Population Heath Interventions Programme

Lead Research Organisation: University of Cambridge

Abstract

Physical activity reduces the risk of diseases such as diabetes and heart disease, and the health of most people in the UK and many other countries would be improved if the population were to become more physically active. However, efforts to bring this about have met with little success to date. One reason may be that the environments we have created for people to live in — our cities, transport systems and workplaces, for example — are not sufficiently conducive to an active lifestyle. Changing the economic, physical and social factors that influence our behaviour is possible, but more scientific evidence about the effects of doing so is needed to guide policy and practice. The aim of this research programme is to investigate the effects of environmental or policy changes on population physical activity patterns. We use a combination of epidemiological and social science research methods to study what happens when people’s circumstances change — for example, when new public transport, cycling or walking routes are provided or when people move into a new neighbourhood. This research is important because it enables us to understand which approaches to changing the environment are more or less beneficial to health, who is likely to benefit most from them and which offer the best value for money. Our findings can therefore make an important contribution to shaping policy to improve the health of the population.

Technical Summary

Rationale: The UK and many other countries have developed policies aimed at creating and fostering an environment that is more conducive to a sustained increase in population physical activity. However, the evidence base to guide policy in this area is limited. Aetiological epidemiology has quantified many of the health benefits of physical activity, behavioural epidemiology has explored its individual, social and environmental correlates and determinants, and some interventions have been found to be effective in increasing physical activity at the individual level, at least in the short to medium term. Nevertheless, major scientific uncertainty surrounds the effects of interventions to change population patterns of physical activity and the mechanisms by which that might be achieved. Aim: To elucidate the potential of population-level approaches to the promotion of active living by evaluating the effects of environmental and policy interventions and understanding related patterns and mechanisms of behaviour change. Approach: Drawing on a broad social-ecological conceptual framework and collaborations within the MRC, the UKCRC Centre for Diet and Activity Research (CEDAR) and other networks, the programme focuses on investigating approaches to changing physical activity behaviour that involve modifying the physical environment or influencing wider societal determinants of active living in the social or economic environments. The programme addresses two main concurrent research themes: 1. Quantifying the overall and distributional effects of interventions It is important to reduce the uncertainty surrounding the effects of interventions in order to discriminate between promising and ineffective approaches, identify those most likely to benefit the least active or the least healthy, compare the cost-effectiveness of different approaches, and inform the accurate modelling of their ultimate health impacts. This entails the empirical evaluation of environmental and policy ‘natural experiments’, such as the provision of new transport infrastructure, in a variety of settings. 2. Understanding related patterns and mechanisms of behaviour change It is also necessary to understand why interventions are or are not effective, for whom and in what circumstances so they can be appropriately targeted and tailored. Environmental and policy interventions are often somewhat specific to their contexts, which presents a challenge for deriving generalisable causal inference from evaluative studies. Addressing this challenge entails the empirical analysis and synthesis of quantitative and qualitative data from natural experimental and other observational datasets collected in a variety of settings. Impact: The programme provides a significant test-bed for and methodological development related to MRC guidance on natural experimental studies. It aims to provide empirical quantitative and qualitative inputs into the economic appraisal and evaluation of environmental and policy interventions, the development of models of physical activity behaviours, and the modelling of the ultimate health impacts of current and future interventions. It also aims to produce empirical research outputs with actionable messages for policymakers, particularly through evidence synthesis and by directly serving the needs of NICE guidance and other translational processes.
 
Description Mill Road closure evaluation (RP)
Geographic Reach Local/Municipal/Regional 
Policy Influence Type Influenced training of practitioners or researchers
 
Description Using the planning system to promote healthy weight environments (TB/MK)
Geographic Reach National 
Policy Influence Type Citation in other policy documents
URL https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/8638...
 
Description BBC - differences in COVID-19 infection and death rates between communities (OM) 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact Oliver Mytton spoke with BBC Journalist Michael Buchanan about differences in COVID-19 infection and death rates between communities, as background for subsequent report.
Year(s) Of Engagement Activity 2020
URL https://www.bbc.co.uk/news/education-52662338
 
Description BBC Radio Kent Breakfast show - COVID-19 and schools closure (OM) 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Media (as a channel to the public)
Results and Impact Oliver Mytton gave an interview on BBC Radio Kent Breakfast show on COVID-19 and schools closures.
Year(s) Of Engagement Activity 2020
 
Description BBC Worklife article - How outdoor advertising can deepen inequality (JA) 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact Dr Jean Adams was quoted in article "How outdoor advertising can deepen inequality"
Year(s) Of Engagement Activity 2020
URL https://www.bbc.com/worklife/article/20200817-the-inequality-of-outdoor-advertising-exposure
 
Description BMJ podcast on ultraprocessed food (JA) 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact For a Public Health response to ultra-processed food and drink, Dr Jean Adams was interviewed about a recently published BMJ article by Gary Taubes in Podcast for BMJ - Swiss Re Food for Thought 2020 event.
The BMJ article tweeted by more than 380 Twitter accounts https://www.altmetric.com/details/84765097/twitter
Year(s) Of Engagement Activity 2020
URL https://www.swissre.com/institute/media-detail.html?video=25e173ff-aa6f-4456-91c3-d43ca1459574&page=...
 
Description Bennett Prospect Prize for Public Policy - The Healthy Food Act (OM) 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Oliver Mytton was a finalist in 2019/2020 The Bennett Prospect Prize for Public Policy for essay ". The Bennett Prospect Prize for Public Policy is awarded by the Bennett Institute for Public Policy at the University of Cambridge and is held in partnership with Prospect Magazine. The goal is to encourage early career researchers and policy professionals to explore creative and generative solutions to a pressing public policy question of our age. In 2019/2020 they asked entrants the question 'Which single public health intervention would be most effective in the UK?'
The essay republished on Unit and CEDAR research blogs, and shared on social media channels.
Year(s) Of Engagement Activity 2020
URL https://www.mrc-epid.cam.ac.uk/blog/the-healthy-food-act-bennett-prospect-prize/
 
Description CSaP podcast - Food Insecurity During the Covid-19 Crisis (JA) 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Dr Jean Adams recorded the Podcast titled "Food Insecurity During the Covid-19 Crisis" as part of the Centre for Science and Policy (CSaP) Science, Policy & Pandemics series.
Year(s) Of Engagement Activity 2020
URL https://www.youtube.com/watch?v=QZGbNl3aKxA&feature=youtu.be
 
Description Conversation - Cycling and walking to work lowers risk of cancer, heart disease and death (RP) 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Richard Patterson co-authored a piece published in The Conversation titled "Cycling and walking to work lowers risk of cancer, heart disease and death - new research". The article was republished in 5 online news outlets, including Yahoo News, Inverse and MedicalXpress.
Year(s) Of Engagement Activity 2020
URL https://theconversation.com/cycling-and-walking-to-work-lowers-risk-of-cancer-heart-disease-and-deat...
 
Description Food insecurity in the UK - why we need a new normal (JA/MW) 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Unit Blog post "Food insecurity in the UK - why we need a new normal" posted on Unit http://www.mrc-epid.cam.ac.uk/blog/food-insecurity-need-new-normal/ CEDAR, which was also published by the Bennett Institute and Cambridge Global Food Security. Retweeted author tweets on Unit and CEDAR twitter accounts 27/04/20 - 30/04/20.
Year(s) Of Engagement Activity 2020
URL https://www.mrc-epid.cam.ac.uk/blog/food-insecurity-need-new-normal/
 
Description Government Obesity Strategy launch - interview (JA/MW/DT) 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact Martin White, Jean Adams, and Dolly Theis discussed launch of Government Obesity policy with producers of BBC R4 "The Briefing Room", but were not interviewed in the report itself.
Year(s) Of Engagement Activity 2020
URL https://www.bbc.co.uk/programmes/b07cblx9
 
Description Lancet - School closure and management practices during coronavirus outbreaks including COVID-19 (OM) 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact Lancet press release article "School closure and management practices during coronavirus outbreaks including COVID-19: a rapid systematic review".
Reported by the BBC https://www.bbc.co.uk/news/health-52180783, Guardian https://www.theguardian.com/education/2020/apr/06/school-closures-have-little-impact-on-spread-of-coronavirus-study and Telegraph https://www.telegraph.co.uk/news/2020/04/06/school-closures-do-not-have-significant-effect-spread-ofcoronavirus/, Independent, CNN, Sydney Morning Herald and more than 230 other print and online news outlets.

It was considered at SAGE 30 on 30 April 2020 https://www.gov.uk/government/publications/susceptibility-to-sars-cov-2-infection-amongst-children-and-adolescents-compared-with-adults-30-april-2020. Cited by WHO report in May 2020 https://apps.who.int/iris/handle/10665/332052.

Also cited by several Australia & New Zealand Analysis & Policy Observatory reports, and by the Scottish Government.

Altmetric score of 5393 on 15/01/2021 https://www.altmetric.com/details/79228974
Year(s) Of Engagement Activity 2020
URL https://www.bbc.co.uk/news/health-52180783
 
Description Mandala consortium funding announcement (MW) 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact MRC Epidemiology Unit and CEDAR blog posts "New consortium funded to deliver systems research programme to transform urban food system" on announcement of UK Research and Innovation (UKRI) Strategic Priorities Fund (SPF) funding award to the Mandala consortium.
Year(s) Of Engagement Activity 2020
URL https://www.mrc-epid.cam.ac.uk/blog/mandala-food-systems-funding-04-01-21/
 
Description Media interview - The Economist (RP) 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact Richard Patterson gave a telephone interview to The Economist and his work featured in an article titled "Why remote workers should reinvent commuting"
Year(s) Of Engagement Activity 2020
URL https://applied.economist.com/articles/why-remote-workers-should-reinvent-the-commuting-ritual
 
Description NIHR School for Public Health ResNet Committee Member (MK) 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Postgraduate students
Results and Impact Matt Keeble was appointed a Committee Member of the NIHR SPHR Researchers' Network (Resnet). The SPHR Researchers' Network (ResNet) links researchers working on projects across the eight members of the School. It is a forum for communication, peer support and networking to aid the professional development of researchers at any level, through virtual meetings, events and networking at the NIHR SPHR Annual Scientific Meeting. The ResNet committee is made up of nominated representatives from each member of the School. The committee meets every two months to plan and coordinate activity in line with the aims and objectives of the group, which are continuously assessed. The group comes together to collaborate, think innovatively and work together on future endeavours.
Year(s) Of Engagement Activity 2020
URL https://sphr.nihr.ac.uk/training/our-research-network-resnet/
 
Description Northstowe Community Forum (KE) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Dr Kate Ellis attended an event organised by South Cambridgeshire District Council and organisations related to Northstowe present updates to the community. These include, but are not limited to home developers, eg, L&Q, South Cambridgeshire District Council Planning Department, Stagecoach, Smart Journeys.

Northstowe Community Forums happen once per quarter. Organisations involved in Northstowe (eg, home developers, Smart Journeys, South Cambridgeshire Council, Living Sport) have the opportunity to present updates or display exhibition stands. The event is attended by residents in Northstowe and surrounding villages.
Year(s) Of Engagement Activity 2020
URL https://www.scambs.gov.uk/community-development/northstowe-community-forum/
 
Description Northstowe Wing Wednesday (KE) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Organised by South Cambridgeshire District Council, Northstowe Wing Wednesday is a monthly drop in sessions at the local community centre and provides an opportunity to talk to Northstowe residents informally. Dr Kate Ellis has attended 3 of these events prior to the national lockdown.
Year(s) Of Engagement Activity 2020
 
Description Ongoing relationship with local policy makers (KE) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Policymakers/politicians
Results and Impact Cambridgeshire County Council, South Cambridgshire District Council; Smart Journeys; Living Sport

We maintained an ongoing relationship with the local organisations listed above. The relationship was established to deliver the research studies funded by the Environmental Approaches to promote active travel grant by NIHR SPHR Programme grant. This relationship has been maintained over the past year to continue to deliver this programme of work.
Year(s) Of Engagement Activity 2020
 
Description Press releases - Potential health impact of restricting less-healthy food and beverage advertising on UK television (JA/OM) 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact PLOS Medicine press release, and Unit Press release to UK national, regional and specialist outlets for paper 'The potential health impact of restricting less-healthy food and beverage advertising on UK television between 05.30 and 21.00 hours: A modelling study'. Reported in the Daily Mail https://www.dailymail.co.uk/sciencetech/article-8835011/Junk-food-ad-ban-stop-160-000-children-overweight-obese-study-claims.html, Sun https://www.thesun.co.uk/news/12923415/ban-junk-food-adverts-9pm-watershed-slash-obese-children/ and about 20 online news outlets.

OM pitched comment article to the Telegraph. Oliver Mytton comment article in Telegraph on 26/10/2020 https://www.telegraph.co.uk/global-health/science-and-disease/time-take-unhealthy-options-spotlight-need-tough-restrictions/.

Links to Unit news article (press release) shared on Unit and CEDAR Twitter, Faceboook and LinkedIn accounts.

Oliver Mytton interviewed by Naked Scientists for broadcast later.

Included in the University of Cambridge School of Clinical Medicine newsletter on 23/10/20
Tweeted by 49 twitter users. Altmetric score of 210 on 15/01/2021 https://www.altmetric.com/details/92317086/news
Year(s) Of Engagement Activity 2020
URL https://www.mrc-epid.cam.ac.uk/blog/restricting-unhealthy-advertising/
 
Description Society for Social Medicine and Population Health Annual Scientific Meeting (RP) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact Richard Patterson presented a poster at the Society for Social Medicine and Population Health Annual Scientific Meeting ECR event held online on 8 September 2020. The presentation was well received.
Year(s) Of Engagement Activity 2020
 
Description Telegraph - Time to take unhealthy options out of the spotlight - we need tough restrictions on junk food ads (OM) 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact Oliver Mytton published in The Telegraph opinion article "Time to take unhealthy options out of the spotlight - we need tough restrictions on junk food ads".
Year(s) Of Engagement Activity 2020
URL https://www.telegraph.co.uk/global-health/science-and-disease/time-take-unhealthy-options-spotlight-...
 
Description University of Cambridge - Beyond the pandemic - what should we do? (JA) 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Dr Jean Adams authored a University of Cambridge blog post "Beyond the pandemic - what should we do? Rethink the menu and how much it costs".
Year(s) Of Engagement Activity 2020
URL https://www.cam.ac.uk/stories/BeyondThePandemic_rethinkthemenu
 
Description i newspaper - multi-buy offers in supermarkets and health (JA) 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact Dr Jean Adams was interviewed by a journalist for the I newspaper on multi-buy offers in supermarkets and health.
Year(s) Of Engagement Activity 2020
URL https://inews.co.uk/inews-lifestyle/wellbeing/buy-one-get-one-free-deals-in-supermarkets-tackle-obes...