Poverty Reduction's Influence On Risk factors for non-communicable diseases: A systems approach (PRIOR)
Lead Research Organisation:
University of Manchester
Department Name: School of Health Sciences
Abstract
People from poorer backgrounds have higher levels of chronic diseases e.g. heart disease, chest problems and mental health conditions. We also know of the vicious cycle of debt leading to poorer mental and physical health. In some parts of our cities, there is increasing food and fuel poverty leading to terrible consequences, including children having lower life expectancies than their parents and more chance of multiple diseases developing during their working age. To prevent people from becoming poorer, many councils work with employers and other agencies, such as voluntary groups, to develop 'poverty alleviation' activities. Health professionals often measure poverty to find where the most deprived communities live and target health activities in these areas and then measure the impacts on health, taking into account poverty. Many health policies have focused on lifestyle changes for the individual. This relies on high levels of health and digital literacy and changing behaviour being the individual's responsibility. Financial literacy has also suffered the same problem. People are expected to know how to avoid debt, spend wisely and develop skills to improve their wealth. We also know that poorer people suffer from many mental and physical diseases earlier in life than those from richer backgrounds. We noticed from when we speak to people from these communities they tell us how their finances mean they are not able to make healthy choices for themselves and their families or able to navigate the latest digital technologies. They also describe their frustration with the vicious cycle of being in debt and not being able to provide all that is needed to thrive. The importance of place and community on how people make healthy and other life choices is becoming an important area for research, policy and practice. This unique programme called "Poverty Reduction's Influence On Risk factors for non-communicable diseases: A systems approach (PRIOR)", aims to combine all the professional disciplines, charities and the voluntary sector in poverty alleviation with the public and business. The aim is to improve health and wellbeing, with a focus on mental wellbeing, through the co-design, co-financing, implementation and evaluation of poverty alleviation strategies which include education interventions, improving health, financial and digital inclusivity and literacy, a microgrant scheme, and non-communicable disease (NCD) prevention through incentivised schemes to improve wellbeing. We will focus on the most deprived communities in Manchester, Cheshire and Doncaster to demonstrate improved social capital and cohesion, employability and improving public spaces. By changing the various systems that influence poverty and health, we will be able to reduce the burden of NCDs on the most vulnerable in our communities. Health promotion theory is based on developing 'organised efforts of society' to help individuals make "the health choice the easy choice". Financial inclusion interventions, similarly, make sure people have good understanding of their finances. Our project management only has five universities because we will focus on our consortium including the wide range of people who directly work with individuals in communities. We will work together with communities, bringing our own expertise to come up with novel solutions e.g. health, digital and financial literacy training, microgrant schemes, incentivised healthy options. They will decide on what is important and how best to implement it. We will then use robust methodologies to bring about system change to measure whether it is effective both for the individuals and is affordable. We know the system has a huge impact on the choices that an individual will make, so we will change the systems to ensure everyone fairly has the skills they need whilst comparing this to areas without our way of working. This evidence can be used in other places at little or no additional cost.
Technical Summary
The vision is to transform deprived communities in the North of England through equitable place-based interventions that empower individuals to escape debt and poverty and improve their mental and physical health. We will focus on the most deprived communities in Manchester, Cheshire and Doncaster demonstrating improving social capital and cohesion, employability, improving public spaces. The aim is to bring about systems change through interdisciplinary work with all the professional disciplines, charities and the voluntary sector in poverty alleviation in these three areas and co-produce interventions with the communities themselves and linking with business using big data techniques. The objectives include co-design cost-effective interventions that will improve the socio-economic determinants of mental and physical health through educational interventions for health, digital and financial inclusivity and literacy, community-led interventions including microgrants, wearable technologies and incentivised schemes to reduce the risk factors for NCDs; produce a sustainable model of co-financing interventions using a public/private partnership for scalability, dissemination and replication; demonstrate improvement in health and wellbeing using validated tools on socio-economic and health indicators to determine success. The methodology will be a controlled pre-post study that will allow economic, clinical and societal benefit. The process evaluation will be through Rapid Cycle and realist approach.
We have user groups in each of the three active areas and will build on this during the CDG phase to align with the rest of the Consortium. They will be integral to the entire programme being part of the co-design, implementation and evaluation. The control sites will not have this level of co-production. The comparison between active and control sites will be useful in defining the benefits, providing a contemporaneous evidence base that can be scaled.
This grant is funded by the UK Prevention Research Partnership (UKPRP) which is administered by the Medical Research Council on behalf of the UKPRP's 12 funding partners: British Heart Foundation; Cancer Research UK; Chief Scientist Office of the Scottish Government Health and Social Care Directorates; Engineering and Physical Sciences Research Council; Economic and Social Research Council; Health and Social Care Research and Development Division, Welsh Government; Health and Social Care Public Health Agency, Northern Ireland; Medical Research Council; Natural Environment Research Council; National Institute for Health Research; The Health Foundation; The Wellcome Trust.
We have user groups in each of the three active areas and will build on this during the CDG phase to align with the rest of the Consortium. They will be integral to the entire programme being part of the co-design, implementation and evaluation. The control sites will not have this level of co-production. The comparison between active and control sites will be useful in defining the benefits, providing a contemporaneous evidence base that can be scaled.
This grant is funded by the UK Prevention Research Partnership (UKPRP) which is administered by the Medical Research Council on behalf of the UKPRP's 12 funding partners: British Heart Foundation; Cancer Research UK; Chief Scientist Office of the Scottish Government Health and Social Care Directorates; Engineering and Physical Sciences Research Council; Economic and Social Research Council; Health and Social Care Research and Development Division, Welsh Government; Health and Social Care Public Health Agency, Northern Ireland; Medical Research Council; Natural Environment Research Council; National Institute for Health Research; The Health Foundation; The Wellcome Trust.
Organisations
- University of Manchester (Collaboration, Lead Research Organisation)
- Manchester City Council (Collaboration)
- BetterPoints (Collaboration)
- University College London (Collaboration)
- PUBLIC HEALTH ENGLAND (Collaboration)
- CHESHIRE WEST AND CHESTER COUNCIL (Collaboration)
- Good Things Foundation (Collaboration)
- Newcastle University (Collaboration)
- GLASGOW CALEDONIAN UNIVERSITY (Collaboration)
- National Institute for Health Research (Collaboration)
- Cheshire Community Action (Collaboration)
- Third Space Agency Limited (Collaboration)
- Northern Health Science Alliance Ltd (NHSA) (Collaboration)
- University of Chester (Collaboration)
- Doncaster Council (Collaboration)
- Bradford Institute for Health Research (BIHR) (Collaboration)
- UNIVERSITY OF EDINBURGH (Collaboration)
- Leeds Beckett University (Collaboration)
- HEALTH INNOVATION MANCHESTER (Collaboration)
- UNIVERSITY OF YORK (Collaboration)
Description | 3rd Space |
Organisation | Third Space Agency Limited |
Country | United Kingdom |
Sector | Private |
PI Contribution | Collaboration on the PRIOR consortium development grant. |
Collaborator Contribution | Collaboration on the PRIOR consortium development grant. |
Impact | No outputs or outcomes as yet. |
Start Year | 2020 |
Description | Better Points |
Organisation | BetterPoints |
Country | United Kingdom |
Sector | Private |
PI Contribution | Collaboration on the PRIOR consortium development grant. |
Collaborator Contribution | Collaboration on the PRIOR consortium development grant. |
Impact | No outputs or outcomes as yet. |
Start Year | 2020 |
Description | Bradford Institute for Health Research (BIHR) |
Organisation | Bradford Institute for Health Research (BIHR) |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Collaboration on the PRIOR consortium development grant. |
Collaborator Contribution | Collaboration on the PRIOR consortium development grant. |
Impact | No outputs or outcomes as yet. |
Start Year | 2020 |
Description | Cheshire Community Action |
Organisation | Cheshire Community Action |
Country | United Kingdom |
Sector | Charity/Non Profit |
PI Contribution | Collaboration on the PRIOR consortium development grant. |
Collaborator Contribution | Collaboration on the PRIOR consortium development grant. |
Impact | No outputs or outcomes as yet. |
Start Year | 2020 |
Description | Cheshire West and Chester Council |
Organisation | Cheshire West and Chester Council |
Country | United Kingdom |
Sector | Public |
PI Contribution | Collaboration on the PRIOR consortium development grant. |
Collaborator Contribution | Collaboration on the PRIOR consortium development grant. |
Impact | No outputs or outcomes as yet. |
Start Year | 2020 |
Description | Consortium to put in bid for NIHR HDRC call 2 April 2023 |
Organisation | Manchester City Council |
Country | United Kingdom |
Sector | Public |
PI Contribution | We will be the main HEI for a bid led by Manchester City Council |
Collaborator Contribution | Input into Making Manchester Fairer and poverty strategy |
Impact | None |
Start Year | 2023 |
Description | Doncaster Council |
Organisation | Doncaster Council |
Country | United Kingdom |
Sector | Public |
PI Contribution | Collaboration on the PRIOR consortium development grant. |
Collaborator Contribution | Collaboration on the PRIOR consortium development grant. |
Impact | No outputs or outcomes as yet. |
Start Year | 2020 |
Description | Evaluation of Making Manchester Fairer and Poverty strategy and indicators for health inequalities with Manchester City Council |
Organisation | Manchester City Council |
Country | United Kingdom |
Sector | Public |
PI Contribution | We received two awards for evaluating Making Manchester Fairer and Poverty strategy and building indicators to measure inequalities via policy@manchester and CAPE https://www.policy.manchester.ac.uk/about-us/partnerships/cape/ |
Collaborator Contribution | policy@manchester and Manchester City Council commissioned the work |
Impact | Just started |
Start Year | 2023 |
Description | Glasgow Caledonian University |
Organisation | Glasgow Caledonian University |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Collaboration on the PRIOR consortium development grant. |
Collaborator Contribution | Collaboration on the PRIOR consortium development grant. |
Impact | No outputs or outcomes as yet. |
Start Year | 2020 |
Description | Glasgow Caledonian University |
Organisation | Glasgow Caledonian University |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Collaboration on the PRIOR consortium development grant. |
Collaborator Contribution | Collaboration on the PRIOR consortium development grant. |
Impact | No outputs or outcomes as yet. |
Start Year | 2020 |
Description | Good Things Foundation |
Organisation | Good Things Foundation |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Collaboration on the PRIOR consortium development grant. |
Collaborator Contribution | Collaboration on the PRIOR consortium development grant. |
Impact | No outputs or outcomes as yet. |
Start Year | 2020 |
Description | Health Innovation Manchester |
Organisation | Health Innovation Manchester |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Collaboration on the PRIOR consortium development grant. |
Collaborator Contribution | Collaboration on the PRIOR consortium development grant. |
Impact | No outputs or outcomes as yet. |
Start Year | 2020 |
Description | Leeds Beckett University |
Organisation | Leeds Beckett University |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Collaboration on the PRIOR consortium development grant. |
Collaborator Contribution | Collaboration on the PRIOR consortium development grant. |
Impact | No outputs or outcomes as yet. |
Start Year | 2020 |
Description | Manchester City Council |
Organisation | Manchester City Council |
Country | United Kingdom |
Sector | Public |
PI Contribution | Collaboration on the PRIOR consortium development grant. |
Collaborator Contribution | Collaboration on the PRIOR consortium development grant. |
Impact | No outputs or outcomes as yet. |
Start Year | 2020 |
Description | National Institute for Health Research |
Organisation | National Institute for Health Research |
Country | United Kingdom |
Sector | Public |
PI Contribution | Collaboration on the PRIOR consortium development grant. |
Collaborator Contribution | Collaboration on the PRIOR consortium development grant. |
Impact | No outputs or outcomes as yet. |
Start Year | 2020 |
Description | Newcastle University |
Organisation | Newcastle University |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Collaboration on the PRIOR consortium development grant. |
Collaborator Contribution | Collaboration on the PRIOR consortium development grant. |
Impact | No outputs or outcome as yet. |
Start Year | 2020 |
Description | Northern Health Science Alliance Ltd (NHSA) |
Organisation | Northern Health Science Alliance Ltd (NHSA) |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Collaboration on the PRIOR consortium development grant. |
Collaborator Contribution | Collaboration on the PRIOR consortium development grant. |
Impact | No outputs or outcomes as yet. |
Start Year | 2020 |
Description | Public Health England |
Organisation | Public Health England |
Country | United Kingdom |
Sector | Public |
PI Contribution | Collaboration on the PRIOR consortium development grant. |
Collaborator Contribution | Collaboration on the PRIOR consortium development grant. |
Impact | No outputs or outcomes as yet. |
Start Year | 2020 |
Description | University College London |
Organisation | University College London |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Collaboration on the PRIOR consortium development grant. |
Collaborator Contribution | Collaboration on the PRIOR consortium development grant. |
Impact | No outputs or outcomes as yet. |
Start Year | 2020 |
Description | University of Chester |
Organisation | University of Chester |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Collaboration on the PRIOR consortium development grant. |
Collaborator Contribution | Collaboration on the PRIOR consortium development grant. |
Impact | No outputs or outcomes as yet. |
Start Year | 2020 |
Description | University of Edinburgh |
Organisation | University of Edinburgh |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Collaboration on the PRIOR consortium development grant. |
Collaborator Contribution | Collaboration on the PRIOR consortium development grant. |
Impact | No outputs or outcomes as yet. |
Start Year | 2020 |
Description | University of Manchester - Institute of Data Sciences and AI |
Organisation | University of Manchester |
Department | Institute for Data Science & Artificial Intelligence |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Collaboration on the PRIOR consortium development grant. |
Collaborator Contribution | Collaboration on the PRIOR consortium development grant. |
Impact | No output yet |
Start Year | 2020 |
Description | University of Manchester - Manchester Urban Institute |
Organisation | University of Manchester |
Department | Manchester Urban Institute |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Collaboration on the PRIOR consortium development grant. |
Collaborator Contribution | Collaboration on the PRIOR consortium development grant. |
Impact | No impact |
Start Year | 2020 |
Description | University of Manchester - Pankhurst |
Organisation | University of Manchester |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Collaboration on the PRIOR consortium development grant. |
Collaborator Contribution | Collaboration on the PRIOR consortium development grant. |
Impact | No outputs yet |
Start Year | 2020 |
Description | University of Manchester Innovation Factory (previously UMIP) |
Organisation | University of Manchester |
Department | Innovation Group (UMI3) |
Country | United Kingdom |
Sector | Private |
PI Contribution | Collaboration on the PRIOR consortium development grant. |
Collaborator Contribution | Collaboration on the PRIOR consortium development grant. |
Impact | N/A |
Start Year | 2020 |
Description | University of York |
Organisation | University of York |
Department | York Health Economics Consortium (YHEC) |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Collaboration on the PRIOR consortium development grant. |
Collaborator Contribution | Collaboration on the PRIOR consortium development grant. |
Impact | No outputs or outcomes as yet. |
Start Year | 2020 |
Description | University of York |
Organisation | University of York |
Department | York Health Economics Consortium (YHEC) |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Collaboration on the PRIOR consortium development grant. |
Collaborator Contribution | Collaboration on the PRIOR consortium development grant. |
Impact | No outputs or outcomes as yet. |
Start Year | 2020 |
Description | Centre for Cities talk |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Policymakers/politicians |
Results and Impact | Discussion and presentation on local knowledge and community participation as found in the PRIOR study. |
Year(s) Of Engagement Activity | 2021 |
URL | https://www.centreforcities.org/event/devolution-data-and-levelling-up/ |
Description | Conservative Party Conference Panel with Policy@Manchester and SMF and roundtable |
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 | A panel at the Conservative Party Conference on the link between digital, financial and health literacy and reducing inequalities. |
Year(s) Of Engagement Activity | 2021 |
URL | https://www.smf.co.uk/party_conferences/smf-at-2021-party-conferences/ |
Description | Digital Inequalities |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Professional Practitioners |
Results and Impact | A seminar for the Pankhurst Institute on Digital Inequalities focusing on the link between health, financial and health literacy as found in the PRIOR study. |
Year(s) Of Engagement Activity | 2022 |
Description | Inequalities Talk |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Policymakers/politicians |
Results and Impact | Local authority event on inequalities and focussed on Digital Inequalities focusing on the link between health, financial and health literacy as found in the PRIOR study. |
Year(s) Of Engagement Activity | 2021 |
Description | National Expert Reference Group - Health Inequalities |
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 | A roundtable of experts for inequalities where I spoke about PRIOR |
Year(s) Of Engagement Activity | 2021,2022 |
Description | PRIOR presentation at the 9th International Festival of Public Health |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | We had a plenary talk with Andy Burnham, Mayor of Greater Manchester, and presented the results of the CDG. The Festival had 1272 people registered, 29 sessions (plenary, workshop, parallel), with over 100 different speakers from 20+ countries. |
Year(s) Of Engagement Activity | 2021 |
URL | http://www.festivalofpublichealth.co.uk/ |
Description | Policy@Manchester and Manchester City Council Roundtable |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Policymakers/politicians |
Results and Impact | A special roundtable utilising the link between health, financial and health literacy as found in the PRIOR study to reduce nequalities |
Year(s) Of Engagement Activity | 2022 |
Description | Poverty Reduction's Influence On Risk factors for non-communicable diseases (PRIOR): Community engagement through an online photography project |
Form Of Engagement Activity | Engagement focused website, blog or social media channel |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Public/other audiences |
Results and Impact | The aims of this project were: - To engage local residents with the key project themes and build relationships between the researchers and the community - To discuss issues affecting people's health and wellbeing, digital lives and financial lives - To identify community assets and gaps in relation to health, digital and financial services and opportunities Over the 6-week period, 441 people joined the Facebook groups and 165 photos were posted across all groups, generating long threads of comments. Preliminary thematic analysis has been used to elicit initial themes from the discussion threads and the focus groups. • West Cheshire https://www.facebook.com/WestCheshirePhotoProject • North Manchester https://www.facebook.com/NorthManchesterPhotoProject • Doncaster https://www.facebook.com/DoncasterPhotoProject Findings from this project were fed into the full proposal and to the CDG. The full proposal was influenced directly by the resultsof this study. |
Year(s) Of Engagement Activity | 2020 |
URL | https://sites.manchester.ac.uk/prior/activities/ |
Description | Presentation at European Public Health Week Organised by WHO Europe Healthy Cities Network and EUPHA |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Policymakers/politicians |
Results and Impact | Local spaces and places - How healthy is your city? Organised by WHO Europe Healthy Cities Network and EUPHA. 19 May 2021, 10:00-11:00 CET, Confirmed Speakers: Åsa Nihlén, WHO Europe Healthy Cities Secretariat, Dineke Zeegers, EUPHA, Nino Berdzuli, Director, Country Health Programmes, WHO Europe, Aron Anderson, WHO Europe Ambassador for Cancer, Pierpaolo Mudu, WHO, Stephen Whiting, WHO, John Howie, Public Health Scotland, EUPHA Urban Health Section: Stefano Capolongo, Italy and Greg Williams, UK |
Year(s) Of Engagement Activity | 2021 |
URL | https://eupha.org/EUPHW_2021#:~:text=17%2D21%20May%202021 |
Description | Westminster Health Forum policy conference Policy priorities for tackling health inequalities, improving public health, and the role of the Office for Health Improvement and Disparities |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Policymakers/politicians |
Results and Impact | A forum to discuss with policy makers especially relating to reducing inequalities |
Year(s) Of Engagement Activity | 2022 |
URL | https://www.westminsterforumprojects.co.uk/publication/Public-Health-22 |
Description | policy@manchester blog |
Form Of Engagement Activity | Engagement focused website, blog or social media channel |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Policymakers/politicians |
Results and Impact | A policy blog on digital inequalities that have led to a number of different outcomes from further events to participation in research. |
Year(s) Of Engagement Activity | 2021 |
URL | https://policyatmanchester.shorthandstories.com/on-digital-inequalities/ |