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We improve Public Health and facilitate personal growth through promoting active lifestyles. We have provided an evidence-base of effective intervention approaches across settings, in `hard-to-engage' populations and through distinctive planning and delivery approaches. Our support for practitioners and commissioners has developed (i) ways to show the effectiveness of interventions to increase activity and (ii) programmes that achieve wider developmental aims. These effects are achieved by deploying innovative, often bespoke, realistic impact measures that improve programme effectiveness in locations, venues and groups where other groups do not go.
This case study describes the research pathway and impact of a behaviour change DVD designed to increase physical activity in sedentary individuals in deprived communities. Developed as part of a randomised controlled trial with the National Institute for Health Research's Health Technology Assessment programme (HTA), together with supporting research expertise, the DVD is now part of NHS/local authority commissioned standard care in Barnsley and has reached over 7,000 individuals and families. Service evaluation data confirm the DVD has significantly improved the cardiovascular risk profiles of users and contributed to a population level rise in physical activity in Barnsley.
Men who have sex with men (MSM) are at highest risk of acquiring HIV in the UK and an estimated one-quarter of HIV-infected MSM have not been diagnosed. The Gay Men's Sexual Health (GMSH) Survey, conducted by University of Glasgow researchers, has provided robust evidence of sexual behaviours as well as prevention and testing activities of MSM in Scotland since 1996. These findings have shaped health policies in Scotland, the UK and Europe and have been used by health practitioners in the conduct of successful NHS sexual health campaigns in Scotland. The campaigns have been credited with increased testing rates and increased awareness of HIV risks demonstrating the effectiveness of direct promotion of sexual health awareness within the gay community.
It is widely acknowledged that increasing physical activity (PA) levels within `hard-to-reach' groups is challenging. Researchers in the School have addressed these challenges resulting in impacts in two recognized `hard-to-reach' groups: ethnic minority communities and patients who are at risk of disease onset and/or are suffering from diminished quality of life/disability due to chronic disease. In the former, our research has demonstrated how to make PA accessible and appropriate; in the latter, in addition, we have increased physical activity levels. In both examples, our research has changed professional training and/or standards.
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.
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.
Lower Urinary Tract Symptoms (LUTS) in men is a chronic disease of ageing that causes significant quality of life impairment in one third of men over the age of 60. Traditional management comprises a step-up regimen of drugs and surgical interventions aimed at relieving symptoms. At UCL we conceived, developed, evaluated and implemented a self-management intervention that results in greater symptom reduction than that achieved by medication, reduction in the use of medication and of referrals to secondary care, and reduced costs. The intervention is now a global standard of care.
Research at Coventry University has produced innovative approaches to addressing sexual health and wellbeing issues, sexual health promotion and sex education. The research has resulted in:-
The work of White has led to a re-appraisal of men's risk of premature death, both in the UK and abroad. His analysis of morbidity and mortality data has helped stimulate a worldwide debate on the health of men and the risks they face with their health. In the UK, analysis of cancer data has led the leading cancer charities to have a rethink on men's risk of cancer. The EC State of Men's Health in Europe report has helped create a new insight into the equality needs of men and stimulated the production of similar reports globally.
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.