Transaction data for population health

Lead Research Organisation: University of Bristol
Department Name: Bristol Medical School

Abstract

Digital technology opens up a new era in the understanding of human behaviour and lifestyle choices, with people's daily activities and habits leaving 'footprints' in their digital records. For example, when we buy goods in supermarkets and use loyalty cards to obtain benefits (e.g., future discounts), the supermarket records our purchases and creates a representation of our habits and preferences. Until now the use of 'digital footprint' data has mostly been limited to private companies. Companies have been using aggregates of these data to track sales of their products, to understand the factors that impact sales levels, and to target marketing and promotions. Changes in Data Protection law in the UK, i.e. General Data Protection Regulation, mean the public can now access and donate their data for academic research. Shopping history data, recorded through loyalty cards by retailers, are an extremely useful source of information for population health research as it can provide granular, objective data on real world choices and behaviours (e.g. painkillers, food) and other behaviours (e.g., pain and weight, wellbeing management). This information is often hard to obtain in the health research domain. Links between lifestyle choices and health outcomes are commonly studied through self-report questionnaires that ask people to remember their everyday choices and behaviours, which can bias results: responses about behaviours do not always reflect the reality of what people actually do. If and when shopping history data are used in a privacy preserving and ethical manner, these data can be utilised for public good, benefiting health research (e.g., helping to understand how everyday behaviours and lifestyle choices impact health and social outcomes). For example, what are the exact levels of alcohol consumption that lead to irreversible health damage for unborn babies accounting for moderating factors (e.g., age, gender, genetic makeup, etc.)? Under which conditions do different types of ready meals contribute to obesity? Do chemicals in household products lead to higher risks of cancer and other adverse health outcomes in children?
The Transaction Data for Population Health research programme utilises commercially collected datasets for privacy-preserving, ethical research to benefit the public good. This program questions whether shopping history data can be used in a positive way to support health research and the development of new interventions. The fellowship will establish the feasibility of novel ways of assessing both health outcomes and associated lifestyle choices through objective measures of real world behaviours reflected in retail shopping history data recorded through loyalty cards. At the same time it will build a framework that can be used by future researchers. My research programme in Yrs 1-4 will unfold in three stages. First, it will use commercially collected datasets to identify and study reproductive health outcomes through patterns in the shopping data. Second, it will validate patterns in the data which are associated with health outcomes using established Longitudinal Population Studies such as the Avon Longitudinal Study of Parents And Children (aka Children of the 90s). Third, I will use the linked datasets to research questions of population health importance in the domain of reproductive health, such as what are the true rates of miscarriages, how do women manage postpartum health and wellbeing, whether breastfeeding is better in the long run for children's mental health, and others. This will be done through studies with Children of the 90s participants and the general public helping to validate the results. The impact of the project will realised in Yrs 5-7 and include a conceptual change in techniques for studying population health, making it possible to identify lifestyle causes of diseases, assess the impact of national policies, and provide recommendations for health interventions.

Planned Impact

Creating the data sharing mechanisms described in Transaction Data for Population Health programme provides a gateway to unlock the potential of large datasets to study individual lifestyle choices for population health research. The ultimate long-term goal of this program is to put large commercial datasets - such as shopping history data - at the service of the public healthcare through contributing to early detection of diseases, developing and testing targeted interventions, and contributing to the evidence-based healthcare and health research. If this research is successful, we will benefit healthcare through improved allocative efficiency in public spending in a variety of domains as well as through novel ways to assess the success of health interventions. The programme will provide significant long-term benefits to the wider public through better provision and access to healthcare. The development and implementation of frameworks allowing companies to share consumer data with academic researchers for public benefit will create long-term impact for retailers and other industries that rely on consumer data through reputation benefits and lead to long-term social impact through improving lives of people. All outputs of the programme will be open access and publicised through relevant routes (e.g., policy reports, journal publications, reports available through project website).
In addition, the outputs of the fellowship will provide multiple short-term benefits to different groups of users, including public and third sector (i.e., policymakers, healthcare services, health charities), retail industry and the general public. These have been identified through my previous research and impact work, through monitoring policy developments, responding to government consultations (e.g., on Online Targeting and Personalisation, Department for Culture, Media and Sport), membership on policy-makers' Advisory Boards (e.g., for Centre for Data Ethics and Innovation) and extensive work with retail industry and the general public.
Public service departments, such as the National Health Service and the Office for National Statistics, will learn about relevant work on data sharing and data linkage, as well as novel data analytic techniques. This will impact their strategies of using new streams of data in their practices and create new opportunities for data driven research. Policy-makers and regulators, such as Department of Culture Media and Sport and Information Commission Officer, short-term benefit will constitute learning about novel data sharing practices that can help to improve policies and regulations, and create more efficient routes of sharing data between academia, industry and third sector.
Retail industry project partners (e.g., Walgreen Boots Alliance) will benefit from skills development and knowledge transfer. They will learn novel techniques of data analysis helping to understand their consumers better and to provide more targeted advertising to their consumers. This will ultimately increase their profits, build stronger relationships with consumers, achieve better visibility in a crowded marketplace and help to realise the value of their data for public services. Retailers will benefit from a newly created blueprint for satisfying data sharing requests from consumers and will have reputational benefits by helping to create a more fair and sustainable society through efficient use of already collected health data for public good.
The members of the general public and population studies participants who took part in the research will benefit in the short-term though learning about data sharing and possibilities of using loyalty cards data for research and will be empowered in their decisions of sharing their personal data for public good.
 
Description Citation in a policy report by Ada Lovelace Institute
Geographic Reach National 
Policy Influence Type Citation in other policy documents
URL https://www.adalovelaceinstitute.org/report/participatory-data-stewardship/
 
Description Evidence to parliamentary committee
Geographic Reach National 
Policy Influence Type Contribution to a national consultation/review
URL https://committees.parliament.uk/writtenevidence/43526/html/
 
Description Investigation of Nutritional Behaviour Data linkages with a National Core Study Cohort and Boots
Amount £29,631 (GBP)
Organisation University of Nottingham 
Sector Academic/University
Country United Kingdom
Start 04/2023 
End 10/2023
 
Description Jean Golding Institute Seed Corn Funding
Amount £5,000 (GBP)
Organisation University of Bristol 
Sector Academic/University
Country United Kingdom
Start 01/2023 
End 06/2023
 
Description Postdoc Enrichment Scheme
Amount £2,000 (GBP)
Organisation Alan Turing Institute 
Sector Academic/University
Country United Kingdom
Start 03/2022 
End 09/2022
 
Description Research Staff Development Fund
Amount £400 (GBP)
Organisation University of Bristol 
Sector Academic/University
Country United Kingdom
Start 01/2023 
End 07/2023
 
Description The University of Nottingham Horizon CDT the Impact Activity Large Grant
Amount £16,388 (GBP)
Organisation University of Nottingham 
Sector Academic/University
Country United Kingdom
Start 03/2023 
End 03/2024
 
Description BBC Radio 4 Inside Health interview 
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 Public/other audiences
Results and Impact Dr Skatova have given an interview to BBC 4 Inside health, which should feature in the programme that hasn't been aired yet.
Year(s) Of Engagement Activity 2023
URL https://www.bbc.co.uk/programmes/m001k7mm
 
Description Big Tent Ideas Festival 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact On Saturday the 11th of June 2022 Bristol hosted Big Tent Ideas Festival attended by around 850 people. It brought together politicians, including sitting members of parliament, medical practitioners, journalists, artists, scientists, health campaigners and the general public to talk and debate about pressing issues facing society. Dr Skatova was invited to be a part of an expert panel (chaired by Lord Andrew Lansley) who discussed the challenges that the NHS and public health sector faces post COVID, and what lessons were learned from the pandemic that can be taken forward to improve health services of the future.

This insightful session covered many issues that became apparent during the pandemic such as under-staffing of the NHS and lack of continuity of care. The panellists and the audience also discussed positive shifts that were achieved during pandemic, which included the widespread use of medical and other forms of data for cutting-edge health research. The room (or, rather, the tent!) agreed that future of health research is in improving the use of all sorts of novel data sources to understand people's lifestyle choices, and making those work for nation's health and wellbeing.
Year(s) Of Engagement Activity 2022
URL https://bigtent.org.uk/festival-2022/
 
Description Data Donation Advisory Council founding and inaugural meeting 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Dr Skatova, together with Dr James Goulding and Louise Barnard from University of Nottingham founded DDAC - Data Donation Advisory Council. This is a cross universiies group to bring efforts on working with new forms of data about human behaviour together. Four members of of Digital Footprint Lab - Neo, Lizzie, Steve and Anya - took part in the inaugural meeting of DDAC at the University of Nottingham. The council aims to build opportunities for easier knowledge exchange and collaborations, as well as create code of standard for research with novel data about human behaviour.
Year(s) Of Engagement Activity 2022
URL https://www.ddac.org.uk/blog
 
Description Invited talk for Levelling up Department 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact On 21st of September, Anya, together with James Goulding and Georgiana Nica-Avram from N/Lab at University of Nottingham, presented to the Spatial Unit at Levelling Up Department on Shopping Data and Inequalities. The slides can be found here. The talk was attended by about 20 colleagues from the Spatial Unit. We received a lot of interesting and insightful questions, and after the talk had a long chat with Tom Smith, the director of the unit and Chief Data Officer for Levelling Up department. The talk sparked discussions about future collaborations which are ongoing.
Year(s) Of Engagement Activity 2022
 
Description Jean Goulding Institute Showcase, University of Bristol 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact The Digital Footprints Lab was invited to participate in the Jean Golding Institute (JGI) Data & AI Showcase 2022 on the 7th of June 2022. The Showcase was the flagship event of JGI and discussed the latest development in data science, computational social science, and artificial intelligence, with a mix of high-profile speakers, exhibitions, workshops, and interactive displays. Over 300 guests attended the Showcase, including academic researchers and practitioners in both business and governmental bodies, and explored the impacts of data-intensive research.

Dr Anya Skatova and Dr Neo Poon were among the exhibitors who illustrated the use of massive transactional data to examine the long-term shopping patterns of customers of a major retail chain in the United Kingdom. This research programme is part of the UKRI Future Leaders Fellowship granted to Dr Skatova and facilities the investigation into crucial consumer, healthcare, and economic topics. The two researchers demonstrated how the degree of diversity in shopping records can be measured by adopting a concept from computer science to behavioural and psychological science, as well as how the socioeconomic drivers behind self-medication in England can be studied. The presentation sparked further discussion with attendees and questions afterwards.
Year(s) Of Engagement Activity 2022
URL http://www.bristol.ac.uk/golding/get-involved/workshops-and-seminars/
 
Description Public Engagement event at We The Curious 
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 On 4th and 5th December, we hosted an event in the Open City Lab at We The Curious, the science and educational centre in Bristol. 'Shopping Trolley Secrets' provided visitors with the chance to visit researchers in the Lab and engage with a real-life research project. Younger visitors could fill their shopping baskets with their favourite food and come and talk to researchers about their choices. Over 100 people attended the event space over two days.

Visitors were also asked to imagine what kind of stories their loyalty card could tell about their health and to envisage how their shopping history data could be used for health research. We talked visitors through the various different categories of data that researchers would have access to, such as the timestamp and type of product purchased. We
were also interested in how they would feel about sharing their health status alongside their shopping history data for greater insight into the link between diet and disease.

Many visitors were enthusiastic about sharing the novel form of data with university researchers in order to understand more about various diseases, such as diabetes, albeit with certain caveats. For instance, they were interested to learn more about how data could be transferred to researchers, how reliable the data was and how it would be kept safe.
The event provided us with invaluable feedback about how best to develop our future research programme and in particular, how we can get the public on board for sharing
shopping history data for health research.
Year(s) Of Engagement Activity 2021
 
Description Public Engagement work with We The Curious 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact The Digital Footprints Lab collaborated with We The Curious, which is a major science and educational centre in Bristol, and delivered the public events Shopping Trolley Secrets throughout the past summer. In total three events were delivered in Sep 2022 to the general public, and one for West of England Inclusive Living event at MShed.

A main goal of Shopping Trolley Secrets was to raise awareness of how transactional data is collected and utilised by various organisations, especially through long-term partnerships between research institutes and businesses. Guests were invited to imagine the types of shopping data that are available to retail chains and researchers, and to identify the how data donation can contribute to research in medical and economic sciences.Guest at the event were invited to vote on the areas of data science research that they considered as important for the public, including research programmes on respiratory diseases, diet and nutrition, and alcohol consumption. They were also invited to describe - or, for our younger guests, to draw - the types of information they would like to see from they own shopping data, which provided valuable insights for our research development and public engagement strategies.
Year(s) Of Engagement Activity 2022
 
Description Turing Special Interest Group on Novel Data Linkages Health and Wellbeing 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The SIG was founded by Dr Anya Skatova and Dr Michelle Morris (University of Leeds). The main goal of the group is to create a forum and a platform to bring multi discipline and multi sector communities together in order to exchange ideas, network and develop projects in the booming area of research with novel digital footprint data. In October 2022 Dr Skatova, together with Dr Morris from University of Leeds, hosted an inaugural meeting of the Turing Special Interest Group on Novel data Linkages for Health and Wellbeing. The event on the 26th of October 2022 was joined by about 40 people, both in person - at the Alan Turing Institute - and online.
The event sparked a lot of discussion, follow up conversations and plans for further steps. As a result of the event, Dr Skatova and the SIG is organising 1st Digital Footprints conference at the University of Bristol in May 2023.
Year(s) Of Engagement Activity 2022
URL https://www.turing.ac.uk/research/interest-groups/novel-data-linkages-health-and-wellbeing
 
Description Turing-Roche Knowledge Share Event: Digital Health 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Elizabeth Dolan, a PhD student associated with Dr Skatova's lab and fellowship presented at one of a series of knowledge share series aiming to bring together members of Roche (a large biotech company, and leading provider of in-vitro diagnostics and innovative solutions across major disease areas https://www.roche.com/about/) and The Alan Turing Institute's networks (the UK's national institute for data science and artificial intelligence https://www.turing.ac.uk) as well as the wider scientific community, to showcase partnership updates and research, knowledge share and hear different academic and industry perspectives on data science topics to gain insight and help build new connections and collaborations (https://www.turing.ac.uk/events/turing-roche-knowledge-share-series).
Year(s) Of Engagement Activity 2023
URL http://www.turing.ac.uk/events/turing-roche-knowledge-share-series-digital-health
 
Description Welsh NHS Confederation Conference talk 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Back in November, Anya presented her and fellowship work at the Welsh NHS Confederation Conference in Cardiff. It was attended by over 800 attendees from Welsh NHS, central and local government, charities, community groups, industry and academics. There were many follow up discussion and questions about the research project.
Year(s) Of Engagement Activity 2022
URL https://www.nhsconfed.org/articles/welshconfed22-key-takeaways-relationships-listening-and-community