52 weeks in public health research, part 43

Posted by Amelia Lake, Emily Henderson, Lorraine McSweeney and Peter Van Der Graaf

From Lorraine McSweeney: It was a proud and surreal moment to see my PhD thesis join eminent academics’ work on the Fuse Director's bookshelf of fame at Newcastle University!

From Amelia Lake and Emily Henderson: Emily has fashioned a temporary standing desk so we, at Durham University's centre for public policy & health, can introduce a bit more activity into our working life!

From Amelia Lake: Halloween a time of... excessive sugar intake? What happened to carving turnips, eating satsumas and the best treat (well in the Lake household circa 1985) a big box of pomegranates!

From Peter Van Der Graaf: Poster presentations at the 1st International Conference on Realist Approaches to Evaluation and Synthesis with two posters from Fuse's Monique Lhussier (see below). A surprising amount of papers and presentations on public health including a keynote address by Professor Mike Kelly from NICE.  Is Fuse missing a trick?

------------------
A reminder from the Fuse blog group:

Each Thursday of 2014 we’ll try and post around four pictures on the Fuse blog that capture our weeks in public health research, from the awe-inspiring to the everyday and mundane. Given that more of the latter than the former exists in most of our lives, we foresee problems compiling 208 images worth posting on our own. So this is going to have to be a group project. Send an image (or images) with a sentence or two describing what aspect of your week in public health research they sum up and we’ll post them as soon as we can. You don’t have to send four together – we can mix and match images from different people in the same week.

Normal rules apply: images you made yourself are best; if you use someone else’s image please check you’re allowed to first; if anyone’s identifiable in an image, make sure they’re happy for it to be posted; nothing rude; nothing that breaks research confidentiality etc.

Email your posts to m.welford@tees.ac.uk or contact any member of the Fuse blog group.

Moving on in Knowledge Exchange: part 2 of the KE blog series

Posted by Mandy Cheetham

This is the second in a series of three posts on knowledge exchange and translational research.

Whatever we call it, translational research, knowledge exchange, knowledge to action, researchers are generally interested in how our research can make a difference; its impact. In the messy world of public health, it isn’t always easy to ensure this happens, but there are good reasons to try, and lots of experience to draw on in Fuse.

Working with people who are interested in our research findings makes sense in all sorts of ways, especially if we involve them early on. It’s all about developing positive relationships, and maintaining these before, during and after the research process. Policy and practice partners can help identify topics that are relevant and useful, think about how to frame the research questions, contribute to funding applications, work out what design to use, what methods will work, recruit participants, make sense of the data, and use it to inform policy and practice. It relies on being able to collaborate with people, so everyone benefits.

In the last month, I attended two events, the Fuse Members' meeting and a Partnerships for Public Health research meeting, where researchers described how they’d worked alongside public health colleagues in different ways to ensure their research was relevant and useful. There were discussions about the benefits and pitfalls of collaborative research, academics and practitioners working and learning together, ‘researchers in residence’, embedded researchers, developing new skills and perspectives, writing and publishing together.

The events made me think about writing this (my first) blog, to highlight the opportunities for translational research in Fuse. Most of you will know about AskFuse (there'll be more about it in next week's blog) and Fuse Quarterly Research Meetings, planned in collaboration with colleagues in practice. This month’s meeting is on patient and public involvement in research.  There’s a programme of ‘knowledge exchange’ seminars - see link for the latest seminars coming up in November. ‘Open conversations’ are opportunities for anyone with an interest in research to come and test out their early ideas with friendly academics in the Knowledge Exchange Group. This group includes people with experience of collaborative public health research and practice. We take a broad view of translational research, and have drawn on the many different approaches in Fuse to put together a Question and Answer resource about translational research. It includes questions like why bother with translational research, ideas for identifying and involving stakeholders, what to consider in engaging stakeholders, what research designs to use and ways to share results widely, and some of the people in Fuse who can help. We’d welcome your comments on the Q&A resource and how it could be improved, so do let us know what you think.

I started to think about the wide range of ways in which Fuse staff and members are involved in translational research - setting up a research practice network in partnership with Public Health England, topic based research development groups, interactive web discussions, time limited placements for academics in strategic planning meetings. There are more examples and we’re keen to hear about your experiences of translational research, so please do get in touch.

In the NIHR research project I worked on recently, one of the participants talked about ‘connecting with people in different ways’. Put simply, translational research is just that. We need to do better to demystify the language we use, learn from our collective experience across and beyond Fuse, and (for those in Fuse) celebrate our achievements as a Centre for translational research. Our research and the strength of our collaborative partnerships will be all the better for it.

52 weeks in public health research, part 42

Posted by Peter Van Der Graaf and Mark Welford

From Peter Van Der Graaf: The Fuse stand before the maternal, infant and child health conference held in the Legends Lounge at The Riverside Stadium, home of Middlesbrough Football Club.

From Peter Van Der Graaf: The audience for the event was broad: from pharmacy, marketing and child nutrition to maternal mental health, smoking and alcohol misuse, and immunisation.  Key message: we need clear and consistent messages across all health professionals.  But what about 'pleasures' of unhealthy behaviours and structural inequalities in accessing opportunities to change behaviours?

Meanwhile in Sheffield...

From Mark Welford: A sister Fuse stand at the National Institute for Health Research School for Public Health Research (NIHR SPHR) Annual Scientific Meeting.  The ASM showcases the School’s research priorities and themes and sets out the School-wide programmes of research. 

From Mark Welford: Established in April 2012, the SPHR is a partnership between eight academic centres, including Fuse, with excellence in applied public health research in England. The School aims to build the evidence base for effective public health practice.  

Bonus pic from Mark Welford: No '52 weeks...' post would be complete without the obligatory food image.  It's a close run thing between the muffins and fruit in the refreshment break popularity contest.

------------------
A reminder from the Fuse blog group:

Each Thursday of 2014 we’ll try and post around four pictures on the Fuse blog that capture our weeks in public health research, from the awe-inspiring to the everyday and mundane. Given that more of the latter than the former exists in most of our lives, we foresee problems compiling 208 images worth posting on our own. So this is going to have to be a group project. Send an image (or images) with a sentence or two describing what aspect of your week in public health research they sum up and we’ll post them as soon as we can. You don’t have to send four together – we can mix and match images from different people in the same week.

Normal rules apply: images you made yourself are best; if you use someone else’s image please check you’re allowed to first; if anyone’s identifiable in an image, make sure they’re happy for it to be posted; nothing rude; nothing that breaks research confidentiality etc.

Email your posts to m.welford@tees.ac.uk or contact any member of the Fuse blog group.

Getting going in knowledge exchange: part 1 of the KE blog series

Posted by Avril Rhodes

This is the first in a series of three posts on knowledge exchange and translational research.

How do you explain and sell knowledge exchange in public health? This is a minefield. Definitions are legion. Hard words, like “translational” act like bumps in the road to trip up the unwary. And there are many harbingers of doom, talking about barriers at every turn. Wizards fret (rightly) about how long it takes to get research findings into practice, what counts as evidence, and how to engage with and keep people working in the field interested in projects and their results. It would seem that no sooner are research partners identified and engaged then they are spirited away by a re-organisation, a change of role or a new job entirely.  

AskFuse is shedding light on practice driven research and evaluation

Unfortunately, there is a dilemma at work here. The drivers of academic life (grant applications and production of papers) are activities that may not be of high priority to potential research partners. Researchers research the questions that funding bodies will support, publish in the most prestigious journals available, and present at the most significant conferences in the field. Curiously despite best efforts in the process taken to identify what will be researched by funding bodies, it seems it is still possible to end up with topics and questions that don’t resonate widely, and the sheer volume of publications holds no great incentive for extensive reading. An early casualty of any funding crisis can be training, reducing the number of people who might be interested in research results attending conferences, and those that do are open to criticism for appearing to take time out. The constant stream of short term operational pressures, new policies and initiatives, targets and deadlines will come first, and given the pressures in the practice environment, research soon fades into the background. The pace of events can be just too fast and too pressing.   

There is light at the end of the tunnel – and it’s not an approaching train. The experience of AskFuse over the past year has shown that there is a healthy appetite for practice driven research and evaluation, demonstrated in the number of queries raised (over 100 at the last count) and the breadth of topics from lifestyles and behaviour to system transformation has been both encouraging and enlightening. This has shown that research activity led by service providers can provide useful work for academic researchers. In addition, some of the elves in Fuse-land have produced a concise, handy Q&A resource, full of ideas and tips for working alongside people in the field, from the outset of thinking about a project. Thinking about it though, the key to this must be putting yourself (as an academic) in the shoes of the service partner, finding contact(s) in the service environment who are prepared to say what the realities of life are like for them so that the project and engagement with service partners is both realistic and rewarding. This may seem like a big ask, but what you’re really doing is asking your potential partners about their working life – and most people like to talk about themselves. It might even be therapeutic for both parties. Get into listening mode and prepare for new and exciting research territory.

52 weeks in public health research, part 41

Posted by Amelia Lake and Mark Welford

From Amelia Lake: Is it really 19 years since I started my first degree in human nutrition & dietetics at Glasgow Caledonian University?? It is! Three years were spent living on Byres Road completely in the central hub of a vibrant neighbourhood. I was there last week reflecting on changes good and bad but mainly missing the buzz of the west end of Glasgow.

From Amelia Lake: New Fuse Director Prof Ashley Adamson presents about public health nutrition at the Human Nutrition Research Centre (HNRC) Newcastle University 20 year anniversary event.

From Mark Welford: I saw this illustration by Cartoonist André Carrilho on The Independent newspaper's website under the headline "What's wrong with how the West talks about Ebola in one illustration".  Coincidently a day earlier, Professor Eugene Milne had used the same image in his guest lecture "How Fit For Purpose Is The New English Public Health System?" at Durham University to illustrate his point about the response to Ebola.  

From Mark Welford: Martin White and Jean Adams use twitter to thank everyone in Fuse and the Institute of Health & Society at Newcastle University for a great send off (they're both heading to the University of Cambridge).  They were particularly impressed by the Fuse branded draft excluder/snake created by Avril Rhodes, our resident knitter extraordinaire!  But what's this got to do with public health?  Well this extract from the letter introducing Fuse snake to the pair might shed some light on the matter:

"We snakes have had a bad reputation since the Garden of Eden which I’m working to improve constantly. For example, I’m not without academic qualifications myself – I am a Graduate of the Royal Academy of Draught Excluders and have the letters GRADE after my name (at every opportunity). GRADE members have undertaken a number of prestigious and tough draught excluding assignments, including, the Castle of Mey, Wormwood Scrubs, the House of Lords, York Minster (brrgh – chilly one that!) and Parkside.

"GRADE members are at the cutting edge of public health. We know cold kills (statistics demonstrate this unequivocally) and that Winter warmth campaigns make a real difference – please, we don’t need a four year evaluation or a meta-analysis to tell us. Consequently, GRADE members are constantly rushing to new assignments.

"I am working tirelessly to get a minimum level of insulation in all British homes and compulsory inclusion of solar panels in all new builds, running a special competition to improve the aesthetics of these panels (don’t they look awful??) in conjunction with the Royal Institute of British Architects. I’m no stranger to slithering my way into the boardrooms of Wimpey, Persimmon, Councils up and down the land, and current party conferences to make my point, and present them with incontrovertible evidence without any reference to “p” values, and whilst speaking with forked tongue. I’ve worked personally with Everest (and all the rest) to improve window draught proofing – even though it could put me out of a job."


------------------
A reminder from the Fuse blog group:

Each Thursday of 2014 we’ll try and post around four pictures on the Fuse blog that capture our weeks in public health research, from the awe-inspiring to the everyday and mundane. Given that more of the latter than the former exists in most of our lives, we foresee problems compiling 208 images worth posting on our own. So this is going to have to be a group project. Send an image (or images) with a sentence or two describing what aspect of your week in public health research they sum up and we’ll post them as soon as we can. You don’t have to send four together – we can mix and match images from different people in the same week.

Normal rules apply: images you made yourself are best; if you use someone else’s image please check you’re allowed to first; if anyone’s identifiable in an image, make sure they’re happy for it to be posted; nothing rude; nothing that breaks research confidentiality etc.

Email your posts to m.welford@tees.ac.uk or contact any member of the Fuse blog group.

First week as a public health researcher

Posted by Christina Cooper

The week begins with a feeling of curiosity and excitement; looking forward to new challenges and working alongside new colleagues; and, a healthy dose of 'imposter syndrome'! It has been nice over the summer, telling friends and family that I am undertaking a PhD in public health, but now the day is here I am fairly sure they will realise very quickly, they have made a mistake, and I will be sent back to the job queue.

 

Broadly speaking, the Dunning-Kruger Effect is defined as "a cognitive bias in which unskilled individuals suffer from illusory superiority, mistakenly rating their ability much higher than is accurate.

I am housed within the Early life and adolescense branch of Fuse, investigating prevention straegies for risky behaviour in adolescence. The first step is attendance at the Fuse members meeting, where academics, students and other practitioner guests come together to discuss issues from the current ongoing research. It all sounds very intelligent and I am convinced that as a newbie I will stick out like a sore thumb! On arrival I feel a strange mixture of comfort from the familiarity of being back in Newcastle at my old university, and fear of the unknown, the realisation that I am an independent research student and nobody is going to tell me where I should be or what I should be doing over the next three long years.

I am thrilled to see one or two friendly faces amongst those gathered; fellow research students I met during orientation, lecturers from my previous course, and my supervisor among them. Fairly early on in the proceedings it transpires that it is not just my first day, there are many of us beginning this journey together; PhD students, postgraduate research associates, supervisors, program leaders and a new director. All of us finding our feet and settling in to our new role together. Each of us are welcomed as members of the ‘Fuse family’ and, by the end of the day, that is just how it feels, an extended family ready to reach and lend support to any one of us.

Following this well-timed glimpse into life as a public health researcher comes the first day proper. Meetings with supervisors and fellow students; finding our way around the university buildings; and receiving the coveted student cards, fob keys, and other small necessities which say ‘this will be your home for the next three years’. Go!

In the post graduate research room I find a desk, and take a seat. There is a quiet hum of concentration from second and third year students as they work. I turn on my computer, register my name for postgraduate induction and check my emails. I open the web browser and stare at the white screen in front of me, the cursor flashing patiently, and waiting for instruction. I feel a little overwhelmed and wonder if I will ever get to the stage of my colleagues around me. One of them looks over, knowingly and says ‘don’t worry, the first day is always like that’. I’m so grateful.

Today is the beginning of my second week and I have so many ideas I don’t know where to start.

52 weeks in public health research, part 40

Posted by Greg Rubin, Amelia Lake, Mark Welford

From Greg Rubin: Seen in a Luxembourg motorway service area. Vive le free market in smoking related diseases (not).

From Amelia Lake: Scotland is not renowned for its healthy cuisine however today I enjoyed a vegetarian haggis at a well established vegetarian restaurant in Edinburgh - and it was very, very lovely!

From Amelia Lake: A whole new meaning to farm fresh... Enjoying beautiful free range eggs laid by very happy hens on a farm we are staying at. Plenty of food for thought regarding sustainability and food miles!

From Mark Welford: CEDAR's Dr Esther van Sluijs and Fuse's Liane Azevedo pose for the obligatory (cheesy) photo with the Fuse banner at the Third Physical Activity Workshop. Esther kindly travelled from Cambridge to give her keynote address. These events bring together professionals with an interest in physical activity and are open to delegates from academia, private, public and the voluntary sector. In keeping with the theme there was an optional lunchtime 'network walk' through Middlesbrough's Albert Park; unfortunately I forgot to take a photo as I was jointly leading the line.

------------------
A reminder from the Fuse blog group:

Each Thursday of 2014 we’ll try and post around four pictures on the Fuse blog that capture our weeks in public health research, from the awe-inspiring to the everyday and mundane. Given that more of the latter than the former exists in most of our lives, we foresee problems compiling 208 images worth posting on our own. So this is going to have to be a group project. Send an image (or images) with a sentence or two describing what aspect of your week in public health research they sum up and we’ll post them as soon as we can. You don’t have to send four together – we can mix and match images from different people in the same week.

Normal rules apply: images you made yourself are best; if you use someone else’s image please check you’re allowed to first; if anyone’s identifiable in an image, make sure they’re happy for it to be posted; nothing rude; nothing that breaks research confidentiality etc.

Email your posts to m.welford@tees.ac.uk or contact any member of the Fuse blog group.

Context, complexity, mixed methods and multidisciplinarity

Posted by Emily Henderson

As the new Research Associate lead on Fuse’s Complex Systems Research Programme, I was funded by Fuse to attend a training course on Evaluating Complex Public Health Interventions in Cardiff, 25-27 June. It was delivered by our partners in DECIPHer (Development and Evaluation of Complex Interventions in Public Health), one of five UKCRC Public Health Centres of Excellence (PHCoE). As we know from Prof Simon Murphy’s lecture, presented at the Complex Systems Research Programme’s inaugural event last May, DECIPHer have a successful record of doing localised, translational research. So it struck me and Prof David Hunter (Programme Leader, Complex Systems Research Programme and Fuse Deputy Director) as a great opportunity to exchange experiences with other PHCoE.

As a mixed methods medical anthropologist, I was hoping on this course I would 1) make new and interesting acquaintances, which I did, and 2) learn about how the diversity of methods can be best used in addressing complex public health issues. The three-day course, which followed its two-day counterpart on Developing Complex Public Health Interventions, covered: process evaluations, feasibility studies, large-scale effectiveness studies and alternatives to randomisation and data linkage. The DECIPHer approach was clearly outlined as adopting 1) the MRC Framework on developing and evaluating complex interventions; 2) Ecological Thinking, 3) Co-Production Models and 4) Complex Systems Thinking. And echoing the MRC Framework on process evaluation - coming to a theatre near you - that, despite the range in methods that can be adopted, there is “no hierarchy of evidence”.

This was welcome news - given the diversity of methods adopted within Fuse, e.g. embedded ethnography, realist evaluation, economic evaluation of trials - excepting that the focus of the training was exclusively on trials. In certainly what was not an unusual experience for me, I was the odd-(wo)man-out at this event (emphasis on odd). But this lonely position has its rewards, as participant-observer:

“The magic of anthropology is precisely its ability to self-critically live with the almost schizophrenic contradiction of adhering to two worlds simultaneously”. Messac et al. Soc Sci Med 2013. p185

 

It seemed my chummy classmates were by-and-large RCT researchers, and many told me they left the course wanting to re-read the notebooks to apply what they learned to their research. Pfft, over-achievers. The task I left feeling that I needed to address, was to consider in greater depth this question:

‘In adopting socio-ecological models, how can we as public health researchers, if at all, adequately consider context?’

Just last week, I was asked by a medical anthropology PhD student from the University of California Los Angeles to use my PowerPoint slides as a complement to a podcast of a talk I gave at the University of Oxford, which, dear reader, I wouldn’t shamelessly draw your attention to here. This bright and motivated student wanted to illustrate to her undergraduates how anthropologists can address “real world” problems using mixed methods approaches.

 Induced to dig out my own mixed methods lecture (delivered for Durham’s Methods and Analysis anthropology module), I was reminded of the premise I taught: *only* use mixed methods when the sum of methods reveals more than the methods as parts, or some such or other. I used Durham City’s biennial Light Festival as an analogy of how mixing unrelated media (a cathedral, a slide projector and spooky music) can enhance one’s experience of learning about Durham’s history. But why the proviso “only”? Why not have a light festival every night? Indeed Durham City, why not? Because mixed methods approaches also have many drawbacks. They require: added time, added expertise and multidisciplinary working, to name but a few, not to mention the added funding all this entails. 

 

'Lumiere' - Durham Light Festival

 

No, it’s not possible to create time - we as academics know this all too well - but somehow the latter point - multidisciplinary working - seems more challenging. The debate on ‘Realist RCTs’ for example raises the important issue of the researcher’s epistemological lens. The what? That is, the researcher’s understanding of knowledge and how knowledge is constructed. Do you believe reality can be objectively measured, or rather that reality exists only as a subjective experience, or something in between? Disagreements on this fundamental of doing research can make combining methods - for example embedding ‘qualitative’ methods within trials to provide context - a challenge and at times implausible. However, as with epistemological views, there is a continuum of mixed methods approaches, including triangulation - no, not strangulation - where methods complement each other but retain their disciplinary roots.

Given the range in my own multidisciplinary background, from neuroscience to biocultural anthropology to health policy, my tendency is to at least consider, albeit critically, the range of approaches to researching humans and human health. As social animals we are, after all, complex beings (or at least we’re quite happy to get ourselves into a muddle over what it all means), thus one perspective surely cannot paint the entire picture. Enter multidisciplinarity. However, as with all disciplines, multidisciplinary working itself requires skills, training and experience, especially interpersonal skills to facilitate collaboration, or to recognise when this is impracticable. 

All views expressed are exclusively those of the author.

52 weeks in public health research, part 39

Posted by Amelia Lake, Mark Welford and Jean Adams

From Amelia Lake: At the Fuse members' meeting new Director Ashley Adamson thanks Martin White for his leadership of the Centre and wishes him well in his new role with the Centre for Diet and Activity Research (CEDAR) and the MRC Epidemiology Unit at the University of Cambridge.

From Mark Welford: Avril Rhodes reveals the mysteries of being a Knowledge Exchange Broker during her table session at the Public Health Intelligence Northern England (PHINE) network meeting. If you think your event could benefit from a Fuse presence please email avril.rhodes@tees.ac.uk or m.welford@tees.ac.uk

From Amelia Lake: Managing the family actually eating against a busy work schedule means late night cooking! Sweet potato & coconut curry! Looking forward to it already!

From Jean Adams: Research suggests that calorie labelling works to decrease intake in some people, some of the time. When I found out how many calories were in coffee shop cakes, I was slightly horrified and stopped buying them. It's also been suggested that forcing food companies to come clean on food content may encourage reformulation. So I was interested to see these 'petite' treats at Birmingham New Street, with a slightly more appropriate number of calories for a snack. Would love to know effect of these on choice and consumption.

------------------
A reminder from the Fuse blog group:

Each Thursday of 2014 we’ll try and post around four pictures on the Fuse blog that capture our weeks in public health research, from the awe-inspiring to the everyday and mundane. Given that more of the latter than the former exists in most of our lives, we foresee problems compiling 208 images worth posting on our own. So this is going to have to be a group project. Send an image (or images) with a sentence or two describing what aspect of your week in public health research they sum up and we’ll post them as soon as we can. You don’t have to send four together – we can mix and match images from different people in the same week.

Normal rules apply: images you made yourself are best; if you use someone else’s image please check you’re allowed to first; if anyone’s identifiable in an image, make sure they’re happy for it to be posted; nothing rude; nothing that breaks research confidentiality etc.

Email your posts to m.welford@tees.ac.uk or contact any member of the Fuse blog group.