Title: Innovative lifestyle interventions to improve population health
Funder: Department of Health and Social Care

Abstract: Background: More than two thirds of the population are either overweight/obese because of excessive energy intake and/or insufficient physical activity. Based on objective assessment only 6% of men and 4% of women in England achieve 150-min per/week of moderate intensity physical activity in line with guidance. Approximately 6-10% of global mortality associated with non-communicable diseases is due to physical inactivity, yet there is compelling evidence that inactivity and high levels of sitting are both independently associated with disease and mortality. This is of real concern and there is no reason to assume this will improve unless effective population interventions are put in place.Aims and Objectives: This application involves four workstreams to develop and test innovative lifestyle interventions to address the problem of physical inactivity, sedentary behaviours and overweight. It seeks to involve and combine the individual, NHS and environment. The application builds directly on work funded by NIHR and my previous NIHR senior fellowship. There is a particular emphasis on delivering pragmatic evaluations in conjunction with health services, patients and the public. There is a focus on testing interventions that meet the ambition of the NHS to 'make every contact count'. Objective: 1: Develop and test a snacktivity intervention to promote physical activity in the population Objective 2: Obtain public feedback on the usefulness of physical activity calorie equivalent food labelling (PACE) when making food choices and evaluate the usefulness of PACE labelling in real life contexts. PACE is an approach where by the number of calories in food is displayed in the number of minutes of activity required to expend a food/drink item (e.g. this cake requires 45 minutes of running to burn).Objective 3: Investigate the feasibility of implementing a brief weight management programme for postnatal women embedded within the national child immunisation programme.Objective 4: Develop a world class Centre for Public Health Physical Activity Research at Loughborough University. Methods: Programme 1 involves early phase studies to develop a 'snacktivity' intervention, prior to testing in feasibility and effectiveness trials.Programme 2 will investigate feasibility and acceptability of physical activity calorie equivalent (PACE) food labelling in a caf/cafeteria environment and whether PACE labelling encourages physical activity. Programme 3 focuses on women who have recently given birth and tests the procedures involved in delivering an intervention where practice nurses routinely promote self-monitoring of weight within the national child immunisation programme/appointments. Programme 4 aims to establish a world class Centre for Public Health Physical Activity Research by working in partnership with patients, health professionals, commissioners, policy makers and industry to ensure our work is relevant to the public and the NHS. Outputs: My ambition is to evaluate lifestyle interventions that can be easily implemented within the NHS and public health settings, to reduce diseases. This award will provide opportunities to develop a large team of researchers and help them become independent researchers in this field. This award will develop my senior research leadership skills and allow me to firmly establish myself as a world expert in physical activity research.

Lay abstract: Background: Many people are either overweight/obese because they eat too much food, do not do enough physical activity and spend too much time sitting. This is very concerning and many diseases could be stopped if the public were more active and spent less time sitting. We need interventions to help the public to be more physically active and stop them developing diseases, improve their psychological health and how they feel about themselves. Aims and Objectives: This application involves four related topics of work to develop and test new lifestyle interventions to help the public to become more physically active, reducing the time they spend sitting and reduce overweight/obesity. The research aims to involve the public, NHS and the wider environment, to promote healthier lifestyles in the population. The application builds directly on previous research that has been funded by NIHR and a previous NIHR senior research fellow awarded to the applicant. This application is particularly focused on testing lifestyle interventions in partnership with the NHS, patients and the general public. The Department for Health would like to integrate more opportunities for NHS staff to promote healthy lifestyles within routine NHS consultations-they have called this campaign 'make every contact count'. We have therefore focused this application on testing interventions that can be delivered to the public during routine consultations with health professionals. This application has four objectives: Objective: 1: Develop and test an intervention we have called 'snacktivity' to see if it encourages the public to be more physically activity and sit less.Objective 2: Evaluate the usefulness of physical activity calorie equivalent (PACE) food labelling on food purchasing decisions by the public. PACE food labelling is an approach where the number of calories in food/drinks is converted in to the number of minutes required to expend the calories in the food/drink item (e.g. this pizza will take 55 minutes of running to burn; this cake will take 2 hours of walking to burn) . Objective 3: Investigate the feasibility and usefulness of implementing a brief weight management programme for postnatal women that takes place when women attend their general practice to have their baby immunised. Objective 4: Aims to establish a world leading centre at Loughborough University that focuses on Public Health Physical Activity Research. Methods: Programme 1 involves a series of connected studies to develop a 'snacktivity' intervention, before it is tested to see if it is feasible in increasing physical activity levels and time spent sitting in the population. Programme 2 will investigate the feasibility and acceptability of introducing physical activity calorie equivalent (PACE) food labelling in cafs/cafeterias and whether PACE labelling encourages physical activity in the public. Programme 3 focuses on women who have recently given birth and tests the procedures involved in delivering an intervention where practice nurses encourage women to weigh themselves to check their weight, when women visit their general practice to have their baby immunised.Programme 4 aims to establish a Centre for Public Health Physical Activity Research by working with patients, health professionals, policy makers and food manufacturers/shops to ensure our work is relevant to the public and the NHS. Outputs: This award will provide me with opportunities to build a team of researchers who are focused on conducting lifestyle research that can be translated in to everyday life. It will provide the opportunity to increase my international profile and establish myself as a leading world expert in physical activity research. This award will raise my profile as a senior research leader and strengthen my collaborations with other partners who have an interest in promoting physical activity in the population.

Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING;6.7 PHYSICAL
Health categories: CANCER AND NEOPLASMS;CARDIOVASCULAR;METABOLIC AND ENDOCRINE;ORAL AND GASTROINTESTINAL;STROKE