NIHRDataInsights/HRCSData huggingface dataset:
Title: Development and feasibility testing of an interactive, educational programme to facilitate Proactive Assessment of Obesity Risk during Infancy: ProAsk
Funder: Medical Research Council

Abstract: Childhood obesity risk can be identified during infancy and risk models have been developed with moderately good levels of predictability. The Infant Risk of Obesity Checklist (IROC) [1] is a screening tool that can be used with infants at 4 months. However, the impact of implementing risk prediction models into clinical practice has not been explored. This study will design and develop a computer-based educational programme, using interactive multimedia digital technologies, which will sensitively contextualise the problem of childhood obesity and facilitate communication between health practitioners and parents about obesity risk and prevention during infancy. The Proactive Assessment of Obesity Risk during Infancy (ProAsk) programme will be theoretically grounded in the Expanded Health Belief Model (EHBM) [2] and include the IROC [1] and strategies to improve parental feeding behaviour, infant diet and physical activity. A feasibility study will assess parents' and health practitioners' views about obesity risk communication and use a causal model [3] to determine the fit between the intervention strategies and outcome measures, ascertain recruitment and retention rates, determine the availability of data and data collection methods to inform the design of a future definitive trial to evaluate the benefits and harm of ProAsk compared with current practice. 1. Weng S, Redsell, SA, Nathan, D, Swift, JA, Yang, M, Glazebrook, C: Developing an algorithm to estimate overweight risk in childhood from predictors during infancy. Pediatrics, 2013, Published on-line 15th July 2013 doi: 10.1542/peds.2012-3858. 2. Strecher V, Rosenstock I: The Health Belief Model. San Francisco, CA: Jossey-Bass; 1997. 3. Hardeman W, Sutton S, Griffin S, Johnston M, White A, Wareham NJ, Kinmonth AL: A causal modelling approach to the development of theory-based behaviour change programmes for trial evaluation. Health education research 2005, 20(6):676-687.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: STROKE;CANCER AND NEOPLASMS;METABOLIC AND ENDOCRINE;CARDIOVASCULAR;ORAL AND GASTROINTESTINAL
Title: Developing a novel model to assess the specificity of appetite-reducing agents
Funder: National Centre for the Replacement, Refinement and Reduction of Animals in Research

Abstract: Obesity is a major public health issue. Current anti-obesity agents are ineffective. There is thus great interest in identifying novel targets for anti-obesity drugs. Energy homeostasis relies on complex systems impossible to reproduce in vitro. In vivo studies allow the analysis of these systems However, it is difficult to determine whether an agent that reduces appetite is doing so specifically. The rat is a widely used experimental model for the study of energy homeostasis. Many agents can reduce food intake in the rat following peripheral or central administration. However, it can be difficult to establish whether such an effect represents a specific effect on physiological appetite-regulating pathways, or whether it is due to toxic or other non-specific effects. Currently it is necessary to carry out a number of in vivo protocols to establish whether an agent is specifically influencing appetite, and thus whether it represents a good target for anti-obesity drug development. Non-specific appetite-inhibitors often result in side effects such as alterations in blood pressure and locomotor activity, and may result in disrupted eating patterns. However, there is currently no single protocol or model that can be used to determine whether an appetite inhibitor is specific. This aim of this studentship is to develop a novel model to assess the specificity of appetite-inhibiting agents. The student will centrally and peripherally administer recognised physiological and non-physiological appetite inhibitors to animals implanted with telemetry devices, and will then use the Comprehensive Laboratory Animals Monitoring System to measure parameters including food intake, oxygen consumption, behaviour, blood pressure and body temperature. In collaboration with the mathematics department at Imperial, the student will use this data to establish a mathematical model that can robustly distinguish between physiological and non-physiological anorectic factors. Establishing a single experimental model to identify specific inhibitors of appetite will significantly reduce animal use across industry and academia, and will facilitate more rapid development of agents to treat obesity.


Research activity codes: 5.9 RESOURCES AND INFRASTRUCTURE (TREATMENT DEVELOPMENT)
Health categories: STROKE;CANCER AND NEOPLASMS;METABOLIC AND ENDOCRINE;CARDIOVASCULAR;ORAL AND GASTROINTESTINAL
Title: The impact of a bariatric rehabilitation service on weight loss and psychological adjustment.
Funder: Department of Health (England)

Abstract: Background Bariatric surgery is currently the most effective form of obesity management for those whose BMI is greater than 40 (or 35 with co morbidities), (1, 2). A minority of patients, however, either do not show the desired loss of excess weight or show weight regain by follow up. Research by the present author (3, 4) and discussions with patient support groups (BOSPA; WLSinfo) highlights some of the reasons for this variability, most of which centre on the absence of any psychological support with patients describing how although surgery fixes their body, psychological issues relating to dietary control, self esteem, coping and emotional eating remain neglected. Aims The study aims to evaluate the impact of a health psychology led bariatric rehabilitation service (BRS) on patient health outcomes and NHS costs. The bariatric rehabilitation service will provide information, support and mentoring pre and post surgery and will address psychological issues such as dietary control, self esteem, coping and emotional eating. The package reflects the rehabilitation services now common place for patients post heart attack and stroke (5) which have been shown to improve patient health outcomes. Plan of Investigation The study is a randomised control trial and patients will be allocated to receive either usual care or the bariatric rehabilitation service pre and post bariatric surgery. Follow up measures of weight loss and psychological issues will be taken at baseline (1 week preoperatively), 3, 6 and 12 months postoperatively. The contents of the bariatric service and the follow up measures are based on previous pilot work and have been developed further by the research team working closely with two patient support groups (BOSPA & WLSinfo). St Richard’s Hospital in Chichester offers a NHS based bariatric service for obese patients which is the largest centre in the UK, with 600 patients per year receiving an operation. The study will take 34 months. Potential Impact It is predicted that a bariatric rehabilitation service will improve weight loss following surgery and will also facilitate changes in other psychological variables such as quality of life, dietary control, self esteem, coping and emotional eating. This also has costs implications for the NHS as improved effectiveness of bariatric surgery reduces the health costs of obese patients in the longer term. At 30 months a health economist will evaluate the cost effectiveness of the BRS. Results will be fed back to the user support groups involved in the design and published in academic and professional journals.


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS;8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: STROKE;CANCER AND NEOPLASMS;METABOLIC AND ENDOCRINE;CARDIOVASCULAR;ORAL AND GASTROINTESTINAL
Title: Development, implementation and evaluation of a complex intervention for the management of adolescent overweight and obesity in Scotland.
Funder: Chief Scientist Office (Scotland)

Abstract: Purpose: The overall aim is to develop, implement and evaluate an integrated care programme for overweight and obese adolescents in Scotland. The principal research questions to be addressed: 1. What are the components of an effective intervention programme for overweight and obese adolescents? 2. How best could primary care implement and deliver the integrated intervention? 3. How the intervention will affect a) the Body Mass Index of overweight and obese adolescents and b) their psychological well-being and quality of life?


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS;8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: STROKE;CANCER AND NEOPLASMS;METABOLIC AND ENDOCRINE;CARDIOVASCULAR;ORAL AND GASTROINTESTINAL
Title: Promoting active travel in the UK: effectiveness and equity of individual and infrastructural interventions
Funder: Department of Health (England)

Abstract: Promoting active travel (walking and cycling) is a public health and environmental priority, but little is known about how to achieve this or how effects vary by socio-economic position. I will jointly lead a large randomised controlled trial promoting active travel among NHS staff. I will also examine the physical activity, travel and carbon impacts across of large-scale infrastructure projects aiming to encourage active travel. In both studies I will examine whether the effects vary by socio-economic group. This cross-disciplinary program will contribute high-quality evidence about what works in promoting active travel, and how promising interventions may affect health inequalities.


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;CANCER AND NEOPLASMS;METABOLIC AND ENDOCRINE;CARDIOVASCULAR;ORAL AND GASTROINTESTINAL
Title: Accuracy assessment of reported dietary intake using established nutritional biomarkers.
Funder: Department of Health (England)

Abstract: At the present time it is difficult to assess what people eat in their home environment accurately. The work proposed in this fellowship aims to quantify a panel of existing chemical markers in urine that will quantitatively reflect intake of foods commonly consumed in the UK such as fruit, vegetables, carbohydrate, fat, fish, sugar, dietary fibre and salt. As well as assess good validated dietary biomarkers in free living people to improve nutritional accuracy characterising dietary intake and behaviour in a population framework. Should this prove successful this will be a major step forward to improving public health policy; it will allow for the first time accurate monitoring for uptake of healthy eating in the UK population.


Research activity codes: 4.2 EVALUATION OF MARKERS AND TECHNOLOGIES
Health categories: STROKE;CANCER AND NEOPLASMS;METABOLIC AND ENDOCRINE;CARDIOVASCULAR;ORAL AND GASTROINTESTINAL
Title: Health impacts of the Cambridgeshire Guided Busway
Funder: Department of Health (England)

Abstract: The project will address the following primary research question:Is investment in new high-quality transport infrastructure associated with an increase in the use of active modes of travel (walking and cycling)?and the following secondary research questions:— What are the wider health impacts of changes in travel behaviour in terms of overall physical activity wellbeing sickness absence and carbon emissions?— What are the determinants of the use and uptake of active modes of travel?— How are any changes in travel behaviour distributed in the population?— How are any changes in travel behaviour brought about and experienced?— Are changes in travel behaviour sustained over time?The core of the project will be a controlled quasi-experimental cohort study with the following elements:Population: Adult commutersIntervention: New high-quality transport infrastructure provided in the intervention areaComparator: No comparable improvement to transport infrastructure in the control areaPrimary outcome: Change in daily active commuting time (time spent walking or cycling on the journey to and from work)Secondary outcomes: Changes in (a) total daily active travel time (b) overall physical activity (c) wellbeing (d) sickness absence and (e) estimated carbon emissions attributable to travel.These outcomes will be ascertained using a combination of questionnaires and activity monitoring using accelerometers completed at baseline and repeated after one and two years. The core study will be complemented by nested in-depth studies comprising a longitudinal qualitative semi-structured interview study a household travel diary study and an enhanced activity monitoring study using combined heart rate and movement sensors and global positioning system (GPS) monitors.The intervention to be examined is the natural experiment of the opening of the Cambridgeshire Guided Busway a major and innovative transport infrastructure project that will provide a dedicated high-quality off-road route for buses and cyclists between Cambridge and its hinterland.


Research activity codes: 3.2 INTERVENTIONS TO ALTER PHYSICAL AND BIOLOGICAL ENVIRONMENTAL RISKS
Health categories: STROKE;CANCER AND NEOPLASMS;METABOLIC AND ENDOCRINE;CARDIOVASCULAR;ORAL AND GASTROINTESTINAL
Title: Measuring the productivity of the NHS - national, geographical and organisational analyses
Funder: Department of Health (England)

Abstract: Productivity as defined in the national accounts as the ratio of the amount of output produced to the amount of input used to produce the output. The fewer inputs used for a given amount of output, the higher is productivity. The amount of NHS output comprises the number and type of patients treated in different healthcare settings, the quality of the care received and measures of the success of treatment. NHS input includes NHS and agency staff, equipment and supplies, and buildings. In the current economic climate, the need to assess the productivity of National Health Service is ever more important, both to account for how resources are used and to identify room for improvement. There is intense public debate about NHS productivity. We will continue to produce annual estimates of productivity growth for the NHS as a whole to provide an accurate assessment of what the NHS does and what it achieves. This will facilitate a more informed debate about the value for money secured by the NHS. In the face of planned ‘efficiency savings’, there is a danger is that fewer patients will be treated and the quality of their care will deteriorate. To guard against this, input reductions will have to be targeted where there is greatest scope for improvement. This involves identifying variations in productivity and encouraging poor performers to attain the standards of the best. Our analyses of variations in productivity across the country and across organisations will reveal where improvements may best be secure. They will also identify reasons why some organisations are more productive than others: perhaps they are larger, focus on delivering specific services or have a different staff mix. Comparisons and analyses of productivity across organisations will provide an evidence base to indicate where efforts to improve performance should be targeted, thereby supporting the QIPP (Quality, Innovation, Productivity and Prevention) agenda.


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: STROKE;CANCER AND NEOPLASMS;METABOLIC AND ENDOCRINE;CARDIOVASCULAR;ORAL AND GASTROINTESTINAL
Title: Developing the mental health funding formula for allocations to general practices
Funder: Department of Health (England)

Abstract: Background The recent Resource Allocation for Mental health and Prescribing (RAMP) Review estimated needs for mental health services for small geographical areas that could be used for Primary Care Trust allocations. The White Paper, ‘Equity and Excellence: Liberating the NHS’, set out the intention that financial allocations will be made directly to GP commissioners. These allocations are expected to be built-up from allocations for the constituent GP practices. As the size and geographical constitution of each group will be determined locally, practices may choose to move between groups over time and patients will have more choice of practice, there are considerable gains expected from adopting a person-based approach to resource allocation for mental health and potential incentive consequences. Aims The aim of this project is to estimate robust, person-based equations for the age and additional needs components of the mental health services formula. These aims will be achieved by: • examining whether the recommended RAMP formulae could be adapted to be more appropriate for practice allocations • assessing further the feasibility of developing a person based formula for mental health services using the Mental Health Minimum Data Set (MHMDS) • estimating a person-based mental health services formula and testing whether this is preferable to existing alternatives • quantifying the budgetary risks to GP consortia of different sizes and patient compositions • advising on different cost-sharing arrangements and commissioning incentive regimes. Plan of Investigation The project will initially examine what adaptations could be made to the preferred RAMP formula to render it more appropriate for practices. We will then develop the preliminary analyses undertaken as part of the RAMP study designed to estimate the effects of age and additional need variables on needs for health care resources at person level. We will compare the robustness and distributional consequences of different approaches. We will then simulate the total costs of populations of different sizes and compositions and consider how different cost-sharing rules between comissioning groups and constituent practices and incentives for commissioning grouos will affect budgetary risk. Potential Impact Weighted capitation formulae will be used to distribute resources between the new GP commissioners and commissioners will face new incentives. The preferred formula for mental health services from a recent review was designed to be applied at PCT level and will need to be adapted for application to commissioners. The results of this research will be presented to TAG and ACRA to enable them to recommend to Ministers an improved formula for distributing mental health resources between the new commissioners.


Research activity codes: 8.2 HEALTH AND WELFARE ECONOMICS
Health categories: STROKE;CANCER AND NEOPLASMS;METABOLIC AND ENDOCRINE;CARDIOVASCULAR;ORAL AND GASTROINTESTINAL
Title: Policy Research Unit in Behaviour and Health
Funder: Department of Health (England)

Abstract: Aims: The aim of the Policy Research Unit on Behaviour and Health is to contribute evidence to national and international efforts to achieve sustained behaviour change that improves health outcomes and reduces health inequalities. The specific objectives are: to generate evidence on the effectiveness, value for money and impact on health inequalities of interventions delivered at individual, community and population levels; and, to provide policy makers with timely and authoritative information to support decisions on investing or disinvesting in interventions designed to change health-related behaviour. Plan of Investigation: Our planned research includes a programme of evidence synthesis that will run in concert with a programme of primary research. We are focusing initially on four behaviours: diet, physical activity, smoking and alcohol consumption which together are responsible for the majority of premature deaths worldwide and disproportionately affect those from lower socioeconomic groups. Evidence synthesis: A programme of reviews is on-going to consider the impact on behaviour of economic, physical and social environments. Our initial focus is on two areas: (a) altering “choice architecture” to change population diet, physical activity, smoking and alcohol consumption, and (b) altering economic environments to change diet and physical activity-related behaviours. Primary research: Three sets of studies are underway: a workplace-based trial of brief interventions to increase physical activity; a series of studies aimed at improving the nutritional profile of food purchased; and, a series of studies aimed at understanding the acceptability to the public (and in turn, policy makers) of population and individual level interventions to change behaviour. Potential Impact: We envisage the findings from our evidence synthesis programme and our primary research will inform the work of directors of public health working at local levels, as well as informing the relevant policy teams at DH. This will concern policies aimed at preventing obesity, increasing physical activity, reducing alcohol consumption, and tobacco control. We also envisage that our findings will inform research policy for NIHR as we identify gaps in the evidence base needed to inform policy to change behaviour in populations. Finally, we expect the results of our work to contribute to the international academic community understanding of human behaviour and behaviour change with implications beyond health and the four behaviours that are currently the focus of our work.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING;8.3 POLICY, ETHICS AND RESEARCH GOVERNANCE
Health categories: STROKE;CANCER AND NEOPLASMS;METABOLIC AND ENDOCRINE;CARDIOVASCULAR;ORAL AND GASTROINTESTINAL
Title: A randomised controlled trial of a pedometer competition to encourage physical activity in schools: A feasibility study
Funder: Health and Social Care Research and Development Division (HSC R&D) of Public Health Agency, Northern Ireland

Abstract: Enabling Research Award: We have designed a physical inactivity intervention with several nudge components, but which also draws upon evidence from the behavioural science literature, with respect to pro social behaviour (i.e. a behaviour that benefits others without personal cost or reward). We aim to test the feasibility of conducting a RCT to investigate the effectiveness of a pedometer competition as an incentive to encourage PA behaviour change in 12-14 year olds.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: STROKE;CANCER AND NEOPLASMS;METABOLIC AND ENDOCRINE;CARDIOVASCULAR;ORAL AND GASTROINTESTINAL
Title: Exploring muscle biology in the context of obesity,insulin resistance and related phenotypes using next-generation RNA sequencing.
Funder: Wellcome Trust

Abstract: Obesity is a result of an inherited tendency for weight gain acting together with environmental factors (overeating in combination with lack of exercise). Genetic factors canaffect appetite, the rate at which individuals burn energy (metabolic rate) and how and where the body stores fat. It is not just the overall amount of fat that matters but where it is deposited. Fat in the abdomen is associated with far more serious effects than fat deposited elsewhere. My hypothesis is that there are distinct pathways influencing development of overall obesity and central obesity, with the latter involving mechanisms both in brain and fat. Therefore it is not just important to Science understand the ways in which individuals differ in the total amount of fat that they accumulate, but also to understand differences between individuals in the sites at which fat is deposited. Also, I will try to test possible explanations for how the biological mechanisms highlighted are involved in the control of how fat is distributed over the body. By developinga better understanding of mechanisms regulating central fat storage we may learn what biological pathways we should target for drug intervention.


Research activity codes: 2.1 BIOLOGICAL AND ENDOGENOUS FACTORS
Health categories: STROKE;CANCER AND NEOPLASMS;METABOLIC AND ENDOCRINE;CARDIOVASCULAR;ORAL AND GASTROINTESTINAL