPHer Involving Young People
  Officer

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Engagement in research

• Particularly relevant to policy makers,
  practitioners and public
• Involve in all groups in aspects of research
• Direction (Advisory Groups)
• Design
• Delivery
• Dissemination
• Build capacity
• Two way secondments
• research ? policy/practice

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• To address the almost complete absence of an
  evidence base on the cost effectiveness of public
  health interventions, substantial investment will
  be necessary, backed up by building the capacity
  of the public health research sector
• Derek Wanless, Securing Good Health for the Whole
  Population, HMSO, 2004

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DECIPHer Public health research capacity
development

• Academic wider public health community
• Enabling capacity development to take place at a
  variety of different levels
• Research studentships
• Research fellow / lecturer posts
• Structured mentoring and academic learning sets
• Placements

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DECIPHer Research posts

• Cardiff
• 1 Senior Research Fellow, 2 Research Fellows
• Bristol
• 3 Research Fellows
• Swansea
• 1 Research Fellow, 1 Research Assistant

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Externally funded fellowships

• Walport academic fellows and lecturers
• MRC Population health scientist Methodology
  research fellowship
• MRC/ESRC Interdisciplinary post-doctoral
  fellowships

• ESRC/MRC/NIHR Early career fellowship in
  economics of health
• ESRC post doctoral and mid career fellowships
• NIHR Research Training, Post Doctoral, Career
  Development Senior Fellowships

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Doctoral studentships

• 10 PhD Studentships (4 Cardiff, 4 Bristol, 2
  Swansea)
• 5 provided by host institutions
• 38 titles advertised

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Department of Social Medicine Short Courses
2009_10
The University of Bristol Department of Social
Medicine is a leading centre for epidemiology,
health services research and public health in the
UK. We offer a comprehensive short course
programme, for researchers and health care
practitioners. All courses are available for CME
credits.
Computing Introduction to Stata Advanced
Stata Data Management for Health Research Methods
using MS Access Geographical Information
Systems Introduction to Bioinformatics Research
methods Research Governance Critical Appraisal of
Quantitative Research Introduction to Qualitative
Research Methods Health Protection Principles and
Practice Applied Health Protection Questionnaire
Design Analysis Introduction to Health
Economics
Epidemiology and Medical Statistics Introduction
to Statistics Basic Epidemiology Introduction
to Linear and Logistic Regression Rates and
Survival Analysis Advanced Epidemiological and
Stats Methods Genetic Epidemiology An
Introduction to Human Genetics Genetic
Association Studies The Complex
Genome Randomised Trials and Systematic
Reviews Systematic Reviews in Healthcare
Meta-analysis in Context Design and Analysis of
RCTs
For more information and booking
www.epi.bris.ac.uk/shortc/shortc.htm Email
short-course_at_bristol.ac.uk
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New short courses

• Developing and evaluating public health
  interventions (4 days)
• Health data and health informatics to support
  public health research (2 days)
• Advocacy for public health researchers (1 day)
• Public health research ethics (2 days)

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Getting involved

• DECIPHer website
• http//www.decipher.uk.net
• Here today
• Lynnette Thomas Operations Manager
• Philip Daniels Involving Young People
  Officer
• Ben Wheeler Research Fellow
• Mailing list
• Member of DECIPHer policy practice engagement
  group in SW
• Involvement in research programme
• Rona. Campbell_at_bris.ac.uk