NIHRDataInsights/HRCSData huggingface dataset:
Title: "Information about Drinking for Ex-serving personnel (InDEx)" - Development of a personalised alcohol app
Funder: Medical Research Council

Abstract: Hazardous alcohol use remains high among Service personnel even after they have left service, more than twice as high as in the general population. Binge drinking is also very common, with established negative health consequences. Yet there is poor recognition of this misuse within personnel, little understanding of the motivations and beliefs leading to heavy alcohol use and a lack of tailored alcohol interventions, with none tested in the UK. The effectiveness of electronic brief alcohol interventions has been evidenced in the general population, with effects maintained up to 12 months. The aims for this research are to study the effectiveness of a tailored electronic alcohol app 'Information about Drinking for Ex-serving personnel' (InDEx) to reduce the frequency of binge drinking in ex-serving personnel who meet criteria for hazardous use. The aims for the early phase study are to 1) to identify what are the motivations for drinking in a military population, how they may differ in ex-serving personnel, and associations with drinking patterns; 2) develop a tailored brief alcohol mobile phone app for ex-serving personnel and 3) to examine the acceptability and usability of this alcohol app in a small number of ex-serving personnel. This research is novel because there is no UK data on motivations for drinking in ex-serving personnel, which is required to develop relevant health messages. The InDEx app also focuses on patterns of alcohol use and the social context of drinking, which differs to existing apps that focus on consumption. InDEx will be a tailored intervention that uses personalised information to target the motivational drivers of binge drinking and hazardous use. This early phase work will lead into a larger randomised trial through the platform for the InDEx app, quantitative data on adherence and usage, qualitative data on acceptability and usability, and information on the feasibility of recruitment in Defence Dental Services.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: CANCER AND NEOPLASMS;CARDIOVASCULAR;ORAL AND GASTROINTESTINAL;STROKE
Title: MICA: Minimising Mortality from Alcoholic Hepatitis
Funder: Medical Research Council

Abstract: Alcoholic hepatitis (AH), a florid presentation of alcohol related liver disease, carries a mortality risk of 30% over 90 days. In this programme, we will carry out studies to develop biomarkers for diagnosis, prognosis and stratification of infection risk which arose from the NIHR-funded STOPAH trial(1). Metabonomic analysis revealed high levels of taurocholate in AH compared to decompensated controls. Once taurocholate is validated, we will generate a miniaturized LC-MS assay to replace biopsy for diagnosis. Prognostic information provides a basis for selecting patients for admission, treatment (or trials), transfer to ITU and for transplantation. Current models lack sufficient precision to support clinical decisions. We have generated new prognostic models using data from STOPAH and have identified transferrin and PNPLA3 genotype as prognostic biomarkers. The ELF score, a validated prognostic marker in chronic hepatitis will be evaluated in AH(2). Prognostic models will be revised to incorporate the new biomarkers and validated in the cohort study. STOPAH demonstrated a borderline survival advantage with prednisolone treatment at 28 days but short term survival benefits were lost by 90 days due to increased incidence of infection(3). Data and samples from the STOPAH study facilitated analysis of serum, genetic and cellular biomarkers and development of prognostic models. We identified bacterial 16S ribosomal DNA (16S-DNA), monocyte oxidative burst and HLA-DR expression as biomarkers for infection susceptibility(4). When validated these would be used to stratify patients for use of prophylactic antibiotics, potentially leading to a survival benefit. A prospective cohort study with nested case control studies for survival, infection, diagnosis and acute kidney injury will be conducted to validate the results generated in STOPAH. Mechanistic studies using precision-cut liver slices and gene expression analysis will be used to support biomarker validation


Research activity codes: 2.1 BIOLOGICAL AND ENDOGENOUS FACTORS;4.1 DISCOVERY AND PRECLINICAL TESTING OF MARKERS AND TECHNOLOGIES;4.2 EVALUATION OF MARKERS AND TECHNOLOGIES
Health categories: CANCER AND NEOPLASMS;CARDIOVASCULAR;ORAL AND GASTROINTESTINAL;STROKE
Title: Determinants and Mechanisms Involved in Alcohol Consumption and its Health Consequences
Funder: Medical Research Council

Abstract: Here, I propose to use genetic and phenotype data to systematically explore genetic and environmental factors as well as gene-environment interactions involved in alcohol consumption and alcohol induced latent changes in liver. I will use large-scale genetic and phenotype data from the UK Biobank study and he Airwave health monitoring study. I will validate the results in collaboration with universities of Liverpool and Leicester. My main aim is to unravel mechanisms involved in alcohol consumption and its consequences. I specifically aim to identify (1) phenotypic and genetic determinants and gene-environment interactions involved in alcohol consumption and its related disease. Here, I will use UK biobank study data and agnostically identify phenotypes associated with alcohol consumption. I will additionally select alcohol-related genetic variants from existing literature and identify phenotypes associated with selected genes in the UK Biobank and consequently test gene-environment interactions. (2) Identify biologic mechanisms involved in alcohol consumption using animal models. This will be done in collaboration with universities of Liverpool and Leicester (3) Identify pathways involved in fat accumulation in liver. Here, I will use metabolites from the Airwave study to identify alcohol-related metabolites. Consequently using the Airwave study, I will identify genes associated with alcohol-related metabolites for further investigation using the UK Biobank genetic and imaging data, to identify pathways involved in fat accumulation in liver through alcohol consumption. (4) Highlight brain areas involved in alcohol consumption using bioinformatics approaches in combination with brain imaging and genetic data (5) Identify novel outcomes caused by alcohol consumption. Here, I will use Mendelian Randomization (MR) study to investigate causality between alcohol consumption with related diseases.


Research activity codes: 2.2 FACTORS RELATING TO PHYSICAL ENVIRONMENT
Health categories: CANCER AND NEOPLASMS;CARDIOVASCULAR;ORAL AND GASTROINTESTINAL;STROKE
Title: The spatial epidemiology of alcohol availability, consumption and harm
Funder: Medical Research Council

Abstract: The purpose of the project is to investigate the spatial epidemiology of alcohol availability, consumption and harm. Understanding the impact of the geographical density of alcohol availability and to explore its associations to behaviours of consumption and misuse, is of great importance to inform alcohol regulation and prevention of misuse and harm in the UK. We propose a spatial analysis of the relationship between alcohol outlet density and incidence of alcohol misuse and harm. To achieve this, we will develop a model of spatial availability of alcohol (outlets) at local authority level for three urban areas in the UK, using spatial mathematics, graph theory, (network) topology, and spatial statistics to properly capture the notion of alcohol availability, considering density, proximity, accessibility (hours of operation, logistics). The use of spatial epidemiology, and uncertainty quantification will play an important role in this part of the project. These models will be used to compare evidence regarding measures of outlet availability, and to explore the existence of local predicting mechanisms for harm and misuse based on outlet utility and availability. The project will also investigate trends in alcohol availability, consumption, and harm, in view of examining the existence of a causal relationship between them. We propose the use of geographically fine, longitudinal data on type, location, and temporal availability of alcohol outlets; and will resource to the analysis of large routinely collected data. Data on operating alcohol outlets is usually not readily available from the UK government, thus will be obtained from commercial sources (market research companies) which are deemed to cover 98% of the UK's alcohol outlets. Geospatial data will then be obtained from the Office of National Statistics and large routine data on hospital admission and emergency services data will be obtained from NHS digital and ambulance trusts.


Research activity codes: 2.3 PSYCHOLOGICAL, SOCIAL AND ECONOMIC FACTORS
Health categories: CANCER AND NEOPLASMS;CARDIOVASCULAR;ORAL AND GASTROINTESTINAL;STROKE
Title: The impact of peers in relation to alcohol use in adolescence: investigating social influences to inform a peer-led school-based intervention.
Funder: Department of Health and Social Care

Abstract: This research will use mixed methods to explore the relationship between social networks and alcohol use behaviour during adolescence to inform development of a school-based intervention. Social network analysis will be used to investigate the associations between characteristics of peer networks and the initiation and frequency of alcohol use and drunkenness. Complementary qualitative research will explore young people's perspectives regarding social influences on alcohol consumption and related harms, and their views around effective interventions. The findings will be used to inform development and implementation of a pilot peer-led intervention to prevent harmful alcohol use during adolescence.

Lay abstract: This research will use mixed methods to explore the relationship between social networks and alcohol use behaviour during adolescence to inform development of a school-based intervention. Social network analysis will be used to investigate the associations between characteristics of peer networks and the initiation and frequency of alcohol use and drunkenness. Complementary qualitative research will explore young people's perspectives regarding social influences on alcohol consumption and related harms, and their views around effective interventions. The findings will be used to inform development and implementation of a pilot peer-led intervention to prevent harmful alcohol use during adolescence.

Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: CANCER AND NEOPLASMS;CARDIOVASCULAR;ORAL AND GASTROINTESTINAL;STROKE
Title: Opportunity-Led Research Proposal: STAMPP in Northern Ireland
Funder: Health and Social Care Research and Development Division (HSC R&D) of Public Health Agency, Northern Ireland

Abstract: For the past four years children in 70 post-primary schools in Northern Ireland have been taking part in STAMPP, a randomised cluster control trials fundeded (c£1 million) by the National Institute of Health Research (NIHR). The trial also involves 35 post-primary schools in Glasgow and Inverclyde. The trial is a combination of a universal school-based alcohol intervention (SHARHP, which is currently being delivered in Northern Ireland based on our previous work in Belfast) and a parental intervention. As part of this trials the PHA have previously provided £50,000 support (£25,000 pa for two years to support teacher training and other activities linked to PHA objectives). The TAMPP trial collected a range of data (see below) from a large cohort of young people (c7,000 in NI) from the start of their post primary education (i.e. school year 8; aged 11-12). These young people are currently coming into their final year of complulsory education (i.e. they are taking their GCSEs this academic year). As we had already conducted a smaller SHARHP trial in Belfast we did not sample from this area (sampling from this area would have caused "contamination" in the randomisation process) and therefore these young people are located all over NI to provide a mix of urban and rural participants (for example participants are as far afield as Carrickfergus and Ballyclare in the East; Ballycastle in the North; Derry, Enniskillen and Irvinestown in the West; and Newry, Keady and Markethill in the South). CURRENT POSITION. The STAMOO trial is due to end in March 2016 and all data collection will cease. In order to maintain the cohort for on-going and potentiall valuable research purposes, we have already secured funding from NHSC Scotland to continue to gather data from the Scottish portion of the cohort as they progress through their final years of school-based education. The aim of this work is to examine the role of the risk factors collected throughout the trial on outcomes of use to our stakeholders. To date all of our efforts have been focused on the alcohol-related outcomes for the NIHR, however going forward from the delivery of the final report in March 2016 we will not be restricted to this focus.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: CANCER AND NEOPLASMS;CARDIOVASCULAR;ORAL AND GASTROINTESTINAL;STROKE
Title: Interdisciplinary Research into political interest, civil society support and available data to strengthen Alcohol Policy Systems in Brazil and Peru
Funder: Medical Research Council

Abstract: Alcohol consumption is a major contributor to disease and death globally and harms are rising in LMICs. Harms can be reduced by taxation of alcohol and controls on advertising and availability, measures which need political support. Civil society actors (NGOs, health) can successfully advocate for policy change but are routinely opposed by commercial actors. Research on alcohol policy systems is a notable gap in health policy analysis with no theoretically informed studies in Latin America. Alcohol policy appraisal and evaluation is a gap in LMICs more generally, data is little used, and few countries have adopted comprehensive alcohol control policies. Brazil and Peru (combined population 242M) have largely unregulated alcohol markets, despite high levels of harm particularly in disadvantaged areas. This co-developed study will utilize the Advocacy Coalition Framework to analyze the alcohol policy system in these two countries, to accelerate research, policy development and advocacy in Peru, Brazil and the region. The study includes: 60 in-depth qualitative interviews with policymaker/civil society stakeholders (30 in each country) to explore values, beliefs and interests regarding alcohol problems and policy solutions; and scoping work to assess the availability and quality of alcohol data to underpin future policy appraisal or evaluation studies or inform advocacy or policy development. Interview data will be analyzed using the Framework method; and data assessments recorded in a database. The study team includes local lead co-investigators (CIs) and new fulltime researchers in Brazil and Peru, and integrates CIs from multiple disciplines. Local researchers will benefit from access to a rich capacity-building programme. Impact plans include sustained engagement with national and regional policy stakeholders via four workshops, bilateral meetings, a study advisory panel, policy briefings, conference presentations, and co-authored peer-reviewed outputs.


Research activity codes: 3.2 INTERVENTIONS TO ALTER PHYSICAL AND BIOLOGICAL ENVIRONMENTAL RISKS
Health categories: CANCER AND NEOPLASMS;CARDIOVASCULAR;ORAL AND GASTROINTESTINAL;STROKE
Title: Regulating alcohol packaging and supply to protect health in Sub-Saharan Africa: evidence from policy systems in Malawi and Uganda
Funder: Medical Research Council

Abstract: The age-standardized alcohol-attributable burden of disease and injury is highest in the WHO African Region, at 70.6 deaths and 3 044 DALYs per 100 000 people, placing an enormous strain on already challenged health systems. Drinkers in Africa consume 21% more alcohol per day than the global average. Small disposable plastic sachets- pouches which contain single use quantities of alcohol which often contain 40% spirits- have led to significant abuse amongst the most vulnerable and poorest communities in Malawi and Uganda. Concerns about harmful consumption and the public health and societal impact led to national bans on sachets of alcohol in Malawi (2016) and Uganda (2019), but those may not have had the impact anticipated. We will conduct interviews with key policy stakeholders and with district and local stakeholders in enforcement and trade in Malawi and Uganda to understand the adoption and formulation of the bans, what mechanisms for implementation were proposed and put in place, how the bans were enforced in practice, and any unintended consequences that have resulted. We will conduct focus group discussions with community members, health staff from local health centres and with traditional/ church leaders and school headteachers to explore the perceived impact of the ban and any unintended consequences from a local community perspective. Our multidisciplinary international team will conduct a robust analysis based the Health Policy Analysis framework to highlight contextual factors important for the transferability of findings to other Sub-Saharan countries in order to inform alcohol policy development and implementation across the region. We will publish results in peer reviewed journals and share them at stakeholder events in each country to discuss how the results may be used to further regulation of the supply of alcohol and reduction of related harms. Our researchers in LMICs will benefit from a strong capacity-building and research skills programme.

Lay abstract: Note - this award is managed by MRC but funded via Foreign, Commonwealth & Dev Office

Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: CANCER AND NEOPLASMS;CARDIOVASCULAR;ORAL AND GASTROINTESTINAL;STROKE
Title: The Impact of Minimum Pricing of Alcohol on Ambulance Call-outs in Scotland (IMPAACT)
Funder: Chief Scientist Office, Scotland

Abstract: This study will be the first to determine whether increasing the price of cheap alcohol affects ambulance call-outs and to examine in-depth the impact of alcohol on a public ambulance service. Ambulance call-outs due to alcohol cost ~£52 million annually in Scotland (York Health Economics Consortium 2010). Under the Scottish Government’s (SG) world-first ‘Minimum Unit Pricing’ (MUP) policy, the cheapest alcoholic drinks became more expensive from 1st May 2018. Research suggests that this will reduce drinking especially in heavier drinkers from deprived backgrounds, and should reduce ambulance call-outs, but the actual impact of price changes on call-outs has not previously been studied. Objectives: (1) Using detailed data from the Scottish Ambulance Service (SAS), we will identify alcohol-related ambulance call-outs and examine statistically if MUP had an impact on the number of call-outs, including in different groups (varying by sex/age/wealth). (2) Using indepth interviews with ambulance staff, we will explore how they experience, identify, handle and record alcohol-related call-outs. The findings will: help the Scottish Parliament who must decide in 2024 if enough evidence exists of benefits from MUP to continue it beyond that date; inform wider alcohol policy; and support SAS with planning and training staff for future alcohol-related incidents


Research activity codes: 8.3 POLICY, ETHICS AND RESEARCH GOVERNANCE
Health categories: CANCER AND NEOPLASMS;CARDIOVASCULAR;ORAL AND GASTROINTESTINAL;STROKE
Title: Understanding experiences and impacts of alcohol provision in changing public spaces
Funder: The British Academy

Abstract: Public spaces, and the ways we use them, are changing. Within the ‘Build Back Better’ agenda for UK high streets and city centres are competing priorities about the resources provided in our future public spaces. One important focus is the provision of alcohol. While different social and health impacts of alcohol consumption are well-researched, what is little understood is how alcohol provision affects people’s experiences of, and access to the amenities of, public spaces. This project will develop understanding of the impact of alcohol provision on experiences of public spaces, in the context of changing local areas. This will be achieved through i) the development of a conceptual framework, and ii) a case study of a UK city, to understand experiences of alcohol provision in different, and changing, public spaces. This will be valuable for informing decision-making about designing inclusive public spaces for the future.


Research activity codes: 3.2 INTERVENTIONS TO ALTER PHYSICAL AND BIOLOGICAL ENVIRONMENTAL RISKS
Health categories: CANCER AND NEOPLASMS;CARDIOVASCULAR;ORAL AND GASTROINTESTINAL;STROKE
Title: Preventing Return to Smoking Postpartum (PReS Study) - Development of a complex intervention to sustain smoking cessation in postpartum women
Funder: Medical Research Council

Abstract: In the UK 26% of women smoked tobacco in the 12 months before pregnancy (1). Although 54% of smokers quit during pregnancy, 94% of those re-start smoking by 6 months postpartum (5). Continued postpartum abstinence has major health benefits, as many of the risks attributable to smoking, including cancer and heart disease, can be minimised by cessation. Abstinence also reduces children's exposure to second hand smoke, with associated risks including respiratory conditions and cot death (7, 8). In 2015, the UK Royal College of Physicians (9) estimated passive smoking in children had an avoidable annual NHS cost of approximately £23.3 million. This study aims to develop a novel intervention to support women who have stopped smoking in pregnancy to stay stopped in the postpartum period. In phase 1, we will collate evidence from systematic reviews undertaken by our team (15, 25) and other studies to identify suitable intervention components and the underlying theoretical processes of change (behaviour change techniques, BCTs). Promising components are likely to include goal setting, incentives for continued cessation, advice on medication, and social support specifically tailored to postpartum status. The intervention will be developed and refined during phase 2 which involves focus groups with pregnant and post-partum women (smokers and ex-smokers), their partners, healthcare and stop smoking professionals. Focus groups will refine intervention content through discussion, and define procedures for delivery of the intervention, (e.g. brief intervention by a healthcare professional then online, or text message support). In phase 3, we will model the intervention to test it out and further refine it. This modelling phase will confirm the optimal and achievable procedures for delivery, exploring tailored dose and targeting. The output of the study will be the development of a new intervention suitable for further testing in a clinical trial.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: CANCER AND NEOPLASMS;CARDIOVASCULAR;REPRODUCTIVE HEALTH AND CHILDBIRTH;RESPIRATORY;STROKE