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Edinburgh Napier University led on a large quasi-experimental study which evaluated a National Health Service (NHS) Demonstration Project called Healthy Respect. Healthy Respect was a complex public health intervention based on the latest evidence and theory, which combined school sex education with sexual health drop-in clinics in or near to schools, and was supported by large media and branding campaigns. The research was commissioned by the Scottish Government (2006-2010). Our findings were reported directly to Government and the NHS and were synchronized to fit their policy-making cycles. It shaped Government policy and steered service provision in the NHS.
Research on health promotion in schools undertaken by UWE has demonstrated that vulnerable young people at the centre of the Government's Teenage Pregnancy Strategy can be reached via their involvement in interactive sexual health drama and further work has had direct influence on national policy in England. Following recommendations from research at UWE, Bristol, 12,000 Bristol school pupils have benefited from the introduction of sexual health clinics. UWE research demonstrated how school meal take-up and healthier eating behaviour has been increased by the work of the Food for Life Partnership. This research contributed directly into the development of the English National School Food Plan particularly into the business case for investing in increased school meal take-up.
The National Surveys of Sexual Attitudes and Lifestyles (Natsal) have made major contributions to sexual health policy in Britain, and are widely regarded as among the most reliable sources of scientific data in the field, not replicated with such frequency, detail or sample size in a single country anywhere in the world. Since 2008 they have influenced (amongst other things) HIV services, HPV vaccination policy, the national chlamydia screening programme, teenage pregnancy strategy and health education campaigns for young people and gay men. Our data are widely used in the NHS and third sector. We have disseminated the results of our research through public engagement activities including extensive media work, podcasts, and science festivals.
During the 1990s, LSHTM researchers documented a steep rise in HIV prevalence among young people between the ages of 15 and 24 in eastern and southern Africa. Subsequent trials in Tanzania and Zimbabwe examined the effectiveness of interventions to reduce HIV incidence among this age group. The results, and subsequent reviews, have substantially influenced the HIV policies of international organisations such as UNICEF, UNESCO and WHO, and HIV programmes in individual African countries. In particular, findings on knowledge and attitude change through sexual health education have been widely implemented.
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.
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.
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.
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]).
Research by the School of Pharmacy has been used by the UK Government in their drive to improve the nation's public health. Our evidence base was used to inform the 2008 White Paper "Pharmacy in England: Building on Strengths — Delivering the Future". Healthy Living Pharmacies, recommended by the White Paper, have been piloted leading to improved engagement with local commissioners, further training for pharmacy staff, more cost-effective delivery of public health services, and an increase in public awareness and access to these services. In addition, the Government backed Pharmacy and Public Health Forum is utilising our research in its remit to develop, implement and evaluate public health practice in pharmacy.
School dental screening was a statutory function of the NHS. University of Manchester (UoM) research demonstrated that the national screening programme was ineffective and likely to increase inequalities in health and service utilisation. As a direct result of UoM research, the National Screening Committee recommended that the national programme should stop. This changed Departments of Health policy resulting in new guidance to the NHS, which stopped the screening programme and redirected resources to treatment services for vulnerable groups and prevention programmes. In 2010 in England the costs of a national screening programme were estimated to be £17m per year; money released for reallocation to other dental services.