Exercise as a treatment or intervention in chronic disease
Exercise in patients with vasculitis
Vasculitis patients often suffer severe fatigue. Currently there are no proven treatments but increasing physical activity helps reduce fatigue in other conditions and may help patients with vasculitis. We are about to start a new project to assess the feasibility of exercise as a treatment for fatigue in patients with vasculitis. This study will investigate the feasibility and acceptability of an exercise intervention that combines supervised exercise sessions and telephone home coaching to promote participation in regular exercise. This study will also help us to understand what patients think about the intervention and its impact on their health and wellbeing. The study will run for two years and is funded by Arthritis Research UK. (PI: Professor Lorraine Harper).
People with lung disease (COPD)
The PSM-COPD randomised controlled trial has recruited 577 participants with COPD that causes them to be mildly breathless. The trial has been testing a nurse delivered telephone coaching intervention to increase levels of physical activity and self-management of their condition. Results are expected towards the end of 2016. The trial was funded by the NIHR School for primary Care Research and is a collaboration between the Universities of Birmingham, Manchester, Keele and Oxford. (PI Prof Kate Jolly).
Home-based cardiac rehabilitation for people with heart failure
The Rehabilitation Enablement in Chronic Heart Failure (REACH-HF) programme of research studies is a collaboration between the Universities of Exeter, Birmingham, York, the Royal Cornwall NHS Trust, Leicester NHS Trust and Aneurin Bevin Health Board. The programme has developed a new, evidence-based self-help manual for people with heart failure and their caregivers, which is being evaluated by an RCT. The programme is funded by the NIHR Programme grants, led by Professors Hayes Dalal and Rod Taylor. (Local PIs Prof Kate Jolly and Dr Russell Davies).
Web-based cardiac rehabilitation for people who decline supervised centre-based cardiac rehabilitation
The WREN Feasibility Study is a Web-Based Cardiac REhabilitatioN Alternative for Those Declining or Dropping Out Of Conventional Rehabilitation. It is funded by the NIHR RfPB and is led by Professor Sally Singh, University Hospitals of Leicester NHS Trust. Local investigators Professors Kate Jolly and Tom Marshall.
Weight management
Preventing weight gain over the Christmas holidays
Studies show that Christmas holidays are a very high risk period for weight gain that is not later compensated and retention therefore occurs. Holiday periods are a high risk time for weight gain because they typically involve consumption of high fat energy dense food, increased snacking, reduced physical activity, increased alcohol consumption, longer eating durations and easy access to food. People often feel holiday periods are a time where they can eat what they chose. There is a need therefore to investigate the effectiveness of simple, low cost interventions that can be delivered to prevent the public from gaining weight. With funding from the University of Birmingham for a PhD studentship we will assess the effectiveness of a brief intervention to prevent weight gain over the Christmas holidays. This study will start in September 2016 and run for three years. (PhD supervisors: Drs Amanda Daley and Helen Parretti, Professor Sheila Greenfield).
Preventing weight regain after weight loss (LIMIT Study)
Typically people who try to lose weight will regain, most, if not all of this weight over time. We are not currently sure how to best stop people putting weight back on once they have lost weight because only a few studies have investigated this question. One promising strategy for weight maintenance is regular self weighing, which is a simple instruction for a health professional to give, is simple for people to do every day and can become as habitual as teeth brushing. With funding from the NIHR Public Health Research Programme we conducting a randomised controlled trial (n=583) the effectiveness and cost effectiveness of a brief behavioural intervention to promote regular self weighing to prevent weight regain after weight loss. This study is a collaboration between the Universities of Birmingham and Oxford. The study started in June 2014 and will be completed by May 2017. (PI: Dr Amanda Daley).
Preventing weight gain after kidney transplantation
We are investigating the feasibility of an intervention to prevent weight gain in renal transplant recipients. Previous studies have shown that renal transplant recipients gain weight post transplant and that obesity and weight gain lead to poorer outcomes with regards to mortality and morbidity including graft function and failure. This study involves an intervention that is embedded into existing outpatient contacts and so could be relatively easily implemented by the NHS if effective. We are investigating the feasibility of a behavioural change intervention that includes a weight management consultation from a dietitian with regular monitoring and feedback on an individual’s weight. NIHR CLAHRC-West Midlands are also part funding this study. (PI: Dr Helen Parretti).
Preventing excessive weight gain during pregnancy (POPS and POPS2)
Many women gain excessive weight during pregnancy and this can cause complications for the mother and the baby. After completing a feasibility trial we are examining the effectiveness of regular weighing and feedback by community midwives in preventing excessive weight gain in pregnant women. This study recruited 656 pregnant women and trained 103 community midwives to deliver the intervention as part of routine antenatal care. This study is based on a collaboration between the Universities of Birmingham and Oxford. The NIHR School for Primary Care Research are part funding this study NIHR CLAHRC-Oxford and NIHR CLAHRC-West Midlands are also providing part funding. This study will be completed in June 2016. (PI: Dr Amanda Daley).
Healthy dads, Healthy Kids UK
This study is taking a healthy lifestyles programme developed in Australia by Professor Phil Morgan and colleagues for fathers and their primary school aged children and adapting and testing it is the multi-ethnic UK context. This study is a collaboration between the Universities of Birmingham and Newcastle, New South wales and the Fatherhood Institute. The study starts May 2016 and will be completed by July 2018. It is funded by the NIHR Public Health Research programme. (PI: Prof Kate Jolly).
Prevention and management of obesity in children
A number of studies are led by Professor Peymane Adab and Dr Miranda Pallan
BEACHeS Study – the development of a childhood obesity prevention intervention focused on South Asian children
WAVES Trial – this is one of the largest childhood obesity prevention studies undertaken to date, set in a diverse socioeconomic and multi-ethnic population and addressing the main limitations identified in previous research
CHANGE study – the design and development of a child weight management programme that is culturally relevant to minority ethnic groups
Chirpy Dragon Study – development and evaluation of a childhood obesity prevention intervention targeting children, as well as their parents, grandparents and school teachers through primary schools in Guangzhou, China
Childhood obesity determinants in China Study – this collaborative study with Guangzhou CDC, aims to examine modifiable risk factors for childhood obesity among urban Chinese children
Effectiveness of monetary incentives on child nutritional status and development among left-behind children in rural China – this cluster randomised controlled trial is a collaboration between our research team and researchers in Central South University, Changsha, China, and aims to tackle the important health problem of children affected by rural-urban migration in China
Tobacco control and harm reduction
Parental use of electronic cigarettes in the home
This mixed-methods study, a first in the UK, will explore parents’ perceptions and experiences of using electronic cigarettes in homes with children. The results from this early exploratory study will be used to help develop novel interventions to support families to change their home smoking behaviours. The study starts in May 2016 and will be completed in June 2017. It is funded by Cancer Research UK [grant number C50276/A21555]. (PI: Dr Laura Jones).
Delivering secondhand smoke harm reduction messages to families in primary care
Currently there is only limited, outdated and conflicting evidence as to whether and how healthcare professionals deliver harm reduction advice to smoking parents in primary care. There is a need to further explore, using mixed-methods, how healthcare professionals currently address the issue of secondhand smoke and harm reduction advice with smoking families and whether there is scope and support for developing interventions, in particular around training for healthcare professionals, to address secondhand smoke exposure risk in primary care. This mixed-methods study will explore if primary care is an appropriate setting for delivering secondhand smoke harm reduction messages to parents and carers who cannot or will not stop smoking. This three year studentship, funded by the College of Medical and Dental Sciences, started in October 2015 and will be completed by September 2018. (PI and lead supervisor: Dr Laura Jones, co-supervisors Prof Kate Jolly and Dr Amanda Farley).
Protecting children and non-smokers from secondhand smoke in disadvantaged homes
This work is a collaboration between the University of Birmingham (Dr Laura Jones) and the University Centre for Rural Health North Coast, University of Sydney (Dr Megan Passey and Dr Jo Longman). The group (with support from collaborators from the University of Liverpool – Prof Jude Robinson and the University of Newcastle, Australia – Prof John Wiggers) recently published a qualitative systematic review and synthesis of the motivators and barriers to creating smoke-free homes. Based on the findings of this review, a new two phase longitudinal qualitative study has been established to explore the views, behaviours and experiences of pregnant women living in smoking households in disadvantaged areas of rural Australia. Recruitment started in March 2016 with the study expected to run for at least 18 months. The study is supported by funding from the New South Wales Cancer Institute and the National Health and Medical Research Council of Australia. (PI: Dr Megan Passey, local collaborator: Dr Laura Jones)
Changing professional behaviour
Weaning food hygiene in Gambian villages
Described in the maternal and child health work, this is an important study that could have large impact in low and middle income countries (LMIC) where hygiene and food contamination problems lead to a high burden of diarrhoea and death in young children and adults. The intervention based upon identification of critical control points (adapted from the industry) and motivational behaviour change, is novel and we hope widely adopted through promotion in LMIC and through UNICEF that have co-funded the work.
Professional health care provider behaviour change
Clinical handover is the cornerstone of patient safety, patient centred care, and continuation of care. Effective clinical handover is particularly important for conditions where care extends beyond one service provider such as chronic diseases. We have established a programme of work investigating clinical handover in LMIC and developing interventions based on health care provider behaviour change supported by organisational and systems change models. Such multi-dimensional intervention packages are complex to implement and evaluate. UOB was a collaborator on the European Commission funded FP7 HANDOVER project ended 2012, as the evaluation and health economic expert partner. Currently, our work extend to India, Mongolia, and Nigeria, and Europe.
Behaviour change delivery: community health workers