Impact case study database

Impacts stem from interdisciplinary, applied public health-focused research on health improvement and inequalities. Our research between 2006 to 2015 led to the establishment of the Centre for Health and Development (CHAD) in 2015. CHAD is a GBP900,000 partnership between Staffordshire University, SoTCC and Staffordshire County Council. It has been instrumental in developing and strengthening partnerships with stakeholders from local authority, NHS, and third sector, and influencing their practice and policy. These stakeholders are the main beneficiaries of our research. Through them, impact has developed and will continue in the populations they serve. The significance of our impact can be seen in our work with SoTCC that has led to local changes in public health practice and policy. Impact reach has been extended through: research and consultancy projects influencing practice across approximately 50 local organisations; public engagement activities (reaching approximately 1,600 stakeholders from approximately 30 organisations); and developing relationships between local and national organisations, particularly through NHSHC research. We have achieved three main types of impact:

1. Influencing Urban Planning – Practice and Policy

Our underpinning research into neighbourhood/natural environments and health had economic impact through creating 2 collaborative Healthy Urban Planning (HUP) posts (headcount: 2 FTE: 2) in SoTCC public health and planning departments. Funded by SoTCC, we employed HUP researchers (>GBP160,000), both health psychologists, who led the integration of health into planning decisions (2015-2018). Bringing health psychology into planning was significant in its novelty and presented as good practice by SusTrans and the Town and Country Planning Association [ 5.2: Links 1-2]. Responsibilities included evidence-informed plans, reviewing developers’ Health Impact Assessments, and creating a HUP developer checklist. As a result:

• Developers were requested to make health-promoting changes ( e.g., increased green space, landscaping to reduce noise pollution) to 30 major developments [ 5.3-section 3.2.2].

• The HUP officers ‘assist[ed] with the design’ of the GBP450,000 Legible Stoke wayfinding programme in 2016, which introduced 81 signs across the city to promote walking, connectivity between the railway station, city centre, and canal network. They brought ‘the psychology of finding your way’ to the scheme, a methodology described at the time as ‘ very different from traditional highway engineering’ [Transport Officer; 5.3-section 3.2.2].

• Our evidence of the high prevalence of fast-food outlets in deprived communities led to the Hot Food Takeaway Supplementary Planning Document by SoTCC Planning Department [ 5.2: Link 3, p18] to prevent licensing of hot food takeaways near schools (currently 98 in total) in Stoke-on-Trent. In 2016/17, our HUP officer was involved in reviewing the Document’s scope and increasing its reach to identify more schools and making it easier to apply [ 5.3, section 3.2.5]. This contributed to efforts to reduce the ‘obesogenicity’ of areas surrounding schools.

2. Improving NHS Health Checks – Uptake and risk communication

• ‘… training materials and evidence related to communication of risk helped to improve the competency in the communication of risk and therefore allowing professionals to better support the public to recognise the benefits of risk reduction interventions following the NHS Health Check’. National lead for CVD prevention, PHE [ 5.1]

In SoT, our NHSHC research led to changes that ‘ directly impacted on service specifications held with GPs’ [ 5.3-section 3.2.2]); specifically, the 53 SoT practices (more than 100,000 eligible patients) were asked to use telephone (rather than postal) invitations. As a result, uptake of NHSHC in SoT increased from 50.8% (2014/15) to 63.4% in 2016/17 (after findings implemented), and has remained 62.5% to 73.5%, well above the national average for the corresponding period (46% to 48%) [ 5.4].

• To extend the reach and sustainability of our impact, in 2018-2019 we delivered CVD risk communication training to 60 NHSHC practitioners across 16 local authorities in the North West and South East of England, including a ‘train-the-trainer’ model (which cascaded to 280 practitioners). Evaluation of this model identified impacts including: wider delivery of risk communication training delivery, now expanded to NHSHC practitioners in 12 additional local authority areas; positive changes to local programme specifications for practitioner training; and widespread use of training resources and use of alternative metrics to communicate CVD risk more effectively [ 5.5]. A truncated version was also delivered to 50 practitioners/commissioners at the national NHSHC conference (2019). The resource pack was requested by 62 people from local authorities across all regions of England, many of whom confirmed they will implement it in their areas [ 5.1, 5.5].

‘I have attended CHAD lectures and events and shared information across the organisation, we refer to research and data CHAD have shared when developing projects and strategy’ [ 5.3, p4]

3. Increasing Understanding, Learning and Participation through Public Engagement

• Between Sep 2016 and Dec 2019, CHAD held 25 events (public talks; Big Community Conversations; and externally focused conferences, co-run with non-academic organisations) engaging approximately 1,600 people including public, professionals, and academics [ 5.6], developing awareness of key health and social inequality issues, and connecting stakeholders [ 5.3, 5.6].

• Engagement activities included 12 collaborative seminars on key CHAD research themes, co-delivered with local stakeholders. Since Nov 2019, these have engaged approximately 400 people representing approximately 30 external organisations, who confirmed these events raised awareness of local health issues, made connections among local stakeholders, and were used for continuous professional development [ 5.3].

• Between Feb 2016 and Apr 2020, CHAD researchers undertook 15 community-focused applied research projects (with approximately 30 local stakeholder organisations) in response to findings detailed in section 2. Projects have related to perceptions and support for vulnerable populations ( e.g., homeless, vulnerable women), health, adversity in young people, healthy ageing and end of life care, to support the work of local stakeholders (social welfare organisations). Evaluation evidence suggested a range of benefits:

• Independent evaluation provided ‘credibility and kudos of working with the University’, allowing partners to influence organisations like SoTCC or CCGs that are ‘ evidence-based in their decision-making processes’ [ 5.3-section 3.2.7]

• Professional development through interview methods training of four members of Expert Citizens (collaborators with lived experience of multiple and complex needs) in 2017; they progressed to do many projects, independently and with CHAD [ 5.3-section 3.2.4].

• Reduced severity of wording in a Public Space Prevention Order (in 2019), which reduced the onus on Police to intervene, unless in cases of aggressive street begging by rough sleepers in Stoke-on-Trent. VOICES and the Hardship Commission used our research evidence to lobby for changes to the order, which originally showed ‘ a lack of empathy’ and framed the issue of street begging as ‘ one of community safety and anti-social behaviour’, rather than extreme social disadvantage [ 5.3-section 3.2.5, 5.7]. VOICES is a partnership project in Stoke-on-Trent working with people experiencing combinations of homelessness, mental ill-health, addiction, or histories of offending behaviour. The Hardship Commission is made up of organisations and services that have an involvement with, or influence on, poverty-related hardship.

• CHAD’s research into children/young people’s (CYP) emotional well-being led to changes that shaped the local Emotional Health and Wellbeing Strategy 2018-2023. Information gathered from parents and CYP was used to refine the use of digital technology, simplify language used by those supporting CYP, and increase parent engagement. This led to commissioning of the city council’s Stay Well initiative; a citywide programme to support approximately 4,000 CYP across SoT requiring mental health support [ 5.3-section 3.2.5, 5.8-p17, section 7.3].

• Evaluation of the North Staffordshire Cancer Lifestyle Project resulting in funding being awarded to the Beth Johnson Foundation (BJF) to continue providing lifestyle support for people with cancer (GBP170,000, 2017-2019) [ 5.9]. This was through the evaluation providing evidence of programme impact.

• ‘We’ve had trouble securing funding over the years… when you did the evaluation of our Mid-Life Health Project, there is a theme that runs straight from that, all along the years, into us securing that National Lottery funding 2019’ (Director of Policy and Engagement, BJF) [ 5.3, p11]

Evidence from an early evaluation into BJF’s Mid-life Health Programme resulted in them continuing with a preventive, life course approach and securing: GBP300,000 from National Lottery for the Healthy Generations Project 2019-2021 (young/older adults learning new ways to improve health); GBP100,000 from Calouste Gulbenkian Foundation, 2015-2017, for Healthy Transitions (supporting transitions to later life) [ 5.9].

• Re-design and city-wide roll-out of a community development programme (My Community Matters), which now operates across 12 areas of Stoke-on-Trent (approximately 7,800 households) [ 5.10].