Completed Projects
In addition to our current projects, we also provide information and/or conclusions for trials or studies which have now finished.
Environment
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Healthy Kitchens and Healthy Cities
Within the context of rapid and uncontrolled urbanisation, the activities in the kitchen and the risks they may lead to are changing, as is the resultant disease pattern. This study has several interlinked components including qualitative interviews and participatory workshop with women living in two of Kathmandu’s largest slums, analysis of routine burn injury data to explore connections with climate, gas and electricity shortages; a scoping review of intervention to address lung health, burn injury and other risk to health linked to kitchen activities and the piloting of interventions in slum areas in South Asia. Ultimately this programme aims to identify and find funding for studies assessing the effectiveness of holistic interventions focused on the kitchen to reduce risks to health.
Link to project
HOPE
The HOPE project seeks to put the Earth's life supporting systems – its soil and water systems, its climate, its biodiversity - at the heart of public health research and policy. Today’s societies are changing these systems in ways that threaten people’s health, particularly for future generations.
Link to project website.
Long term conditions
Adult Siblings of People with Autism and High Support Needs
This study aims to build on existing knowledge about sibling childhood relationships and experiences in the field of disability to explore and understand the perspective of audlt siblings of people with autism and high support needs in the UK.
Link to project.
Advocacy, Communication and Social Mobilisation: Does it improve TB case detection rates?
Advocacy, Communication and Social Mobilisation (ACSM) is a WHO Stop TB strategy aimed at improving case detection and treatment adherence rates by combating stigma and discrimination, empowering people affected by TB, mobilising communities and advocating for political commitment and resources. Supported by Global Fund, ACSM was introduced in 57 districts between mid-2008 and September 2012 in Pakistan. We choose difference-in-differences (longitudinal analysis approach) to test the hypothesis that there was a significant change over time, in the case detection rates after introducing ACSM in the intervention districts. We compare ACSM districts to 82 ‘control’ districts in which ACSM was not implemented.
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Alexander Technique Lessons and Acupuncture Sessions (ATLAS) Trial
The £720,000 ATLAS trial, funded by Arthritis Research UK, is currently being conducted over a three-year period. The trial has recruited 517 participants who were randomly allocated to receive either 12 acupuncture sessions, 20 Alexander Technique lessons, or to continue to receive usual GP care alone.
Link to project.
Culturally Competent Pain Management for Older People
This qualitative project, by talking to older people and health care practitioners, explores the experience and treatment of pain.
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Family carers' perceptions of their educational needs when providing end of life care
Family carers play a significant and important role in ensuring that people with cancer and other life threatening diseases can be cared for in their own home.
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Implications for public health: research of models and theories of disability
A major new review aims to identify and assess different theories of disability and use this knowledge to critically appraise public health interventions where people with disabilities are a key target group. Public health interventions which are effective in the general population are often assumed to apply to people with disabilities, however, evidence for this is limited and there is a need for more inclusive and better informed research.
Link to project.
Living with Inflammatory Bowel Disease: the experience of those of South Asian origin
The primary aims of the study are to describe what living with IBD is like for SA adults, including their experiences as health service users, and to understand whether ethnicity impacts on this experience and, if so, how.
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Living with sickle cell or beta thalassaemia trait: Implications for identity and social life
Aims to understand the long term social implications of being identified as a ‘healthy carrier’ of sickle cell or thalassaemia trait, the two most common recessive gene disorders affecting people living in the UK.
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Making sense of chronic pain among people who have had encephalitis and developing service support that meets their needs
The study, funded by the Big Lottery, and undertaken in collaboration with the Encephalitis Society aims to enhance quality of life and addresses social exclusion for people who have had encephalitis and their families.
Link to project.
How effective, accessible and acceptable are self-management interventions for men with long-term conditions?
How effective, accessible and acceptable are self-management interventions for men with long-term conditions?
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The experience of cancer related fertility
With improved cancer survival rates, attention is drawn to long term side effects, their impact on well-being and quality of life and any related need for services. Fertility impairment is a potential outcome for some cancer survivors but there is little research into its impact and none specific to minority ethnic groups.
Link to project.
Older people
Equitable Care for an Ageing Population
Loneliness and admission to care homes
A study of data from the English Longitudinal Study of Ageing is investigating the influence of loneliness and other factors on admission to care homes.
Link to project.
Loneliness and social isolation and use of health and social services by older adults
Older people’s social relationships have been implicated as a cause of premature mortality and increased morbidity. However, the effect of loneliness, isolation and social support on older adults’ use of services is less well understood. This project aims to assess the evidence on the relationship between social support, loneliness, social isolation and older adults’ use of health and social services, through systematic review.
Link to project.
Men in Sheds: A systematic review of gendered social activity interventions for older men
Older adults with advanced cancer living alone
Many people living with advanced cancer are elderly and increasing numbers of older patients live alone. Whilst health status will clearly help to determine where an older adult can live, this study explored the possibility that living arrangements may themselves have consequences for the health experience of older adults towards the end of life.
Link to project.
The health of residents in UK care homes. How can we promote equitable outcomes?
An estimated 400,000 people aged over 65 live in care homes. They are a population with complex needs, receiving care of variable standards, often influenced by ability to pay. Yet very little is known about their health needs and how best to organise health and social care services to promote equitable outcomes in long term care. A multi-disciplinary research team planned a programme of work to fill some of these important gaps in research.
Link to project.
Transitions between services at the end of life for older people – patient carer and provider perspectives
Transitions in care settings are associated with poor continuity and quality of care. At the end of life, health and social care aims to optimise quality of life, yet existing evidence suggests that movements between place of care in the months before death may be frequent, and result in little improvement in pain control or wellbeing. This multi method study funded by NIHR HSR&D explored the causes and consequences of transitions in care settings from the perspective of people living with heart failure, stroke and lung cancer.
Link to project.
Parenting, children and young people
Building Blocks
A home-visiting programme especially designed for young, first-time parents and their children living in areas of socio-economic deprivation.
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Children in Scotland requiring palliative care: identifying numbers and needs (ChiSP)
Life-limiting conditions (LLC) are defined as health conditions with no reasonable hope of cure and that will ultimately lead to early death. For children and young people who are affected by these conditions, it is important that palliative care services are available. Dr Lorna Fraser (Health Sciences) and Professor Bryony Beresford (SPRU) have successfully won a £107K grant through the Children’s Hospice Association Scotland to identify those children and young people who may be affected with these conditions and their needs.
Link to project.
Deprivation, difference and early development: Healthy societies for healthy families
This programme of research is designed to test an integrated explanation of the social determinants of population health and health inequalities.
Link to project.
Education for Minority Ethnic Pupils: Young People with Sickle Cell Disease
A team of researchers at De Montfort University, University of York and Loughborough University was been funded by the Economic and Social Research Council to report on the experiences of young people with sickle cell disorders in the education system in a multi-method study between 2006 and 2011.
Link to project.
Evaluating models of care closer to home for children and young people who are ill
This project will identify models of health care for children and young people who are ill that involve delivery of ‘care close to home’. It will explore how these models respond to different needs, e.g., age, condition, ethnicity, deprivation and explore the benefits, drawbacks and costs of shifting from hospital in-patient care to community-based models of care. The project will also establish evidence-based principles of good practice about establishing and running ‘close to home’ models of care.
Link to project.
Involving fathers in ante-natal screening for sickle-cell disorders: improving informed decision making
This two year qualitative study explores fathers' attitudes, experiences and perceptions of ante-natal screening; and identifies potential factors which could influence uptake of testing.
Link to project
Maternal and Child Health(CLAHRC)
Focuses on reducing harmful exposures (such as smoking) in utero; improving infant and child feeding and reducing obesity; improving maternal mental health and improving access to health and social care services.
Link to project
Discussing Inequality: materials for the classroom and beyond
Millennium Cohort Study
The Millennium Cohort Study (MCS) is the fourth of Britain’s major birth cohort studies – the others began in 1946, 1958 and 1970. The survey for the first wave of the MCS took place between June 2001 and January 2003, collecting data from the parents of 18,818 babies born in the UK over a 12-month period at the average age of 9 months. Subsequent waves have collected information from the families at ages 3, 5 and 7, with a further wave planned for age 11.
Link to project.
Multiple Risk Behaviours Among Parents with Dependent Children
Focuses on cigarette smoking, diet, physical activity and alcohol consumption among parents living with children.
Link to project
Multi-site implementation of a promising innovation in low income communities: support for childbearing women
Volunteer doula project evaluation. Studies of doula support from a number of other countries have now shown a range of benefits for both women and babies.
Link to project.
The natural history and NHS service use of women with depression and impact on children in a multi-ethnic inner-city population.
PIP – an evaluation of a programme designed to increase physical activity in pre-schoolers in the playground
An outdoor playground based physical activity programme which aims to increase physical activity in children.
Link to project
Prevalence of Life Limiting Illness in Young Adults in England
This project aims to estimate the prevalence of young people aged 19- 35 years old with life-limiting or life-threatening conditions in England using routinely collected NHS data to assist with service provision.
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Residential mobility and the health of families with young children in Wales
Families with infants and young children in the UK have high rates of residential mobility in comparison to other population groups. Relatively little is known however about the implications of mobility for the well being of families with young children in Wales or for policy makers providing services to them.
Link to project.
Sonifying health data to promote public health risk communication
The chronic health of adolescents: is the world listening?
Multi-media installation at the 3Sixty space, Ron Cooke Hub, Heslington East, University of York, September-October 2013.
Link to project.
Smoking and other addictions
Adapting a behavioural support intervention for smokeless tobacco cessation in South Asians
This study aims to identify the modification required in behavioural counselling to make it more effective, feasible and acceptable to South Asians in supporting them to quit smokeless tobacco. The research team will initially identify required modifications in the counselling sessions. They will then offer these to smokeless tobacco users in two health facilities in the UK and two in Pakistan. By recording these sessions and interviewing counsellors and clients, the team will assess their feasibility, adherence rates, and acceptability.
Link to project.
A dynamic model of adult smoking related costs and consequences for England
Most estimates of the harms from smoking are based on a snapshot taken for a single year. Estimates of such costs of the life years lost from smoking related diseases are useful background information but do not indicate how consequences may change as the patterns of smoking change either for the population as a whole or for specific sub-groups.
Link to project.
Barriers and Facilitators to Smoking Cessation in Pregnancy and Following Childbirth
This study will explore barriers and facilitators to smoking cessation in pregnancy and following childbirth involving pregnant women, their partners, other family members and health professionals who have a role to play in supporting women to stop smoking. The study will examine why women do not use existing services, how these services and other forms of support could be improved and whether there are new forms of support that should be developed and tested in future research.
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Behavioural support to help South Asians to quit smokeless tobacco
The study aims to investigate and explore the potential gaps in the standard treatment program for tobacco cessation and suggest appropriate modifications and adaptations to make it relevant for cessation of smokeless tobacco products used by south Asian communities in the UK. We will observe and interview cessation advisors followed by a series of expert panel workshops to develop an inventory of modifications in the intervention.
Link to project
Communities Learning About Second-hand Smoke (CLASS) in Bangladesh- a pilot cluster randomised controlled trial
In Bangladesh, second-hand smoke (SHS) is recognised as a principal source of indoor air pollution and a major public health concern. A recent community survey of 722 households in Bangladesh revealed that smoking indoors was a common practice, with more than half (55%) of the households having at least one smoker. A majority of these smokers did not practice smoking restrictions at home (including smoking in front of children), exposing almost 40% of the children to SHS. In this study we aim to reduce children’s exposure to SHS in their homes. The salient objectives of CLASS Bangladesh study are; (i) to develop a school-based intervention to enable children as agents of behaviour change; (ii) to pilot test the developed intervention; and (iii) to test its effectiveness and cost effectiveness in reducing SHS.
Link to project
Estimating the costs of smoking in pregnancy
Smoking in pregnancy is recognised to have major health costs, both for the mother and her child.
Link to project.
Global Burden of Disease due to the Consumption of Smokeless Tobacco Products
This study aims to estimate the worldwide burden of disease attributable to smokeless tobacco use, measured in terms of number of deaths and disability adjusted life years (DALYS) lost due to smokeless tobacco use. The study involved a series of literature reviews and epidemiological modelling to estimate the attributable burden.
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To evaluate the effectiveness of smoking cessation interventions in HIV positive people: a Cochrane review
The prevalence of smoking in people living with HIV or AIDS (PLWHA) is two to three times that of the general population. Frequent blood tests and clinic appointments mean that many PLWHA are in regular contact with health professionals providing an opportunity for smoking cessation interventions to be initiated. However some HIV clinicians report a lack of confidence in facilitating patients to stop smoking and others do not prioritise it. The high prevalence of smoking, despite a substantial proportion expressing a desire to quit, reflects unmet need for effective smoking cessation interventions in PLWHA. This review aims to summarise the evidence to reduce the uncertainty felt by clinicians regarding the most effective smoking cessation interventions in PLWHA. In addition, the review aims to highlight areas in need of investigation in this emerging area of research.
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MCLASS – Muslim Communities Learning About Second-hand Smoke in Bangladesh: a pilot study
A clustered, randomised, controlled pilot trial of 'Smoke Free Homes' delivered in Islamic religious settings.
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Mothers Learning About Second-hand Smoke (MLASS)
The aim of Mothers Learning About Second-hand Smoke (MLASS) is to test the feasibility of delivering and evaluating the effectiveness of a Smoke Free Homes health education intervention in antenatal and postnatal healthcare settings.
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Prenatal smoking and patterns of youth problem behavior
This study is funded by the United States National Institute for Drug Abuse (NIDA) and is designed to elucidate mechanisms by which antenatal exposure to cigarette smoke may contribute to the development of problem behaviour.
Link to project.
An analysis of the production and supply chain of smokeless tobacco in South Asia: a feasibility study
Smokeless tobacco consumption is a global public health threat. It is a particular problem in South Asians. Existing tobacco control policies are either inadequate or poorly implemented. Policy makers lack intelligence on the production and supply chain of a diverse group of smokeless tobacco products in South Asia. In an international meeting in York, experts recommended conducting a large multi-country study to address this gap. We are conducting a feasibility study to inform the design, methods and tools for such a study. We are conducting a survey of the actors involved in this chain in Bangladesh, Nepal and Pakistan using snowball sampling. The actors involve retailers, wholesale dealers, manufacturers and farmers.
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Symptoms Awarenss Study (SASS): Understanding of Cancer Symptoms and Healthcare Interactions Among Smokers
The aim of the study is to investigate the impact of smoking status on responses to potential cancer symptoms. We will focus on symptoms of lung, head and neck cancers as examples of cancers of which smokers are at higher risk than non-smokers.
Link to project.
Second-hand Smoking and risk of pulmonary TB: a systematic review and a meta-analysis
The exposure to second-hand smoke (SHS) in households has been implicated as a risk factor for acquiring tuberculosis (TB) and worsening of its treatment outcomes. The systematic review and meta-analysis will assess the association between SHS in households and; (i) the risk of acquiring TB infection and disease in non-smoking people of all age groups; and (ii) on disease outcomes among non-smoking TB patients. Although tuberculosis and exposure to second-hand smoke exposure is common in several countries, this review is likely to be relevant to those where both TB and tobacco use is endemic.
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Social Norms Intervention to Prevent Smoking
Social norms approaches are based on the premise that we frequently overestimate risk behaviours among our peers. By conducting campaigns to reduce any dissonance between perceptions and reality, social norms approaches aim to reduce risk behaviours. This study was conducted in five schools in West Yorkshire during 2010/11 to identify any dissonance between actual (self-report) and perceived smoking among 12 to 13 year olds and assess the feasibility of using a social norms approach in secondary schools to prevent the uptake of smoking. The study found significant levels of dissonance among pupils. Implementing the approach was not only feasible but also welcomed by schools.
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TB patients learning about second hand smoke (TBLASS): a pilot individual randomised controlled trial, Pakistan
This pilot trial is aimed to develop and evaluate a behavioural intervention 'Smoke Free Homes (SFH)' for tuberculosis patients to encourage them to negotiate a smoke free environment within their homes. It will inform the design of a future definitive trial. The SFH intervention was developed using taxonomy of behaviour change techniques to encourage families of non-smoking TB patients to implement smoking restrictions at home following a logic model of the intervention. The intervention was piloted in two routine National TB Programme hospitals. The eligible TB patients, attending the trial sites were randomised and allocated to one of the two trial arms (“individual based care” and “individual based care” plus “supplementary support”). We recruited 75 participants in each arm. The primary outcome measure was SFH of participant by validating through 'Urine Cotinine' test. We also determined qualitatively the barriers and key drivers to the creation of smoke free homes.
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Developing an Intervention for Tobacco Cessation within Primary Care in Nepal
There are currently no comprehensive behaviour change programmes to support patients in primary care to stop tobacco use in Nepal. WHO’s Practical Approach to Lung Health is one approach that does attempt to address smoking cessation for lung health patients and is currently being implemented in 10 districts across Nepal. However, PAL has only a limited focus on tobacco cessation. This study has used qualitative research with health workers and smokers with lung health problems, evidence review, behaviour change theory and action research to develop a intervention to support tobacco users to quit. The intervention is being piloted in three primary health care centres using CO monitors to objectively measure smoking cessation at 6 months.
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Other
Ethnic group density effects on physical health
There is some evidence that the health of members of low status ethnic minorities is less good if they live in areas where they are in more of a minority.
Link to project.
Methodologies to assess the relationship between residential histories and the geography of mortality
There are significant variations in the risk of death found between populations living in areas of the UK with different levels of deprivation which have persisted through the twentieth century.
Link to project.
Health inequalities and public health policy
Support matters: Use of assistant staff in the delivery of primary and community nursing services in England
The evaluation of the use of health advocates and improving the skills of health advocates
This project evaluates a training programme provided by the British Foundation for Health Advocates working among ethnically diverse populations.
Link to project.
Multiple risk factors and multiple risk factor interventions – what do we know?
Modifiable risk behaviours such as smoking, excessive alcohol use, inactivity and poor nutrition contribute significantly to the global burden of disease. Promoting the uptake of healthy lifestyles is central to England’s public health strategy, which to date has largely been pursued through targeting individual risk behaviours. There is evidence to suggest that the majority of adults in England engage in multiple risk behaviours at the same time and that the clustering of unhealthy behaviours is socially patterned.
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Public Health Research Consortium
The Public Health Research Consortium (PHRC) brings together senior researchers from 11 UK institutions in a new integrated programme of research, with the aim of strengthening the evidence base for interventions to improve health, with a strong emphasis on tackling socioeconomic inequalities in health.
Link to project.
Developing effective interventions to prevent or address the adverse effects of loneliness and isolation on the health of older people
This NIHR doctoral award for Nicole Valtorta will use systematic review methods and longitudinal data analysis to understand the relationship between older adults’ social relations and health. It aims to provide essential information for the design of interventions.
Link to project.
Paediatric Palliative Care Program
A program of research of paediatric palliative care led by Dr Lorna Fraser, Department of Health Sciences at the University of York, working with Martin House Children’s Hospice and Dr Roger Parslow from the Division of Epidemiology at the University of Leeds.
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Assessing the Trends in the Burden of Paediatric Neurology Diseases in England using Linked Administrative Data
This study will use anonymised hospital data to assess the trends in the numbers of children with neurological diagnoses in England and the patterns of health care usage. The results will provide evidence for current future service need for this population of children.
Link to project.
Do older carers of patients dying with non-cancer diagnoses have different experiences and needs for support?
Family carers play an essential role in palliative and terminal care and may hold the key to improving health services for older people. As we are living longer, many carers are older adults with their own health problems. The aim of this study is to explore how the age of the carer influences the experiences of carer and patient at the end-of-life, and identify ways in which services can better support older carers.
Link to project.
Smoking prevention in young people
The vast majority of smokers take up the habit as adolescents between the ages of 10 and 20 years. The present research focuses on reducing smoking initiation as potentially the most effective way to reduce smoking-related harm.
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Children Learning About Second-hand Smoke (CLASS II): A pilot cluster randomised controlled trial
The pilot trial will be conducted in Dhaka Division, Bangladesh. We will recruit a total of 12 primary schools and 360, year 5 (10-12 years old) children. The information obtained from the pilot study will help us to carefully plan for the large study and help us to test our assumptions. These include the number of schools and children to be recruited, feasibility and acceptability of the specified measurements and resource requirement for scaling up the intervention.
Link to project.
A multi component intervention to reduce home-exposure to second-hand smoke (SHS) during pregnancy and postnatal period: a randomized controlled trial
South Asia has one of the highest numbers of male smokers anywhere in the world. As a result, over a third of pregnant women in South Asia are exposed to second-hand smoke in their homes. This has serious health consequences for both mothers (such as increased heart- and lung-related illnesses) as well as the newborn (higher chances of stillbirth, being born prematurely and lung-related illnesses).
Link to project.
Connect project: Co-production of policing evidence, research and training - focus mental health
Connect is a collaborative project between the University of York and North Yorkshire Police on new approaches to dealing with mental health problems.
More information.
Improving the Management of Advanced Cancer Pain in the Community
The aim of this program of research is to benefit NHS patients suffering with pain from advanced cancer by earlier identification of patients and their carers that need support, promoting self-management, assessing and monitoring their pain and communicating this data between primary and secondary care, and ensuring good management of analgesic drugs.
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