UK Prevention Research Partnership Professor Dame Sally Macintyre Chair, UKPRP Expert Review Group and UKPRP Scientific Advisory Board 24 September 2019

Why prevention? Under investment in prevention research across the UK The need to address the burden and costs of non-communicable diseases (NCDs) in the UK Cost effectiveness of prevention Common drivers of NCDs, therefore co-benefits of acting on those drivers The need to develop realistic, actionable, sustainable approaches to NCD prevention Recognising that research funders should work together to address problems beyond their individual remits

National Prevention Research Initiative (NPRI) Four funding calls between 2005 and 2011 £34m supported 74 primary prevention research projects Focused on alcohol, smoking, diet and physical activity NPRI 2015 review identified a need to: focus on population-level interventions work on the cost-effectiveness of prevention strategies solve problems rather than simply describing them understand the mechanisms of action improve health where need is disproportionate: mental health, low SES, minorities

Academy of Medical Sciences 2016 report Report emphasised the importance of prevention research Identified challenges and opportunities for research into preventing NCDs and reducing inequalities in health Considered different environments which influence health and health behaviours Identified limitations of current biomedical approaches to solving major prevention problems Recognised that multi-disciplinarity and systems-levels approaches needed

The Partnership UK charities, UKRI Councils and health and social care departments Invest £55m over 6-7 years (through 2 funding calls) Covers physical and mental health and wellbeing in the UK

Objectives Produce robust new knowledge about actionable, cost effective and scalable ways to improve population health and reduce inequalities in health Provide substantial long-term investment to bring together a wide range of disciplines and stakeholders to build multidisciplinary teams focused on the primary prevention of NCDs Enable change within complex systems to prevent NCDs Co-develop ideas and research programmes with end users Capitalise on emerging technologies, big data etc. Support methodological innovation Promote coordination of prevention research across funders

Focus NCDs, not infectious disease Upstream, population level, determinants Primary prevention Best ways of modifying common drivers for a number of NCDs Solving problems rather than describing them Improving the development and evaluation of preventive strategies Understanding issues of transferability: context, settings, environments Improved targeting Cost effective, scalable and sustainable solutions Reducing health inequalities Studying existing as well as proposed new preventive strategies

Prevention research post-NPRI: focus on upstream health determinants

Upstream influences and complexity Swinburn et al. (2011) The Lancet 378 (9793): 804-814

Inter-disciplinarity Developing effective preventive strategies requires understanding complex systems and their inter-linkages UKPRP believes this can best be achieved through interdisciplinary research UKPRP keen to see genuinely multidisciplinary teams, if appropriate bringing in disciplines not typically engaged in disease prevention research The Partnership is not prescriptive about what disciplines should be included Disciplinary mix should be appropriate to the research question

Co-develop research programmes Co-develop ideas, research questions, evidence and implementation of strategies to maximise impact Users of evidence and those with experience of implementing interventions, e.g. Local Authorities, Local Government Association Government Departments / Agencies Third sector, civil society groups – charities and professional groups Practitioners Communities Industry Co-development with users is essential and should be appropriate to the work

Methodological approaches Funded groups can use and/or develop a diverse range of methods Methods must be appropriate to the research questions Systems thinking and systems science approaches particularly welcomed Exploiting digital technologies, social media, or large-scale datasets

Knowledge brokering Knowledge transfer and exchange will be an integral aspects of the UKPRP: to enable the transfer of outputs into policy and practice to foster the development of long-lasting relationships between researchers and users Mechanisms must be appropriate to the topic

Call 1 – outcome (consortia) Institution Topic area University of Bristol Prof Matthew Hickman Urban planning and development. Embedding the prevention of NCD risk factors and health inequalities in decision-making on planning. Bradford Teaching Hospital NHS Trust Prof John Wright Improving the life chances of children in Bradford and Tower Hamlets (London) – focus on healthy places, healthy learning and healthy livelihoods. University of Edinburgh Prof Linda Bauld Commercial determinants of health and health inequalities - focus on tobacco and alcohol and food high in fat, salt and sugar. University of Sheffield Prof Petra Meier Systems-based economic evaluation methods and tools to provide a common basis for appraising the effectiveness and costs and benefits of policy measures on housing; mental wellbeing; inclusive economic growth; and adverse childhood experiences.

Call 1 – outcome (networks) Institution Topic area Queen's University Belfast Prof Jayne Woodside The food system across preschool, primary and secondary school settings, and school food provisions to influence the quality of children’s diets and reduce inequalities in dietary intake. University of Glasgow Ruth Dundas Aims to lay the groundwork to develop research programmes to exploit linked, population-level administrative data to evaluate the impact of policies and determinants of maternal and child health across the four UK nations. Prof Laurence Moore The application and use of agent-based models among researchers and decision makers in order develop insights on the interdependent and interacting processes that result in NCDs and health inequalities. University of Chester Prof Paul Kingston Explore the relationships between trade and investment agreements and NCDs by focussing mainly on tobacco, alcohol and ultra-processed foods.

Call 2 – Scope; Particular priorities Aim to have a balanced portfolio complementing Call 1 funding Preventing poor mental health and promoting mental wellbeing Reducing health inequalities as a primary focus Using fiscal and economic strategies to prevent NCDs and reduce health inequalities Modifying other social and economic determinants of health and wellbeing Tackling food systems that perpetuate unhealthy diets and obesity Improving the urban environment, including transport systems and air quality Using green and blue spaces for improving population health and preventing NCDs Targeting specific life course stages or transitions

What we’re looking for / “What good looks like” Dealing with important (high burden/prevalence) NCDs Dealing with important drivers of those NCDs Realistic, ambitious, original, good value, excellent research Providing concrete and explicit accounts of: What activities will be conducted if funded What is already known about the specific topic, and what these activities will add The mechanisms by which these activities are likely to effect change in drivers of NCDs The appropriateness of the proposed: membership of consortia/networks networking strategies methods disciplines user partnerships knowledge brokering plans

In summary, the UKPRP will: fund research into the primary prevention of physical and mental NCDs generate useful new knowledge about how to prevent NCDs encourage an upstream, and whole systems, approach to prevention provide substantial long-term investment to develop and build on basic research in a number of relevant disciplines build ambitious new multidisciplinary teams and researcher networks engage with stakeholders at every stage to produce clear answers relevant to decision makers capitalise on emerging digital technologies, ‘big data’ and basic science