1. UK Prevention Research Partnership
Professor Dame Sally Macintyre

2. Headline message: the focus of the partnership is on the primary prevention of noncommunicable diseases, by addressing upstream influences on risk factors for these diseases.
Upstream means trying to avoid people getting into to trouble in the first place rather than rescuing them or treating them when they are already in trouble; for example, avoiding people becoming obese in the first place, rather than treating their obesity by bariatric surgery or weight management classes.
A number of organisations including the OECD have demonstrated the cost effectiveness of such preventive strategies compared with dealing with problems which have already developed.

3. Background Increasing burden of NCDs Common risk factors for NCDs
Clustering of risk factors
Cost effectiveness of preventive strategies
Recent capacity building in public health research
AMS report
NPRI review
We are seeing an increasing burden of noncommunicable diseases such as diabetes, dementia, poor mental health, cancer, heart disease, and stroke in the UK and worldwide, including in low and middle income countries.
Many NCDs are caused or exacerbated by common risk factors such as obesity, tobacco use, poor working conditions, and poverty. Reductions in these risk factors are therefore likely to have co-benefits across a range of NCDs.
Many risks for NCDs cluster together; social deprivation is associated with smoking, smoking is associated with drinking, and workplace stress often co-exists with exposure to poor air quality.
Preventive strategies targeted at the common determinants of such risk exposures may therefore improve several outcomes. Smoke free legislation, for example, has had an impact on hospital admissions for asthma among children, as well as hospital admissions for acute myocardial infarctions among adults and respiratory health among bar workers.
Some preventive measures have been very successful in improving population health (e.g, Clean Air Acts, workplace legislation, smoke-free laws) and shown to be highly cost effective. Upstream measures focusing on people’s environments tend to be more effective, sustainable, and cost effective than relatively downstream interventions such as smoking cessation or weight management programmes.
In the last decade there have been a number of initiatives to improve capacity and infrastructure for public health research, for example the UKCCRC centres of excellence in public health research, or the DH public health research consortium, and the funders believe it is important to continue the momentum of his capacity building in order to fund large-scale research programmes.
You have already heard about the AMS report; another key background factor is the review of the National prevention research initiative, which emphasised the need in future for more focus on mental health; solutions to problems rather than analyses of them; and targeting settings and systems rather than just individuals

4. What is UKPRP?
Multi-funder partnership of Research Councils, Health Departments and Charities
£40-50 million over 6-7 years
Aim to produce robust new knowledge about implementable, cost effective, scalable, ways to improve population health and reduce inequalities in health
Substantial long term investment to bring together a wide range of disciplines and stakeholders to build multidisciplinary teams answering big questions
Capitalising on/developing opportunities: e.g. digital technology, ‘big data’, basic sciences
The partnership consists of three research councils (engineering and physical sciences research Council, economic and social research Council, the medical research Council); health departments from across the UK; and charities including the Wellcome trust and the British Heart Foundation. Funding to date is £40 million, but the existing funders would welcome new funders coming on board.
Their vision is the generation of well evidenced new knowledge about interventions, policies, strategies, products, or designs that can be implemented by the relevant providers or authorities, are good value for money, and can be scaled up to a national level, which improve population health and reduce inequalities in health.
The partnership will bring together a number of different disciplines, not all of whom may have worked with each other before, and potential users and providers of research findings (users of research including both those who might implement research findings, and the ultimate beneficiaries of any new policies, services or designs). Multidisciplinary teams will be created, funded and supported to undertake ambitious programmes of research.
The funders have a particular interest in using capitalising on new opportunities provided by large-scale data capture and data linkage; new digital technologies, means of communication and social media; and recent developments in basic science whether that be in psychology, engineering, or biological science.

5. Focus NCDs, not infectious disease
Common risk factors for a number of NCDs
Solving problems rather than analysing or describing them
Focus on systems, settings and environments
Mental health and wellbeing as well as physical health
Improving population health
Reducing inequalities in health
Improved targeting
Costs and benefits of proposed solutions/strategies
Studying existing and proposed new preventive strategies
The focus of the partnership will be on noncommunicable diseases, since there are already other funding streams available for infectious diseases research.
The Funders are not specifying particular risk factors, or behaviours, as they did in the National prevention research initiative, but are keen to see research on common risk factors which impact on a number of NCDs (eg air quality, obesity, smoking).
The focus will be on finding solutions to problems rather than describing or explaining those problems; the emphasis is therefore on useful outcomes.
Rather than focusing solely on individuals the focus will be on systems (such as local government, education, welfare, industry), and on environments or settings (for example schools, neighbourhoods, workplaces)
Funders are particularly keen to include mental health and wellbeing, given the burden on individuals, families and society of common mental disorders such as anxiety, depression and dementia.
The partnership is interested in strategies and solutions which are generalisable and relevant to whole populations, but is also keen to see research which examines how best to reduce inequalities in health (eg by ethnic, gender or socio economic groups), or which can be successfully tailored to particularly vulnerable groups; ie improved targetting, or ‘precision prevention’.
It is important that the funded research includes robust assessments of the value for money for any proposed interventions, policies, or solutions, using appropriate economic techniques.
Given that many preventive policies have been introduced without robust prior evaluation, some existing policies or practices may not be particularly effective or cost-effective, so studying where disinvestment in existing policies might be appropriate would be within the scope of the partnership.

6. Some other key features
Disciplinary mix should be appropriate to the research question
Stakeholder and user engagement is essential and should be appropriate to the research question
Methodological approaches should be appropriate to the research question
Continuous effort actively to align the interests of the funders, stakeholders and research teams
The outcomes and value for money of the partnership will be evaluated
The partnership is keen to see genuinely multidisciplinary teams, which might include for example urban planners, engineers, psychologists, economists, educationalists, political scientists, biomedical scientists. However there is no one size or one mix fits all assumption; the partnership is not prescriptive about what disciplines should be included, since this will depend on the focus of the research.
It is essential that research is co-designed from the beginning not only by researchers but also by those who may benefit (or not), from any proposed solutions, and those who may have to implement and pay for them. This might include among others, members of the general public, potential service or product users, and representatives of local or central government,, NHS or social care providers, educationalists, and industry. Working with industry may be particularly important if the intended product or solution needs to be provided by industry, but obviously there are major sensitivities about collaboration with industry in the field of public health, so the funders have drawn up guidelines for partnerships with industry.
Again perhaps repeating the obvious, the funders are not prescriptive about what methodological approaches are taken, believing that the methods adopted should be appropriate to the research question, and may vary across disciplines and problems. It is perhaps worth noting however that the evaluation of natural experiments, such as legislative or environmental changes, and modelling approaches, are suitable as well as the design, testing and implementing and evaluation of new strategies, solutions or policies..
You will hear more from the funders at the end about the management of this initiative, but I thought it worth pointing here out that the partnership proposes to remain actively involved with the funded research teams and stakeholders throughout the course of the initiative; and that a framework is being designed to assess the outcomes of the investment..

7. In summary, UKPRP will:
fund research into the primary prevention of physical and mental 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
in order to generate useful new knowledge about how to prevent NCDs
In summary, here are the key features of the partnership again. I’d like to reiterate that the overarching aim is to generate robust new knowledge about strategies (or products, or interventions or policies) which will work to prevent common NCDs, and which are implementable, sustainable, equitable, and scalable..