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Clinical research conducted at the UCL Institute of Child Health between 1998 and 2011 under the direction of Professors Alan Lucas and Atul Singhal showed that a slower rate of infant weight gain had long-term benefits to reduce the risk of obesity and cardiovascular disease. This contradicted the accepted view, which favoured the promotion of rapid weight gain in infancy. This work has had a significant influence on public health policies and initiatives in the UK and elsewhere. It has changed the way infant formulas are made and used. Two new interventions for overweight children have been developed and are helping families around the world.
The `People in Public Health' (PIPH) study and related research on health trainers, health champions and volunteers has brought together evidence on rationales for lay engagement, effectiveness and models of support. Dissemination activities, supported by a Department of Health grant, have achieved reach into various policy arenas and national networks. At the same time there is evidence of research utilisation in public health practice. One of the impacts has been the establishment of `Active Citizens for Health', a national network of partner organisations to bring together evidence and learning that has been hosted by Leeds Metropolitan University.
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.
Health inequalities are recognised as a critical UK policy issue with life expectancy gaps of up to 28 years between the least and most deprived areas. This case-study demonstrates how Durham University research has led to: (a) changing health service commissioning (with County Durham and Darlington Primary Care Trust [PCT]): (b) influencing NHS funding policy (by generating Parliamentary debate); as well as (c) contributing to the development of the new public health system in England and Wales (as part of the Strategic Review of Health Inequalities in England post-2010 [Marmot Review]).
This case study highlights a body of research around health Research Priority Setting (RPS) that assists policy makers in effectively targeting research that has the greatest potential health benefit. Empirical research on RPS led to organizational changes, and new policies within the Cochrane Collaboration along with new training resources and new RPS exercises. A research gap on inequalities in the risk of oral cancer in the English South Asian population led to an evidence synthesis exercise being carried out by the National Institute for Health and Care Excellence (NICE) and the formulation of a new public health guideline.
The Health Advancement Research Team (HART) members critically evaluated the North-East Lincolnshire Obesity Prevention Strategy, the first such evaluation in the UK. The research led directly to measureable improvements: specific new training programmes and resource allocations; partnership development and co-ordination; health-worker behaviour change; increases in employment amongst obesity prevention healthcare staff; a new communications strategy; and an increase in healthy eating opportunities. The Care Trust considers that the research has had a beneficial impact on obesity levels in North-East Lincolnshire. The research team/Care Trust partnership has strengthened and is continuing, and the results are replicable nationally and internationally.
Insufficient levels of physical activity are a major public health challenge. In the 1990s, approaches to meeting the challenge of increasing physical activity (PA) shifted to a focus on the accumulation of activity during daily living and interest in the potential effects of the built environment on lifestyle physical activity. Researchers from the University of Birmingham tested methods to encourage the increased use of stairs, rather than escalators and lifts, with the aim of increasing calorific expenditure during daily life. This research made a major contribution to the evidence base for NICE (UK), as well as CDC (USA), leading to recommendations to use signage as a public health message to increase stair use. Campaigns prepared for the Department of Health (Cataluyna, Spain) were rolled out nationally, with advice currently being extended to worksite campaigns. At a regional level, councils throughout the Midlands have employed the stair use campaigns, as have the police and commercial firms, with Unilever requesting them for use nationally and internationally and an improved campaign rolled out by National Car Parks Ltd.
Evidence about the need for and provision of health visiting services generated through research undertaken at King's College London (KCL) has underpinned major changes in national policies for health visiting. Our findings about health visitors' practice, availability and distribution of services and effectiveness in terms of parenting/child outcomes, revealed both shortfalls in provision and opportunities for improvement and led to the development of a new caseload weighting tool and funding model for service planning. The accumulated evidence from this research helped convince the UK Government in 2010 to commit to 4,200 more health visitors by 2015 — a workforce expansion of nearly 50% — in a time of austerity and restraint elsewhere in the public sector.
Obesity in the UK is a growing problem for individuals and for NHS resources.a,f There is evidence to suggest that the Government's healthy living messages are failing to get through, as figures show obesity levels have almost doubled in 14 years.a,f More than half the adult population are now overweight or obese.b The report led by Waumsley that reviews the evidence base for psychological approaches to obesity and provides guidelines for practitioners forms the basis for this impact case. This influential research on secondary data was commissioned by the British Psychological Society (BPS) and remains their position statement on obesity, and features in advice to the general public on obesity in adults. As lead, Waumsley participated in a House of Lords cross-party seminar on behaviour change and obesity, has been an expert discussant on obesity at the BPS Annual Conference, and will lead the BPS's response to the National Institute for Health and Care Excellence (NICE) consultation on Overweight and obese adults: lifestyle weight management.
Childhood obesity is an increasing problem in the UK with roughly one in seven school aged children in Scotland and England being classified as obese. The picture is similar in Wales where the prevalence is one in eight. The direct cost of obesity to the NHS is estimated to be £4.2bn a year, with this set to rise if the causes of childhood obesity are not addressed. The contribution of the research described below to tackling this issue is manifold: it has enabled the development and improvement of child health interventions/programmes; it has allowed commissioners and programme leads to make more informed decisions about investment in these interventions/programmes; and it has contributed to the development of regional healthy weight strategies and national guidelines on weight management.