Title: Policy Research Unit on Obesity in Children and Across the Life-course
Funder: Department of Health and Social Care

Abstract: Our strategic approach is to build a world-class inter-sectorial team able to bring novel methods to tackle obesity from a multi-scale systems perspective, drawing upon our extensive experience of policy research to undertake a workplan based upon key policy priorities and disseminate findings with impact. A world-class inter-sectorial collaboration We bring together world class lead researchers with strengths in economic modelling, behaviour change, child health, maternity, environmental and behaviour change across multiple aspects of energy intake (food) and energy expenditure/physical activity, education, transport and the built environment. We will work in an interdisciplinary fashion with the voices of children, young people, families and older adults at the heart of our work (see PPI/Management sections). Building on experience Our strategy and structures are based upon what we know works in producing high quality policy evidence for the DH and other government departments. Many of the structures we propose are evolved from those found to be effective in Viner s 6 years of experience in the CPRU, NCB s long experience of providing PPI into policy research, 20 years of experience in the UCL Institute of Education EPPI-Centre s systematic review facility (PI Thomas), the 6 years of work by Steptoe s team in the Policy Research Unit in Cancer Awareness and experience by multiple researchers and collaborators in the Public Health Research Consortium and the NIHR School of Public Health. Bringing novel methods to hear We will take a systems approach, understanding risk for/protection against obesity as a highly complex system requiring responses across multiple sectors and coordinated across levels from national to local to individual. We will bring new methodologies and neglected sectors into our efforts to prevent obesity, merging novel approaches with our broad strengths in more conventional approaches. Structures to enable productivity We plan a management structure and ways of working for our PRU that promote interdisciplinary working that adds value over and above the sum of the constituent research groups, within a strong governance framework that ensures accountability and productivity (see Management section). A strategic workplan Our workplan will align with policy priorities outlined in the governments Childhood Obesity Plan, yet will also more broadly address key evidence gaps across the life-course in prevention and management of obesity. Our central focus will be on childhood obesity, but recognize that many policy actions directed at children will have impact across the whole population. Inequality and diversity will be key analytic lenses for all work. We will evaluate potential policy interventions across social levels from individual, family, school, neighbourhoods, local authorities to the national level. Key to our work will be the incorporation of researchers from disciplines not traditionally associated with obesity research. We will seek to leverage additional outside funding to widen the scope of our work. We will work closely with PPI partners to ensure we are addressing issues that are important for the public. The forward workplan will be undertaken within the named investigator group, drawing upon additional expertise amongst named collaborators where necessary. Pooled methodological resources to speed up evidence production We will build novel pooled methodological resources to speed up the production of policy evidence (Methodology section), and provide deliverables in a range of formats for different audiences (see Dissemination). A pathway to impact Our key output will be rapid production of quality policy evidence in a form that facilitates dissemination and knowledge exchange with policymakers, analysts, practitioners and service users (see Dissemination section). Challenges, risks and mitigation: We exceed the essential DH requirements for a PRU. We include a wide range of disciplines with each of the researchers having an international reputation, a demonstrated ability to engage with policy-makers, a track record of delivering large projects with high quality and with impact on real-world policies. We have a track record of delivering a rapid response facility. We describe potential risks and how we will mitigate each below: Organisational issues: 1. Risk: Lack of cohesive working across a multi-institution collaboration Mitigation: We are geographically close (all partners within 1 mile except Poston who is within 3 miles), we already have established collaborations between many partners and we will institute a management structure that promotes collaboration. Our workplan will be developed collaboratively and all projects will be necessarily cross-workstream. We will organise researchers to work cross- workstream where appropriate. We will hold 2nd or 3rd -monthly sandpits where we present work in progress to the Unit and regular meetings of early career researchers from across the PRU. 2. Risk: Inability to act quickly on response facility requests Mitigation: We have considerable experience of delivering response facilities, plus we plan 3 novel pooled methodological resources to enable more rapid delivery of policy evidence. The breadth of our collaboration, the depth of expertise contained within partner universities, together with data resources and strategic partnerships available (see Partnerships/Collaborations Section) mean that we will be able to respond rapidly and effectively to policy projects across all aspects of obesity. 3. Risk: lack of available of data required for project. Mitigation: Our experience from CPRU is that delays in obtaining data permissions (e.g. from NHS Digital) can substantially delay projects. We will use our pooled data methodological resource to identify timelines for obtaining data, and use 'big data' resources/expertise within UCL (e.g. Farr Institute/ADRC-E: see Partnerships section) to aid obtaining data. Ethical issues: 1. Risk: Conflicts of interest: Mitigation: We will institute appropriate conflict of interest policies. In particular we will institute a policy that all named coinvestigators in the PRU have no commercial links with the food industry during the time of the grant. 2. Risk: Data protection issues: Mitigation: We will adhere to standard UCL/other institution as appropriate data protection guidelines and DH data protection requirements. Additionally where identifiable data are being used, we will adhere to ethical requirements for data use. The UCL Data Safe Haven, currently used by us for a number of projects, provides an appropriate safe data working environment for handling identifiable or sensitive data. Note: Diversity & Inequality and PPI are covered in separate sections.

Lay abstract: Our aims To undertake research of the highest quality to support the government and partners to i) combat the environments and systems that drive obesity; ii) modify people s behaviours relevant to obesity; and iii) reduce health inequalities and the consequences of obesity across the life-span. Our strong focus will be on on children and young people (CYP) although we will work across the life-span from pregnancy/birth to old age. The voices of children, young people, families and older adults will be at the heart of our work. About us Our Unit brings together world-class expertise in working with CYP, food policy, economic modelling and research on environment and behaviour change. We will bring new methodologies and neglected sectors together in our work, including researchers in new areas of health, physical activity, education, the built environment, transport and local government. We will develop new research resources to ensure rapid production of policy evidence. Our research plan Our workplan will be co-produced with PPI partners working with children and adults. Research priority areas we propose to investigate include: 1. Using economic modelling to understand how consumers and industry change their behaviour in response to government obesity policy 2. Identifying and evaluating innovative new policy targets in the food system and how policies can work together for better effects 3. Working with schools, families and neighbourhoods to get CYP and families more active, use healthier transport and support healthier food choices 4. Working with the public to improve the acceptability of potential new food policies 5. Supporting pregnant women in improving lifestyles and promoting infant feeding to prevent childhood obesity 6. Improving access to treatment for obese people at local and specialist levels In all projects we will have a strong focus on combating inequalities. The three projects we will initiate first are: 1. Economic modelling of the impact of fiscal incentives on sugar consumption in children and adults We will use leading edge economics methods to evaluate the impact of fiscal measures, including the soft drinks industry levy and other policies that change prices of sugary food products, on a) consumers sugar purchases, including those of CYP; and b) responses by industry, including reformulation and price changes. 2. Maximising the effectiveness of the school system in the prevention of obesity We will a) use very large national datasets to identify which children are most likely to become obese across primary school and which school factors increase this risk; and b) work with schools to better understand school environments (physical activity, food, architecture, transport) using cutting-edge methods, and help schools improve obesity prevention efforts 3. Identifying possibilities to reduce inequalities in obesity through supportive retail and food provisioning environments We will work with families with obese CYP in deprived communities to understand what influences their/their children s food choices and what policy choices would make a difference to them. We would also work with food providers to see what they could do to better provide healthier diets for communities, while also remaining economically viable

Research activity codes: 3.5 RESOURCES AND INFRASTRUCTURE (PREVENTION)
Health categories: METABOLIC AND ENDOCRINE;ORAL AND GASTROINTESTINAL;CANCER AND NEOPLASMS;STROKE;CARDIOVASCULAR