NIHRDataInsights/HRCSData huggingface dataset:
Title: First Steps to Smoke-free: Using air-quality feedback to facilitate smoke-free homes through the NHS Lanarkshire First Steps Programme
Funder: Chief Scientist Office (Scotland)

Abstract: Exposure to second-hand smoke (SHS) in early life is damaging to lifelong health. Recent work has suggested that providing personalised data on the considerable adverse effect of smoking on household air quality can be a powerful motivator to changing behaviour. Building on the results of a feasibility study, this project aims to utilise the NHS Lanarkshire First Steps Programme to test the efficacy of providing disadvantaged families with information about SHS levels in their own homes. One group will receive a real-time graph of smoke levels in their home together with comparison data and advice on steps to reduce SHS levels in their home; with the other group receiving standard advice on SHS. Participants will be followed up at 1 and 6 months to determine changes in air quality, smoking behaviour and household smoking rules. Qualitative interviews will also be carried out to explore perceived benefits and barriers to change.


Research activity codes: 3.2 INTERVENTIONS TO ALTER PHYSICAL AND BIOLOGICAL ENVIRONMENTAL RISKS;3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: STROKE;RESPIRATORY;CANCER AND NEOPLASMS;CARDIOVASCULAR
Title: Why do some smokers, and those diagnosed with lung cancer, delay or avoid presenting symptoms to their GP because of factors associated with smoking?
Funder: Division for Social Care and Health Research (Wales)

Abstract: This project is a qualitative study designed to identify reasons why people who smoke might hesitate to see a doctor when they suffer symptoms of potentially severe chest disease. The prospective doctoral student will interview patients with a recent diagnosis of lung cancer and conduct focus groups with smokers who do not have chest symptoms The study is intended to find out why smokers may not want to see a doctor when symptoms arise and is particularly concerned with feelings of blame and stigma. The research aims to use the information gained from the interviews and focus groups to inform the general public of the importance of seeing a doctor when chest symptoms arise, particularly if they smoke. The findings of the project are also likely to be of use to doctors and nurses when they treat patients who smoke, either in private appointments or as part of patient groups and smoking cessation clinics.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING;7.3 MANAGEMENT AND DECISION MAKING
Health categories: STROKE;RESPIRATORY;CANCER AND NEOPLASMS;CARDIOVASCULAR
Title: Evaluating long term outcomes of NHS stop smoking services (ELONS)
Funder: Chief Scientist Office (Scotland)

Abstract: Design:Observational study including:1. Secondary analysis of routine data collected by SSSs using the North51 database2. Prospective study of service clients from 9 PCTs Follow up at 4 weeks & 12 months. Gold standard NHS SSS client satisfaction questionnaire.Setting:NHS SSSs in EnglandTarget population:Smokers who make contact with NHS SSSsHealth technologies:Treatment provided by SSSs – a combination of behavioural support and medication. We will focus on evaluating outcomes for smokers who receive one of the 5 main forms of behavioural support (intervention types) provided. These are: closed groups rolling groups one to one drop in one to one appointments with a specialist adviser one to one appointments with a sessional adviser (usually a pharmacist or practice nurse). Measurement of costs and outcomes:Primary outcome is prolonged abstinence at 12 months. We will also assess abstinence at 4 weeks. Measurement will follow the Russell Standard (intention to treat and biochemically validated). We will measure uptake by assessing what proportion of their smoking population SSSs reach and we will explore the reasons for and timing of relapse amongst smokers who do not remain abstinent. We will also assess client satisfaction with NHS stop smoking services. Sample size:Secondary analysis:All smokers who set a quit date with an SSS who uses the North 51 database during the period Jan-Dec 2010.Prospective study:3000 smokers using NHS stop smoking services in 9 PCTs with representation from each intervention type.Project timetable:Start October 1st 2011. Secondary analysis October 2011-February 2012. Four week follow-up May 2012-February 2013. Client satisfaction survey May 2012-February 2013. Satisfaction survey and short term follow up analysis June - September 2013. Twelve month follow-up April 2013 - February 2014. Analysis write-up dissemination to services Febraury - September 2014.


Research activity codes: 6.6 PSYCHOLOGICAL AND BEHAVIOURAL;6.1 PHARMACEUTICALS
Health categories: STROKE;RESPIRATORY;CANCER AND NEOPLASMS;CARDIOVASCULAR
Title: Barriers and facilitators to smoking cessation in pregnancy and following childbirth
Funder: Chief Scientist Office (Scotland)

Abstract: Maternal smoking in pregnancy causes substantial harm and while many women in the UK stop smoking before or soon after becoming pregnant one in four women smoke for part of pregnancy and one in eight smoke continually. This study will explore barriers and facilitators to smoking cessation in pregnancy by reviewing relevant literature conducting qualitative research and developing proposals for future interventions.A qualitative study design will combine three systematic reviews and three exploratory studies conducted over a two year period with data from a rapid mapping exercise to identify existing and in-development interventions for cessation in pregnancy. Firstly a set of three reviews of barriers and facilitators to cessation in pregnancy and following childbirth will be undertaken focusing on pregnant women partners/family members and professionals respectively.Secondly a set of three exploratory studies will be undertaken. These will focus on pregnant women partners/family members and health professionals. The three studies will be undertaken in one study site in Scotland (NHS Lothian) and one in England (NHS North Yorkshire and York). The sample will comprise:• 20 pregnant women who are continuing to smoke during pregnancy (10 in each site)• 20 to 25 household members residing with these pregnant women (10 to 12 in each site)• 20 pregnant women who have recently stopped smoking (10 in each site)• 20 to 25 household members residing with these pregnant women (10 to 12 in each site)• 20 professionals in each site including midwives and midwifery managers consultant obstetricians health visitors and cessation advisers.A subsample of 10 women originally interviewed will also be followed up post-partum to identify longer term experiences. Findings from the interviews will identify barriers and facilitators to cessation in pregnancy from the perspective of each group of interviewees. These will be compared and contrasted and brought together with the evidence from the systematic reviews to produce a narrative synthesis of key themes and issues. These findings will inform recommendations for practice and lead to the development of proposals for interventions to address smoking in pregnancy that can be tested in future research.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING;8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: STROKE;RESPIRATORY;CANCER AND NEOPLASMS;CARDIOVASCULAR
Title: Adapting a behavioural support intervention for smokeless tobacco cessation in South Asians
Funder: Medical Research Council

Abstract: Around 300 million people worldwide consume smokeless tobacco. Considered to be a part of the culture, its use is particularly common in people of South Asian-origin1. A quarter of adults in India and Bangladesh and a fifth in Pakistan use smokeless tobacco. Also popular in the South Asian diaspora; one in five Bangladeshi women in the UK is a regular user. In addition to cardiovascular diseases, smokeless tobacco use leads to oral, oesophageal, and pancreatic cancers. A recent Cochrane review suggests that behavioural support interventions are likely to be effective in smokeless tobacco cessation. However, studies in this review were mainly conducted in the US and European populations who, compared to South Asians, use less addictive and less hazardous products (e.g. moist snuff). Moreover, its consumption among South Asians has strong socio-cultural dimensions, which need to be considered in behavioural support interventions. The cessation advisors in the UK, offering behavioural support to smokeless tobacco users of South Asian-origin commonly modify their advice according to what they perceive appropriate. However, there are variations in practice, no standard treatment protocol for a culturally adapted intervention and no evidence for its effectiveness. We aim to identify the modifications required to a behavioural support intervention in order to make it more effective, feasible, and acceptable for South Asians in smokeless tobacco cessation. We will adapt, test and refine the intervention in three phases. An expert panel will agree on the required adaptations. We will then assess the feasibility, adherence and acceptability of the adapted intervention. The intervention will be delivered by four cessation advisors to 32 participants (smokeless tobacco users) at two different sites (UK and Pakistan). We will audiotape and analyse 96 behavioural support sessions, interview 16 participants and four advisors to assess feasibility, adherence and acceptability. Findings will inform any further modifications.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING;7.1 INDIVIDUAL CARE NEEDS
Health categories: STROKE;RESPIRATORY;CANCER AND NEOPLASMS;CARDIOVASCULAR
Title: Feasibility & acceptability of novel smoking cessation smartphone sensing app delivering support by realtime events
Funder: Medical Research Council

Abstract: Three million UK adult smokers attempt to quit smoking each year. However, most of these attempts fail, caused in part by a failure to manage cravings brought about by a smoking cue from the environment. These are implicated in almost half of all smoking lapses1 and are not alleviated by the most commonly used cessation medications. The use of behavioural coping strategies can help smokers manage these cue-induced craving episodes without lapsing. However, most smokers either fail to use a coping strategy or use them inadequately during these episodes and relapse within 4 weeks of a quit attempt, even after receiving cessation counselling and pharmacological support. The proposed research will assess the feasibility and acceptability of a novel type of smoking cessation smartphone app we have developed to help smokers avoid or cope with cue induced craving episodes. This app (QSense) builds on two tailored SMS text message support systems for smoking cessation that we have developed and evaluated (MiQuit and iQuit) and combines the existing tailored message libraries with a smartphone sensing system. This sensing system will deliver real-time behavioural support triggered by a smoker’s proximity to a pre-identified high risk location for a cue-induced craving episode, using location sensors in their smartphone (e.g. the Global Positioning System, GPS). We propose two studies (‘early phase studies’) to guide continued intervention development and inform the parameters of a future explanatory randomised controlled trial (‘main study’). Study 1 will assess the feasibility of using the sensing system when integrated into a smoking cessation app running on smokers’ personal smartphones (N=15). After an intervention refinement phase, study 2 will use mixed methods to assess the acceptability and usage of the refined app among smokers accessing smoking cessation support at their local GP practice (N=40).


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: STROKE;RESPIRATORY;CANCER AND NEOPLASMS;CARDIOVASCULAR
Title: The effectiveness of mass media campaigns in reducing smoking, second-hand smoke exposure and smoking-related disease in England & Wales
Funder: Medical Research Council

Abstract: This research will evaluate the effectiveness and cost-effectiveness of anti-tobacco mass media campaigns in England and Wales since 2004 using key indicators of smoking behaviour and smoking-related health outcomes in the general population, and in specific population groups. We will use a combination of time series analysis and longitudinal panel study analysis, using data from national datasets. Our outcomes will include smoking prevalence, rates of smoking cessation medication prescriptions, and GP consultations for children's respiratory disease (The Health Improvement Network primary care data), NHS quitline calls, NHS stop smoking service (SSS) attendees and 4 week quitters, NRT sales, Health Survey for England children's cotinine measurements, and Hospital Episode Statistics on acute MIs. Autoregressive time series models will be used to estimate population-level change in smoking behaviours and health outcomes in response to specific campaigns, or month-to-month change in advertising reach and spend, specifying the appropriate autoregressive process and transfer function, and modelling underlying trends, seasonality, and impacts of other tobacco control policies. Longitudinal analysis will use International Tobacco Control (ITC) UK data of over 2000 adult smokers and recent ex-smokers to assess individual changes in smoking behaviour and attitudes pre and post campaigns using random effects regression models. The economic model will link mass-media campaigns (via expenditure and coverage) to intermediate stop-smoking outcomes (calls to quit helplines, SSS attendance), the impact of those stop-smoking outcomes on intermediate health outcomes (AMI and respiratory disease) and the costs avoided following reductions in those health outcomes. The study will provide evidence as to whether government spending on mass media campaigns is effective and cost-effective, and for prioritising future funding to maximise its impact and reach its target audience.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING;8.2 HEALTH AND WELFARE ECONOMICS
Health categories: STROKE;RESPIRATORY;CANCER AND NEOPLASMS;CARDIOVASCULAR
Title: Muslim Communities Learning About Second-hand Smoke - MCLASS pilot cluster randomised controlled trial
Funder: Medical Research Council

Abstract: Second-hand smoking (SHS) is a serious health hazard to non-smokers, especially children. Smoking restrictions in households reduces children's exposure to SHS, encourages smokers to quit and discourage young people to initiate smoking. We aim to identify effective ways to protect children and non-smoking adults from SHS, reduce uptake and improve quit rates of smoking in Bangladeshi and Pakistani-origin Muslim communities in the UK. Smoking prevalence is higher and relevant outcomes are poorer in these communities compared to general population. Following a feasibility study of 'Smoke Free Homes', and pursuing a community-faith leaders approach, we developed a Smoke Free Homes' toolkit for three key groups of Muslim religious leaders i.e. Imams, Qur'an teachers and women circle leaders to encourage their respective congregations to have household smoking restrictions. In order to establish the effectiveness of this approach, a cluster randomised controlled trial (RCT) is needed. However, prior to a definitive trial we plan to carry out a pilot trial to inform its design. Our objectives include: ascertaining the number and size of clusters, recruitment and attrition rates, and other statistical requirements (effect size and ICC) for the definitive trial; establishing feasibility, acceptability and resource requirements for delivering the intervention and assessing outcomes; and understanding the extent to which 'Smoke Free Homes' can be integrated into mosques' routine. We will carryout a pilot cluster RCT over 24 months in fourteen mosques, which host communal prayers, convene study circles for women and have regular Qur'an classes for children. We will recruit at least 50 households from each mosque. We will measure salivary cotinine levels in non-smokers in the households before and after the intervention in each trial arm. Secondary outcomes include assessment of smoking restrictions at home, smoking status of adults' and their intention to quit.


Research activity codes: 3.2 INTERVENTIONS TO ALTER PHYSICAL AND BIOLOGICAL ENVIRONMENTAL RISKS
Health categories: STROKE;RESPIRATORY;CANCER AND NEOPLASMS;CARDIOVASCULAR
Title: What types of interventions reduce or worsen inequalities in adolescent smoking? A review of the literature and reanalysis of intervention studies.
Funder: Medical Research Council

Abstract: Phase 1 (the review) will identify and synthesise evidence for impacts of interventions on inequalities in adolescent smoking. CINAHL, Cochrane Central, Embase, Medline, Medline In-Process, PsycINFO and Web of Science will be searched for evaluations of interventions to reduce or prevent smoking amongst adolescents, categorised as acting at the level of the individual, community, society, or at multiple levels. Percentages reporting impact on inequality will be presented by intervention type. A database will be compiled of studies which collected SEP measures, but did not report impacts on inequality, providing the sampling frame for the programme of reanalysis in Phase 2. Finally, the review will draw tentative conclusions regarding the impact of interventions on inequalities in adolescent smoking, through synthesising studies reporting impacts on inequality, using Ogilvie and colleagues' (2008) harvest plot methodology. Phase 2 will explore which types of interventions impact on inequalities through reanalysis of evaluations which collected SEP measures without examining differential effectiveness. Up to 40 studies will be selected for reanalysis, including a range of intervention types (individual, community, society level or multi-level interventions) and contexts. Authors will be asked whether unpublished analyses of impacts on inequality were conducted, and if they are willing to share these. Where they were not, authors will be asked to provide an anonymised dataset, or reanalyse data by SEP and provide syntax and output. Analyses will divide samples into equal high and low SEP subgroups, presenting effect sizes in each subgroup before entering an interaction term for intervention*SEP. Attention will be paid to how well powered studies are to detect interactions. The harvest plot developed in Phase 1 will be extended to incorporate Phase 2 studies. Meta-analyses will be conducted where feasible.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING;2.3 PSYCHOLOGICAL, SOCIAL AND ECONOMIC FACTORS
Health categories: STROKE;RESPIRATORY;CANCER AND NEOPLASMS;CARDIOVASCULAR
Title: Translating Non-Communicable Disease Interventions for African Contexts a Socio-Cultural Study of the Bloomberg and Gates Initiative to Reduce Tobacco Use in Kenya and Burkina Faso.
Funder: Wellcome Trust

Abstract: This research addresses the growing epidemic of non-communicable diseases (NCDs) like cancer and diabetes in the Global South. Contrary to received knowledge, NCDs are not only the leading cause of death in developed countries but, increasingly, also in developing countries. This epidemic will be especially devastating for African countries already plagued by infectious diseases and a lack of resources. It is therefore vital that we stem this epidemic by transposing to the Global South the publi c health programmes that have been successful in tackling NCDs in the Global North. This research purports to facilitate this process by demonstrating the importance of adapting these programmes to the new political and cultural contexts in which they are being transposed to avoid them being resisted, misunderstood or otherwise rendered ineffective. It does this by exploring in detail an international initiative led by the Bloomberg and Gates foundations to reduce tobacco consumption - a key NCD risk factor - in Kenya and Burkina Faso. Specifically, it studies how the initiative's international experts and their local partners have reframed, translated and adjusted North American and European tobacco control expertise, advocacy and policies to make them work in Kenya's and Burkina Faso's political and cultural settings.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: STROKE;RESPIRATORY;CANCER AND NEOPLASMS;METABOLIC AND ENDOCRINE;CARDIOVASCULAR
Title: Exploiting the potential offered by the increasing computerisation of health records for population based research.
Funder: Wellcome Trust

Abstract: Research has shown that inflammation is associated with heart disease and stroke. The focus of this proposal is how to use this knowledge to improve patient health, a process called translational research . We intend to achieve this using electronic health records, which hold computerised information on patients in primary care or attending hospital. Such records are already used in health research but we believe that they offer further potential due to their wide population coverage and clinic al detail. Therefore we propose a programme of work with two approaches. Firstly we will develop and implement new methods to carry out clinical trials of drugs within routine clinical practice in primary care. These will use electronic health records to determine patient treatment, and ascertain information about patient healthcare before, during and after the trial. We will use this method to test whether statins (widely used cholesterol lowering drugs) protect people during periods of par ticularly high risk of heart attacks and strokes. Secondly, we will undertake a series of studies looking at specific questions around inflammation and cardiovascular disease using electronic health records. Together, the proposed work will make a major contribution to translating knowledge of inflammation in vascular disease into improved health.


Research activity codes: 7.3 MANAGEMENT AND DECISION MAKING;8.4 RESEARCH DESIGN AND METHODOLOGIES (HEALTH SERVICES)
Health categories: STROKE;RESPIRATORY;CARDIOVASCULAR