Public health research (Southampton, England)最新文献

{"title":"Improving the Oral Health of Older People In Care Homes: the TOPIC randomised feasibility study.","authors":"Georgios Tsakos, Paul R Brocklehurst, Saif Syed, Michelle Harvey, Sana Daniyal, Sinead Watson, Nia Goulden, Anna Verey, Peter Cairns, Anja Heilmann, Zoe Hoare, Frank Kee, Joe Langley, Nat Lievesley, Ciaran O'Neill, Andrea Sherriff, Craig J Smith, Rebecca R Wassall, Richard G Watt, Gerald McKenna","doi":"10.3310/GJGT0613","DOIUrl":"https://doi.org/10.3310/GJGT0613","url":null,"abstract":"<p><strong>Background: </strong>The National Institute for Health and Care Excellence guideline NG48 aims to maintain and improve the oral health of care home residents. However, evidence on oral health interventions among care home residents is weak. A co-design process with residents and care home staff refined National Institute for Health and Care Excellence guidance NG48 aspects to facilitate implementation. This study aimed to assess the feasibility of undertaking a large-scale definitive trial on this intervention. A parallel theoretically informed process evaluation explored factors affecting implementation. The feasibility of collecting data to inform a cost-consequence model was also explored.</p><p><strong>Methods: </strong>A pragmatic cluster randomised feasibility study with 12-month follow-up was undertaken in 22 care homes across two sites (London, Northern Ireland). Care homes were randomised into an intervention arm (<i>n</i> = 11) that received the National Institute for Health and Care Excellence guidance NG48-based complex oral health intervention, and a control arm (<i>n</i> = 11) that continued with routine practice. The complex intervention included a training package for care home staff in oral health promotion knowledge and skills; using the Oral Health Assessment Tool to assess residents' oral health needs; and a 'support worker assisted' daily toothbrushing regime with 1500 ppm fluoride toothpaste. Dentate residents aged 65 years or over without severe cognitive impairment were recruited, resulting in a sample of 119 participants. Assessments were undertaken at baseline and 12 months through clinical dental examination and questionnaires. A parallel process evaluation involved semistructured interviews to explore how the intervention could be embedded in standard practice. Rates of recruitment and retention and intervention fidelity were also recorded. Economic evaluation or cost-consequence indicators were collected through interviews with stakeholders, survey and questionnaire data.</p><p><strong>Results: </strong>Eighty-four per cent of care homes and 88% of residents agreed to participate; 86% of care homes and 69% of residents were retained at 12-month follow-up. Researcher-collected data on clinical and subjective measures had successful completion rates, but completion rates were very low for the weekly symptoms checklist collected by care home staff. The process evaluation highlighted that most care homes were keen to participate, as accessing oral care provision was challenging. The values and beliefs of managers and staff within each care home were key to intervention adoption. Collecting outcomes relevant for cost-consequence modelling is feasible, therefore, supporting an economic evaluation alongside the definite trial. Residents' quality of life was identified as a key outcome for stakeholders, including care home managers.</p><p><strong>Limitations: </strong>As ethical approval was granted for care home r","PeriodicalId":74615,"journal":{"name":"Public health research (Southampton, England)","volume":"14 5","pages":"1-28"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards optimal public health interventions for preventing obesity in children: a synopsis of a novel evidence synthesis.","authors":"Julian Pt Higgins, Francesca Spiga, Annabel L Davies, Jennifer C Palmer, Sarah Dawson, Deborah M Caldwell, Lucy Condon, Fiona B Gillison, Eve Tomlinson, Theresa Hm Moore, Katie Breheny, James Nobles, Sharea Ijaz, Jelena Savović, Rona M Campbell, Carolyn D Summerbell","doi":"10.3310/AKHD0407","DOIUrl":"https://doi.org/10.3310/AKHD0407","url":null,"abstract":"<p><strong>Background: </strong>Childhood obesity is a major public health concern worldwide, yet the best way to prevent it remains unknown.</p><p><strong>Objective(s): </strong>To determine what types of intervention strategy are most effective at preventing the development of obesity in children aged 5-18 years, as measured by change in body mass index, and to determine whether interventions work differentially in children with different characteristics associated with inequities.</p><p><strong>Design: </strong>Systematic reviews and statistical evidence syntheses.</p><p><strong>Eligibility criteria: </strong>Randomised controlled trials of dietary and/or activity interventions that aimed to prevent overweight or obesity in children and young people aged 5-18 years and reported outcomes at least 12 weeks after baseline. Non-randomised evidence was identified through an overview of systematic reviews. Sources of inequity of interest were those defined by the PROGRESS (place of residence, race/ethnicity/culture/language, occupation, gender/sex, religion, education, socioeconomic status, social capital) acronym: place, race/ethnicity, occupation (of parents), gender/sex, religion, education (of parents), socioeconomic status and social capital.</p><p><strong>Data sources: </strong>Updating of an existing Cochrane Review, searching bibliographic databases up to February 2023, including MEDLINE, EMBASE, PsycInfo® (American Psychological Association, Washington, DC, USA) and Cochrane Central Register of Controlled Trials on the Cochrane Library, international trial registers and grey literature databases, and examining reference lists. Results subgrouped by inequity factors were sought directly from trialists.</p><p><strong>Review methods: </strong>Cochrane Reviews followed standard Cochrane procedures. The main statistical synthesis was informed by a novel analytic framework developed iteratively through discussions with children and young people, schoolteachers and public health professionals. Methodology was developed to analyse the data using multilevel metaregression. To examine the impact of inequity factors, we performed a two-stage meta-analysis of interactions, based on subgroup-level aggregate data collected directly from the trialists. We collected available information on intervention costs.</p><p><strong>Results: </strong>We included 172 trials in ages 5-11 and 74 in ages 12-18. In the main synthesis, of 204 trials from both reviews, we found interventions were effective on average (mean difference in standardised body mass index -0.037, 95% credible interval -0.053 to -0.022, which would correspond to a reduction in a proportion of 2.3% with obesity to a proportion of approximately 2.1%). Larger effects were associated with physical activity rather than dietary interventions, after 12 months of follow-up and in the older age group. The overview of non-randomised evidence included 24 systematic reviews, yielding mixed results. The inves","PeriodicalId":74615,"journal":{"name":"Public health research (Southampton, England)","volume":"14 2","pages":"1-22"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146208234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conducting a large-scale randomised controlled trial in children's social care: reflections on challenges, successes and lessons learned from the Reflective Fostering Study.","authors":"Karen Irvine, Beth Rider, Caroline Cresswell, Shayma Izzidien, Erika Sims, Caroline Smith, Rachael Stemp, Nick Midgley","doi":"10.3310/GJNM1603","DOIUrl":"https://doi.org/10.3310/GJNM1603","url":null,"abstract":"<p><strong>Background: </strong>Research in Children's Social Care in the United Kingdom operates in a framework that was initially designed to support medical research within healthcare settings. Although adaptations to this framework have been made for social care settings, our experience suggested that significant systemic and organisational challenges to conducting large-scale randomised controlled trials in fostering services in the United Kingdom still remain, which work against the likelihood of such studies being completed successfully. A further challenge we faced was that that many fostering services were relatively inexperienced with research and lacked the infrastructure to support it.</p><p><strong>Objective: </strong>To report on the opportunities, obstacles and challenges faced when conducting a trial evaluating foster care support in a children's social care setting and to describe how those working on this research project came together to adapt the existing systems and processes and overcome the challenges.</p><p><strong>Design: </strong>The Reflective Fostering Study was a randomised controlled trial evaluating an intervention to help foster carers care for the children they look after.</p><p><strong>Setting and participants: </strong>Local authority and independent fostering services in the United Kingdom. The main study recruited 524 foster carers and kinship carers. The main study was evaluating the Reflective Fostering Programme, a group intervention designed to improve reflective functioning in foster and kinship carers.</p><p><strong>Results: </strong>The main challenges identified in this study were lack of infrastructure, both within fostering organisations and outside, a lack of capacity, and on occasion, unnecessary bureaucracy. Working with fostering sites, the Clinical Research Network and across collaborating partners, we were able to make changes to existing processes so that the governance and oversight of the study were proportionate and the workload for our sites was minimised. Identifying likely departments to obtain key approvals, working with local Clinical Research Networks and providing templates made the site set-up process faster and supported recruitment.</p><p><strong>Limitations: </strong>The challenges reported were those encountered by a study that took place in fostering services in the United Kingdom. The challenges faced, and solutions identified, may not be mirrored in other sectors of children's social care, or other countries.</p><p><strong>Conclusions: </strong>Carrying out high-quality clinical trials within fostering services in the United Kingdom can face significant barriers. There has been a move to address these issues, but our study suggests that more could be done so that research in these settings increases. Ongoing review of the regulatory framework, which is designed to ensure best practice for research in children's social care, could ensure that research governance is proportiona","PeriodicalId":74615,"journal":{"name":"Public health research (Southampton, England)","volume":" ","pages":"1-16"},"PeriodicalIF":0.0,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning together to promote mental health and well-being in English secondary schools: LTMH study refinement and feasibility evaluation, a comprehensive synopsis.","authors":"Oliver Lloyd-Houldey, Neisha Sundaram, Semina Michalopoulou, Joanna Sturgess, Rosa Legood, Oliver Carlile, Elizabeth Allen, Stephen Scott, Dasha Nicholls, Steven Hope, Lee Hudson, Deborah Christie, Andrew Briggs, Russell Viner, Chris Bonell","doi":"10.3310/PFHR4141","DOIUrl":"https://doi.org/10.3310/PFHR4141","url":null,"abstract":"<p><strong>Background: </strong>Young people's mental health worsened during and since the coronavirus disease discovered in 2019 pandemic. School environments play a key role in young people's mental health. Learning Together for Mental Health is a whole-school intervention aiming to promote mental health in secondary schools, adapted from the previous Learning Together intervention which was found effective in reducing bullying and promoting mental health.</p><p><strong>Objective: </strong>To adapt Learning Together to increase focus on mental health so producing the Learning Together for Mental Health intervention and evaluate the appropriateness of conducting a Phase III trial of the Learning Together for Mental Health intervention regarding pre-defined progression criteria relating to the intervention and trial methods, and assessing intervention feasibility, reach and acceptability, feasibility of trial measures and procedures, potential mechanisms and possible harms.</p><p><strong>Design and methods: </strong>We conducted a feasibility study with baseline and follow-up surveys, process evaluation and economic-evaluation feasibility-testing.</p><p><strong>Setting and participants: </strong>One school participated in intervention adaptation. Our feasibility study included four state, mixed-sex secondary schools in southern England (one of which dropped out after baselines and was replaced with another). We recruited 640 year-7 (age 11-12) students at baseline survey and 566 year-10 (age 14-15) students at 12-month follow-up. Baseline and follow-up participants were different groups, as the focus was assessing feasibility for the age groups to be surveyed at baseline and follow-up in a Phase III randomised controlled trial. Twenty staff, 27 year-8 (age 12-13) students and 22 year-10 students participated in qualitative research as did two trainers and one external facilitator.</p><p><strong>Interventions: </strong>As part of our feasibility study, all schools received the Learning Together for Mental Health intervention for one academic school year.</p><p><strong>Main outcome measures: </strong>Pre-defined criteria for progression to a Phase III trial.</p><p><strong>Results: </strong>The intervention was successfully adapted from the previous intervention using public involvement. The trial met all criteria for progression to Phase III. The all-staff and in-depth restorative practice training were implemented with fidelity in all schools and all schools had at least two staff trained in-depth in restorative practice. Curriculum training was delivered with fidelity in three of four schools. The response rate to the baseline (needs) survey across the three participating schools was 79%. Progression required at least two schools to have delivered the curriculum with at least 50% fidelity, which was achieved; one of the two schools which delivered the curriculum reported over 80% fidelity and the other school reported over 75% fidelity. All stude","PeriodicalId":74615,"journal":{"name":"Public health research (Southampton, England)","volume":"14 1","pages":"1-34"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Population health and health sector cost impacts of the UK Soft Drinks Industry Levy: a modelling study.","authors":"Linda J Cobiac, Cherry Law, Richard Smith, Steven Cummins, Harry Rutter, Mike Rayner, Oliver Mytton, Adam D M Briggs, Henning Tarp Jensen, Marcus Keogh-Brown, Jean Adams, Martin White, Peter Scarborough","doi":"10.3310/GJMW1501","DOIUrl":"https://doi.org/10.3310/GJMW1501","url":null,"abstract":"<p><strong>Background: </strong>The United Kingdom Soft Drinks Industry Levy was introduced in April 2018, resulting both in changes in sugar levels in drinks and purchases of drinks. Both mechanisms could impact on the incidence and prevalence of raised body weight, diabetes and diet-related diseases, and therefore, have implications for economic costs to the health sector.</p><p><strong>Objectives: </strong>To model future impacts of the Soft Drinks Industry Levy on population health and health sector costs and to estimate net monetary benefit to the health system.</p><p><strong>Design and methods: </strong>Proportional multistate lifetable modelling study - open and closed cohort analyses.</p><p><strong>Setting and population: </strong>All children and adults in the United Kingdom.</p><p><strong>Intervention: </strong>The Soft Drinks Industry Levy is a two-tier levy of £0.18/l on drinks with between 5 and 8 g of total sugars/100 ml and of £0.24/l on drinks with ≥ 8 g of total sugars/100 ml.</p><p><strong>Main outcome measures: </strong>We evaluated impact of the sugar reduction on: (1) prevalence of overweight and obesity, obesity-related diseases and dental health out to 2050 and (2) lifetime population health (measured in quality-adjusted life-years), change in costs to the health sector and the resulting net monetary benefit.</p><p><strong>Data sources: </strong>We estimated a per person reduction in sugar from a previously published interrupted time series analysis, which found an 8.0 g/household/week (95% confidence interval 2.4 to 13.6) reduction in sugar at 1 year after implementation. Our multistate lifetable model is parameterised using data from population health monitoring surveys, the Global Burden of Disease project, the Human Mortality Database and the Office for National Statistics. Health sector costs were obtained from Department of Health and Social Care budget allocations.</p><p><strong>Results: </strong>The model predicts that the Soft Drinks Industry Levy will reduce the prevalence of overweight and obesity in the United Kingdom by 0.18% points (95% uncertainty interval: 0.059 to 0.31) for males and by 0.20% points (0.064 to 0.34) for females. In the first 10 years of implementation, the reductions in sugar and overweight/obesity are predicted to prevent 270,000 (35,000-600,000) dental caries, 12,000 (3700-20,000) cases of type 2 diabetes, 3800 (1200-6700) cases of cardiovascular diseases and 350 (110-590) cases of obesity-related cancer. For the current United Kingdom population, it is estimated that the Soft Drinks Industry Levy will add 200,000 quality-adjusted life-years (63,500-342,000) over their lifetime and avert £174 million (£53.6-319) in their costs of health care (discounted at United Kingdom Treasury rates). At a United Kingdom Treasury value of £60,000 per quality-adjusted life-year, it is estimated that the Soft Drinks Industry Levy will produce a net monetary benefit of £12.2 billion (£3.88-20.8) for the he","PeriodicalId":74615,"journal":{"name":"Public health research (Southampton, England)","volume":" ","pages":"1-17"},"PeriodicalIF":0.0,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimisation of a sexual health and healthy relationships intervention for Further Education in England and Wales (SaFE).","authors":"Rabeea'h Waseem Aslam, Rhys Williams-Thomas, Julia Townson, Ruth Lewis, Jason Madan, G J Melendez-Torres, Fiona Lugg-Widger, Philip Pallmann, Rachel Brown, Chris Bonell, Gemma S Morgan, James White, Honor Young","doi":"10.3310/AHDP8546","DOIUrl":"10.3310/AHDP8546","url":null,"abstract":"<p><strong>Background: </strong>Adverse sexual health, dating and relationship violence, and sexual harassment are significant public health concerns, especially among young people. Sexually transmitted infection rates are at a 10-year high, and dating and relationship violence affects nearly half of young people. Further education provides a population-wide setting for delivering dating and relationship violence and sexual health interventions, but only a few interventions have been shown to be effective in further education.</p><p><strong>Objectives: </strong>To optimise intervention materials and identify refinements for the Sexual Health and Healthy Relationships for further education (SaFE) intervention, an intervention to improve sexual health and reduce dating and relationship violence and sexual harassment among young people attending further education. Optimised materials were used in a pilot cluster randomised controlled trial of SaFE. SaFE had three components: (1) onsite access to sexual health and relationship services in further education settings provided by sexual health nurses for 2 hours, 2 days per week; (2) publicity about onsite services and (3) further education staff training on how to promote sexual health and recognise and respond to dating and relationship violence and sexual harassment. This paper reports on the optimisation of the SaFE intervention materials.</p><p><strong>Design and methods: </strong>A multistage iterative process was used to optimise further education staff training and publicity materials. This involved a series of consultation and focus group feedback sessions.</p><p><strong>Setting and participants: </strong>In Stage 1, feedback was collected from the SaFE Trial Management Group. Stage 2 involved: (1) two focus groups; one with four further education staff and one with three further education students at one further education institution and (2) stakeholder consultation with seven experts. Stage 3 saw consultation with the Trial Steering Committee who had independent oversight of the study. The operational feasibility of the training was evaluated in Stage 4 through a trial run with further education safeguarding and well-being teams. Stage 5 comprised a final review of intervention material by the Trial Management Group. Stage 6 gained online feedback from a young people's advisory group. The study was conducted in England and Wales.</p><p><strong>Results: </strong>In Stage 1, Trial Management Group reviewers recommended improving clarity and factual accuracy, reducing the length of slide decks and adding content on sending explicit images. Stage 2 feedback from further education staff and students focused on training content addressing comprehensiveness, structure and visual design and training delivery addressing preferred training formats and opportunities for scenario-based learning. The Trial Steering Committee in Stage 3 advised on managing participant disclosures and reordering content. St","PeriodicalId":74615,"journal":{"name":"Public health research (Southampton, England)","volume":" ","pages":"1-20"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145703179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of e-cigarettes for smoking cessation at homeless support centres: SCeTCH cRCT.","authors":"Jinshuo Li, Qi Wu, Steve Parrott, Sharon Cox, Francesca Pesola, Kirstie Soar, Rachel Brown, Allison Ford, Peter Hajek, Caitlin Notley, Deborah Robson, Emma Ward, Anna Varley, Charlotte Mair, Lauren McMillan, Jessica Lennon, Janine Brierley, Amy Edwards, Bethany Gardner, Allan Tyler, Linda Bauld, Lynne Dawkins","doi":"10.3310/GJLD2428","DOIUrl":"https://doi.org/10.3310/GJLD2428","url":null,"abstract":"<p><strong>Background: </strong>While smoking is common among those experiencing homelessness, the effectiveness of an e-cigarette intervention to reduce smoking in this population is unclear.</p><p><strong>Objective: </strong>To determine the cost-effectiveness of providing an e-cigarette for smoking cessation in homeless support centres compared to usual care.</p><p><strong>Design and methods: </strong>A multicentre two-arm cluster randomised controlled trial, with data collection time points at baseline, 4, 12 and 24 weeks post baseline.</p><p><strong>Setting and participants: </strong>Adults (aged 18+) who smoked daily and accessed 32 homeless support centres across six areas of Great Britain received either e-cigarette intervention (<i>n</i> = 239 in 16 centres) or usual care (<i>n</i> = 236 in 16 centres) by centre (cluster) randomisation.</p><p><strong>Intervention: </strong>The intervention was the provision of an e-cigarette starter kit plus 4 weeks' supply of e-liquids. The usual care comprised very brief advice for smoking cessation and signposting to local Stop Smoking Services.</p><p><strong>Main outcome measures: </strong>The total costs included costs of intervention/usual care, costs of smoking cessation outside of the trial and costs of general healthcare services use over 24 weeks. Quality-adjusted life-years were derived from EuroQol-5 Dimensions, five-level version administered at each data collection point. An incremental cost-effectiveness ratio was calculated for 24 weeks using the difference between groups in total costs and quality-adjusted life-years, with cost-effectiveness acceptability curve constructed based on bootstrap to examine uncertainty. A long-term model was employed to project a lifetime incremental cost-effectiveness ratio with probabilistic sensitivity analysis to examine uncertainty.</p><p><strong>Data sources: </strong>The analysis over 24 weeks was based on research team records and data collected via self-reported questionnaires. Unit costs for valuation were extracted from published secondary sources. The parameters of the long-term model were based on the 24-week results and published secondary sources.</p><p><strong>Results: </strong>Mean intervention costs were estimated at £92 [standard error (SE) £0] per participant and mean usual care costs at £50 (SE £0) per participant. Mean total costs per participant were estimated at £3859 (SE £441) in the e-cigarette group and £2716 (SE £386) in the usual care group. Mean quality-adjusted life-years were estimated at 0.303 (SE 0.008) in the e-cigarette group and 0.295 (SE 0.010) in the usual care group. Adjusting for baseline covariates and respective baseline values, e-cigarette group were £1267 (95% confidence interval £600 to £1938) more costly and yielded 0.007 (95% confidence interval -0.017 to 0.027) more quality-adjusted life-years than usual care. The incremental cost-effectiveness ratio was calculated at £181,000 per quality-adjusted life-year gai","PeriodicalId":74615,"journal":{"name":"Public health research (Southampton, England)","volume":" ","pages":"1-45"},"PeriodicalIF":0.0,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An evaluation of economic evidence included in published randomised controlled trials of interventions to prevent obesity in children.","authors":"Katie Breheny, Francesca Spiga, Eve Tomlinson, Carolyn D Summerbell, Julian Pt Higgins","doi":"10.3310/GJJH1321","DOIUrl":"10.3310/GJJH1321","url":null,"abstract":"<p><strong>Background: </strong>Childhood obesity is a public health policy priority. Policy-makers need an understanding of the costs of interventions to prevent childhood obesity alongside their effectiveness when tested in randomised controlled trials. It is not known what cost data have been included in published randomised controlled trials of childhood obesity prevention interventions. This study aimed to summarise these costs and identify associated economic evaluations published separately.</p><p><strong>Methods: </strong>This review summarises data extracted from studies included in two Cochrane systematic reviews of interventions to prevent obesity in children aged 5-11 and 12-18 years old. Eligible interventions could be delivered in any setting and studies were randomised controlled trials reporting (standardised or unstandardised) body mass index outcome data at a minimum follow-up of 12 weeks post baseline. Databases searched included Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and PsycINFO. Searches were limited to between 1990 and 2023. Any cost data reported in the publications were extracted, in addition to citations of linked economic analyses. Data were tabulated and summarised using a narrative approach.</p><p><strong>Results: </strong>Of the 244 randomised controlled trials included in the Cochrane systematic reviews, 85 (35%) included costs related to the trial, intervention, school, health sector, out-of-pocket or productivity costs, or were linked to a full economic evaluation published separately. Of the studies reporting costs, five (6%) studies reported results of a full economic evaluation within the trial paper. The majority of research costs were incentives for participation, identified in 41 (48%) studies. Where these are not part of the intervention itself, these would not usually be included in economic evaluations. Thirty (35%) studies included intervention costs, although reporting was inconsistent. The payer of the intervention was unclear in most publications, making the attribution of costs to sectors difficult. Only one study reported healthcare resource use data, but some estimated the cost of obesity-related chronic conditions in linked decision models.</p><p><strong>Limitations and future work: </strong>The findings of this review are limited to randomised controlled trials only and interventions for children aged 5 years and over. Other study designs may provide important cost data. Future work could explore the cost data needs of public health policy-makers and the impact of including incentives on the effectiveness and cost-effectiveness in public health randomised controlled trials.</p><p><strong>Conclusions: </strong>This is a novel synthesis of costs reported in randomised controlled trials of interventions to prevent childhood obesity. Overall, the reporting of any type of costs was low (35% of studies). The most common type of reported costs were intervention costs (e.g. staff","PeriodicalId":74615,"journal":{"name":"Public health research (Southampton, England)","volume":" ","pages":"1-28"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145574804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adapted Safety Plans to Address Self-Harm and Suicide Behaviours in Autistic Adults: single arm feasibility trial and external pilot RCT.","authors":"Jacqui Rodgers, Nawaraj Bhattarai, Jane Goodwin, Isabel Gordon, Phil Heslop, Emma Nielsen, Rory Ciaran O'Connor, Emmanuel Ogundimu, Mirabel Pelton, Sheena Ramsay, Ellen Townsend, Luke Vale, Janelle Wagnild, Colin Wilson, Sarah Cassidy","doi":"10.3310/CGDF8525","DOIUrl":"10.3310/CGDF8525","url":null,"abstract":"<p><strong>Background: </strong>Suicide prevention is a national priority for United Kingdom government policy, and autistic people have recently been identified as a high-risk group in both the Department of Health and Social Care suicide prevention strategy and National Institute for Health and Care Excellence suicide prevention guidelines. No suicide prevention interventions have been developed specifically for autistic people. Safety plans are a simple, cost-effective, potentially life-saving intervention.</p><p><strong>Aims: </strong>To evaluate the feasibility and acceptability of the use of Autism Adapted Safety Plans for autistic adults and to undertake an external pilot to explore whether a larger future definitive trial is achievable.</p><p><strong>Methods: </strong>Stage 1 involved focus groups with autistic adults (<i>n</i> = 15), family members (<i>n</i> = 5) and service providers (<i>n</i> = 10) to inform adaptations to the Autism Adapted Safety Plans. Stage 2 was an interventional single-arm feasibility trial where autistic adults (<i>n</i> = 8) completed an Autism Adapted Safety Plans with a supporter (<i>n</i> = 8). Data on recruitment, completion of study measures and participant feedback informed final adaptations to the Autism Adapted Safety Plans and research methods prior to stage 3. Stage 3 was a pilot feasibility randomised controlled trial of Autism Adapted Safety Plans. Autistic adults were recruited via non-National Health Service organisations and self-referral. Participants were randomised without stratification to usual care ± Autism Adapted Safety Plans. The Autism Adapted Safety Plan was completed by the autistic adults with someone trained to support them. Research staff completing follow-up assessments were blind to participant allocation. Primary outcomes were feasibility and acceptability of the Autism Adapted Safety Plans to inform the parameters of a definitive randomised controlled trial. Participants were assessed at baseline, 1 and 6 months.</p><p><strong>Results: </strong>Stage 1 and 2 interviews highlighted the conditions needed to make the process of creating the Autism Adapted Safety Plans acceptable for autistic adults. Stage 2 also informed modifications to recruitment (to include self-referral) in stage 3. In stage 3, 53 participants consented, 49 were randomised to either Autism Adapted Safety Plans + usual care (<i>n</i> = 25) or usual care (<i>n</i> = 24). Sixty-eight per cent of participants were satisfied with the Autism Adapted Safety Plans and 41% rated it as usable. Feedback on the Autism Adapted Safety Plans and study processes employed in the trial were positive with suggested minor adaptations to some outcome measures. Retention of those randomised was 95% at 6-month follow-up. Completion rates for outcome measures were generally high (> 85%). Fidelity ratings for delivery of the Autism Adapted Safety Plans were 94% for therapeutic components and 91% for adherence to content.</p><p><stron","PeriodicalId":74615,"journal":{"name":"Public health research (Southampton, England)","volume":"13 10","pages":"1-19"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145574740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home-based intervention strategy to reduce new chlamydia infection among young men: the HIS-UK RCT.","authors":"Nicole Stone, Cynthia Graham, Rowena Bedford, Lauren Towler, Louise Jackson, Stephen Bremner, Nuala McGrath, Katherine Brown, Katie Newby, Amanda Clarke, Leanne Morrison, Tom Nadarzynski, Ye To, Nicky Perry, Jake Bayley","doi":"10.3310/GJNS1528","DOIUrl":"10.3310/GJNS1528","url":null,"abstract":"<p><strong>Background: </strong>Sexually transmitted infections pose a significant public health challenge in the United Kingdom, prompting the Department of Health and Social Care to prioritise sexually transmitted infection rate reduction as a means of addressing sexual health inequalities. Correct and consistent condom use is the most effective method of reducing sexually transmitted infection transmission.</p><p><strong>Methods: </strong>A randomised controlled trial with three arms (two intervention arms and one control arm) was conducted to evaluate the effectiveness and cost-effectiveness of the home-based intervention strategy United Kingdom intervention in reducing chlamydia test positivity among 16- to 25-year-old men, and individuals with a penis, at risk of sexually transmitted infections. The home-based intervention strategy United Kingdom intervention, delivered either face to face by health promotion professionals or digitally through an interactive website, aimed to enhance condom use experiences and improve correct and consistent condom use. The control group received usual condom distribution care. Chlamydia screening was conducted at baseline and 6 months post randomisation, with follow-up through online questionnaires. Of the 2387 individuals assessed for eligibility, 1233 were eligible, and 725 participants completed all baseline assessments and were randomised (health promotion professionals: 241, interactive website: 243, control: 241). Five hundred and eighty men received the intervention arm as randomised (health promotion professionals: 51.9%, interactive website: 93.8%, control: 94.2%); 51.7% of participants engaged during follow-up, with 21.4% providing baseline and follow-up chlamydia screening results.</p><p><strong>Results: </strong>Findings showed the home-based intervention strategy United Kingdom to be well received, with participants valuing the condom kit and materials promoting pleasurable condom use. At the primary end point, home-based intervention strategy United Kingdom participants showed a 4.9 percentage point reduction in chlamydia test positivity compared to the control (7.9% vs. 12.8%). The odds of a positive test were 55% lower for home-based intervention strategy United Kingdom participants compared to the control. However, this reduction was not statistically significant due to the lower-than-planned participant recruitment (a consequence of COVID-19) affecting the trial's power. Home-based intervention strategy United Kingdom positively impacted recent condom use along with significant reductions in condom use errors and problems compared to the control. While no marked effect on consistent condom use emerged, attitudinal shifts were highly significant, with sustained positive condom attitudes, reduced perceived barriers and increased confidence in condom use among home-based intervention strategy United Kingdom participants.</p><p><strong>Conclusion: </strong>The home-based intervention strategy ","PeriodicalId":74615,"journal":{"name":"Public health research (Southampton, England)","volume":"13 8","pages":"1-47"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}