The Effect of Gambling Marketing and Advertising on Children, Young People and Vulnerable People
(Funded by Gamble Aware)
There has been a dramatic increase in recent years in the amount of gambling marketing and advertising, and growing concern about its potential effects, particularly on children, young people and vulnerable adults. Although advertising codes of conduct exist to regulate the content and placement of gambling advertising, it has been argued that these have not kept pace with changes in recent years. A better understanding is needed regarding the nature of gambling advertising and how it might influence behaviour. This project, funded by Gamble Aware, aims to understand the content, reach and effect of gambling marketing and advertising on children, young people and vulnerable people. This aim is addressed through three research objectives:
Explore whether gambling marketing and advertising influences children and young people’s, attitudes towards gambling, in what ways and the impact of this
Examine the tone and content of gambling marketing and advertising across all media, including social media affiliates, and explore the potential impact of this on children, young people, and vulnerable people.
Identify specific themes and features of gambling advertising that children, young people and vulnerable groups are particularly susceptible to.
Literature review of recent studies into the nature and effects of gambling advertising.
Five work packages are being conducted:
Content analysis of paid-for advertising across all forms of media, including broadcast, press, online, outdoor and direct mail. Three hundred advertising ‘creatives’ (examples of actual advertising) from two one-week periods in 2018 are being analysed in depth using a detailed codebook. The analysis will provide an in-depth insight into the features and characteristics of gambling advertising including analysis of whether advertising uses elements which potentially increase the appeal of gambling or run counter to existing codes of conduct.
Analysis of sports sponsorship. A sample of football, rugby, boxing, tennis and Formula One fixtures broadcast in 2018 are being analysed in terms of the frequency and nature of gambling marketing references (eg. sponsor logos on shirts, adverts, pitch side borders) shown during the duration of the broadcast. The analysis will provide insight into the extent of routine exposure to gambling references during broadcast sport.
Focus group research with young people and vulnerable adults (conducted by ScotCen Social Research). These will explore in depth how young people and vulnerable adults perceive and respond to gambling advertising in terms of awareness, knowledge of different brands, perceptions of the messages and themes conveyed in advertising about gambling and gambling outcomes, the emotional and other responses evoked by gambling advertising, and perceived effects on behaviour.
Survey of children and young people aged 11-24 years olds (conducted by ScotCen Social Research). This will examine the extent of awareness of and exposure to gambling advertising in the population, and the relationship between exposure and outcomes such as susceptibility, self-reported gambling behaviour, knowledge of gambling brands, and attitudes towards gambling.
ISM Staff: Nathan Critchlow, Martine Stead, Kathryn Angus, Crawford Moodie, Richard Purves and Amber Morgan
External: Fiona Dobbie, University of Edinburgh; Philip Newall, Gerda Reith and ScotCen Social Research
Lung Health in Africa across the life course (LuLi)
(Funded by Medical Research Council)
Almost half of the world's population, including 700 million people in Africa, relies on biomass fuels (animal dung, crop residues, wood) for their everyday fuel-energy requirements. These fuels are typically burned in open fires, often indoors, that emit smoke into the household environment and lead to high levels of household air pollution. Women and children, especially young children, experience high exposures to air pollution in the home; this has been linked to a range of adverse health outcomes including non communicable lung diseases like chronic obstructive pulmonary disease (COPD) and lung cancer in adults and asthma in children. It is now recognised that household air pollution from biomass smoke is the third leading cause of global disability and death with 4 million deaths attributed to this exposure annually. This burden, much of which is represented by non-communicable respiratory disease, falls hardest on poor populations around the world and in countries in sub-Saharan Africa in particular.
To build the foundations for work to tackle this issue we have bought together a network of investigators from ten African countries (Cameroon, Ethiopia, Ghana, Kenya, Malawi, Nigeria, South Africa, Sudan, The Gambia and Uganda) underpinned by support from the Pan African Thoracic Society (PATS), American Thoracic Society (ATS) Methods in Epidemiologic, Clinical and Operations Research (MECOR) programme, MRC BREATHE-Africa partnership, Malawi Liverpool Wellcome Trust (MLW), Burden of Obstructive Lung Disease (BOLD) Centre, Spirometry Training Services Africa, Global Asthma Network (GAN), and Collaboration for Applied Health Research and Delivery (CAHRD). This proposal offers an unprecedented opportunity to create a multi-site multi-disciplinary pan-African platform for clinical, epidemiological and applied health research underpinned by regional and international collaborative research and delivery networks that will allow us to conduct research into the causes, prevention and treatment of non-communicable respiratory disease across the life course. By addressing a major cause of morbidity and mortality across the life course of children and adults living in low or middle-income countries in Africa the proposal is fully aligned with the overall principle of Official Development Assistance (ODA) to promote welfare of developing countries.
Within the two years of this foundations-building grant we will work hard to create a thriving partnership whilst delivering on two specific research aims: to 1) develop and share methodology for the measurement of non-communicable respiratory disease exposures and outcomes tailored to the challenges of conducting research in resource-constrained African environments and 2) use this methodology to generate and share high quality preliminary data from multiple African sites.
ISM Staff: Sean Semple
External: Led by The Liverpool School of Tropical Medicine
Feasibility of an Intervention Co-supporting Children and Fathers in Health Behaviour Change and Maintenance Following Fathers’ Participation in Football Fans in Training: FFITer Families (2018- 2020)
(Funded by Chief Scientist Office)
Changing behaviours such as inactivity and poor diet, and so improving obesity and other related outcomes can be difficult as these behaviours are influenced by several factors including family circumstances. Efforts to improve family health usually focus on mothers, not fathers, even though men are more often overweight and less likely to take part in weight loss or healthy living programs.
We have previously developed and evaluated a highly successful weight loss/healthy living program for men who are overweight or obese (Football Fans in Training, FFIT). FFIT is delivered by trained community coaches in professional football clubs and has proved very popular with the men who take part (Hunt et al 2014a). FFIT helps men to make positive changes to their weight and lifestyles and our studies have shown that these changes can be long-lasting in some men (Hunt et al 2014b; Gray et al 2018).
FFIT is being delivered at professional football clubs throughout Scotland, and in England and Germany. Similar programs have been delivered in Australia (Quested et al 2018), New Zealand (Maddison et al 2019), England, the Netherlands, Norway and Portugal (Wyke et al 2019) and Canada (Capercione et al 2018, Petrella et al 2017).
Feedback from FFIT participants, family members and participating clubs suggested that there was widespread interest in developing a family component for FFIT and similar programs. We have developed and are evaluating a 4-week extension to these programs (‘FITter Families’) which aims to: encourage children (and families) to adopt healthy lifestyles; promote positive parent-child communication about diet, physical activity and wellbeing; and improve long term weight loss and positive behaviour changes in men.
The aim of the current study is to deliver and evaluate a 4-week family extension to FFIT and similar programmes (FITter Families). We will
test whether FITter Families is feasible to deliver;
investigate whether short- and medium-term benefits of FFIT for participating men are likely to be at least maintained or improved;
investigate whether there is evidence of likely benefit for key health behaviours in children and wider families
make changes the programme, if needed, using feedback from coaches, clubs, participating men and their families.
Caperchione C et al (2017). The HAT TRICK program for improving physical activity, healthy eating and connectedness among overweight, inactive men: Study protocol of a pragmatic feasibility trial. BMJ Open, 7(9): e016940.
Gray C et al (2018). Long-term weight loss trajectories following participation in a randomised controlled trial of a weight management programme for men delivered through professional football clubs: a longitudinal cohort study and economic evaluation. International Journal of Behavioral Nutrition and Physical Activity, 15: 60.
Hunt K et al (2014). Do weight management programmes delivered at professional football clubs attract and engage high risk men? A mixed-methods study. BMC Public Health, 14: 50.
Hunt K et al (2014). Football Fans in Training (FFIT): a pragmatic randomised controlled trial and cost effectiveness analysis of a gender-sensitised weight loss and healthy living programme delivered to overweight and obese men aged 35-65 by Scottish Premier League football clubs. Lancet, 383: 1211-21.
Maddison R et al (2019). Rugby Fans in Training New Zealand (RUFIT-NZ): a pilot randomized controlled trial of a healthy lifestyle program for overweight men delivered through professional rugby clubs in New Zealand. BMC Public Health.
Petrella RJ et al (2017). Hockey Fans in Training: A Pilot Pragmatic Randomized Controlled Trial. Medicine & Science in Sports & Exercise, 49: 2506-2516.
Quested E et al (2018). Protocol for a gender-sensitised weight loss and healthy living programme for overweight and obese men delivered in Australian Football League settings (Aussie-FIT): A feasibility and pilot randomised controlled trial. BMJ Open, 8: e022663.
Wyke S et al (2019). The effect of a program for men to reduce sedentary time and increase physical activity delivered in professional football clubs across four countries: The European Fans in Training (EuroFIT) randomized controlled trial. PLOS Medicine, 16(2): e1002736.
Wyke S et al (2015). Football Fans in Training (FFIT): a randomised controlled trial of a gender-sensitised weight loss and healthy living programme for men - end of study report. Public Health Research, 3.
ISM Staff: Professor Kate Hunt (PI) and Matthew McDonald
External: Professor Russ Jago and Dr Simon Sebire, University of Bristol; Dr Craig Donnachie, Dr Alice Maclean, Dr Stephanie Chambers, MRC/CSO Social and Public Health Sciences Unit, University of Glasgow; Dr Cindy Gray, University of Glasgow
Preventing Gambling Related Harm in Adolescents: Developing a Peer-led, Social Network Intervention
(Funded by MRC PHIND)
This study involves the development of a school-based, peer lead, social network intervention to delay the onset of gambling experimentation. In this early phase study, development of the intervention will be grounded in diffusion and network intervention theory, and modelled on an existing intervention called ASSIST, which is a smoking prevention programme that encourages the dissemination of non-smoking messages among 12-13 year olds in the UK.
ISM Staff: Michael Ussher and Catherine Best
External: Led by Fiona Dobbie, University of Edinburgh
Improving the Rate of Bystander CPR in Deprived Communities: A Development Study (2017-2019) (Funded by the Chief Scientist Office)
Out-of-hospital cardiac arrest (OHCA) is a significant health problem in Scotland with approximately 3,000 resuscitation attempts each year. Survival is only 6.4%, with those in the more deprived quintile of the population (SIMD 1) twice as likely to suffer an OHCA, but 43% less likely to survive compared with those who are least deprived. The most important modifiable factor affecting survival is cardiopulmonary resuscitation (CPR) by a bystander. Bystander CPR more than doubles the likelihood of survival, but occurs only around 40% of the time, and least often in the SIMD 1 quintile. In 2015 the Scottish Government launched Scotland’s OHCA strategy with a key aim to improve survival by increasing rates of bystander CPR. This study will contribute to that aim by developing a strategy to ensure that communities who most need increased CPR rates will be targeted. We will accomplish this by designing an evidence-based intervention to improve the rate of bystander CPR in deprived areas using a social marketing framework and social network theory. Our research design includes a systematic review and a range of qualitative methods with key partners and stakeholders.Out-of-hospital cardiac arrest (OHCA) is a significant health problem in Scotland with approximately 3,000 resuscitation attempts each year. Survival is only 6.4%, with those in the more deprived quintile of the population (Scottish Index of Multiple Deprivation 1) twice as likely to suffer an OHCA, but 43% less likely to survive compared with those who are least deprived. The most important modifiable factor affecting survival is cardiopulmonary resuscitation (CPR) by a bystander. Bystander CPR more than doubles the likelihood of survival, but occurs only around 40% of the time, and least often in the SIMD 1 quintile. In 2015 the Scottish Government launched Scotland’s OHCA strategy with a key aim to improve survival by increasing rates of bystander CPR. The proposed study will contribute to that aim by developing a strategy to ensure that communities who most need increased CPR rates will be targeted. We will accomplish this by designing an evidence based intervention to improve the rate of bystander CPR in deprived areas using a social marketing framework (applying commercial marketing tools to create health behaviour change) and social network theory. Research design includes a systematic review and a range of qualitative methods with key partners and stakeholders.
ISM Staff: Fiona Dobbie (PI), Martine Stead, Douglas Eadie, Kathryn Angus and Nathan Critchlow
External: Edward Duncan, University of Stirling; Gareth Clegg, Lisa MacInnes and Liz Hasseld, The University of Edinburgh
Publications: Dobbie F, Angus K, Uny I, Duncan E, MacInnes L, Hasseld L and Clegg G (2018). Protocol for a systematic review to identify the barriers and facilitators to deliver bystander cardiopulmonary resuscitation (CPR) in disadvantaged communities. Systematic Reviews, 7: 143. doi:10.1186/s13643-018-0807-5
Incentivised Opportunities for Physical Activity Delivered in Work During Paid Working Hours: An Exploratory Study (2014-2016) (Funded by the Medical Research Council)
The majority of UK adults do not meet physical activity guidelines. Some workplaces have tried to encourage physical activity at work to keep employees happy and healthy, but it has proved difficult to interest employees and to keep them involved. A new approach could be to provide opportunities for physical activity during paid working hours.
This exploratory project investigated attitudes relevant to such interventions in the workplace. To achieve this we collected the views of people within the organisations (employees, line managers, senior managers and supervisors, HR departments) and explored their thoughts on how such an approach might work. Focus group meetings and interviews were held to discuss how the workplace could provide physical activity during paid working hours, what type of physical activity people were interested in doing, and how this could be delivered. As part of this, we held a workshop for each workplace to generate ideas for addressing potential problems, and how to make the workplace culture and environment more favourable to physical activity.
ISM Staff: Martine Stead
External Department: Led by Josie Evans, Faculty of Health Sciences and Sport
Anti-littering Nudge Project (2014-2015) (Funded by Keep Scotland Beautiful)
A ‘nudge’ is the manipulation of any aspect of ‘choice architecture’ that alters people’s behaviour in a predictable way without forbidding any options or significantly changing their economic incentives. This project aims to encourage better use of street litter bins by enhancing bin salience. It does this by painting the bins in a bright colour to make them more visible and easier for people to find, and by painting footprints on the ground leading up to the bins as a prompt to infer the intended correct action, ie. to use the bin. The project builds on an anti-littering nudge intervention carried out in Copenhagen in 2011 by applying a rigorous experimental design, and extending the original work to examine the impact of longer term exposure on bin use. The study uses a before and after design implemented in a single site to comparing intervention against a normal state baseline over four stages: baseline, one week, four week and eight week follow-up. Impact on littering is assessed by distributing free, single items of wrapped confectionery to people as they move across the study site and measuring numbers of items correctly binned or discarded on the ground within a designated study area. The study is being undertaken with our collaboration partner Keep Scotland Beautiful and is funded by Zero Waste Scotland. It is due to report in 2015.
ISM Staff: Douglas Eadie and Martine Stead
BME Feasibility and Ethnographic Study in deprived areas in the Southside of Glasgow(2013-2014) (Funded by NHS Greater Glasgow and Clyde (GGC))
This is a scoping and feasibility study in deprived areas in the Southside of Glasgow, which will build on previous work on the black and ethnic minority ethic (BME) population in the area, focused on smoking cessation and health inequalities. It will provide baseline data for NHS GGC and a policy-oriented report with recommendations for further research, projects and interventions in these communities using an assets-based approach.
ISM Staff: Marisa de Andrade
Digital Research and Development Fund for Arts and Culture in Scotland: Research Consortium (2012-2013) (Funded by NESTA (the National Endowment for Science, Technology and the Arts)
CREATES (Consortium for Research into Arts and Technology in Scotland) is a multi-university consortium funded by NESTA (the National Endowment for Science, Technology and the Arts), Creative Scotland and the AHRC (Arts and Humanities Research Council). It is working with arts and cultural organisations in Scotland funded it under the Digital Research and Development Fund for Arts and Culture in Scotland to understand and test the potential offered by new digital technologies.
Their research will support the organisations to work with digital experts to understand and test the potential offered by new technologies to connect with wider audiences and explore new ways of working. The interdisciplinary team is led by Professor Claire Squires and includes researchers at Stirling from the Faculty of Social sciences, the Centre for International Publishing and Communication, the Institute of Socio-Management and the Institute for Social Marketing, as well as researchers from the Universities of Strathclyde and St Andrews.
ISM Staff: Mark Grindle
Something to Declare? Gathering Perceptions of Illicit Tobacco Through Radio(2013) (Funded by NHS Greater Glasgow and Clyde)
This project uses innovative methods to explore how illicit tobacco is viewed by deprived communities in Scotland. Unlike the usual survey or interview-based approach, the NHS Greater Glasgow and Clyde (GGC) funded study enables participation via workshops on radio production and broadcasting skills. Whilst engaged in this training, participants are encouraged to discuss their perceptions of illicit tobacco and prepare radio programmes. Guided by an assets-based approach, it empowers participants by teaching essential skills to improve employability and encourage creativity in communities. Findings will be used to inform the development of a social marketing campaign across the NHS Greater Glasgow and Clyde area.
ISM Staff: Marisa de Andrade
Community, School and Workplace Initiatives to Encourage Individuals to Use the Outdoor Environment for Physical Activity(2009-2010) (Commissioned on behalf of the National Physical Activity Research and Evaluation group (NPARE) by NHS Health Scotland)
The aim of this review was to identify and review evidence of the effectiveness of initiatives and interventions delivered in the community, school, or workplace setting which have been designed to encourage individuals to use their local outdoor environment to increase their physical activity, and to identify and describe similar initiatives currently being delivered in Scotland. To do this we conducted a rapid review using systematic methods. The study involved two elements, an Evidence Review and the compilation of a Database of Current Activity in Scotland. For the Evidence Review, we searched for systematic reviews, primary studies and grey literature reports. Studies were assessed for relevance and rated for quality. For the Database of Current Activity, we used a mixed methods approach combining online searches, email and telephone contact. The results suggest that some approaches for promoting physical activity in the outdoor environment are effective (for example, walking groups, modifications to the physical environment, some organisational changes). There is insufficient evidence to date for some other approaches, such as conservation and forest schools.
ISM Staff: Martine Stead and Kathryn Angus
Collaborators: Ruth Jepson, Department of Nursing and Midwifery and Adrienne Hughes, Department of Sports Studies, University of Stirling; and Cecilia Oram, Sustrans
Publications: Stead M, Angus K, Jepson R, Hughes A and Oram C (2010). Community, school and workplace initiatives to encourage individuals to use the outdoor environment for physical activity. Edinburgh: NHS Health Scotland. Report online
National Prevention Research Initiative
ISM has received funding for three major projects under the prestigious National Prevention Research Initiative (NPRI). The NPRI is a national initiative made up of government departments, research councils and major medical charities that are working together to encourage and support research into chronic disease prevention. Its core aim is to develop and implement successful, cost- effective interventions that reduce people's risk of developing major diseases by influencing their health behaviours.
In December 2005 (Phase 1), the NRPI funded 26 new research projects aimed at preventing cancer, diabetes and heart disease. These diseases were targeted because of their considerable impact on public health: in the UK more than 153,000 people died of cancer in 2004; three million people have diabetes, including up to a million in whom the condition hasn't yet been diagnosed, and coronary heart disease is the UK's most common cause of death, killing around 1 in 5 men and 1 in 6 women.
Now in Phase 4 (2010), the funding partners announced a further funding call. This phase aimed at supporting cross-disciplinary research which developed or tested interventions that can potentially have a major impact on population health, using the full range of evaluation methods, including experimental and quasi-experimental (or observational) designs and natural experiments.
Smoking, poor diet, lack of physical activity and excessive alcohol intake are at the root of these and many other diseases. The NPRI-funded studies explore a range of approaches to promoting positive health behaviour, to encourage people to avoid these habits and to follow a healthy diet and physical activity programme.
These are the three NPRI projects which the Institute worked/working on:
Alcohol Policy Interventions in Scotland and England (APISE) - Phase 4
Buywell: Evaluation of a Targeted Marketing Intervention to Influence Food Purchasing Behaviour by Low Income Consumers - Phase 1
Assessing the Cumulative Impact of Alcohol Marketing Communications on Youth Drinking - Phase 1
Public Health Research Consortium (2006-2010) (Funded by the Department of Health)
ISM is a partner in the DH-funded Public Health Research Consortium (PHRC). The PHRC brings together senior researchers from 11 UK institutions in a new integrated programme of research. This aims to strengthen the evidence base for interventions to improve health, with a strong emphasis on tackling socioeconomic inequalities in health. The PHRC is built around a set of research projects led by senior researchers with expertise in public health, social epidemiology, sociology, survey and evaluation research, social marketing and health economics. The PHRC links teams across eight universities, a survey research agency, a children's charity and a Public Health Observatory (PHO).
It was founded in October 2005 by Professor Hilary Graham (University of York), who was Director from October 2005 to March 2011. It entered its current phase in April 2011, and will run until March 2016, directed by Professor Mark Petticrew (London School of Hygiene and Tropical Medicine.
The PHRC is funded by the Department of Health Policy Research Programme (DH PRP). Its research programme has been developed in consultation with the DH PRP and is informed by current priority needs identified by DH policy teams.
Our programme includes projects on smoking, obesity and their associated risk factors, and, as an important wider determinant, the workplace. It also includes cross-cutting projects and projects to support the translation of evidence into policy and practice, and to apply learning from projects on our chosen themes of smoking, obesity and the workplace to other important determinants of health.
The main collaborators for 2011-2016 are:
Prof Mark Petticrew, London School of Hygiene and Tropical Medicine - Director
Prof Ashley Adamson, Human Nutrition Research Centre, Newcastle University
Prof Brian Ferguson, Yorkshire and Humber Public Health Observatory
Prof Chris Godfrey, Department of Health Sciences, University of York
Prof Hilary Graham, Department of Health Sciences, University of York
Seeromanie Harding, MRC Social and Public Health Sciences Unit, University of Glasgow
Prof Gerard Hastings, Institute for Social Marketing, University of Stirling and the Open University
Prof Catherine Law, Institute of Child Health, University College London
Prof Sally Macintyre, MRC Social and Public Health Sciences Unit, University of Glasgow
Sally McManus, National Centre for Social Research (NatCen)
Prof Chris Power, Institute of Child Health, University College London
Prof Mark Sculpher, Centre for Health Economics, University of York
Catherine Shaw, National Children's Bureau
Dr Amanda Sowden, Centre for Reviews and Dissemination, University of York
Martine Stead, Institute for Social Marketing, University of Stirling and the Open University
Prof Martin White, Institute of Health and Society, Newcastle University
Prof Margaret Whitehead, Institute of Psychology, Health and Society, University of Liverpool
ISM Staff: Gerard Hastings, Martine Stead, Louise Hassan (left 2007) and Laura McDermott (left 2008)