National Prevention Research Partnership: Actionable Strategies for NCD Prevention

1. UK Prevention Research Partnership Professor Dame Sally Macintyre Chair, UKPRP Expert Review Group and UKPRP Scientific Advisory Board 24 September 2019

2. Why prevention? • Under investment in prevention research across the UK • The need to address the burden and costs of non-communicable diseases (NCDs) in the UK • Cost effectiveness of prevention • Common drivers of NCDs, therefore co-benefits of acting on those drivers • The need to develop realistic, actionable, sustainable approaches to NCD prevention • Recognising that research funders should work together to address problems beyond their individual remits

3. National Prevention Research Initiative (NPRI) • Four funding calls between 2005 and 2011 • £34m supported 74 primary prevention research projects • Focused on alcohol, smoking, diet and physical activity • NPRI 2015 review identified a need to: • focus on population-level interventions • work on the cost-effectiveness of prevention strategies • solve problems rather than simply describing them • understand the mechanisms of action • improve health where need is disproportionate: mental health, low SES, minorities

4. Academy of Medical Sciences 2016 report • Report emphasised the importance of prevention research • Identified challenges and opportunities for research into preventing NCDs and reducing inequalities in health • Considered different environments which influence health and health behaviours • Identified limitations of current biomedical approaches to solving major prevention problems • Recognised that multi-disciplinarity and systems-levels approaches needed

5. The Partnership • UK charities, UKRI Councils and health and social care departments • Invest £55m over 6-7 years (through 2 funding calls) • Covers physical and mental health and wellbeing in the UK

6. Objectives • Produce robust new knowledge about actionable, cost effective and scalable ways to improve population health and reduce inequalities in health • Provide substantial long-term investment to bring together a wide range of disciplines and stakeholders to build multidisciplinary teams focused on the primary prevention of NCDs • Enable change within complex systems to prevent NCDs • Co-develop ideas and research programmes with end users • Capitalise on emerging technologies, big data etc. • Support methodological innovation • Promote coordination of prevention research across funders

7. Focus • NCDs, not infectious disease • Upstream, population level, determinants • Primary prevention • Best ways of modifying common drivers for a number of NCDs • Solving problems rather than describing them • Improving the development and evaluation of preventive strategies • Understanding issues of transferability: context, settings, environments • Improved targeting • Cost effective, scalable and sustainable solutions • Reducing health inequalities • Studying existing as well as proposed new preventive strategies

8. Prevention research post-NPRI: focus on upstream health determinants

9. Upstream influences and complexity Swinburn et al. (2011) The Lancet 378 (9793): 804-814

10. Inter-disciplinarity • Developing effective preventive strategies requires understanding complex systems and their inter-linkages • UKPRP believes this can best be achieved through interdisciplinary research • UKPRP keen to see genuinely multidisciplinary teams, if appropriate bringing in disciplines not typically engaged in disease prevention research • The Partnership is not prescriptive about what disciplines should be included • Disciplinary mix should be appropriate to the research question

11. Co-develop research programmes • Co-develop ideas, research questions, evidence and implementation of strategies to maximise impact • Users of evidence and those with experience of implementing interventions, e.g. • Local Authorities, Local Government Association • Government Departments / Agencies • Third sector, civil society groups – charities and professional groups • Practitioners • Communities • Industry • Co-development with users is essential and should be appropriate to the work

12. Methodological approaches • Funded groups can use and/or develop a diverse range of methods • Methods must be appropriate to the research questions • Systems thinking and systems science approaches particularly welcomed • Exploiting digital technologies, social media, or large-scale datasets

13. Knowledge brokering • Knowledge transfer and exchange will be an integral aspects of the UKPRP: • to enable the transfer of outputs into policy and practice • to foster the development of long-lasting relationships between researchers and users • Mechanisms must be appropriate to the topic

14. Call 1 – outcome (consortia)

15. Call 1 – outcome (networks)

16. Call 2 – Scope; Particular priorities Aim to have a balanced portfolio complementing Call 1 funding • Preventing poor mental health and promoting mental wellbeing • Reducing health inequalities as a primary focus • Using fiscal and economic strategies to prevent NCDs and reduce health inequalities • Modifying other social and economic determinants of health and wellbeing • Tackling food systems that perpetuate unhealthy diets and obesity • Improving the urban environment, including transport systems and air quality • Using green and blue spaces for improving population health and preventing NCDs • Targeting specific life course stages or transitions

17. What we’re looking for / “What good looks like” • Dealing with important (high burden/prevalence) NCDs • Dealing with important drivers of those NCDs • Realistic, ambitious, original, good value, excellent research • Providing concrete and explicit accounts of: • What activities will be conducted if funded • What is already known about the specific topic, and what these activities will add • The mechanisms by which these activities are likely to effect change in drivers of NCDs • The appropriateness of the proposed: • membership of consortia/networks • networking strategies • methods • disciplines • user partnerships • knowledge brokering plans

18. In summary, the UKPRP will: • fund research into the primary prevention of physical and mental NCDs • generate useful new knowledge about how to prevent NCDs • encourage an upstream, and whole systems, approach to prevention • provide substantial long-term investment to develop and build on basic research in a number of relevant disciplines • build ambitious new multidisciplinary teams and researcher networks • engage with stakeholders at every stage to produce clear answers relevant to decision makers • capitalise on emerging digital technologies, ‘big data’ and basic science