Friday, 3 February 2023

Welcome to your Wrapped, Fuse Open Science Blog

Posted by Mark Welford, Fuse Communications Manager, Teesside University

If you use Spotify (other streaming platforms are available) then you will no doubt have received your own personalised ‘Wrapped 2022’. A helpful (if somewhat creepy!) summary of your annual listening habits in one eye-searing psychedelically coloured package. Apparently, my most listened to song in 2022 was Baby Shark - I have a 3 year old.

Around this time of year I do a similar (if slightly less garish) job of pulling together the top 5 Fuse blog posts from the previous year.

But this year is a little different.

It’s award season and this year the blogs listed below were in the running for a coveted gong. Not at the GRAMMYs, Oscars, Emmys, BAFTAs, or BRITs but the (much more prestigious) first ever Fuse Awards!

Earlier this week (30 January), the post with the most views was crowned best blog of 2022 with the author awarded a shiny trophy at our ceremony in Durham *link may contain SPOILERS*.

So without further ado, here is the full list of the runners and writers in reverse order, culminating with the post that received the most views...




Posted by Tim Townshend, Professor of Urban Design for Health, Newcastle University


“...primarily designing around the needs of the private car - rather than humans - has been a disaster.”

Prof Townshend explores how we can plan for a healthier future by intervening in the built environment. From the 'toxic high street', to the green (and blue) spaces in our cities that encourage physical activity and social interaction, positive for physical health and mental wellbeing.

Posted: 13 May 2022


4. Science, and the art of communication


Posted by Louis Goffe, Research Associate, NIHR Policy Research Unit in Behavioural Science

"...building the evidence-base isn’t enough, we all need to work on at least one aspect of the artistic craft of research promotion."

COVID19 has brought into sharp focus that health promotion takes more than good science, there is an art to the delivery. In this post, Louis explores vaccine misinformation, the infodemic, involving the public and advocacy.

Posted: 28 January 2022


3. What support do children and young people actually want when their parents use drugs and alcohol?

Posted by Cassey Muir, Fuse & NIHR School for Public health Research (SPHR) funded PhD Researcher from Newcastle University and Kira Terry, Lived Experience Expert.

“No-one has ever asked me about how I feel in any of this.”

Fuse PhD student Cassey shares her research aiming to understand the experiences, perceived impacts and coping strategies of young people whose parents use substances. The post ends with Kira’s thoughts about contributing to the project as a Lived Experience Research Advisor.

Posted: 9 December 2022



2. Is a picture truly worth a thousand words?


Posted by Emma Adams, NIHR ARC NENC Mental Health Fellow at Newcastle University, and Experts by Experience from Fulfilling Lives Newcastle Gateshead & #HealthNow Newcastle

Find out how Emma and her Experts by Experience worked together to develop striking visuals to share what they had learned from a study exploring access to community based mental health and substance use support during the COVID-19 pandemic for individuals experiencing homelessness and those providing support.

Posted: 25 March 2022


And in at number one our award winner...





1. Universal Credit experiences and research co-production

Posted by David Black, Fuse Public Partner and Expert by Experience. Introduction by Mandy Cheetham, Research Fellow in the Applied Research Collaboration North East and North Cumbria (ARC NENC), Northumbria University

“In the past I'd always found the process of seeking
 help from the unemployment benefit system to be
 relatively easy, but Universal Credit was a disaster
 for me.”

Ever wondered how you could help shape research as a member of the public? In this Fuse blog, David shares his personal experiences of claiming benefits and how this has informed research to assess the impact of Universal Credit.

Posted: 11 March 2022


Below is a photo of David (second from the right) along with the other Fuse Award winners. Congratulations to all! 
 

Catch up with all the award winners using #FuseAwards23 or see the event programme on the Fuse website for all those shortlisted.

Join Fuse to be in with a shout of winning a coveted Fuse Award in 2024!

Friday, 27 January 2023

Public Health at a crossroads again: meeting the challenge of a reformed system in England

Posted by David Hunter, Newcastle University, Peter Littlejohns, King’s College London, and Albert Weale, University College London



With health policy understandably preoccupied with the pressures on, and changes occurring in, the NHS arising from the impact of COVID-19, implementation of the Health and Care Act 2022, and various strikes among the workforce, it is imperative not to overlook the public health system reforms in England.

Public Health England’s (PHE) sudden demise in August 2020 followed mounting criticisms of its performance during the early stages of the pandemic and general unpreparedness.1 Rather than consider how PHE might be reformed, the government rushed to replace it with two new bodies: UK Health Security Agency (UKHSA), and Office for Health Improvement and Disparities (OHID). Like PHE, the UKHSA is an executive agency with close ministerial oversight while still permitting ‘independence in the delivery of policy advice’. It will act as a ‘system leader’ for health security with responsibility for pandemic preparedness and external threats across the UK while bearing in mind that health is a devolved responsibility.

PHE’s remaining functions in respect of the wider public health, including health improvement and population health, lie with OHID. Located within the Department of Health and Social Care (DHSC) and jointly accountable to the Secretary of State for Health and Social Care and the Chief Medical Officer for England, it enjoys even less independence than the UKHSA. Building on the work of PHE, OHID’s priorities include tackling obesity, improving mental health, promoting physical activity and other population health issues, notably inequalities.

There is merit in taking stock to identify any lessons which might be gleaned from the mixed life of PHE and whether the new bodies offer hope to do things better.2

Learning the lessons

The findings from a research project to explore the circumstances surrounding the rise and fall of PHE may assist with the learning process.3 Five broad underlying issues were identified in the research which contributed to PHE’s demise.
  • PHE did not possess the capacity to undertake a testing regime
     of the size and complexity required by the pandemic
    Severe funding cuts in public health spending, nationally and locally, since 2010 meant that PHE functioned with reduced capacity when the pandemic struck
  • PHE did not possess the capacity to undertake a testing regime of the size and complexity required by the pandemic, the absence of which was the basis of the case against the organisation
  • The governance of PHE as an executive agency meant it lacked independence
  • While decisions made by PHE at the start of the pandemic were later considered mistakes (and judged outside the law by a judicial review) at the time there was little information about the nature and possible effects of the virus and limited capacity in the health system which required tough prioritisation decision to be made
  • The sudden closure of PHE without any consultation was widely reported to be due to blame-avoidance behaviour on the part of key actors, principally Dominic Cummins (as former Chief Advisor to the Prime Minister, Boris Johnson) and Matt Hancock (as former Secretary of State for Health and Social Care). There was also a view that the decision was based on policy favouring use of the private sector and contracting out functions like test and trace.
Key lessons from these findings centre on two major areas of concern: the respective remits of the new bodies, and their governance.

Remits


The respective remits of UKHSA and OHID need to be clearer and more transparent if the risk of fragmentation is to be avoided. A welcome feature of PHE was its attempt to bring together the key public health functions that had previously operated in separate silos. As things now stand, separating communicable diseases (CDs) from non-communicable diseases (NCDs) is a retrograde move since, as the pandemic highlighted in stark terms, close links exist between them when it comes to those groups and communities which suffered most in terms of illness and death. A syndemic understanding of diseases and their underlying social factors is pivotal in preventing disease in the future and avoiding fragmentation.4

Governance


Governance of the new public health bodies requires careful attention. As an executive agency, PHE was criticised for its lack of independence from government which restricted its ability to ‘speak truth to power’. Given UKHSA enjoys the same status, it remains unclear how it intends to avoid a similar fate. The problem is a deep-seated and pervasive one within government. The idea that OHID being housed in the DHSC will allow it to exercise greater influence and have a closer collaboration with ministers could be a good move, or, more likely if history is any guide, it may be overly optimistic. There is a risk that OHID may disappear into Whitehall and become invisible, lacking even the limited degree of independence PHE had. To succeed, OHID has to be visible and have allies inside government.

A further issue concerning the governance and working style of both agencies, especially OHID, centres on their ability to operate effectively across government. Public health comprises numerous ‘wicked issues’, that is, multi-faceted problems that are complex and for which there are no simple or single solutions. Confronting them will be especially challenging for a government which, for all its rhetoric about ‘levelling up‘, remains topic- and department-focused, operating in silos rather than concerned with cross-government issues.5

OHID has a steep hill to climb if it wants to lead a transformational agenda across the wider determinants of health which demands a whole-of-government approach. The hill just got steeper following government delays in tackling child obesity and its failure to implement a national food strategy. In keeping with the prevailing political ethos, there is a renewed focus on individual behaviour change and lifestyle choices rather than tackling the influence on health of commercial interests via taxation and regulation.6,7 If significant inroads into the population health agenda are to be made, then confronting powerful vested interests in, and lobbying from, the food and drinks industry and their ’friends’ in government engaged in what has been termed ’institutional corruption’ cannot be avoided.8 Whether OHID has either the backing from government or competences for such a struggle remains doubtful in the extreme.

Conclusion

Public health once again finds itself at a crossroads. It can either continue to ‘muddle through’ with a broken political and public policy system that is not fit for purpose.9 Or there is an opportunity to construct a strong and confident public health system that is well-placed to confront the challenges facing it. The aftermath of COVID-19 should make the choice of options self-evident. However, as things stand, it is unlikely that the UK’s broken political system with its focus on short-term fixes is up to the challenge. Without major systemic change aimed at overhauling the UK’s political system, a risk of further deterioration in the state of the public’s health may be unavoidable.


References:
  1. Calvert J, Arbuthnott G. Failures of state: the inside story of Britain’s battle with coronavirus. London: Mudlark, 2021. https://harpercollins.co.uk/products/failures-of-state-the-inside-story-of-britains-battle-with-coronavirus-jonathan-calvertgeorge-arbuthnott?variant=39528280391758
  2. Vize R. Controversial from creation to disbanding, via e-cigarettes and alcohol: an obituary of Public Health England. British Medical Journal 2020; 371:m4476 http://dx.doi.org/10.1136/bmj.m4476
  3. Littlejohns P, Khatun T, Knight A, Hunter DJ, Markham S, Coultas C, Kelly MP, Ahuja S. (2022) Lessons from the demise of Public Health England: where next for UK public health? London: NIHR ARC South London. https://arc-sl.nihr.ac.uk/sites/default/files/uploads/files/public-health-report-sept-2022-final.pdf
  4. Horton R. Offline: COVID-19 is not a pandemic. The Lancet 2020; 396: 874. https://doi.org/10.1016/S0140-6736(20)32000-6
  5. Pope T, Shearer E, Hourston P. What levelling up policies will drive economic change? The need for a long-term focus on skills and cities. London: Institute for Government, 2022. https://www.instituteforgovernment.org.uk/publications/levelling-up-policies?
  6. British Broadcasting Corporation (BBC). Junk food: obesity strategy falling apart, Jamie Oliver says. 15 May 2022 https://www.bbc.co.uk/news/uk-61449921
  7. Ralston R, Smith K, O’Connor CH, Brown A. Levelling up the UK: is the government serious about reducing regional inequalities in health? British Medical Journal 2022; 377:e070589 https://doi.org/10.1136/bmj-2022-070589
  8. Draca M. Institutional corruption? The revolving door in American and British politics. SMF-CAGE global perspectives series: 1. 2014. http://www.smf.co.uk/wp-content/uploads/2014/10/Social-Market-FoundationInstitutional-Corruption-the-revolving-door-in-American-and-British-politics.pdf
  9. Ricketts P. Hard choices: the making and unmaking of global Britain. London: Atlantic Books, 2022. https://atlantic-books.co.uk/book/hard-choices

David J Hunter, Emeritus Professor of Health Policy and Management, Population Health Sciences Institute, Newcastle University

Peter Littlejohns, Emeritus Professor of Public Health, Centre for Implementation Science, Institute for Psychiatry, Psychology and Neurosciences, King’s College London

Albert Weale, Emeritus Professor of Political Theory and Pubic Policy, University College 
London


The views and opinions expressed by the authors are those of the authors and do not necessarily reflect those of Newcastle University, King’s College London, University College London, or Fuse, the Centre for Translational Research in Public Health.

Friday, 6 January 2023

What’s really going on when a child is ‘overtired’ – and how to help them have a silent night in the New Year

Posted by Helen Ball, Professor of Anthropology, Director of the Durham Infancy & Sleep Centre (DISC), and Fuse Associate at Durham University

Anyone who’s cared for a young child will recognise the signs. They’ve had too little sleep or missed a nap, they’re cranky, tearful, and stroppy, and they can’t or won’t fall asleep. They are “overtired”. But is such a thing really possible – to be more tired than tired?

What we tend to call overtiredness happens when an emotional state, such as anxiety, distress or fear, blocks our ability to go to sleep even when we’re really tired. This is a survival response that helps us to stay awake when in danger, no matter how tired we are. It suggests overtiredness can be reframed to help us better respond to our child’s needs when it happens.

At the end of the day, the feeling we have of needing to sleep is called sleep pressure. The longer we stay awake the more sleep pressure rises. Typically, the higher it gets, the easier it is to fall asleep. If we stay awake for long enough, eventually we’ll fall asleep even if we are trying not to.

The sensation of sleep pressure is caused by the build-up of chemicals (called adenosines) in the brain. These are proteins that are removed from our brains while we sleep, and build up again while we are awake.

For adults, this process takes about 14-16 hours. When we delay sleep past this point the build-up of adenosines cannot go on unchecked. At some point, eventually, we must sleep.

Babies’ sleep pressure builds up more quickly than adults. Young babies often fall asleep after being awake for an hour or two. As children get older, sleep pressure builds more slowly. But it takes several years until a child is able to stay awake all day.

What stops us sleeping?

To fall asleep we must be calm, relaxed and able to switch off our brains so that the build up of sleep pressure can tip us into sleep. When something blocks the action of sleep pressure, such as fear, pain or racing thoughts, we may struggle with sleeplessness.

In the same way, sleep happens more easily for a baby or child when sleep pressure is high, they are in a calm relaxed state, and nothing is preventing sleep onset. But sometimes babies and children need help to become calm before sleep pressure can kick in and they can nod off.

When a baby or young child’s sleep pressure is high and the need to sleep is strong, but they are emotionally unable to calm themselves, or they are in a situation where they cannot relax – where there is noise, lights, or activity – we may label them as overtired. Emotional exhaustion, which is a form of stress, prevents both children and adults from sleeping and makes them cranky.

Some responses to overtiredness are heavy-handed. Ordering a child to their room, putting them to bed in the face of distress or punishing them for not falling asleep when told to do so will dial up the child further and push sleep further from reach. After all, none of us can fall asleep on command.

Helping babies to sleep

In this situation, we must remember that babies and young children need our help to manage their emotions. It is our job as parents to help them become calm, dial down, and relax in preparation for sleep.

We can do this in many ways. Physical contact such as cuddling, rocking, stroking or patting works for most children, although it must be remembered that some neurodivergent children can find touch irritating rather than calming.

Non-contact methods also work. The presence of a relaxed slow breathing adult can calm a child, as can listening to gentle talking, singing and humming. In the Czech Republic, there is a specific word for lying with and helping a child to relax so they can fall asleep: uspávání.

There is no name in English for the process of helping a child relax so that sleep pressure can tip them into slumber, so we often don’t discuss or acknowledge it. We can use it, though. And we can understand that what we have named “overtiredness” is the conflict between sleep pressure being high and something blocking the effect of that sleep pressure.

In this situation actively removing the blockage – fear, pain, anxiety – by helping babies and children to become calm is the quickest way to help them fall asleep.

Next time your baby is having a meltdown at bedtime, or your child is throwing a tantrum at the end of the day, hug them, cuddle them, talk gently to them and calm them. Let sleep pressure do its thing, and they’ll be snoozing in no time.


The Durham Infancy & Sleep Centre (formerly the Parent-Infant Sleep Lab) is a research centre of the Department of Anthropology. It is the home for a group of researchers examining various aspects of infant and child sleep and parenting behaviour since 1995. Its work with more than 5,000 parents and babies during the last 20+ years has substantially increased parents' understanding of babies' sleep, how best to care for babies during the night, and how best to keep them safe when asleep. 


This article is republished from The Conversation under a Creative Commons license. Read the original article.

Friday, 16 December 2022

Walking football for people with chronic breathlessness – has it got legs?

Posted by Callum Bradford, Research Associate, Teesside University

Following on from the recent success of the England Women’s football team, and with the Men’s World Cup final just around the corner, now seems like a good opportunity to talk about our walking football project, designed exclusively for people with chronic breathlessness. What is walking football you ask? Well it's football, without running (you don’t say?!), and the physical contact is a bit more restricted. Thankfully, FIFA hasn't got its hands on walking football just yet, with the World Cup being an example of why we perhaps should avoid such a thing.

 

Chronic Breathlessness is predominantly caused by pulmonary conditions, such as chronic obstructive pulmonary disease (COPD), impacting 75 million people globally. With Covid-19 and an ageing population this number is expected to rise, increasing the burden on families, carers, and health and social care services. For individuals, breathlessness is associated with a lower quality of life, decreased capacity to do exercise, and higher levels of anxiety and depression

Pulmonary rehabilitation is recommended for everyone with breathlessness. Consisting of both exercise and education, its benefits on health are unequivocal, however, any benefits gained by patients are often reduced three months after completion. This is primarily because patients go back to doing less physical activity once the programme has finished and support from healthcare professionals is removed. With this in mind, we wanted to develop an intervention that could step-in when patients finish their rehabilitation, offering a form of exercise maintenance and continued social support. Given the nation's love of football (most of the time), we believed walking football might have potential.

To develop the intervention, we initially consulted pulmonary physiotherapists, and a local walking football team. The physios were initially very sceptical, raising concerns that the pace would be too fast, and highlighting the number of people with breathlessness who required oxygen or walking-aids. Walking-aids?! Oxygen?! I hadn't even considered that. I was starting to worry that this idea might be a complete non-starter.

So next stop was to see some walking football for myself at Middlesbrough’s Herlingshaw Centre. I left the session with mixed feelings. They played three-touch, meaning everyone got the opportunity to play, forcing that one player who thinks they're Allan Saint-Maximin to pass the ball. It was also proactively refereed to the benefit of everyone, with players encouraged to talk to the ref if they felt the pace of the game was too fast. However, after giving it a go myself, the pace was still surprisingly quick, despite what Father Ted might have you believe, bringing back concerns as to whether it would be too high an intensity. What I really needed to know was what patients themselves thought of walking football.

So we linked up with Breathe Easy Darlington, a local support group for people with lung conditions. Describing the input from Breathe Easy members as invaluable to our research over the last few years would be a massive understatement. So much so that, as a small thank you, we held a fundraiser for them last month on World COPD Day, raising £1120.76.

Their opinions would be vital to walking football’s success... however, they were also dubious of the idea. Again, concerns were raised about the speed, the walking-aids, and the balance required to play. So I asked, under what circumstances – if any – would they consider giving walking football a go? They stated that if the football was exclusive to people with breathlessness like themselves, they would give it a try, as they would be able to dictate the pace of the game and not feel too self-conscious of their footballing abilities. Our original plan involved asking patients to join onto sessions at the Herlingshaw. Luckily, by consulting with Breathe Easy members, I now understand how that plan – to mix people with and without breathlessness - would have likely ended in disaster, demonstrating the importance of including end-users when designing research studies.

Twelve Breathe Easy members agreed to play and the stage was set for our walking football taster sessions, and as you can see from our video, I don't think it could have gone much better.

The players embraced the competitive aspect of football, stating that “On the pitch you forget about breathlessness”; and the concern for walking-aids was turned on its head after we agreed that hitting the ball with a walking-stick is a perfectly fine way to score a goal. Our coach, Monty Towers, was key to its success, mixing up the session with fun games, while allowing everyone to play football at their own pace. In our follow-up conversations, members also suggested implementing a buddy system, where more experienced participants take responsibility for introducing new patients to the group so they feel more welcome – a brilliant idea that we intend to implement in the future.

Throughout 2023 we will be assessing the feasibility of walking football following pulmonary rehabilitation in collaboration with both North Tees & Hartlepool and South Tees NHS Foundation Trusts, plus the North Riding FA; and I’m confident if it’s anything like our sessions with Breathe Easy members, it will be a great success.

And if you’re still upset about the World Cup, don’t worry, I’m sure our walking football team will bring it home next year.


The views and opinions expressed by the author are those of the author and do not necessarily reflect those of Teesside University or Fuse, the Centre for Translational Research in Public Health.

Friday, 9 December 2022

What support do children and young people actually want when their parents use drugs and alcohol?

Posted by Cassey Muir, Fuse & NIHR School for Public health Research (SPHR) funded PhD Researcher from Newcastle University and Kira Terry, Lived Experience Expert. 



“No-one has ever asked me about how I feel in any of this.”


I found the powerful quote above from a young person during my research exploring parent drug and alcohol (or substance) use from the young person’s perspective. Since then the question of ‘what support do children and young people ACTUALLY want?’ has remained central to my PhD research in this area.

Most schemes focus on the parents themselves, to reduce the risk to young people. While these interventions are needed it should be alongside and in addition to support for the child or young person as well. There are currently a very limited number of evidence-based interventions for young people whose parents use substances, with low quality effectiveness. The distribution of support services for children and young people whose parents use substances is also patchy across the country, with practitioners doing really great work with little funding and resources.

In a recently published review of the research in this area, I aimed to understand the experiences, perceived impacts, and coping strategies of young people whose parents used substances. The review was extensive - covering the perspective of over 700 children and young people from across twenty different countries - and I hope that it can help to inform practice and policy through illustrative cases of young people’s experiences, as well as giving insights into what support could be useful.

Feeling different and isolated

Working with PROPS Young Person’s Project, a group of young people with lived experience supported the early stages of this review to help us understand the findings. One area that the young people felt was missing and may not have been explored across the current studies was the experience of feeling different to their peers, and how they felt isolated and like they had to keep everything hidden from others. This idea, relating to the experience of stigma, helped me to explore the data from a different perspective.

Children and young people described living highly disrupted and chaotic lives, characterised by unpredictability and insecurity within their relationships. They also often experienced adversity occurring at the same time in childhood, such as parents with mental health problems, domestic violence and abuse, as well as poverty. Children and young people were impacted both emotionally and socially from their experiences of parental substance use, which often extended beyond their parents stopping use, further highlighting that child-focused support is crucial. The painful experience of shame, stigma, and discrimination due to their close association and relationship with a parent who uses substances, was often further compounded for those who had experienced poverty or lower socioeconomic status.

Resisting and coping

Most of the studies described the negative impacts of parental substance, without recognising children and young people’s agency and attempts to change, control, and resist their experiences or impacts. Children and young people tried to manage and mitigate vulnerabilities and be resilient to unpredictable, adverse, and stigmatising experiences. While it is not a child’s role to resist and cope with the negative impacts of parental substance use, they were trying to do this anyway, often without formal support in place. Formal support was often thought of as something children and young people only have at times of crisis and due to the stigma and fear of speaking out it was also difficult for young people to seek support for themselves before a crisis point.

What can we do to support?

The findings had little to say about how young people wanted to be supported following their experiences. So, as part of my PhD I have been chatting with young people, and the practitioners that support them, around what we can do to support and build on their strengths, agency, resistance, and resiliency. For instance, young people and practitioners thought it would be good to develop a digital app that teenagers and young adults can access themselves at any time of day. They can choose what topics or sessions they want to go through and hear about other young people’s stories. Such digital interventions could be used alongside in-person support with a practitioner or act as a gateway to more formal support, with the aim of helping reduce the stigma of speaking out and accessing help. Additionally, young people wanted free text support lines that they can access out of hours, usually in the evening when things may be worse at home. Text and chat-based support lines provide young people with the opportunity to safely get support without having to physically talk to somebody and gives them more flexibility. Both young people and practitioners wanted in-depth training for professionals (e.g. teachers or first responders) around the experiences and impacts of parental substance use on children and young people and how to signpost to support.

Finally, one of the main areas that the young people and practitioners wanted to focus was on the co-production of resources to be used in primary and secondary schools. Young people wanted parent drug and alcohol use to be talked about in schools, as many reflected that it had never been spoken about making them feel more alone and isolated. Having lessons around the emotional and social impacts of family substance use within secondary school, or having story books read out loud in primary school about a child whose parent drinks alcohol or uses drugs would begin to reduce the stigma and fear of speaking about such a hidden and taboo subject.

“I’ve really enjoyed that chat, thanks for reaching out to me and wanting to hear about my experiences and how to support young people.”
Young person after taking part in this study

 

“He has told us he has gotten so much out of chatting with you and is really happy to have been involved and listened to regarding what might help others.”
Practitioner on behalf of a young person 

The young person’s voice

In any decisions made throughout my PhD, I have tried to ensure that the young person’s voice is lasting and at the forefront. Young people have been involved in this project from the start, guiding the research questions, designing research materials, contributing to ethics procedures, analysing data, and presenting results to over 100 practice and policy professionals. To finish this blog post, Kira shares her thoughts on contributing to this project as a Lived Experience Research Advisor and what she thinks is needed to support young people whose parents use substances:

“It has been an absolute honour to be involved as part of this project. To use my ‘negative’ life experience and be able to turn it into a positive impact for other children like me in the future: to help speak for those who feel they don’t have a voice and aren’t seen by people around them in the position they are in. The main part of supporting young children is accessing them and communicating with them. Reaching out to young people in general about parental substance use issues, getting the knowledge out there about it is important. This in turn will help the young people experiencing parental substance use, as the subject isn’t so hidden anymore as it usually feels hidden in the home. And through that we must back up with access to different support links. Some children aren’t ready, some don’t want help, some we won’t reach, but to push and be as present for as many children as possible, as long as possible and to reduce the isolation of the stigma around it is vital.”



Find out more about this research in the first Public Health Research and Me Fuse Podcast: How can we promote resilience in children and young people affected by parental substance use?



  1. Photo by Polina Zimmerman from Pexels: https://www.pexels.com/photo/young-woman-talking-with-therapist-3958461/
  2. PROPS Family Recovery Service logo. Copyright © 2022 - All Right Reserved - PROPS North East: https://props.org.uk/

Friday, 25 November 2022

How can we give our communities the Best Start in Life?

Posted by Liam Spencer, ARC North East & North Cumbria Mental Health Fellow, Newcastle University

Having had a background in youth and community work within a local authority, the question contained in the title of this blog is one close to my heart.

It is also the name that South Tyneside Council gave to one of their projects - the Best Start in Life (BSIL) Alliance - which really struck a chord with me, especially as my research interests focus on children and young people’s mental health.

I first learned about the project back in May 2019, when I attended an AskFuse brokering event for the Public Health Practice Evaluation Scheme (PHPES) of the NIHR School for Public Health Research. At this event Anna Christie, the Public Health Knowledge and Intelligence Lead for South Tyneside Council, presented on the BSIL Alliance, focussing on three initiatives: Locality Hubs; Mental Health Champions; and Young Health Ambassadors.

This was the beginning of a partnership between Fuse researchers and South Tyneside Council, and after successfully being shortlisted and then submitting a full-length application, in October 2019 we were delighted to learn that our proposal had been accepted – out of 91 registrations of interest for the 2019 PHPES funding call, ours was one of only 10 proposals that were successfully funded!

Best-laid plans

By the time the project started in April 2020, we were living in very different times to when we planned the evaluation, due to the Covid-19 pandemic.

We had hoped as researchers to be embedded within South Tyneside Council; this was not possible.

We had planned to include the Locality Hubs within our evaluation; these were not able to be launched.

Routine data we had planned to include in a cost consequence analysis (a form of economic evaluation where separate costs and a range of outcomes are presented to allow readers to form their own opinion on the relevance and relative importance of interventions) were either not collected or were severely impacted.

Moving from Plan A, to Plan B, to Plan C is commonplace in research, however, throw a global pandemic into the mix and you can find yourself quickly wheeling through all the letters of the alphabet whilst trying to stick to the original plan for your research! Despite the hurdles we had to overcome – the dedication and commitment from our colleagues at South Tyneside Council, and the Fuse team endured, and we were all determined to deliver on the project.

Insightful discussions at the Fuse Research Event in South Tyneside
Fast-forward to the present day and we have completed our evaluation. Thankfully, only being able to meet virtually is a thing of the past and on Wednesday 12 October we were joined by practitioners from local authority and third sector organisations, researchers, and students from across the region, for a Fuse Research Event at The Customs House in South Shields, to finally share learning from our evaluation! The event included academic contributions from myself, Ruth McGovern (study lead), and Sam Redgate, along with Anna Christie, Tom Hall (Director of Public Health), and Chrissy Hardy (Public Health Practitioner, Children & Young People) from South Tyneside Council.

Supporting young people’s mental health

Our findings showed that the successful implementation of Alliances in public health and social care related services within Local Government is dependent upon achieving a system level approach, whereby thinking, methods, and practice are applied to better understand public health challenges and identify collective actions across services. Placing local people at the heart of the system, and creating a cultural shift is also key to a successful Alliancing approach. Mental Health Champions and Young Health Ambassadors were found to influence system change by generating mental health awareness and facilitating more inclusive and supportive environments for children and young people.

As well as sharing findings from the evaluation, we wanted this in-person event to be interactive and collaborative, and asked those who attended to think about the similarities and differences between the Mental Health Champion and Young Health Ambassador initiatives. I thought it was really interesting that people recognised that these initiatives share a similar ethos, with commonality of goals and outcomes – to support young people’s mental health, in both proactive and reactive ways. Attendees felt it was important that both approaches are organic, with ideas emerging ‘from the bottom-up’. Volunteers can utilise the Alliance in a productive way, by accessing training and events, and securing buy-in from senior stakeholders, with support from Chrissy, the facilitator of both initiatives. I was so grateful for all the meaningful and insightful contributions provided, which are proving to be very useful in guiding the write-up of our findings – ensuring that they are as relevant to practice as possible.

We are very thankful to our colleagues at South Tyneside Council for collaborating with us on this project (despite the barriers we faced along the way!) – and we really hope that the findings from this work will help shape their future policies and practices. Personally, this evaluation provided me with an opportunity to learn more about current local initiatives, engage with passionate practitioners and young people, and build some really fantastic relationships with colleagues at South Tyneside Council. I thought that the event was a wonderful way to bring people together from across the region, to share our findings, and to draw the project to the close. A big thanks to the Fuse team for making it happen!

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Friday, 4 November 2022

My passion for research comes from always asking "why?"

Posted by Pascal Landindome Navelle, FRSPH, Public Health Research Operations Officer and Doctor of Public Health Student at Teesside University.

In today's Fuse blog, Pascal gives his top tips for anyone starting out in research, and shares his own experience which began working with Fuse and Teesside University.

His advice? A passion for the "why?" question and accessing the right mentorship.

As part of the NIHR ‘Your Path In Research’ campaign.
 
After working as a clinician for several years, I felt that my impact on service users was limited. So, upon a thorough reflection, I was inspired to progress into public health research, where I felt I would have a broader impact on society.

Research work is fascinating as it provides a clear pathway to contributing to advancing the knowledge of the disciplinary sector to which I am dedicated. The importance of research should go beyond conceiving theoretical works that would only find a physical location in a library. Research should be "living", circulating, interacting, multidisciplinary, and impacting the environment.

What I enjoy about research is that it allows me to pursue my interests, learn something new, hone my problem-solving skills and challenge myself in several unique ways. Working on a faculty-initiated research project enables me to work closely with a mentor–a faculty member, and other experienced researchers. With a self-initiated public health research project, I can leave the community with a service that represents the distillation of my interests and studies and, possibly, a real contribution to knowledge.

There are many training and support systems that I have found valuable during my career. Researchers usually embark on increasingly diverse careers, where collaboration, networking and interdisciplinarity have become more important. Critical reading, academic writing and critical analysis are valuable training and support required of a researcher. Transferable skills, such as effective communication and problem-solving abilities, have helped me operate more effectively in different work environments.

Starting a research career can be daunting but exciting! The challenge of getting the support needed to achieve my dream came true when I enrolled at Teesside University for a research degree. This began by getting involved with AskFuse (Fuse’s responsive research and evaluation service) and with Associate Professor Dr Peter van der Graaf, working on an enquiry to evaluate Northumbria NHS Foundation Trust’s staff health and wellbeing resources during the pandemic, as part of my PhD research. This then led to working on the South Tees Arts Project (STAR) with Peter, a pilot study to co-produce wellbeing measures with primary school children, their parents, teachers, and artists for a school-based dance intervention. I supported the data collection, analysis and report writing for the STAR project as a Research Assistant and even wrote a song for the engagement activities with children in the research!

I had the opportunity of getting mentorship and some academic resources to enhance my knowledge. I connected and contacted very experienced researchers in the field of public health who supported my interest in growing as a research professional. Through the people I’ve met, I have had the opportunity to work on exciting but substantial research projects that have had a massive impact on the public health community.

My top three tips for somebody starting out in research are:
  1. First and foremost, you should be motivated, passionate, and curious about your research topic – do it for science, not tenure! No one ever became a successful scientist with the sole premise of being awarded the Nobel Prize. And remember that plans rarely work out the way you thought they would.
  2. Be prepared for a challenging career. Research is ever-changing. Be prepared for the change that research comes with strengthening your problem-solving skills to enhance the fun aspect of research. Problem-solving skills refer to handling difficult situations and overcoming complex challenges. They involve breaking a problem down into its parts, thinking critically about each element, analysing the information you find and using that information to form an effective solution. Having strong problem-solving skills will help make you an asset in your research practice and help you advance your research career.
  3. Finally, be proactive, network and connect more with like-minded professionals. Sometimes, the key to getting to places is not what you know but who you know. We can learn a lot from talking to peers and senior colleagues. Attending symposiums, seminars and conferences is a great way to meet people who share common interests with you but have different experiences.
The NIHR has supported my career development through the provision of training, access to leadership development opportunities, networking events, mentoring and guidance on research funding.


The NIHR launched the Your Path In Research campaign this week. Better research leads to better services for the public. That’s why the NIHR want to encourage organisations and social care and public health professionals to play an active role in research, as a way to deliver even better services.

The Your Path in Research campaign highlights how people can make research part of their careers. Some amazing researchers have shared their experiences, how they started in research and what advice they can give to researchers that are considering adding research to their careers.

Take your first step in research today.