Purpose: The function of the NIHR School for Public Health Research is to conduct research, the findings from which can be used to inform decision-making in public health practice, particularly at the local level. The evidence base for effective alcohol and sexual health education in young people in the UK is weak, as has been highlighted in a number of systematic reviews over the last 20 years. The intention of this research project is to develop an evidence and theory-based sexual health and alcohol education programme to reduce risky sexual behaviour and alcohol misuse, for use in all types of secondary schools in England. It is intended that this intervention should be shown to be acceptable, capable of implementation with fidelity, scalable, sustainable, effective and cost effective.
Design/Approach: The long term project is planned in three phases. The first phase of the research involves a number of discrete work packages which will be led by members who have particular expertise in the methods required. The second phase will comprise the design or redesign of an existing intervention and a preliminary pilot in one or two schools. The third phase would be a feasibility study for a definitive randomised controlled trial (RCT). In the first phase, we will carry out 4 work packages: a review of reviews; case studies of secondary schools’ approaches to and views of sex and relationships and alcohol education; a study of best practice for local authorities; exploration of data from Natsal 3/Health Survey for England.
Findings: Project started in October 2013. No findings available yet.
Project Award: £561,581
Project Dates: From October 2013 to September 2015
Practical Implications: Ensuring that public health interventions are evaluated for their capacity to diminish and not widen inequalities in health is a fundamental part of the NIHR SPHR’s mission. While there are substantial inequalities in sexual health and alcohol misuse in young people it is a complex picture because, for example, high levels of alcohol consumption are associated with affluence, but alcohol-attributable hospital admissions and teenage conceptions are strongly related to deprivation. A well designed sexual health and relationships education (SHRE) programme, including a component on alcohol, has the potential to impact favourably on such inequalities.
Contact Information: This is a collaborative project being carried out amongst the SPHR partners (Fuse, University of Bristol, University of Cambridge, London School of Hygiene and Tropical Medicine (LSHTM), Peninsula College of Medicine and Dentistry, University of Sheffield, LiLaC collaboration between University of Liverpool and University of Lancaster, and University College London (UCL).
Professor Rona Campbell from the University of Bristol is the overall project lead, Fuse’s contribution is led by Professor Janet Shucksmith of Teesside University (contact firstname.lastname@example.org for further information).
Purpose: Alcohol consumption increases throughout adolescence. Approximately 33% of 15-16 year olds in England report being drunk every month with young people in the UK being amongst the heaviest young drinkers in Europe; leading to high social and economic costs. It is now well known that young people are much more vulnerable than adults to the adverse effects of alcohol due to a range of physical, mental and social factors which often interact. It is recommended that children should abstain from alcohol before the age of 15 and those aged 15-17 are advised not to drink. If they do drink it should be no more than 3-4 units and 2-3 units per week in men and women respectively, on no more than one day per week. Parenting ‘style’ and ‘good’ family relationships have been demonstrated to have a positive effect on young people’s drinking behaviour regardless of family structure or whether parents consume alcohol. Excessively strict or lenient parenting is associated with earlier alcohol use or higher levels of drinking behaviour. Only a few primary prevention programmes - to prevent underage drinking before it has happened - have reported positive outcomes. Thus secondary prevention i.e. targeting interventions at young people who are already drinking alcohol is likely to be a more effective strategy, since the interventions will be more pertinent to the individuals receiving them.
Design/Approach: We worked with year 10 pupils (aged 14-15) in seven schools across one area in the North-East of England. Young people who screened positive on a single alcohol screening question and consented to take part were randomly allocated to one of three groups and either provided with: an advice leaflet (control condition, two schools); a 30-minute brief interactive session which combined structured advice and motivational interviewing techniques delivered by the school learning mentor (Intervention 1, two schools); or the level 1 intervention and then a 60-minute session involving family members delivered by the school learning mentor (Intervention 2, three schools). Young people were followed-up at 12-months. The purpose of the study was to assess the feasibility of trial processes, recruitment and retention and an evaluation examined the pros and cons of the alcohol screening and brief intervention approaches in the school setting in this age group.
Findings: Two hundred and twenty two (222) young people were eligible for the trial. Of these 182 (82%) agreed to take part (53 in the control group; 54 in Intervention 1; and 75 in Intervention 2). Of the 75 in the Intervention 2 group, 67 received Intervention 1 (89%). Eight received both Intervention 1 and Intervention 2 (11%). In total 160/182 were successfully followed up at 12 months (88%). Interviews were carried out with six school lead liaisons; 13 learning mentors; 27 young people and seven parents. Results show that the school setting is a feasible and acceptable place to carry out alcohol screening and brief intervention with learning mentors seen as suitable people to do this. Intervention 2 was not seen as feasible or acceptable by school staff, parents or young people and therefore a definitive study should not include a parental arm.
Patient and public involvement (PPI) was sought at different time-points and at multiple levels throughout the study. PPI representatives included local authority employees, parents, young people and members of staff at participating school sites. Their contribution to the development, management and delivery of this research included input into the design and conduct of the feasibility study (the local authority lead for education was a co-applicant for this research) and piloting of study documentation and intervention materials (parents and young people) to ensure readability and understanding. Participating schools were also heavily involved in the conduct of the feasibility study (trial and survey) and were regarded as key stakeholders and were imperative in decision making regarding modifications for a definitive trial application.
Project Award: £374,033
Project Dates: From 1 October 2011 to 31 July 2013
Practical Implications: This present work builds on the evidence base by focusing on alcohol screening and brief intervention to reduce risky drinking in young people (aged 14-15). It is highly likely that if a brief intervention was effective at reducing harmful drinking, it might also result in a range of other positive behavioural outcomes as has been found in studies with adults and older adolescents.
Contact Information: For further information contact project lead Dr Dorothy Newbury-Birch (email: email@example.com) or project manager Dr Stephanie Scott (email: firstname.lastname@example.org)
Links: Related project pages SIPS JR-High - Newcastle University Institute of Health & Society project page SIPS JR-High - NIHR project page
Purpose: This multistage translational study is funded by the MRC - National Prevention Research Initiative (NPRI). It aims to address the need for improving strategies for informing parents about their child's weight status. The multidisciplinary team includes policy and practice partners in Public Health England Obesity and the delivery team of NHS choices.
Childhood obesity is an important public health problem worldwide and identifying effective preventive strategies remains a priority. Parents are central to the development of their child's health-related behaviours and play a key role in both the development and implementation of prevention strategies. However, many studies show that parents do not recognise when their child is overweight. For example, our previous NPRI funded work showed that over two-thirds of parents of overweight children described their child as being of 'normal weight' at 7 years. Addressing the difference between parents' perceptions and actual child weight status is important. If parents do not perceive their child as overweight they are unlikely to make appropriate changes to their child's lifestyle. However there is evidence that parents are more likely to make such changes if they perceive their child's weight as being a health problem.
Design/Approach: This study is testing tools to improve parents' ability to correctly assess their child's weight status as well to increase their knowledge of the health consequences of childhood overweight. Four body image scales of boys and girls aged 4-5 and 10-11yrs have been created from over 500 3D body scans. These have developed, along with supporting information increase parental knowledge of the consequences of childhood overweight, with extensive input from parents, health visitors and other health care professionals through our Fuse networks. Further a web tool has been developed working with NHS Choices and a paper-based tool has also been developed. A cluster-randomised control trial is currently underway to test whether the tool is effective and which method of delivery is most effective in improving parental recognition of childhood overweight and understanding of its consequences. Partners in local authorities in northern England and beyond are engaged in the project supporting recruitment and, with parental consent, sharing National Child Measurement Programme (NCMP) data.
Findings: No findings available yet.
Project Award: £471,298
Project Dates: From 1 April 2012 to 31 January 2015
Practical Implications: The body image scales (BIS) being tested in this study have already attracted great interest from practice partners working with families and in obesity. If found to be effective these will offer a visual alternative to BMI and a practical tool to use in discussions with parents. The tools will be made available on the NHS Choices website at the end of the study.