Evidence in public health decision-making – its creators and users need to come together

Decision-makers in public health can be confronted with a huge volume of data, evidence, reviews and summaries – from local and national sources. There is also an acknowledged gap between evidence and policy in public health.

In a recent blog on the EPPI centre website CLAHRC researchers Dylan Kneale and Antonio Rojas-García reflect on their work exploring the use of evidence in local public health decision-making – and raise the question – How much research is being wasted because it is not generalisable in local settings?

While reduced resources make judicious use of evidence more important than ever when deciding how and where to apply resources, researchers also need to understand, and better communicate, the generalisability of their research evidence to decision-makers working locally.

Read Evidence use in public health – make-do and mend?

 

Better data to improve health and wellbeing

We have been reaching out to colleagues in local authorities and public health departments to highlight the value of research evidence in improving health and well being among local populations. The CLAHRC is forging useful links with our partners in local councils, bridging the gap between research and the front line.

Local authorities are a key audience for the CLAHRC as they are responsible for public health in their area. Public health includes prevention of illness and disease, sexual health and smoking cessation.

CLAHRC partners Islington and Camden Councils run lunchtime learning sessions for staff as part of their Using Data Better initiative. They invite speakers from various sectors to present the potential for data to improve health and health services for local residents. The boroughs have joined forces to deliver public health, and have a team of data analysts at work –  identifying issues that have a negative effect on people’s health, and planning to deal with those issues.

In October Dr Chiara Di Poli (below left) presented to public health staff and analysts in the two Councils.  Chiara was joined by the CLAHRC’s Professor Gwyn Bevan and health economist Dr Elena Pizzo, presenting evidence of the limited impact of current policy options on the projected diabetes ‘epidemic’ in Islington, which stimulated a lively discussion about what Islington might do to tackle this.

Chiara’s work is part of a wider CLAHRC study, led by Professor Bevan, investigating the design of research and decision support processes to ensure the utility of research outputs. We are making efforts to make our research more “user friendly” and accessible to colleagues in the NHS and local government so they can use it in decision-making around planning and commissioning services and interventions for the populations they serve.

There was learning on both sides – our researchers got an insight into the challenges faced by staff on the front line and an appreciation of the type of data local authorities collect and analyse to improve health and well-being. We offered projections on the likely impact on diabetes prevention of current policies adopted by local authorities.

Feedback from our audience was extremely positive and we hope this is the start of a fruitful collaboration between the CLAHRC and the Public health teams within Islington and Camden.

“Once again, thanks for delivering a wonderful presentation – many of us were fascinated by your progress, and it’s no surprise that our head of dept. is now keen to collaborate further”

Mustafa Kamara, Intelligence & Information Analyst, Camden and Islington Public Health

Patient and public involvement – learning and sharing with Peninsula CLAHRC

We recently went on a “learning exchange” visit to our friends and colleagues at NIHR CLAHRC South West Peninsula (PenCLAHRC).

It was a chance for researchers, staff and patient and public contributors from both CLAHRCs to meet each other.

We also took advantage of the combined expertise and experience of the assembled group to look at a research study early in development.

Read a report of the day here.

 

 

Brian Turley Awards for Patient and Public Involvement 2017

CLAHRC North Thames has joined colleagues at CLAHRC North West London (NWL) and CLAHRC South London to present the 2017 Brian Turley Awards for Patient and Carer Involvement

This inaugural award was made last year by NIHR CLAHRC NWL in the memory of Brian Turley, a dedicated and committed patient advocate and disability rights campaigner.

Brian (pictured left) became involved with NIHR CLAHRC NWL through ‘My Medication Passport’. Together with his mother Margaret, he was a passionate ambassador for the ‘My Medication Passport’.

Brian strongly believed the passport was a way to involve and engage people in their own care and to initiate better conversations with clinicians and other services including the police and the criminal justice system.

Sadly Brian died unexpectedly in February 2016 and in honour of his contribution and as a way to sustain his values and commitment to patient engagement and involvement the award is being extended to all three CLAHRC programmes in London and introducing two new categories.

The awards aim to celebrate and promote patient and carer involvement in healthcare research and improvement.

The awards will:

  • Raise the profile of involvement
  • Showcase examples from practice
  • Promote reflection and shared learning
  • Discourage ‘tick box practice’

For all three awards, we welcome nominations from teams and individuals who are actively and currently involved or working with patients/carers and the wider community.

Category 1 – Teams working with patients, service users, carers, families and communities

Category 2 – Early career researcher, including PhD students, service user researchers and members of CLAHRC Fellowship Programmes

Category 3 – Patient/Service User/Carer with influence

The role of board-level clinical leaders in quality improvement

CLAHRC researcher Dr Lorelei Jones has been invited to deliver a seminar on the role of clinical leaders on NHS boards in quality improvement (QI).

The Health Services Research Centre is a leading authority on health care management and has invited Lorelei as part of their prestigious events series.

The poster below gives an overview of what she will be covering.

Dr Jones is part of our iQUASER study looking at how NHS boards implement QUASER – a dialogical tool for senior hospital leaders to develop and implement QI strategies across their organisation.

Lorelei will be presenting some results from her extensive fieldwork among NHS boards for this research, which involved interviewing board members, observing meetings and scrutinising papers and documents.

Professor Jonathan Grigg on the dangers of air pollution underground

Professor Jonathan Grigg, a practicing pediatrician who leads our Child Health theme has outlined the dangers of air pollution underground.

Millions of the Capital’s tube users are unaware of the greatly increased density of air, and much higher levels of harmful pollutants on the subway system compared to what they breathe above ground.

See Professor Grigg interviewed by ITV London News this week.

Mayor of London Sadiq Khan launched an air quality campaign this week which will see restrictions on the most polluting vehicles
https://www.london.gov.uk/press-releases/mayoral/mayor-unveils-hard-hitting-air-quality-campaign 

Read a blog by Professor Grigg on London’s “toxic air emergency”
https://www.healthylondon.org/latest/blog/londons-toxic-air

Learning exchange trip to PenCLAHRC a success

On Tuesday September 26th CLAHRC North Thames’ public and patient partners took part in a learning exchange visit to Peninsula CLAHRC (PenCLAHRC).

The trip to PenCLAHRC’s Exeter office was part of our wider efforts to make connections with other CLAHRCs, especially those serving different populations in settings different from ours.

A delegation of CLAHRC North Thames public partners, staff and students (below right) visited colleagues at PenCLAHRC to make connections, compare notes on involving people in research and discuss future working together. Eight members of our lay Research Advisory Panel joined our PPI/E officer Steven Towndrow and CLAHRC PhD Nehla Djelloui who is investigating involving people in large scale service change in the NHS.

We were hosted by

We were welcomed by PenCLAHRC Director Professor Stuart Logan who set out the aims and objectives of PenCLAHRC and their partnership working with patients and the public.

After some introductions and networking we then looked at a research study early in development. Both sets of patient and public contributors provided the benefit of their experience and expertise to help shape the research.

Our thanks to Kristin and the PenCLAHRC PPI team –  for making us so welcome and for all their work in making the day a success. We are planning a return visit which will see PenCLAHRC come to London in the new year.

Funding success to develop research on vitamin B12 trial for pregnant women in India

Professor Monica Lakhanpaul, Principal Investigator on our NEON study has successfully applied for funding to develop a major research programme addressing the needs of women and children in India.

Professor Lakhanpaul (pictured below) is leading an application in respond to a call supported by a number of organisations from the UK and India (see below) under the title Global Research Programme; addressing the health needs of women and children in disadvantaged populations globally

The Department of Biotechnology (DBT) in India, in collaboration with Department of International Development(DFID), the Economic and Social Research Council (ESRC) and the Medical Research Council (MRC) joint call to fund global health research addressing the health needs of women and children

Successful applicants will build partnerships across the UK and India to execute research that will impact the ability to prevent, diagnose and manage prevalent chronic and infectious diseases facing women and their unborn children in low-and middle-income (LMIC).

By successfully navigating the initial round of the application process (“the concept proposal”) Professor Lakhanpaul has secured a £4000 travel grant to support the development of a partnership for the full proposal development process. Her initial concept proposal was for a vitamin on vitamin B12 trial in pregnant women and children in India.

A full proposal will be made in September for the larger pot of funding.

Monica’s work with the Bangladeshi community in East London is also referenced in a recent blog Can women talking save lives? Reducing inequalities in newborn mortality in India, Nepal, Bangladesh and Malawi

 

Developing innovative approaches to increasing awareness of asthma control among young people

In Control

Based on findings from research previously conducted by the school-based asthma project, part of our Child and Adolescent Health Theme, the team have worked with Greenwich & Lewisham Young People’s Theatre to develop a theatre production addressing asthma control. The theatre piece In Control has been performed in schools since June 2017, and was recently featured as part of the British Science Festival held in Brighton 5th – 9th September 2017.

Photo credit: Gerard Monaco

The aim of the play is to change the perception and image of asthma among young people, in order to help those with asthma feel supported and therefore better able to manage their condition. Written as a collaboration between the theatre and research teams, young people with asthma were involved to advise on the storylines and dialogue to make the play as real and as accessible as possible.

In Control follows a 15-year old girl, Jazz with asthma through a week of detention with two of her classmates. Usually confident and outgoing, Jazz hides that she has asthma and is reluctant to accept help when finding it difficult to breathe. After the play, the protagonist stays in character as the students participate in a discussion of the themes raised, facilitated by the other two actors. Engaging the school audiences through theatre gives a new angle from which to involve young people in thinking and talking about the challenges faced by those with asthma.

Dr Gioia Mosler from QMUL said: “It was an amazing experience seeing the direct emotional effect that a play can have on these school groups. We have been hugely encouraged by the initial reactions to this project and we are already starting to study how effective this kind of intervention can be to help young people deal with their asthma.”

Dr Jonathan Grigg, professor of paediatric respiratory medicine at QMUL and project lead added: “We must develop innovative ways of improving asthma outcomes in children and young people. Our work with Greenwich & Lewisham Young People’s Theatre has identified a new space where interventions can be delivered and tested outside the standard medical model.”

Photo credit: Tunde Euba

Dr Gioia Mosler, Outreach and Learning Manager for the school-based asthma project, and Tunde Euba, Arts Practitioner working with Greenwich & Lewisham Young People’s Theatre, have written about the development of In Control for The Lancet: Taking Control Through Drama 

 Asthma Dodge

Also featured at the British Science Festival, was Asthma Dodge – a smartphone game developed in collaboration with the Centre of the Cell, a science education centre at Queen Mary University of London. In the game, the player takes the role of a young person with asthma. The aim is to run as fast as possible to reach the Centre of the Cell, dodging the asthma triggers along the way. Information about asthma is incorporated into the game, such as how asthma affects the airways, how different medication works, and the different types of triggers for asthma symptoms.

The ‘Asthma Dodge’ game can be downloaded from the Apple and Google Play stores; visit the Centre of the Cell website to read more. #Asthma Dodge

School-based Questionnaire on Asthma Control in London Secondary School Children

In a previous study from the school-based asthma project team, questionnaires completed by over 750 secondary school-aged students from schools in London revealed that only 54% of participants were managing their asthma well. Out of those whose asthma was not well controlled, almost half thought they had good asthma control. The school-based questionnaire also highlighted that students often feel uncomfortable about using an inhaler at school.

A short summary of this study can be found here, or read the full paper here.

 

 

Registration now open! Introduction to Evaluation Workshop – 13 December 2017

The NIHR CLAHRC North Thames Academy is now accepting applications for the next instalment of our one-day, hands-on Introduction to Evaluation workshop on Wednesday 13 December 2017.

This popular short course provides an overview to the evaluation process, complete with practical examples and useful tips for conducting your own evaluation. Aimed at frontline healthcare and public health staff, this introductory level course is ideal if you are planning your first evaluation within your service.

To read more details about the course, and to download the registration form:

visit the event page here

 

Previous attendees of this course have told us:

“Very useful – will be able to disseminate to team. Planning of projects more of a priority now. Great organisation – many thanks.”

“Good introduction to concepts of evaluation and research. ” 

“The course was extremely well organised, with incredibly knowledgeable speakers, very good session!”

Registration is open until 5pm, 6th October 2017. Our short courses are free for staff working within our partner organisations. If you have any questions about the course, or would like to be added to our mailing list, please send us an email at clahrc.academy@ucl.ac.uk.