Methodological research to improve natural experiment analysis
Dr Frank De Vocht is heading an NIHR School for Public Health Research project on the analysis of natural experiments, with a special focus on alcohol licensing. The project began on 1st June 2017.
Dr De Vocht explains that natural experiments offer the opportunity to evaluate public health interventions using routinely collected data, which is particularly appealing in a time of austerity and budget cuts. At the local level, it would be beneficial if evaluation of the impact of alcohol-licensing activities could be done at very small geospatial level (i.e. street or single premises).
This study follows on from work within SPHR from 2012-2017. A novel statistical methodology that was used in this first phase of SPHR may be ale to help local-level evaluation, but the main obstacles include that it is unknown whether such small-scale data are available, and whether the methodology itself may be useful for local practitioners.
So this study aims to address both obstacles through two parallel work packages: one involving discussions about natural experiments/interventions of interest and data availability with stakeholders and select case areas, and the other involving simulation studies to evaluate the methodology and define the type of data required for robust evaluation (of the case areas).
The outputs of this project will be a detailed assessment of local authority data availability and feasibility of small-scale intervention evaluations, assess whether such evaluations can generate answers to public health and alcohol licensing questions in a timely fashion, conduct robust case study evaluations, and provide an outline for further work/grant funding.
Further details are available here on the NIHR SPHR website.
Extending The Alcohol Toolkit Study: Understanding the population context of alcohol use
This research develops the Alcohol Toolkit Study to enhance our understanding of alcohol use and policy across England. It will include the collection of additional contextual data on alcohol use including beverage type, expenditure, exposure to interventions and attempts, motivations and triggers to reduce consumption. Further details are available here on the NIHR SPHR website.
Safeguarding children affected by parental substance misuse
Professor Matt Mickman is involved with an NIHR School for Public Health Research project on safeguarding children affected by parental substance misuse. Interventions are being developed to support the non-using parent or caregiver. The team say "There are currently no evidence-based interventions delivered to support non-using parents who represent a protective factor in families." Further details are available here on the NIHR SPHR website.
Optimising the alcohol reduction smartphone app 'Drink Less'
Matt Mickman is also involved with an NIHR School for Public Health Research project on 'Drink Less', an evidence- and theory-based smartphone app which was an output of previous research funded by SPHR.
The work will include optimising the app, user testing to improve usability, and developing a funding proposal for a trial with Public Health England collaborators. Further details are available here on the NIHR SPHR website.
The VIDA study aims to provide a greater understanding about the views and behaviours of parents/caregivers around their children’s alcohol use and their views on young people’s drinking in general. The study involves in-depth one-to-one interviews with parents/ caregivers of children aged 13-18 years. The findings of this study will help to identify family factors that affect the way young people drink alcohol, which will help to optimise family or school-based programmes that aim to prevent harmful drinking among young people. This work is funded by Alcohol Research UK. Further details can be found here.
Comparing digital and practitioner delivered interventions for alcohol
Professor Matt Hickman and Dr Debbi Caldwell are involved in the ENGAGE study, which builds on previous findings to clarify the relative effect size, likely duration, and active components of alcohol intervention strategies.
It will help them develop efficient strategies for wide scale roll out of interventions to reduce alcohol harms, which is likely to contribute to the reduction of health and social inequalities in England. Further details are available here on the NIHR SPHR website.
Stoke-on-Trent Smokefree Homes Service Evaluation
This project, carried out from September 2016 to April 2018, was led by Dr Frank De Vocht. It was an NIHR School for Public Health Research 'PHPES' - Public Health Practice Evaluation Scheme.
The aim was to robustly evaluate, both qualitatively and quantitatively, the effectiveness of the implementation of the Smokefree Homes Service in this population.
We know that environmental tobacco smoke (ETS) is harmful to the health of those breathing it in, particularly so in the case of young children. Parental smoking is a common source of children’s exposure to ETS and maternal smoking in particular is seen as a key determinant of ETS exposure for children. There is mixed evidence for effectiveness of interventions aimed at reducing children’s exposure to ETS, including smoke-free home interventions.
A Smokefree Homes Service commissioned across Stoke on Trent consisted uniquely of telephone behavioural support, self-help materials and Nicotine Replacement Therapy (for 12 weeks sent by post to support temporary abstinence from smoking), as well as training and support for frontline staff from a range of organisations encouraging and enabling them to make appropriate referrals to the service. Although the service was developed by a city council, the service was run by a commercial organisation. The organisation was selected via an open tender procurement procedure and were paid an annual upfront cost alongside payment by result for each family successfully recruited and completing the programme.
Recruitment rates to this project were low, so a qualitative process evaluation study was initiated in parallel to monitoring service recruitment. After the recrtuitent stage ended, the study was then solely comprised as a detailed process evaluation. Further details are available here on the NIHR SPHR website.
NIHR SPHR School Wide Alcohol theme
The aim of the NIHR School for Public Health Research alcohol programme, which ran from 2012 to 2017, was to identify and evaluate approaches to reducing alcohol-related harm that are relevant in an English public health policy context. There are multiple causes and influences on alcohol use. Prevention of alcohol consumption and harm inevitably is complex and requires multiple integrated components that operate at individual, community and environmental levels. This programme of research, co-led by Professor Matt Hickman, therefore, focused on multiple research areas and used a range of methodological approaches to support evidence-based decision making at a local level.
Specific studies included:
Work Package 1: New technologies for reducing excessive alcohol use. Further details are available here on the NIHR SPHR website.
Work package 2: Alcohol screening and brief intervention in the police custody setting. Further details are available here on the NIHR SPHR website.
Work Package 3: Risky sexual behaviour and alcohol misuse in young people: developing a multi-component universal education intervention. This work package was led by Bristol, further details are available here on the NIHR SPHR website.
Work Package 4: Changing environmental cues to alcohol consumption - To describe the impact of glass design (shape, size and markings) on alcohol consumption, in laboratory-based and field experiments.
Work Package 5: The Alcohol Toolkit Study: tracking key performance indicators of alcohol consumption in England. Further details are available here on the NIHR SPHR website.
Work Package 6: Preventing alcohol-related harm: Testing and generating evidence for local practitioners and policy makers.
DrinkThink was an Alcohol Screening and Brief Intervention (ASBI) study for young people delivered in youth, social care, youth justice, healthcare and education settings in the Bath and North East Somerset area. It had three components: i) training professionals to deliver the intervention, ii) delivery of ASBI to young people, iii) referral to a young person’s substance misuse team if appropriate.
- Explored the feasibility and acceptability of Drinkthink to professionals within youth, social care, youth justice, healthcare and education settings, and the barriers and facilitators to those professionals delivering it to young people
- Explored the acceptability of Drinkthink to young people who receive it, and barriers and facilitators to them changing behaviour as a consequence
- Explored whether Drinkthink leads to improved alcohol consumption outcomes among 15-19 year olds
The research study, led by Professor Matt Hickman, was funded by the NIHR School for Public Health Research. It was a collaboration between the University of Bristol, Project 28 (a young people’s drug and alcohol treatment service in Bath) and Bath and North East Somerset Council. Further details are available here on the NIHR SPHR website.
The aim of this randomised control feasibility trial was to evaluate whether accelerated access to opiate substitution therapy from Bristol Drugs Project increases uptake and retains patients in treatment. Half of the patients were randomised to receive the new intervention, whilst the remaining half received usual care. Patients were followed for up to three months to see if they remained in treatment and if their health improved as a result.
SUGAR is an MRC Addiction Cluster based in Bristol led by Professors Matt Hickman, Marcus Munafo, John Macleod and Alan Emond. SUGAR is one of 11 MRC funded clusters. The cluster aims to develop public health interventions through understanding better the causal pathways to different substance use (alcohol, tobacco, cannabis and other drugs) and gambling trajectories in adolescence.