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, Martine Stead, Douglas Eadie, Kathryn Angus and Richard Purves
External Department: Eddie Duncan
External: Gareth Clegg and Colleagues, University of Edinbugh
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
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
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
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 R&D 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
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 & 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 & 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 & Midwifery and Adrienne Hughes, Department of Sports Studies, University of Stirling; and Cecilia Oram, Sustrans
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:
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:
ISM Staff: Gerard Hastings, Martine Stead, Louise Hassan (left 2007) and Laura McDermott (left 2008)