Improving health and wellbeing
Our intervention research draws on methodological expertise in prognosis research, pragmatic clinical trials, intervention development and process evaluation, with applications across community, primary care, and secondary settings to improve health and the efficiency of healthcare.
Our models of risk-based stratified care and vocational interventions for common musculoskeletal disorders are recognized in Public Health England’s Return on Investment tool, and are now underpinning efforts to transfer supported self-management interventions from NHS to community settings for low-risk patients and the wider public.
Following from our lifecourse epidemiologic research that identified trajectories and risk factors for pain in childhood and adolescence, our research in now exploring the feasibility and effects of intervening earlier in the lifecourse.
Developing and evaluating interventions to reduce low-value care in the NHS features in our research tackling over-prescribing of opioids and gabapentinoids for adults with persistent pain.
Developing models for early intervention and health promotion
Reducing repeat self-harm in young people in primary care
The COPING study will work in partnership with young people aged 16-25 with lived experience of self-harm and GPs to develop a treatment guide (called COPING) for GPs to use with young people to reduce repeat self-harm.
Links: COPING study
People: Dr Faraz Mughal
Integrating vocational advice into primary care
Building on observational and qualitative research on the needs of adults with long-term conditions for early and effective employment support, we developed a vocational advice service in general practices for adults consulting for musculoskeletal pain and either struggling at work or with recent absence from work. In a cluster randomised trial, compared with best current care, adults in practices offering the new service had fewer days off work and an estimated return on investment from a societal/productivity perspective of £11.14 for every £1 spent on the intervention.
We have extended this work through:
- An implementation project with First Contact Practitioners (I-SWAP)
- A new multi-centre trial expanding the remit of the vocational advice service to other health conditions (WAVE)
- International collaborations with researchers looking to adapt and evaluate this approach in their national settings
Links: SWAP, iSWAP, WAVE, Centre for Musculoskeletal Health & Work
People: Gwenllian Wynne-Jones, Nicola Evans
Key references:
- Effectiveness and costs of a vocational advice service to improve work outcomes in patients with musculoskeletal pain in primary care: a cluster randomised trial. Pain 2018.
- Acceptability of a vocational advice service for patients consulting in primary care with musculoskeletal pain: A qualitative exploration of the experiences of general practitioners, vocational advisers and patients. Scand J Public Health. 2019.
- Public Health England. Return on Investment of Interventions for the Prevention and Treatment of Musculoskeletal Conditions. Final Report. 2017.
- Managing work participation for people with rheumatic and musculoskeletal diseases. Best Pract Res Clin Rheumatol. 2020.
Non-traditional support workers delivering a brief psychosocial intervention for older people with anxiety and depression
Support workers working within third-sector (voluntary) organisations are a valuable source of expertise within the community but are under-used by primary care practitioners in the management of older people with anxiety and depression. This project:
- Developed and refined a behavioural activation psychosocial intervention based on synthesising existing guidelines, an updated systematic review, and results from new empirical qualitative research
- Assessed the feasibility of recruiting and training support workers to deliver the intervention
- Conducted a feasibility study in local general practices to inform a possible future randomised trial
Links: NOTEPAD, Mental health research
Key references:
- Non-traditional support workers delivering a brief psychosocial intervention for older people with anxiety and depression: the NOTEPAD feasibility study. Southampton (UK): NIHR Journals Library; 2019.
- Can support workers from AgeUK deliver an intervention to support older people with anxiety and depression? A qualitative evaluation. BMC Fam Pract. 2019.
- Developing a community-based psycho-social intervention with older people and third sector workers for anxiety and depression: a qualitative study. BMC Fam Pract. 2017.
 | Increasing the activity of older people with long-term painLong-term pain is a common and important predictor of physical inactivity, particularly in older people. This project is intended to find out if a walking programme, delivered and supported by trained healthcare assistants, can encourage people over the age of 65 with joint pain to become more active. Links: iPOPP
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Managing sub-threshold depression in community pharmacy settings
The Community Pharmacies Mood Intervention Study (CHEMIST) seeks to adapt ‘what works’ for people with sub-threshold depression in primary care and examine if this can be translated to the important public health setting of community pharmacy
People: Carolyn Chew-Graham
Key references:
- Community Pharmacies Mood Intervention Study (CHEMIST): feasibility and external pilot randomised controlled trial protocol. Pilot and Feasibility Studies, 2019.
Pain in children
Adult prevalence levels for low back pain appear to be reached by around the age of 18 years, and the patterns and trajectories of musculoskeletal pain in childhood and adolescence differ from those in adulthood, with evidence to suggest greater variability and change. Childhood and adolescence may be a critical period to investigate the development of long-term pain trajectories and our research on this topic seeks to identify risk factors and approaches to earlier recognition and effective management.
People: Kate Dunn
Key references:
