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Childhood obesity is a national problem but it is a problem even more keenly felt in the West Midlands where statistics show the percentage of children classified as obese is higher than the national average. Research demonstrating that simple measures such as waist circumference and body mass index (BMI) are every bit as effective as complex and expensive measuring processes such as magnetic resonance imaging (MRI) scans in identifying high risk obese children has fed into the evaluation and subsequent improvement of child weight management programmes in the region and more widely in the UK. It also informed the development of an obesity strategy and action plan for Worcestershire for the period 2008-11.
This case study represents the work of the Pyramid research team within the INSTIL Education Research Group (INSTIL ERG). Research at the University of West London is characterised by an ambition to promote `useful knowledge' and this case study, with its focus on providing evidence to inform and direct practice, fits within this approach. The case study describes the first rigorous evaluation of the impact of Pyramid after-school clubs that aim to improve the socio-emotional wellbeing of vulnerable children. The work of the Pyramid research team provides an empirical evidence base to support the work of a range of stakeholders including: practitioners; policy makers and researchers in the field of children's socio-emotional well-being, and the children and their families. Drawing on the evidence base, these impacts include the securing of funding for the continuation of Pyramid clubs in schools and informing future development and extension of the Pyramid club intervention for delivery to other age groups.
The Food Dudes scheme devised by the Bangor Food and Activity Research Unit has produced large and lasting increases in children's consumption of fruit and vegetables. More than 500,000 4- to 11-year-old children have participated, in European countries and the US, with funding of more than £20m for research, evaluation, and rollout. Given the major public health challenge of increasing children's consumption of fruit and vegetables (often their least-liked foods), in order to reduce potential risk of future obesity or illnesses including diabetes, cardiovascular disease and some cancers, our unique combination of behaviour change principles -- including Role Modelling, Rewards, and Repeated Tasting -- has achieved significant success.
Our sustained impact in obesity treatment began in 1999 with Europe's first residential camp programme for overweight and obese children. Our impact on treatment grew sufficiently to warrant the formation of a dedicated spin out company, MoreLife. Underpinned by our research, MoreLife is an award winning, Department of Health accredited provider, delivering specialist weight management services, both nationally and internationally. Through NHS and other contracts we are delivering high quality, evidence based services to over 3,500 adults and 3000 young people per year. Our impact on the policy and practice of obesity treatment and public understanding continues in the UK and has been extended internationally.
Research conducted at UCL by Professor Orazio Attanasio and his direct engagement with policymakers has been instrumental in the implementation, design and evaluation of conditional cash transfer (CCT) programmes to stimulate the accumulation of human capital in Mexico and Colombia. The research underpinned the design of an innovative pilot, which he also evaluated, in two major cities, Puebla and Ecatepec, with a combined population of around 4 million. In Colombia, an evaluation led by Professor Attanasio led to improvements in and expansions of the CCT programme, with ongoing benefits to 3 million households. The research team also contributed to a child development programme that launched in Peru in March 2013.
Research in the area of childhood obesity has focussed on the development, implementation and evaluation of interventions. The APPLES Study (1996-99), the first UK school-based RCT was key in contributing to the evidence-base through wide dissemination including 3 BMJ (2001) publications, cited in NICE (2006) and WHO guidance (2004). Collaborations with academics, practitioners and the RCPCH led to the development of further community-based obesity treatment and prevention interventions including WATCH IT; early programmes e.g. EMPOWER, HELP and HAPPY and more recently innovative school-based initiatives involving school gardening. There is evidence of results being disseminated and influencing research, practice and policy.
Sure Start, the flagship New Labour anti-poverty initiative launched in 1999, was an area-based early intervention targeting pockets of social and economic deprivation in England. The multi- disciplinary National Evaluation of Sure Start (NESS), to which Professor Angela Anning was the central educational contributor, was the largest social science evaluation contract ever awarded in the UK. Findings were continually fed back to ministers and civil servants to inform policy and practice. Impacts (discussed below, section 4) include:
(1) systemic changes in integrated services for vulnerable families;
(2) rethinking the resourcing and funding of Children's Centres;
(3) revision of training and qualifications of early childhood staff;
(4) enhancing the role of family support and parenting projects.
Jacqueline Barnes' evaluations of government initiatives promoting parenting and child development for vulnerable families have directly affected major policy decisions since 2008. Her study of the Home-Start programme demonstrated limited benefits of unstructured volunteer support, and informed recent NICE guidance on early intervention. Her subsequent evaluation of the Family Nurse Partnership (FNP) programme for vulnerable mothers changed government policy. The success of FNP, as demonstrated during the initial evaluation phase, led to ministerial decisions to more than double the provisions of this programme in 2010 and 2013. FNP has now been rolled out widely in England, Scotland and Northern Ireland.
This case study describes the policy and practice impacts of a series of studies by Claire Fox and colleagues on children's and young people's social and emotional wellbeing, in particular counselling provision in schools and domestic abuse prevention education. The research on the effectiveness of school counselling has been used by the Welsh Assembly to argue for a national roll-out of counselling in Welsh secondary schools. It is also being used by those responsible for commissioning counselling services in England and Northern Ireland. The research on young people and domestic abuse (DA) centres on the evaluation of a particular DA prevention programme delivered in North Staffordshire by local charity Arch. This organisation has benefited substantially from the research findings in terms of sustaining their work in schools. The research has also had a broader impact in terms of influencing UK, and European, policy on DA prevention education in schools.
During the last 20 years Mascie-Taylor's research has had a significant influence on both the UK and Bangladesh governments' policy, practice and understanding in relation to food supplementation and the association between poverty and undernutrition. This research was responsible for demonstrating that existing approaches to improving nutrition were not effective, and suggested reasons for this. As a result of this advice, both the policy and programme approach were changed in 2011. By being the catalyst for these changes, the study has benefited the poor of Bangladesh, improving their health and wellbeing while supporting the introduction of these changes which have led to improved levels of nutrition and reduced individual and household poverty. For example participants of the programme (n=250,000 households ~ 1million individuals) reported ten-fold increases in savings and reduced prevalence of chronic illness, from 15.6% to 4.8% between 2010-12.