Welcome to the Summer 2018 Issue of Health Psychology and Public Health

HEALTH PSYCHOLOGY AND PUBLIC HEALTH Summer 2018 Volume 2, Issue 2

EDITORS: Prof Katherine Brown , Dr Angel Chater, Neil Howlett, Emma Wilson In this edition

Welcome to the summer 2018 issue of Health Psychology and Public Health. Net- work chair Dr Angel Chater welcomes members to this edition.

Welcome from the editorial board and our plans for change. New editor-in-chief Profes- sor Katherine Brown and senior editor Emma Wilson welcome members and introduce our plans for developing the newsletter.

'….for everything else, there's behavioural science'. Chief Executive of Public Health England Duncan Selbie gave our Public Health keynote. By Katherine Brown Developing and applying translational behavioural science to improve population health and reduce inequalities. A piece reflecting the presentation of Professor Falko Sniehotta our academic keynote. By Angel Chater

The Application of Behavioural Science at Public Health England. Dr Tim Chadborn Welcome to the summer 2018 issue of Health Psychology and from the Public Health England Behavioural Insights Team (PHEBI) offers his perspective Public Health on the contribution of Behavioural Science to Public Health. It is an exciting time for the Network, as we forum for this. We will keep members informed move into a transitional phase of our develop- of these exciting developments via our social ‘But the RCT shows it’s effective!’: Seven reasons why health commissioners may ment! Following our members’ survey, we re- media and website. Watch out for the official be reluctant to use your Evidence-Based ceived unanimous agreement to expand our launch of the BSPHN coming soon! and effective health intervention in prac- membership to the wider remit of behavioural tice. By Katherine Brown, Kristina Curtis and and social sciences and public health. After gath- This edition of Health Psychology and Public Lou Atkinson. ering suggestions for a new name, the most pop- Health, will therefore be our last. But as you ular response was the Behavioural Science and continue to read in this issue, you will hear of our The HPPHN 2018 Conference: Reflections of a Trainee Health Psychologist. Trainee Public Health Network (BSPHN). At our com- plans to develop a new journal with this wider Health Psychologist at NHS Tayside Direc- mittee meeting in June, we agreed that this was focus. I am incredibly happy to announce that torate of Public Health, Emma Wilson, gives the name we will move forward with. We have Professor Katherine Brown has recently joined her perspective on the day. updated our constitution accordingly which can our team to take this forward, with the support be found on our website, along with our annual of Emma Wilson, another new committee mem- What makes a winning poster? Conference reports. ber. So welcome to them both, and please do get scientific committee poster judges, Professor in touch with your suggestions! Mary Barker and Dr Wendy Lawrence offer In line with this, we have been working closely their feedback on what got their vote in the with key organisations in the fields of health Our Honorary Fellowship now boasts a host of poster presentation competition. Featuring the psychology (i.e. the Division of Health Psycholo- leaders in the fields of health psychology and winning posters from the day. gy) and public health (i.e. the Faculty of Public public health and we hope to be able to facilitate Meet the Team! We're a friendly bunch! a meeting over the next year with as many as Health) and have been a key stakeholder in the Come and say hello to the committee! development of a Behavioural and Social Science possible to discuss ways that we can support Strategy for Public Health, led by Public Health training, career pathways, research, funding and Meet our Honorary Fellows! A host of lead- England (PHE). One aim of this strategy is to practice across the disciplines. ers in the fields of Health psychology and develop a ‘community of practice’ for those Public Health have agreed to support and working across the disciplines to come together It was a great honour to welcome two of our promote our network. to network and share ideas. As we are in the Honorary Fellows, Duncan Selbie, Chief Executive process of re-branding, we hope to facilitate a of Public Health England and Professor Falko

1 HEALTH PSYCHOLOGY AND PUBLIC HEALTH Summer 2018 Volume 2, Issue 2

Sniehotta, Director of the Behaviour Change Wiley publishers. I am pleased to say that this Building Successful Partnerships’. We have some Programme in Fuse (Centre of Excellence for is in collaboration with the Division of Health very exciting speakers for this event, including Translational Research in Public Health) as key- Psychology as a joint event. another of our Honorary Fellows, so please keep note speakers at our 2018 annual conference. an eye out for our updates on social media and This issue embraces the conference theme ‘The I would like to take this opportunity to thank come along! Role of Behavioural Science in Public Health: all those who continue to support the Network Application and Impact’ with some excellent and our mission to achieve greater integration Keep networking, keep smiling… articles that aim to facilitate fruitful discussions between health psychology and behavioural of the benefits of bringing these disciplines science and public health. The committee work Best wishes together. To support these discussions further, tirelessly in the background, and I thank them we will be hosting a CPD event on the 28th all, as well as welcoming new faces who have Angel (Chair HPPHN now BSPHN) September 2018 on ‘Writing for Impact: Publi- joined our team. cation, Policy and Media’. As with all our events, we will have speakers from both health Finally, I would like to warmly invite you to our psychology and public health; on this occasion next annual conference which will be held on Professor Jane Ogden and Professor Jim the 27th February 2019 with the theme of McManus, alongside Rebecca Harkin from Health, Wellbeing & Behavioural Science:

Welcome from the Editorial board and our plans for change

As the new Editorial Board of the re-branded Your network needs you: Be part of the widely as possible within your networks. Equal- Behavioural Science and Public Health Net- transformation! ly, if you have ideas for the Network’s new pub- work's (BSPHN) publication, it is our great lication, then we’d very much welcome those pleasure to let readers know about our plans We will rely on contributions from our mem- too! for a transformation that we are planning that bership and collaborators. We want to hear We look forward to hearing from you and to will take the Network from a bi-annual news- from you, regardless of whether you’re an working with the BSPHN committee to deliver letter (as was) to a higher profile members' established author or first time writer. In opportunities and benefits to our members. We publication, with innovative research, opinion return, we offer you the opportunity to dis- hope you enjoy the range of articles selected for pieces, reports and debates. seminate your work to a range of profession- you in this Special 2018 conference edition. als and academics, allowing you to broaden We are aiming to become a focal point for dis- your impact and potentially open up oppor- Prof Katherine Brown Emma Wilson cussion around greater integration of, and in- tunities for collaboration. Editor-in-Chief Senior Editor fluence between, public health professionals and individuals undertaking empirical research If you would like to submit an article, report, in the behavioural sciences. We seek to publish opinion piece or event/book review then Dr Angel Chater Neil Howlett quality papers that detail leading applied re- please contact us at [email protected] Editor Editor search and examples of best practice, currently and soon [email protected]. Please take being developed through effective collabora- the opportunity to review our revised author Email: [email protected] or tion at all levels of the two disciplines, in the guidelines which will be available soon on the [email protected] U.K. and overseas. updated network website and share them as

Calling for conference bursary applications!

Two HPPHN bursaries are available to support two individuals to attend our event HEALTH, WELL-BEING & BEHAVIOURAL SCIENCE; BUILDING SUCCESSFUL PARTNERSHIPS/ 27th February 2019 / BIRMINGHAM. These bursaries cover the event registration fee (including catering) and up to £50 towards the costs incurred by the recipients to attend the full event (excluding accommodation).

Only signed bursary applications submitted using the application form by 28th November 2018 5pm will be considered. Once complete, please send your application to [email protected].

For more information see page 3 Application form is available on page 20

2 HEALTH, WELL-BEING & BEHAVIOURAL SCIENCE; BUILDING SUCCESSFUL PARTNERSHIPS First keynote speaker confirmed: Prof Chris Armitage University of Manchester SAVE THE DATE! 27th February 2019 & The Behavioural Science Consortium Conference Aston, Aston Triangle, Further speakers and de-

Birmingham, B4 7ET tails to be announced soon. Following the success of our 2018 event, we are Delegates of the 2018 pleased to confirm that our next conference & AGM event enjoyed: th will take place in Birmingham on 27 February 2019. “Inspirational speakers” The city centre venue is just a 15 minute walk from “Meeting/hearing from Birmingham New Street Station, with connections people from a wide range across the UK. Birmingham International Airport is of disciplines” just a further 10 minute train journey, with excellent "Refreshing insight into national and international connections. what is possible” Parking and overnight accommodation are both “Good networking oppor- available onsite. tunities”

For updates and news of other events go to www. hpphn.org.uk or www.bsph.org.uk or follow us on twitter

@newshpphn

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'….for everything else, there's behavioural science'

When Public Health England (PHE) Chief have improved: people live longer and healthi- The intention of a tax on sugary drinks wasn’t Executive, Duncan Selbie, gave a keynote er lives than ever before but health inequality – to raise money but to change behaviour; to address at this year's conference, he pre- the difference between the affluent and the motivate the commercial sector to remove or sented the case for the future of behaviour- poor – is as high as it has ever been. reduce some of the sugar content in their al science in increasing years spent in good drinks and some positive action has already Selbie cited PHE work which has established health for our population. He challenged been taken. that around 10% of the contribution to health health psychologists to get organised and within the population is attributable to treating Selbie wants to bring the challenge of making come together to work with public health illness and the NHS, and that a much bigger the nation healthier to our door. He wants and ensure we achieve the impact that re- percentage is about tackling health inequality psychologists to pick up the reins and take a search in our field needs to have. Professor and differences in socio-economic status (and a serious look at how we use behavioural sci- Katherine Brown elaborates on his key bit of genetics). For example, around 30% of ence and bring the evidence to bear on clos- messages... health outcome is attributable to whether or ing the health inequalities gap. The big ques- not you smoke, what and how much you eat, tion is how we make the healthier choices whether or not you take exercise and how the easier choices and recognising that peo- much you drink. He referred to these factors as ple are at the heart of this. He warned that 'choices' that can be influenced and this is the it's not sufficient just to be right. Our evi- role of behavioural science. dence may be strong, we may be building on it all the time, but we must ensure we also Selbie talked about some of the successes to have the consent of the people and build this date for behavioural science from PHE includ- into our activities. ing influencing members of target populations directly and partnerships with commercial He commented on the importance of coming players that influence the choices we make together during the conference to learn from daily. PHE, he said, are getting better and more each other and create new connections for organised at trying to join things up. working together. He said, you are in the foothills of the impact that you must have. Take ‘Stoptober’ – a campaign encouraging a We need to think about how we shift behav- mass quit-smoking attempt every autumn us- iour and how we make it easier to make ing behavioural science techniques to create a healthier choices, while keeping a focus on sense of being part of a community. It feels less closing the gap between the affluent and the daunting to be challenged to quit for one poor. Government can do certain things such month rather than forever and if you can make as bringing in the sugar tax but we need to do it to 28 days smokefree, you’re five times more the rest. likely to never smoke again. So far over a million people have joined Stoptober since 2012. Written by Katherine Brown

Beginning by saying that 'the Golden years are Another example is the Change4Life snacking ahead of us', Selbie explained that in relation to campaign which offers advice on healthier infectious disease, the 'other half ' of what PHE options to the parents and carers of primary does, the organisation has around 3000 scientists school aged children. This age group of chil- working with dangerous pathogens to address a dren in England are the most overweight in wide range of communicable diseases like tubercu- Western Europe and half of their sugar intake losis, Ebola and Zika. They work to be prepared to comes through snacking. Change4Life advises address the next pandemic. He explained that the parents and carers to look out for snacks con- future of this work is mathematics, software engi- taining 100 calories or less, and to give chil- neering, some geography, genome sequencing and dren no more than two a day; this is likely to big data. The pace of change in this field is astonish- reduce their overall food and sugar intake ing and transformational methods of outbreak con- each day. trol are developing at speed. Everything else, he In the commercial sector, organisations are said, is about behavioural science. keen to partner up with PHE because evidence suggests consumers want to see action on Selbie elaborated, when we think about health, we obesity. Greggs are going for healthier options conflate good health with the NHS and “what the and McDonalds, which has 3 million sales NHS can do” – his point being that of course we points every day, has been working on embed- need a strong, properly-funded and confident NHS, ding PHE’s 400 600 600 calorie guidance for but that alone cannot improve the health of the breakfast, lunch and dinner in their menu. people. In the last century or so everyone's lives Similarly, the Sugar tax has been influential.

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Developing and applying translational behavioural science to improve population health and reduce inequalities

In his keynote address at the 2018 Health Psychology in Public Health Annual Conference, Professor Falko Sniehotta (Newcastle University/Fuse) presented an excellent case for the need to apply translational behavioural science to public health. Dr Angel Chater gets to grips with his key points.

Determinants of behaviour and health exist at many levels, from the socio-economic, environmental and cultural, through to community influence and individual factors (Dahlgren & Whitehead, 1991). Conditions such as obesity have a complex web of causality, as exhibited in the Foresight Report (Butland et al., 2007), highlighting the importance of applying a holistic bio-psycho-social approach, as suggested in the 1970’s to challenge the traditional biomedical model of illness (Engel, 1977). However, to date, the focus of intervention efforts is most often on the individual (Sniehotta et al., 2017). While a change in individual ‘lifestyle’ factors, such as diet, exercise, smoking and alcohol are often the target of intervention design, there needs to be an acknowledgement that behavioural science is much more than just ‘lifestyle choice’ .

There has been an increasing interest in ‘choice architecture’ and ‘nudging’ to facilitate behaviour (change), often by manipulating elements of the environment. However, until recently there has been a limited approach to synthesize evidence in this area (Hollands et al., 2017). Moreover, this approach often focuses on the automatic process of decision-making, while omitting the reflective considerations. Public health agencies, policy makers and commissioners often work at a macro, population-based level, aiming to solve population-wide health issues en masse.

Choice architecture and behavioural economics have, therefore, been prominent in many of their approaches such as the EAST model, encouraging interventions to be Easy, Attractive, Social and Timely (Behavioural Insights Team, 2014). The Behaviour Change Wheel(Michie, Van Stralen, & West 2011) in contrast, postulates a model that considers determinants of behaviour in terms of Capability (psychological and physical), Opportunity (social and physical) and Motivation (reflective and automatic), alongside ways in which to intervene, atan individual, micro and macro level (through COM-B, intervention functions and policy categories). This approach, therefore, takes a more holistic view of intervention design than the aforementioned EAST model, yet they both are welcome over none at all.

Behavioural science has a significant role to play within public health, incorporating a number of disciplines to understand the complex influences that may affect population health. To navi- gate through inter-twining and often overlapping disciplines and the multitude of theoretical frameworks and approaches within, it is important to co-create interventions. Such co-creation should involve not only those commissioning and delivering a service but also those who may receive the intervention and those able to support an effective design and evaluation. In doing so, it will reduce the risk of wasted resources or potential inequalities in engagement; two key features in the APEASE framework that suggests interventions should consider: Affordability, Practicability, Effectiveness, Acceptability, Side Effects and Equality (Michie, Atkins, & West, 2014 ). Cross-collaboration with commissioners, designers, deliverers, receivers and evaluators of a service, also provides a prime opportunity to learn from this experience to shape future programmes. While behavioural science has an important role to play in public health, so too does public health have a significant role to play in the understanding and use of behavioural science. We need to create a two-way dialogue so that we can learn from one another, and translational work from academia to practice and visa versa is essential. Sniehotta presented an overview of Fuse, which is a good example of how this can be achieved, and such collaborations should be encouraged. Fuse is one of 5 UK Public Health Research Cen- tres of Excellence that links public health researchers across five universities in north-east Eng- land. For these cross-collaborations to work, it is essential not only to speak the same language, but also to share a mutual understanding of the pressures of each discipline. Public health is under pressure to deal with real world problems, in a timely fashion with limited resource. Be- havioural scientists based in academia are heavily influenced by the Research Excellence Frame- work (REF), an audited measure of research quality and the impact (changes that occur as a re- sult of research) it has made (locally, nationally, internationally). The greater the quality of the research and its impact, the more kudos and financial support the academic institution will re-

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ceive over the next funding period (next assessment occurs in 2021 for the period January 2014 to December 2020). Cross-collaboration will work best, if the needs of each discipline can be considered from the onset. The REF is conducted by the Higher Education Funding Councils for England (HEFCE), Scotland (SFC), and Wales (HEFCW) and the Department for the Economy, Northern Ireland (DfE), and assesses the quality of publications and other research outputs, in addition to the volume of research income the universities have reached, the impact this has made and the research environment that has been developed to be a conduit for this work. Often, to reach high quality, the work must be novel, internationally recognized, evidence-based and replicable, supported by funding and a positive research culture.

Fuse researchers, for which Sniehotta has an integral role, have been able to meet these standards, while also collaborating with public health, publishing over 390 peer reviewed papers between 2009-2014 with over 15,000 citations, showing a high level of dissemination from the work they are involved in. Its core funding is from the British Heart Foundation, Cancer Research UK, the Economic and Social Research Council (ESRC), the Medical Research Council (MRC) and the National Institute for Health Research (NIHR), achieving grants of over £210M. Those affili- ated to Fuse work with policy makers and practice partners in six research programmes: Early Life; Healthy Ageing; Behaviour Change; Complex Systems; Translational Research and Inequalities. Part of the research environment includes the successful completion of PhDs, and Fuse has funded 45 students through this process, adding to the capacity to engage in population-based, translational research.

The challenge going forward is to find ways to link behavioural science and public health together for mutual benefit, however, this equally pre- sents an opportunity. Methods of knowledge exchange used by Fuse include embedding researchers within the public health domain; funded PhD studentships, secondments, involvement of academics in local public health strategies, reviews of funding proposals, support for programme development, joint funding applications and the development of the NIHR School of Public Health Research. A rapid response and evaluation service was launched in 2013 which acts as a portal to broker across the five participating universities that Fuse is part of. This includes an initial free conversation to explore needs, matching enquiries to relevant academics. This has led to long-term working collaborations and has facilitated the flow of evidence into practice. An approach that could be replicated elsewhere.

Fuse has supported over 240 enquiries within a three-year period. The majority of enquiries have been from local authority public health teams (26%) and the voluntary and community sector (25%); and range from rapid service evaluations (31%), developing interventions (20%) and sign- posting (18%). The most common evidence needs are related to lifestyle interventions (27%), integrated health services (22%) and specific diseases (20%). Public health research conducted by the Fuse team includes work that has led to the remission of Type 2 Diabetes (Lean et al., 2017); reducing smoking behaviour in pregnant women (the babyClear© programme: Morgan et al., 2015); and reducing salt intake in takeaway food outlets (Goffe et al., 2016).

In conclusion, we need to see the challenges ahead in terms of population health with a wider lens, ensuring we co-create the interventions we commission, design, deliver and evaluate. We need to ensure multi-disciplinarity and reduce the risk of wasted resources and inequality of services. To achieve this, we need to embrace, in Sniehotta’s words, a ‘translational revolution’ between behavioural science and public health. The developing Behavioural Science and Public Health Network has a significant role to play in linking these disciplines together and supporting this agenda.

Written by Dr Angel Chater, Centre for Health , Wellbeing and Behaviour Change, University of Bedfordshire

References

Behavioural Insights Team. (2014). EAST: Four simple ways to apply behavioural insights. Behavioural Insight Team, Public Health England: London. Butland, B., Jebb, S., Kopelman, P., McPherson, K., Thomas, S., Mardell, J., & Parry, V. (2007). Foresight. Tackling obesities: future choices. Project report. London Dahlgren, G. & Whitehead, M. (1991). Policies and Strategies to Produce Social Equity in Health. Stockholm: Institute for Futures Studies. Engel, G. L. (1977). The need for a new medical model: a challenge for biomedicine. Science, 196(4286), 129-136. Goffe, L., Hillier-Brown, F., Doherty, A., Wrieden, W., Lake, A. A., Araujo-Soares, V., .... & Adams, J. (2016). Comparison of sodium content of meals served by independent takeaways using standard versus reduced holed salt shakers: cross-sectional study. International Jour- nal of Behavioral Nutrition and Physical Activity, 13(1), 102. Holland, G. J., Bignardi, G., Johnston, M., Kelly, M. P., Ogilve, D., Petticrew, M., … & Marteau, T. M. (2017). The TIPPME intervention typology for changing environments to change behaviour. Nature Human Behaviour, 1, 0140. Lean, M. E., Leslie, W. S., Barnes, A. C., Brosnahan, N., Thom, G., McCombie, L., ... & Taylor, R. (2017). Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. The Lancet, 391(10120), 541-545. Michie, S., Atkins, L., & West, R. (2014). The Behaviour Change Wheel: A Guide to Designing Interventions. Great Britain: Silverback Publishing Michie, S., Van Stralen, M. M. & West, R. (2011). The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implementation Science, 6(1), 42. Morgan, H., Hoddinott, P., Thomson, G., Crossland, N., Farrar, S., Yi, D., … & Campbell, M. (2015). Benefits of Incentives for Breastfeeding and Smoking cessation in pregnancy (BIBS): a mixed-methods study to inform trial design. Health Technology Assessment, 19(30). Sniehotta, F. F., Araújo-Soares, V., Brown, J., Kelly, M. P., Michie, S. & West, R. (2017). Complex systems and individual-level approaches to population health: a false dichotomy? The Lancet Public Health, 2(9).

6 HEALTH PSYCHOLOGY AND PUBLIC HEALTH Summer 2018 Volume 2, Issue 2

The application of behavioural science at Public Health England

Dr Tim Chadborn from the Public Health England Behavioural Insights Team (PHEBI) offers his perspective on the contribution of Behavioural Science to Public Health.

How does behavioural science contribute to im- Behavioural Analysis in a Digital Context proving public health? Digital interventions provide a powerful opportunity to drive individ- Changing behaviour is central to shifting public health outcomes. ual behaviour change across the public health domain. The PHE Traditionally, many approaches to behaviour change have existed Behavioural Insights team (PHEBI) was involved in the design and across a range of disciplines. Behavioural science synthesises in- ongoing development of Good Thinking, a pan-London digital well- sights from disciplines including social psychology, health psycholo- being service targeting the 2 million Londoners who experience poor gy and behavioural economics in an interdisciplinary approach mental wellbeing in a given year. This was created through user- which aligns theory, evidence-base and practice. As such, behav- centred co-design, with clear embedding of behavioural models to ioural science offers a method of understanding behaviour within a gain an understanding of the problem, target behaviour and the given content and developing and robustly evaluating interventions service user. Behavioural science was also used to inform the design geared towards shifting it. of supportive user end-to-end journeys, appropriate digital marketing, effective actionable content, and a robust evaluation pro- A behavioural approach cess. The beta phase of the site has seen >5,000 visitors per month, with 30% of visitors returning. A behavioural approach is based on the identification of the specific target behaviour, which may be distinct from both the public health Increasing application of Behavioural and Social problem and of the desired outcome. It requires clarity in definition Science across Public Health of the target individual/group or population and recognises that all behaviour exists as part of a system. Effective behavioural change is In order to increase the potential for positive changes to health dependent on understanding why a given behaviour is or isn’t oc- outcomes in public health interventions, PHE supports greater appli- curring. One way to conceptualise this is through understanding the cation of behavioural science research evidence, theory and meth- interaction between capability, opportunity and motivation (Michie, ods in public health service design and delivery. Indeed, PHE has van Stralen, & West, 2011). A behavioural diagnosis utilises a tool been working with the Association of Directors of Public Health, such as the Behaviour Change Wheel (Michie et al., 2011) to identi- Local Government Association, HPPHN and many other national fy which components of this interrelated system are the effective organisations to collaboratively develop a Behavioural and Social target and levers for change. This can be extended by incorporating Science Strategy for Public Health in England, which will soon be the associated theoretical constructs identified within the Theoreti- launched. This is intended to be the first word in a national conver- cal Domains Framework (Cane, O’Connor, & Michie, 2012) and sation about how we deliver the next revolution in public health mapped across to intervention functions and policy categories. Spe- practice and provides the first steps in a roadmap to get us there cific behaviour change techniques can then be selected in response together. We welcome all those interested to be part of that con- to this analysis (Ambler et al., 2011; Michie et al., 2013; Service et versation via the developing Behavioural Science and Public Health al., 2014). Network.

Strategic Behavioural Analysis References

Strategic behavioural analysis is a method of investigating the ex- Ambler T, Braeutigam S, Stins J, Rose S, Swithenby S, Bates B, et al. tent to which interventions in a policy area are addressing the key (2011). MINDSPACE: Influencing behaviour through public behaviours and drivers of behaviours, using appropriate behaviour policy. Available from: https: change techniques and interventions for delivery of those tech- www.instituteforgovernment.org.uk/publications/ niques. It combines a literature review to identify the behaviours mindspace (accessed 24 July 2018) and drivers of behaviour and can include effect sizes of intervention Cane J, O’Connor D, Michie S. (2012). Validation of the theoretical components and compares the results with an analysis of the be- domains framework for use in behaviour change and imple- havioural components of currently implemented national or local mentation research. Implementation Science, 7(1), 37. interventions. This reveals the extent to which the appropriate Michie S, Richardson M, Johnston M, Abraham C, Francis J, Harde- behaviours and drivers are being targeted and also the missed op- man W, et al. (2013), The behavior change technique taxon- portunities - intervention and policy options which are not being omy (v1) of 93 hierarchically clustered techniques: Building currently drawn upon but which would be expected to have an an international consensus for the reporting of behavior impact. change interventions. Annals of Behavioral Medicine, 46(1), 81–95. Michie S, van Stralen M, West R. (2011). The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implementation Science, 6(1), 42. Service O, Hallsworth M, Halpern D, Algate F, Gallagher R, Nguyen S, et al. (2014). EAST Four simple ways to apply behavioural insights. Available from: http:// www.behaviouralinsights.co.uk/wp-content/ uploads/2015/07/BIT-Publication-EAST_FA_WEB.pdf (accessed 24 July 2018)

7 HEALTH PSYCHOLOGY AND PUBLIC HEALTH Summer 2018 Volume 2, Issue 2

‘But the RCT shows it’s effective!’: Seven reasons why health commissioners may be reluctant to use your evidence-based and effective health intervention in practice.

Katherine E Brown PhD1, Kristina Curtis PhD1, Lou Atkinson PhD2

1Centre for Advances in Behavioural Science, Coventry University, and Public Health Warwickshire, UK. 2School of Life & Health Sciences, Aston University, UK

As the UK-based academic community steels velop and evaluate health promotion and be- erences, PHE annual conference, Health and itself for enlightenment about the specifics of haviour change interventions may need to plan Wellbeing Board conferences, or healthcare spe- the next Research Excellence Framework (REF), more effectively for their interventions to have cialism conferences). one aspect we are certain about is the increased impact. Included in the impact planning frame- importance that will be placed on impact of work that we set out was the need to include 2. Commissioners are often motivated by what research (e.g. see Lord Stern’s review published key stakeholders in the research from the out- works locally and addresses local need in July 2016). Given the gradual proliferation of set (Wallace et al., 2014). This is not a novel similar national research assessment systems idea, and indeed has been promoted in inter- Although academics and researchers are often (e.g. ERA in Australia; VQR in Italy and FCT in vention development frameworks such as in- impressed by the strength of evidence provided Portugal) it seems likely that an increased focus tervention mapping for many years by a well-designed randomised controlled trial on impact of research will only garner greater (Bartholomew et al., 1998; 2001; 2006; 2011; (RCT), the limitations of RCTs (particularly for sway going forward amongst governments 2016). If it can be achieved however, it is one public health interventions) have been well doc- worldwide. For anyone engaged in research of the best approaches for gaining interest in umented (e.g. Victora, Habicht, & Bryce, 2004). which focuses on the development and evalua- and the potential for implementation of inter- In particular, many evaluation designs including tion of health-related interventions, one kind of ventions by the public sector. RCTs ‘seek to eliminate contextual confound- impact they will likely hope for, and may plan to ers’ (May, Johnson & Finch, 2016; p1). Our re- achieve, is uptake and use by the target popula- Many of the best theory-and-evidence-based search has shown that health commissioners like tion of interventions they have developed. In interventions are developed by researchers evidence about what will work locally for their particular, where research funding has been and academics without partnership with com- own populations (Curtis et al., under review). invested in randomised controlled trials (or oth- missioners and other key stakeholders howev- They are interested in what worked elsewhere er methodologically robust evaluations) of inter- er, and in such circumstances, academics may for similar populations, and they like this to be ventions and they are shown to be effective and find promotion of their interventions to those presented in a more ‘anecdotal’ way than the cost-effective at addressing identified health that hold the public purse strings challenging. typical write up of a RCT or systematic review of problems, there is arguably a clear need for We have experience of seven years working such evidence. That is not to say that commis- those interventions to be brought into practice. embedded within a public health department sioners do not access and take account of formal and well over a decade’s experience of working evidence. They do, but often contextual, local There is it would seem however, a long road to in partnership with and delivering commis- factors and ‘real stories’ are simply more com- travel before we see routine application of sioned work for NHS trusts and public health pelling. Making links between the trial popula- theory and evidence-based interventions in departments. Based on this, and some of our tion from your own research and that of com- healthcare and public health practice. Evidence findings from research with health commis- missioners may help to promote your interven- of concern around this issue and the wider sioners and service providers assessing barriers tion. In addition, using qualitative evidence from issue of application of the knowledge base from to and facilitators of use of behavioural science participants and associated professionals (e.g. health psychology was highlighted at the 2016 evidence in the commissioning cycle (Curtis, from process evaluation work) will also support joint conference of the European Health Psy- Fulton & Brown, under review), we present the message that this will likely work for them. chology Society and the BPS Division of Health seven main reasons why health commissioners Psychology in Aberdeen. Here, there was an may be less than enthusiastic about evidence- 3. Local authorities and other public organisa- extremely well attended roundtable discussion based and effective health interventions tions may be fearful about digital solutions due that focussed on how to get health psychology brought to them by academics, and how aca- to Information Governance and data protection research more commonly used in policy-making demics might start to overcome these barriers. issues and practice. There was interesting and useful input from a range of panel speakers and audi- 1. Commissioners often act on what looks Many interventions to support health outcomes ence members, but a stand-out comment came good to them at the time of need are making use of the internet and the growing from Prof Mike Kelly, the former lead for the ubiquity of mobile technologies to support peo- National Institute for Health and Care Excel- Commissioning typically works in cycles with ple to improve health outcomes. The evidence lence (NICE) in the UK. Prof Kelly spoke about contracts of specified lengths and it will de- base suggests that digital interventions have the different world of policy-makers and the pend on where in the commissioning cycle huge potential to support health improvement different agendas and priorities at play. He they are as to how likely they will be to show and the preventive health agenda in areas that made the point that academics cannot expect an interest in an intervention. Understanding include sexual health (e.g. Bailey, Mann, Wayal policy-makers to come to them and simply something about how and when relevant com- et al., 2015), weight management (e.g. Sherring- accept their work and apply it. Instead, aca- missioners are looking to renew service con- ton, Newham & Bell et al., 2016) and smoking demics need to go to them, and seek to under- tracts may help to make timely and relevant cessation (Griffiths et al, 2016; in press; Loren- stand as well as influence policy-makers. approaches to them. This may mean looking catto et al., 2016). Our experience in public for ways to start meeting and engaging with health has shown that even when intervention At the end of the last REF period, Wallace, commissioners, and good places to start will development using digital technologies has been Brown and Hilton (2014), set out the case that include local and national professional confer- commissioned by Public Health, the broader health psychologists and those working to de- ences and learning events (e.g. BSPHN confer- organisational structures in which they reside

8 HEALTH PSYCHOLOGY AND PUBLIC HEALTH Summer 2018 Volume 2, Issue 2

(i.e. local authorities in England, but may equal- those who could potentially put it into practice. workshops focused on behaviour change and ly apply to other health and government organi- Even if you are not trying to draw income or evaluation skills training. Other regional PHE sations across the world) may mean there is profits from the roll-out, there may be costs departments will likely be keen to take similar resistance to uptake because of fears surround- associated with your approach or product that approaches to support the workforce in their ing data security and maintaining good infor- put it beyond the commissioners’ reach. It is area. In addition the BSPHN aims to promote mation governance. In the UK, breaching the important therefore that researchers consider collaboration between research and practice, so Data Protection Act (1998) and the more recent any potential cost implications at the planning get in touch, join our events, and get involved! General Data Protection Regulation (GDPR) can and development stage. mean huge fines for organisations, prison sen- All of this means that some of us need to get better at working in the middle-ground between tences for those at the top of such organisa- 6. Commissioners select service providers research and practice. Those who want to keep tions and huge reputational damage. Hence, they know and trust, or who have a demon- their careers focussed within academia can still caution on these issues is understandable. strable track record of delivery do this, but should link more often with academ- Seeking good advice and support from IG/IT data protection specialists on these issues and ics also working in practice or include practition- Employing an organisation that has previously ers, commissioners or other relevant members making sure that messages about the robust provided a good quality service (for that com- nature of data security and protection of identi- of the workforce in their research (e.g. on advi- missioner or elsewhere) reduces the risk that sory groups and steering committees). Academ- fiable data are included in communications with the commissioned service will be poor or not health commissioners is essential. ics should seek to understand a bit more about delivered to the desired specifica- the world of practice to which their work relates. tions. However, established providers may not For those working within the public health work- 4. Commissioners and others responsible for necessarily be knowledgeable about behav- force, their mission needs to be to seek out aca- what gets funded may not appreciate the ioural science or able to design or offer evi- demics interested in the application of their value of Evidence-Based behavioural or be- dence-based solutions. Rather, providers tend research in practice and teach them about what haviour change interventions to offer pragmatic solutions which fit the budg- it is they need from research as well as taking et and play to their strengths in service deliv- the opportunity to use their academic expertise. There are still many professionals working in ery. Where evidence-based, effective interven- Heads of departments and public health leaders healthcare and public health and in positions tions have been designed and tested by aca- also take note! We need you to support your of power with respect to “who holds the purse demics or via research trials, the originators of workforces to work in this way. strings” that know little about the behavioural such interventions rarely have the remit or sciences and the potential value they offer in ability to provide this as a service on an ongo- relation to improving health and wellbeing ing basis, leaving commissioners wishing to References outcomes. When you work in this field it can deploy that intervention to find a reliable pro- be difficult to fully appreciate the perspective vider who is willing to adopt and deliver some- Bailey J, Mann S, Wayal S, et al. (2015). Sexual that politicians, policy makers, epidemiologists, one else's intervention. This is not only more health promotion for young people difficult to achieve but adds an extra element medics and the whole host of others who may delivered via digital media: a scoping of uncertainty and risk for both provider and hold power to make or break the translation of review. Southampton (UK): NIHR Jour- your work into practice have. Often they will commissioner. For these understandable rea- nals Library; 2015 Nov. (Public Health be focussed on outcomes alone (e.g. have we sons, commissioners are often reluctant to risk reduced sexually transmitted infections?; Did their limited budgets on potentially ground- Research, No. 3.13.) Available from: we reduce hospital admissions?; Did we in- breaking solutions with no track record in the https://www.ncbi.nlm.nih.gov/books/ crease flu vaccinations?) and have little appre- ‘real world’. Partnering with service providers NBK326984/ doi: 10.3310/phr03130 through the intervention development process ciation of the behavioural factors at play and Bartholomew Eldrigde, L. K., Markham, C. M., and conducting pragmatic trials (where inter- the size of the scientific evidence base that can Ruiter, R. A. C., Fernàndez, M. E., Kok, help to illuminate and facilitate actions that ventions are delivered to ‘real’ patients and G., & Parcel, G. S. (2016). Planning will influence that behaviour. Even those with service users), may create the necessary path- health promotion programs: An Inter- good appreciation of this field of work will way to implementation and increase estab- likely have a whole host of other priorities lished service providers’ knowledge and com- vention Mapping approach (4th ed.). baying for their attention when it comes to petence to deliver services which maximise the Hoboken, NJ: Wiley. decision-making. As behavioural scientists we potential for behaviour change. Bartholomew, L. K., Parcel, G. S., Kok, G., hold a collective responsibility to work on our Gottlieb, N. H., & Fernández, M. E. ‘comms and marketing strategy’, and consider 7. Commissioners are sometimes reluctant to (2011). Planning health promotion how we communicate the value of what we do approach academics for support programs: An Intervention Mapping to those who sit outside, but are working alongside, our discipline. have a whole host of approach (3rd ed.). San Francisco, CA: Our research with commissioners indicates that other priorities baying for their attention when Jossey-Bass. they feel more comfortable in approaching a it comes to decision-making. As behavioural Bartholomew, L. K., Parcel, G. S., Kok, G., & healthcare professional compared to an aca- scientists we hold a collective responsibility to Gottlieb, N. H. (2006). Intervention demic for information and support (Curtis et work on our ‘comms and marketing strategy’, al., under review). Some report negative expe- Mapping: Designing theory and evi- and consider how we communicate the value riences of communicating with academics. It is dence based health promotion pro- of what we do to those who sit outside, but important therefore, that commissioners’ per- grams. San Francisco, CA: Jossey-Bass. are working alongside, our discipline. ceptions of academics are changed to increase Bartholomew, L. K., Parcel, G. S., Kok, G., & their approachability. Increasing our ‘user- Gottlieb, N. H. (2001). Intervention 5. Cost-effective may still not be affordable friendliness’ will help. For example in the West Mapping: Designing theory and evi- Midlands, PHE have been working as a conduit dence based health promotion pro- Even if the RCT results show that an interven- bringing together academics from local univer- tion is not only effective but cost-effective, it sities and those from public health depart- grams. Mountain View, CA: Mayfield may remain outside the budget constraints of ments and third sector providers to engage in Publishing.

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Bartholomew, L. K., Parcel, G. S., & Kok, G. Griffiths, S. E., Parsons, J., Fulton, E., Naughton, Stern, N (2016). Research Excellence Frame- (1998). Intervention Mapping: A pro- F., Tombor, I. & Brown, K. E. (2018). Are work Review: Building from success cess for developing theory- and evi- digital interventions for smoking cessa- and learning from experience. Availa- dence based health education pro- tion in pregnancy effective? A system- ble at: https://www.gov.uk/ grams. Health Education and Behav- atic review and meta-analysis. Health government/publications/research- ior, 25(5), 545–563. Curtis, K., Fulton, E., & Brown, K. E. (under re- Psychology Review https:// excellence-framework-review view). Factors influencing application doi.org/10.1080/17437199.2018.1488602 Victora, C. G., Habicht, J-P., Bryce, J. (2004) of behavioural science evidence by May, C.R., Johnson, M., & Finch, T. (2016). Im- Evidence-Based Public Health: Moving public health decision-makers and plementation, context and complexity Beyond Randomized Trials, American practitioners, and implications for Implementation Science 11, 141 https:// Journal of Public Health 94 (3), 400- practice. Preventive Medicine Re- doi.org/10.1186/s13012-016-0506-3 405. DOI: 10.2105/AJPH.94.3.400 ports Wallace, L.M., Brown, K.E., & Hilton, S. (2014). Griffiths, S., Brown, K. E., Fulton, E. Naughton, Sherrington, A., Newham, J. J., Bell, R., Ad- Planning for, implementing and as- F. & Tombor, I. (2016). Are digital amson, A., McColl, E., & Araujo-Soares, sessing the impact of health promo- interventions for smoking cessation V. (2016). Systematic review and meta- tion and behaviour change interven- in pregnancy effective? A systematic analysis of internet-delivered interventions: a way forward for Health Psy- review protocol. BMC Systematic tions providing personalized feedback chologists. Health Psychology Review, Reviews 5:207 DOI: 10.1186/s13643- for weight loss in overweight and obese 8(1), 8-33. 016-0390-6 adults. Obesity Reviews, 17, (6), 541- 551. https://doi.org/10.1111/obr.12396 DOI:10.1080/17437199.2013.775629

The HPPHN 2018 conference: reflections of a trainee health psychologist

The fourth annual Health Psychology in Public ago – but being right isn’t enough. Behavioural provement and reduced health inequalities, I Health conference – ‘The Role of Behavioural science is needed to understand the complex would reinforce another layer of collaboration Science in Public Health: Application and Im- psychosocial environments in which people to Prof Sniehotta’s call to action – namely, the pact’ – was held on 28th February 2018 and live, the choices that people have available to value of cross-collaboration between trainees hosted by the Hertfordshire Development them and that they subsequently make, and of each discipline. Collaboration between pub- Centre in the town of Stevenage, Hertford- how we can best support and engage them lic health and behavioural science trainees and shire. The audience was an interdisciplinary towards a health-promoting future. Closing early career researchers will help to embed the mix of scholars, students and practitioners the health gap isn’t just about healthcare – it’s multidisciplinary approach on the first step of working in a range of applied areas. The event about behaviour. This one-hour call to realise the career ladder, recognising the value of co- also attracted an unexpected guest – the the contribution of behavioural science for creation across discipline boundaries at the ‘Beast from the East’, bringing snowfall to population health was as provocative as it was earliest opportunity. Stevenage and mild travel chaos (I was due to enjoyable. return to the East coast of Scotland the following morning. It took 4 days). The aim of the Testimony to the multidisciplinary make-up of Conference lunches are the opportune mo- conference was to explore the mutual goals the network, a health psychology keynote ment for catching up with familiar faces and and challenges of Behavioural Science and followed, as did the Twitter rush with the networking with new ones – the HPPHN lunch Public Health and to share best practice with hashtag #hpphn. Falko Sniehotta, Professor of didn’t fail in fun or flavour. The bustling room others in the Network working across these Behavioural Medicine and Health Psychology was alive with intellectually stimulating con- two spheres. It was my first time attending a at Newcastle University, presented on the versation, debate and introductions. In paral- HPPHN conference since joining the Network. need to develop and apply translational be- lel, delegates were treated to an array of post- havioural science to improve population ers showcasing innovative applications of The event opened with a welcome address health and reduce inequalities. In order to Health Psychology practice and research in from the Chair of the HPPHN, Dr Angel Chater, minimise service inequalities and maximise Public Health. A staple of many conference who reaffirmed that the goals of health psy- intervention success, Prof Sniehotta called for programmes, I enjoy shuffling between poster chology and public health are aligned – to co-creation and cross-collaboration between presentations for the opportunity they provide maintain health, prevent illness, treat disease public health and behavioural science profes- to quickly learn about new science and new and develop effective healthcare systems – sionals, encouraging a two-way dialogue be- collaborations in an often fun and creative and called on delegates to open up a dialogue tween academia and practice for mutual bene- presentation. It’s where science met design at in order to collectively achieve these mutual fit. Having straddled academia and public the HPPHN conference. Prize-winning posters aims. A public health keynote from Duncan health settings myself, I found his argument showcased the broad impact of behavioural Selbie, Chief Executive of PHE, was first on the compelling and honest with regard to the science to public health challenges, including programme. In his keynote, Mr Selbie gave challenges that both face. Equally, his argu- the reduction of dog fouling in public areas recognition to the pivotal role of behavioural ment to recognise the pivotal role of frontline (Hargreaves et al); increasing access to, or science in closing the health inequalities gap, staff and service users in the co-creation of uptake of, physical health screening in people ensuring that healthy choices become the easy health improvement interventions with a view with severe mental illness (Lamontagne- choices and that people (and subsequently, to understanding the complex pattern of hu- Godwin et al); and developing behaviour retailers) are nudged in the right direction to man behaviour and to having maximal impact, change competence in staff delivering commu- make (and provide) healthy choices. In line is a foundation of my personal practice. nity-based healthy lifestyle services (Atkinson with my own work, he reflected that the evi- et al). I hope to present some of my own re- dence for tobacco harm was known decades When it comes to collaboration for service im- search and intervention work undertaken as

10 HEALTH PSYCHOLOGY AND PUBLIC HEALTH Summer 2018 Volume 2, Issue 2 part of my NES Stage II training at next year’s conference.

Lunching, networking and poster perusal done; afternoon workshop to follow. Dr Amanda Bunten and Dr Tim Chadborn from PHE co-presented on a new behaviour and insights strategy for public health and Prof Katherine Brown from Coventry University presented passionately on the application of behavioural science to public health priorities. Collectively, they spoke of a marriage between behavioural science and public health that has given birth to choice architecture experiments in public sector food The conference closed with an open discussion complementary training routes once a year for environments (health improvement), adap- on the future of the HPPHN, including possibili- our collective endeavour of improving population tations to existing care pathways to increase ties of extending the network and a democratic health. At the same time, I ask the BSPHN to engagement with a stop smoking in pregnan- decision on a new name and branding that consider funded places at future conferences, cy service (health improvement), and trials would reflect its broader reach, beyond health thereby removing barriers to shared learning and to reduce inappropriate prescribing of antibi- psychology. This is an interesting crossroads for collaboration among trainees at the early stages otics and risk of antimicrobial resistance the network and one that I’m excited to be a of their careers. (health protection), to highlight a few exam- part of as I personally identify with the broader ples. In showcasing case studies of good behavioural science remit that the network is I’m grateful to the conference organisers for a practice, presenters acknowledged that iden- expanding into. stimulating and enjoyable day and I look forward tifying the behaviour to change isn’t easy. to reconvening with faces old and new in 2019; Indeed, behaviour change isn’t easy. The Based on my experience, I would highly recom- and, dare I say, to better weather. presenters called for a systems-based ap- mend the next BSPHN conference to Stage I and proach, involving a range of stakeholders Stage II health psychology trainees and to post- and partners, in order to effectively map out graduate students in public health. Attendance Written by Emma N. Wilson BSc (Hons) MSc. a behavioural pathway for intervention that encourages trainees to forge relationships early MBPsS is rigorous, feasible and impactful. in their careers and bring together our two

What makes a winning poster? Dr Wendy Lawrence and Dr Mary Barker from the University of Southampton judged the poster presentations at this year’s conference. Here they give us some insight into the thinking behind the judging and what makes a winning poster…..

As the scientific sub-committee we had the Colour – ensure you’ve used eye-catching col- Title – grab your audience’s attention. honour and privilege of judging the posters at our combinations, without looking like an ex- this year’s HPPHN annual conference in Steven- plosion in a paint factory! age. It occurred to us as we spoke to some of the presenters during and after this process that it might be useful for us to reflect on this Our winning poster (No. 1) used eye- experience and provide some general feedback catching yellow to stand out against on what it takes to produce a good poster. Get the crowd and illustrations to repre- it right, and you’ll engage with a larger audi- PRISMA flow diagram in one ence potentially leading to opportunities for sent their sign-posted dog walking of our runners-up posters further research, funding and collaboration so it route intervention. is an important skill to develop. We hope that (No. 2) nicely breaks the text, The authors also included one short the practical tips and advice below are helpful reassuring the reader at first sentence under the title that presented for when you next need to present your work in glace that they will be able the main finding, which we thought this way. to follow the detail of this was a really good technique for getting study So what does make a good poster? We believe our attention it comes down to three overarching factors: impact, content and presentation. We will be using some examples from the prize-winning posters to illustrate our key points. See poster No. 1 Impact Pictures and graphics – use plenty of appropri- See poster No. 2 ate photos, pictures and graphs If no-one stops to read your poster amongst a sea of posters, then it doesn’t matter how im- Text – don’t overload your poster with small, portant the work is or how well you’ve laid out tightly-packed text … that can be very off- your poster! So how do you make your poster putting to your potential audience. “Embrace stand-out across a crowded room? the space”!

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Content Font size and colour contrasts – if the session is busy, people will be trying to read your poster “Without science it’s all just fiction” – we saw from a distance, so be kind! Make the font a Using boxes to present the results on that quote at a rally to support science funding decent size and a good contrast in colour and like to share it with our colleagues at every against its background. poste NO. 3 was an excellent way of opportunity! A good poster needs to clearly making these stand out and easy to present the research being undertaken, digest. demonstrating scientific rigour in a range of All our winning posters used a good size ways: block font against a pale background, with No. 3 also using white against dark back- A succinct but powerful rationale for the study See poster No. 2 ground to contrast their results. These are classic choices and generally work well. Be wary of choosing unusual colour back- See poster No. 3 In one of our runner-up posters (No. 3) ground, where the text can disappear the authors neatly aligned the project against particularly light or dark sections. Many of the posters on the day got much of aims (to increase staff confidence and this right, making our decisions hard to competence as behaviour change practi- make. There was some good use of photos tioners) to NICE guidance and recom- Headings – conferences often provide instruc- and coloured images to illustrate from a mendations tions on which headers to use, so always follow distance what the poster was about. Some these. But it’s fine to use additional ones to used arrows to guide the reader which is illustrate key separate sections of your poster another good strategy to improve the flow. to which you want to draw people’s attention. Finally, don’t be afraid to think outside the box. We have seen posters with interactive In our winning poster the public health Flow – make it easy for your reader to follow elements (pinned on spinning wheels for your story from start to finish. It’s frustrating risk of dog fouling was highlighted as example) which got conference delegates well as the increasing use of behaviour- when your eyes are skipping about trying to very excited and engaged with the real science, rather than education and decide which way to read a poster, or when you search. have just a few minutes to find the key points. enforcement, to discourage undesira- Many congratulations again to our winning ble behaviour posters (detailed below) and thanks to everyone we spoke to during our poster- judging session – it was a pleasure to meet Enough detail in the method to convey what Our two runners up posters (No.2 & 3) you all. Good luck with future posters! was done and how used simple top-to-bottom design, which makes it very easy for the reader to fol- Prize-winning posters: In poster NO 3. the authors presented low the story. It means that if the reader the design of their study in an easy-to- is in a rush, they can quickly find and The Big Scoop: A behaviour change inter- follow chronological order. Thus the absorb the information they’re most vention to reduce dog fouling in public area reader can effortlessly understand what interested in—eg skipping straight to the was done before, during and after the conclusion calling for better coordination J Hargreaves et al (No. 1) intervention. with primary care to improve physical Interventions to increase access to or up- health screening in people with severe take of physical health screening in people Brief reflection to demonstrate the novelty, mental illness. with severe mental illness: a Realist Review importance and interest of the research F Lamontagne-Godwin et al (No. 2) Boxes and bullets – good use of these can help In the winning poster, the authors re- with all the above points Developing behaviour change competenc- flected on the additional (unforeseen) es in staff delivering community-based outcome of increased outdoor use, healthy lifestyle services highlighting potential health benefits of this unexpected finding. L Atkinson et al (No. 3) All three posters used bullet points to some extent in differ- Presentation ent sections. This is and excellent strategy to break up large We’ve already highlighted the important fac- chunks of text so can be used tors to get a delegate to cross the room to look throughout your poster at your poster. But once you have their attention, you want to keep it, so you need to make your poster easy to read and digest by focusing on how you present your work.

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Poster No. 1

Poster No. 2

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Poster No. 3

14 Confirmed Speakers

Professor Jane Ogden Professor in Health Psychology, University of Surrey

Professor Jim A BEHAVIOURAL SCIENCE AND PUBLIC McManus HEALTH NETWORK AND THE BPS DIVISION OF Director of Public Health, HEALTH PSYCHOLOGY JOINT EVENT Hertfordshire County Council CPD EVENT Rebecca Harkin WRITING FOR IMPACT: PUBLICATION, Publisher, Psychology and Edu- POLICY AND MEDIA cation, Wiley

Join us for this great event and net- What’s the difference between a working opportunity! scientific report, a policy making 09.30am—4.30pm report and an article? 28th September 2018 How would you write for politi- Farringdon Room, St Bride Founda- cians and senior decision- tion, Bride Lane, Fleet Street, London makers? EC4Y 8EQ This workshop will help you un- Nearest underground station is Blackfriars derstand your own assets, adapt

Agenda View the agenda for this event your writing style and give you some tools and tactics for Booking link - Writing for Impact: Publication, writing for different audiences. Policy and Media. Tickets, Fri, 28 Sep 2018 at 09:30 | Eventbrite

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FRIDAY 28th SEPTEMBER 2018

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Meet the Team! Following the Annual General Meeting on 28th February 2018, we’d like to introduce you to the new HPPHN (soon to be BSHPN) Committee for 2018-19.

Dr Angel Chater Neil Howlett

Chair Treasurer

Dr Angel Chater is a Chartered Psychologist, an Associate Fel- Neil Howlett is a Research Fellow in the Department of Psy- low of the British Psychological Society (BPS) and a Registered chology and Sport Sciences at the University of Hertfordshire. Health Psychologist and Sport and Exercise Psychologist with His research focus is behaviour change, with particular exper- the Health and Care Professions Council (HCPC). She is a tise in physical activity. Neil is currently finishing a PhD which Reader in Health Psychology and Behaviour Change at the has involved designing, implementing and evaluating the Ac- University of Bedfordshire, situated within the Institute for tive Herts programme using evidence-based behaviour change Sport and Physical Activity Research (ISPAR) where she leads techniques and the COM-B model of behaviour. He is also Prin- the Centre in Health, Wellbeing and Behaviour Change. She is cipal Investigator on both Department of Health and Lottery- also an Honorary Senior Lecturer in Health Psychology and funded evaluations of a programme aimed at parents of chil- Behavioural Medicine at UCL School of Pharmacy and a dren who are at risk of obesity for the charity HENRY. Addition- Course tutor to UCL Centre for Behaviour Change’s Summer ally, Neil supervises several undergraduates and postgradu- School. In her roles, she integrates health psychology into ates. Neil’s role as Treasurer (previously, Conference Organis- non-psychology curriculum, CPD training and applied health er) involves processing invoices and guiding network strategy research, with a focus on communication skills, behaviour on the Executive Committee. change interventions and adolescent health. She is the UK National Delegate for the European Health Psychology Society (EHPS). She is passionate about the scientific application of behavioural science to public health and its role in intervention design.

Stefanie Williams

Publicity and Liaison Chair

Dr Stefanie Williams is a Chartered Psychologist and is Re- Jim McManus search Fellow at the Centre for Advances in Behavioural Sci- ence (CABS) at Coventry University. Stefanie completed her Chair Elect PhD in Health Psychology in 2015, investigating the role of self- efficacy in changing lifestyle physical activity behaviour. The Jim McManus is a Chartered Psychologist and Associate Fel- focus of her research has been on the development and evalu- low of the British Psychological Society and is Director of Pub- ation of theory-based interventions for changing physical activ- lic Health for Hertfordshire. He is Visiting Senior Clinical Fellow ity and other weight-related behaviours. Stefanie has had over at the University of Hertfordshire and a Visiting Research Fel- 10 years’ experience collaborating with public health depart- low at Heythrop College, University of London, working on the ments across the West Midlands and Warwickshire on a range links between psychology, health and faith. He is a Member- of projects. She is passionate about the translation of behav- ship Secretary of the Association of Directors of Public Health ioural science into public health practice, and particularly its and co Chair of the British Psychological Society’s Cross Divi- role in supporting the efficient design and delivery of new and sional Network on Applied Psychology in Public Health. Jim existing public health services. Stefanie is delighted to have has worked on public health projects in the voluntary sector, joined the network as a co-opted member, and looks forward NGOs, commercial sector, NHS and local government since to increasing awareness and further development of the net- 1990. He is committed to realising the benefits health psychol- work in her new role as Publicity and Liaison Chair. ogy can bring to population health. Outside work his interests are Scots history, languages and powerlifting.

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Sophie Dawson Michelle Constable Publicity & Liaison Officer Secretary – Universities

Michelle Constable is a Health Psychologist in Training based Sophie has recently completed an MSc Health Psychology de- in the Public Health Service at Hertfordshire County Council gree at the University of Nottingham, whilst working as Clinical and undertaking a Professional Doctorate in Health Psycholo- Product Executive for a digital health app company. She has a gy at University of the West of England. The focus of her work range of experience working in the healthcare industry across in public health has been in the field of smoking cessation and the public, private and third sectors. Sophie worked for nearly she is currently leading on a number of county wide initiatives four years at the Stroke Association as Information, Advice & mainly focusing on the self-management of long term condi- Support Co-ordinator for North Derbyshire. During this time, tions, which is also the focus of her research. A founder mem- Sophie led on several successful projects, including the devel- ber of the Health Psychology in Public Health Network, she is opment of a new stroke support group for stroke survivors and currently Committee Secretary responsible for membership, carers and a series of mindfulness sessions. Sophie has recent- reporting and supporting all aspects of Network development. ly started working as Local Lead for System Optimisation, Be- haviour Change & Quality Improvement for a NHS National Innovation Programme. Within the HPPHN, Sophie’s role as Publicity & Liaison Officer – Universities is to promote the HPPHN to academics and students working in the fields of health psychology and public health at universities across the country. She is looking forward to meeting people from a range of disciplines and hopes to expand the network across the UK.

Katherine Brown

Editor-in-Chief

Katherine is Professor of Health Psychology Applied to Public Health and leads the Health Behavior and Interventions Re- search team at the Centre for Advances in Behavioral Science at Coventry University. She is a Chartered Psychologist, a full member of the DHP and a Registered Health Psychologist Emma Wilson (HCPC). Katherine has held a joint post with Public Health Warwickshire since 2011, works closely with a number of pub- Senior Editor (co-opted) lic health departments in the Midlands region and has an honorary contract with PHE. Katherine's work has focused around the development and evaluation of interventions targeted at Emma is a NHS Education for Scotland Trainee Health Psy- preventive health behaviors. Her research began in the field chologist, based in NHS Tayside Directorate of Public Health. of sexual health, and has since expanded to include the chal- The focus of Emma’s training is using behavioural science to lenges of obesity, smoking cessation and low breastfeeding improve smoking cessation/reduction rates in acute psychiatric rates. She has published widely and contributed to a number settings and to healthy weight promotion in adults with learn- of national strategies, including the female genital mutilation ing disabilities. She is passionate about applying health psy- care pathway for the Department of Health. Katherine has chology research and theory in meeting public health priorities recently assumed the role of Editor-in-Chief of this publication and promoting the science as a necessary foundation to im- and is ambitious about mobilizing the evidence base from proving population health. In parallel, Emma remains fervent health psychology into public health commissioning and prac- about the need to involve service users and frontline staff in all tice. aspects of her research and intervention work. Emma completed her MSc Health Psychology in 2016 at the University of Bath and has previously collaborated with academics, practitioners and local government in a number of research roles. Emma is delighted to have joined the committee as Assistant Journal Editor and looks forward to further promoting the Network where she lives in Scotland.

17 HEALTH PSYCHOLOGY AND PUBLIC HEALTH Summer 2018 Volume 2, Issue 2

Meghan Linscott Lou Atkinson Conference Organiser Conference Chair

Meghan is a Health Psychologist in Training at Staffordshire Dr Lou Atkinson has been conducting applied research in the University, currently working across Public Health and Planning fields of obesity and physical activity for over a decade. Hav- within Stoke-on-Trent City Council. Meghan is excited to be ing worked with individual and corporate clients in the health working in Healthy Urban Planning, a new arena for Health Psy- and fitness industry, she completed her MSc Health Psychol- chology. Her work is wide ranging and includes using behav- ogy in 2007 and was employed as a researcher at Coventry ioural science to influence the design of the build environment University from 2008 to 2017, during which time she also to enhance physical activity, active travel and the lives of indi- completed a PhD in Health Psychology entitled “A multi- viduals living with dementia. Meghan’s previous experiences perspective examination of women’s engagement with include supporting Stroke Survivors with an app-based inter- weight management behaviours and services during preg- vention, working within disadvantaged communities, managing nancy.” Alongside delivering research studies and consultan- experiences of health and social care services and supporting cy projects for a variety of health-related organisations, Lou students experiencing eating disorders/difficulties. She would also completed a one year secondment as an embedded eventually like to move back to working 1:1, in long-term condi- health psychologist in a public health team. Lou joined Aston tion management. Meghan thoroughly enjoys events, both of a University as a Lecturer in Psychology in 2017 where she con- personal and professional nature and is very passionate about tinues to develop her research into weight management, moving Health Psychology forward as a profession. Meghan is dietary and physical activity behaviours in pregnancy, and in delighted to be a part of the Network. childhood obesity, particularly around parental engagement with family weight management services and the National Child Measurement Programme. Lou is excited to join the committee as Conference Chair.

Mary Barker

Scientific Sub-committee Chair

Tiffany Palmer Mary Barker is a Professor of Psychology and Behavioural Sci- CPD Chair ence at the Medical Research Council Lifecourse Epidemiology Unit, Faculty of Medicine, University of Southampton. She co- leads the Behavioral Science theme for the NIHR Southampton Tiffany Palmer is a Health Psychologist in Training based in a Biomedical Research Centre and directs the Centre for Public Community Learning Setting delivering Health and Well- Collaboration and Participation in Health Research. Her main being sessions both within an adult college, and as outreach research interest is in understanding and supporting behaviour in various locations in Southend-on-Sea. Tiffany works as a change, primarily to improve nutritional status before concep- consultant for agencies concerned with seafaring, and sits on tion and during pregnancy and so address the public health an expert panel for the International Transport Federation. implications of the developmental origins of health and disease. Her research focus is the impact of loneliness on the psycho- Mary runs a programme of work aiming to engage teenagers logical general well-being of seafarers, and whether this is and young women in improving their diets physical activity hab- mediated by their self-efficacy. Tiffany is keen to develop and its, using a combination of one-to-one support from health and deliver CPD opportunities that bridge behavioural science social care professionals and digital sources which include and public health. smartphone games. Her role on the committee is to lead on the scientific input to the annual conference, including assessing abstracts and judging posters, and to BSPHN publications.

18 HEALTH PSYCHOLOGY AND PUBLIC HEALTH Summer 2018 Volume 1, Issue 2

Meet our Honorary Fellows!

Duncan Selbie, Chief Exec, Public Health England

Professor Kevin Fenton, Director of Public Health, Southwark London Borough Council Wendy Lawrence Dr Andrew Furber, President, Association of Directors Scientific Sub-committee (co-opted) of Public Health

Professor Simon Capewell, Trustee, Faculty of Public

Health Wendy Lawrence is Associate Professor of Health Psychology at the MRC Lifecourse Epidemiology Unit, University of South- ampton, and the BPS Division of Health Psychology’s Practition- Professor Eugene Milne, Editor, Journal of Public Health er sub-committee Lead. Her research interests cover all as- and Director of Public Health, Newcastle City Council pects of health improvement, with a particular focus on trans- lating research observations into activities to bring about be- Professor Marie Johnston, Professor Emeritus of Health haviour change to improve population health. Wendy has led Psychology, University of Aberdeen the development and delivery of a training intervention, “Healthy Conversation Skills”, to front-line practitioners to ena- Professor Susan Michie, Director of the Centre for Be- ble them to better support people to make sustainable behav- haviour Change, University College London iour changes. The training has been commissioned by agencies in the UK and internationally to support workforce development and improvements in population health. It is being used Professor Falko Sniehotta, Centre for Translational Re- as one mechanism of delivery of Health Education England’s search in Public Health, Newcastle University work to meet the UK government’s Making Every Contact Count agenda, with Wendy acting as consultant and advisor to Professor Tony Cassidy, Ulster University HEE (Wessex). In addition, Wendy has led the delivery, roll-out and evaluation of the training overseas. Her role on the com- Professor Chris Armitage, University of Manchester mittee is to provide scientific input to the annual conference, including assessing abstracts and judging posters, and to Professor Jane Ogden, University of Surrey BSPHN publications. Professor Viv Swanson, Reader in Health Psychology, University of Stirling

Dr Jo Hart, Reader in Health Professional Education,

University of Manchester

Dora Kukucska Follow us on: Journal team

Dora obtained her BSc in Psychology in 2015 and an MSc in www.facebook.com/hpphn Health Psychology in 2016. She is currently completing her Pro- fessional Doctorate in health psychology. Dora has worked on a variety of research projects as a research assistant since her undergraduate studies, these have included personality testing, www.hpphn.org.uk exercise and obesity and adolescent drinking related projects. Currently she is employed as a research assistant in the Active Herts project, which is aimed at getting people suffering from www.twitter.com/newshpphn obesity and/or mental health issues and comorbid diseases more active in the Hertfordshire area, in Hertsmere, Brox- bourne, Watford and Stevenage in particular. As part of her Search for: health psychology doctoral training, she also teaches Public Health and Health in public health Psychology as a Visiting Lecturer at the University of Bedford- shire.

19 Two HPPHN bursaries are available to support two individuals to attend our event HEALTH, WELL-BEING & BEHAVIOURAL SCIENCE; BUILDING SUCCESSFUL PARTNERSHIPS/ 27th February 2019 / BIRMINGHAM. These bursaries cover the event registration fee (including catering) and up to £50 towards the costs incurred by the recipient to attend the full event (excluding accommodation).

Only signed bursary applications submitted using this form by 28th November 2018 5pm will be considered. Once complete, please send your application to [email protected].

As there is healthy competition for a bursary place, should your application be unsuccessful, we will still offer you the opportunity to purchase a ticket to attend the event, at the early bird rate. When you send in your bursary application, please inform us if you would like this option, so we can set up a unique Eventbrite ticket for you.

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20 In no more than 500 words, please tell us why you believe you should be awarded the HPPHN Bursary.*

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By signing this form, you confirm the information disclosed is true and accurate to the best of your knowledge. By signing this form, you also agree to provide a short written piece about the event for HPPHN newsletter, should you be awarded the bursary.

21 The HPPHN Committee will judge application. The successful application will be noti- fied at least two weeks before the day of the event. Monies will only be transferred to award holders after their attendance at the event and the submission of a written piece.

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END