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894e3c82-d20e-4fbc-a56a-7d96277ba61e COMPLETED: PARTNERS Project: Development and implementation of a digital tool for multisectoral support and management of long-term condition PARTNERS Project: Development and implementation of a digital tool for multisectoralsupport and management of long-term condition Principal Investigator: Professor Mari-Carmen Portillo Co Applicants : Line Bragstad, Dr Dorit Kunkel, Dr Kat Bradbury, Dr Lindsay Welch, Hayden Kirk, Dr Caroline Barker, Sandra Bartolomeu Pires, Christopher Edwards, Lindsay Cherry, Francesca White, Caroline Aylott, Cathal Doyle. Partners: University of Southampton, University of Oslo, Hampshire and Isle of Wight NHS Foundation Trust, University Hospital Southampton NHS Foundation Trust, Hampshire and Isle of Wight ICS, Versus Arthritis, and Parkinson’s UK. Lay Summary Background to the research : Self-management is an approach to help people with long term conditions manage their health daily. Existing NHS self-management tools focus on healthcare (medication management, appointments) and fail to capture aspects of how people live with and adjust to long-term conditions. This includes social support (family/friends) and other resources and networks available like the voluntary sector, industry and community groups.We have created an intervention (an action to improve a situation or prevent it getting worse) to support self-management for people with Parkinson’s Disease and their family/carers. This intervention recognises the role of social support, voluntary sector, industry, and community groups in adjusting to living with a condition. Our next step is toadapt this intervention to the needs of people living with other conditions like Arthritis and for those living with more than one condition and create a digital tool. Aim of the research : To develop, implement and evaluate a digital tool that supports the management of people with Parkinson’s Disease and/or Arthritis. The tool will support professionals and other organisations to connect, share resources and optimise communication and referrals, leading to more personalised and cost-effective use of resources (beyond healthcare) in the community. Design and methods: The research will take place in community settings in Wessex. We will prioritise disadvantaged groups (those less comfortable using technology and less able toaccess available resources and support). We will : 1. Work with our patient and public involvement (PPI) representatives, relevant voluntary organisations, health and social care providers, and key people involved in policy making and NHS strategy. They will have a voice ineach decision to ensure our tool is relevant and acceptable to those using it. 2. Host discussion groups with people with Parkinson’s Disease and/or Arthritis and theirfamily/carers to understand the positive and negative aspects of existing digital tools, from a patient perspective. 3. Design our self-management tool. 4. Test the tool through two primary care surgeries (GP) and voluntary organisations (Parkinson’s UK and Versus Arthritis).Testing will help understand how the tool is used and what helps or hinders its success. Deliverables : The research will generate: a digital tool to support more effective self-management of Parkinson’s Disease and/or Arthritis, recommendations for policy development, evidence for how to improve NHS services. Public Patient Involvement: We willwork with people with Parkinson’s Disease and/or Arthritis and their families/carers. We will work together as equal partners to define their level of involvement, roles, methods to input and training needs. We will also explore what works best or what we should do differently intheir involvement. Dissemination : We will share our learning across the different groups involved. This will include presentations, policy briefings, newsletters, and public events. What did we find out? We found that people with Parkinson’s and/or arthritis, their carers and professionals involved in their care wanted a digital app that was: • Simple • Easy to navigate • Hybrid – in person contact also signposted Included: • Community resources from voluntary/charity sector • Free or inexpensive resources • Links to peers/buddy for support What next? PARTNERS 2 has evolved, as a continuation project. This allowed time for: A suitable digital company to be found with previous experience of working with people with health condition Full briefing of the digital company about what was required of the digital web app. Development of a 'Life Boost' app Trade marking 'Life Boost' Real-world evaluation of the app with Social Prescribers in Hampshire Linking 'Life Boost' to MyMedical Record (University Hospital Southampton NHS Foundation Trust) The PARTNERS 2 project will now: Ga in full exposure by having it adopted onto the My Medical Record platform at the University Hospital Southampton NHS Foundation Trust Be used in the real-world and a business/company/organisation will be sought to adopt the app for further development and management

596abb82-50f3-40e1-8d8d-a89073038260 ADOPTED: DASA - Domestic abuse and housing: local authorities' provision of safe accommodation for adults living with disabilities and/or long-term/life-limiting illness: a mixed-methods study Principal Investigator: Dr Michelle Myall , School of Health Sciences, University of Southampton. Team: Dr Sophia Taylor and Dr Susi Lund , School of Health Sciences, University of Southampton. Professor Julie McGarry and Professor Parveen Ali University of Sheffield. Mrs Samantha Dawson, Body Positive Dorset - Public and Patient Contributor Summary In 2022 an estimated 2.4 million adults experienced domestic abuse in England and Wales. Some people are at increased risk because of additional inequalities, vulnerabilities, and other factors. This includes adults with complex health and social care needs such as those living with physical disabilities and long-term/life-limiting illnesses. In April 2021 the Domestic Abuse Act was introduced in England. This created a new definition of domestic abuse to include any incidents of controlling, coercive, or threatening behaviour, violence or abuse between those aged 16 or over, who are or have been, intimate partners or family members regardless of gender or sexuality. Domestic abuse also includes psychological, physical, sexual, financial and emotional abuse. Domestic abuse can happen to anyone and is a leading cause of homelessness. In England, the Domestic Abuse Act has changed housing law to give priority accommodation to a person made homeless because of domestic abuse and requires local authorities to offer support in safe accommodation and alternatives to refuge provision. Refuges are notsuitable for all victim-survivors, particularly those who have additional and specific health and care needs. There is little research on the housing needs of domestic abuse victim-survivors with physical disabilities, longterm conditions or life-limiting illnesses. Understanding the requirements of these groups and how local authorities are meeting their responsibilities under the Domestic Abuse Act is important and timely. What are the study aims? Working with people with lived experience, local authorities, and domestic abuse organisations we aim to: 1) identify and explore the experiences of victim-survivors living with a physical disability and/or long-term/life-limiting illness affected by domestic abuse and 2) understand how local authorities are meeting their responsibilities in providing safe accommodation and prioritising those made homeless because of domestic abuse. We will explore what local authorities already provide and how they are responding to the requirements of The Domestic Abuse Act. We will review published research and policies, map existing housing provision, and undertake interviews with key stakeholders. To ensure the voices of people with lived experience are included and listened to, we will hold creative workshops, using art, poetry or stories to explore their experiences. Findings will be used to develop a toolkit for local authorities and their partners to inform practice and improve user experience. What will happen to the study findings? We will work with our project partners and people with lived experience to identify who we need to engage and how to reach them. We will hold an event at the end of the study to share findings with stakeholders. Findings will be reported on social media for the wider public, and attendance at conferences and publications in academic and professional journals.

7982ebd7-aab7-4e3f-8493-b1caebcd4bea COMPLETED: The Wessex FRIEND Toolbox (Family Risk IdEntificatioN and Decision) Identifying high risk groups early to improve health in young families in Wessex Principal Investigator: Professor Nisreen Alwan and Dr Dianna Smith Team members: Professor Nisreen Alwan (Professor in Public Health, School of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton), Dr Dianna Smith (Lecturer in Geographic Information Science, Geography & Environment, University of Southampton), Professor Paul Roderick (Professor of Public Health, School of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton), Dr Ivaylo Vassilev (Principal Research Fellow, School of Health Sciences, University of Southampton), Dr Grace Grove (Clinical Research Fellow, School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton), Dr Nida Ziauddeen (Research Fellow, School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton),Dr Lauren Wilson (Research Fellow, Geography & Environment, University of Southampton) Read report: Food Insecurity Risk Indices for Neighbourhoods 2021 Food Insecurity Brief LSOA Level Estimates Sept2021_online[2] .pdf Download PDF • 363KB Start: 21 October 2019 Ended: 30 September 2022 Project Partners: University of Southampton, Solent NHS Trust, Southampton City Council, Portsmouth City Council, Hampshire County Council, Health Education England, Oxford Brookes University Lay summary We know that prioritising health is complex, particularly for families living in social and economic disadvantage. The SLOPE CORE tool estimates the future risk of childhood overweight at the start of primary school. It can be used by health professionals in consultation with the families they are working with to help facilitate various interventions towards the prevention of childhood obesity. We have tested the acceptability and feasibility of this tool in the first phase of the Wessex FRIEND project, as part of a broader programme of work, aiming to improve the health of children and families in Wessex. We have trialled it with health visitors in the first instance, just so that we can get some initial feedback and improve it before combining it with other components of interventions. We have also been refining and tailoring area-based child poverty, food poverty and greenspace access measures to the local and regional context and population, so that our risk tool takes into account the area profile and resources where the family lives. These area-based measures, which represent neighbourhoods, may also be used independently by local governments and civil society/third sector to help in targeting resources to better support people living in areas of higher risk for food and child poverty, or with poorer access to greenspaces. What have we found out? We tested a digital tool called SLOPE CORE which predicts if preschool children are likely to be overweight by the time they start school. Health visitors and parents found the obesity prediction tool quick and easy to use. Using the tool provided the opportunity for health promotion, and may facilitate difficult conversations by giving an objective result and removing the perception of professional judgement. This may encourage conversations on healthy weight and could influence health visitor practice by increasing provision of anticipatory support on feeding. Health visitors felt that, when using the tool, the healthcare professional should have sufficient time to have a sensitive discussion and explain a conceptually difficult concept (risk). Parents felt that the tool provides an opportunity for behaviour change and potential to improve health for the child but can also provide reassurance. They appreciate the provision of additional resources and support with the results. However, before using the tool the healthcare professional should consider whether the tool is appropriate, as it may be unsuitable for some parents. We refined and tailored area-based child poverty, food poverty and greenspace access measures to the regional context and population. These provide improved tools for better planning and targeting of services by the local councils. These area-based measures are combined with the individual childhood obesity estimation provided by the SLOPE CORE Tool on one platform, which can be utilised by frontline professionals dealing with disadvantaged families. We also tested the feasibility of the Generating Engagement in Network Involvement (Genie), a facilitated social network intervention, as a means towards reducing risk of adverse family health outcomes. We tested this with Home-Start in Portsmouth which is a voluntary organisation. Staff found Genie simple to use, really liked the concept and found that familiarity with the system meant the process was much smoother for later entries. Staff felt that being able to fill out Genie on a phone or app would be quite useful. The option of other languages or built-in translation could also make it easier to use. Staff felt that Genie was particularly good for families feeling isolated or new to the area but was unlikely to be relevant for all. However, staff thought it was less realistic for them to use it within the timeframe of visits and other things that need to be done during a visit but they could potentially facilitate the use of Genie by encouraging people to do so themselves. The network mapping was useful as it made people realise what they have and what they need. Staff found it an interesting exercise to start the conversation and find out what was going on in the lives of individuals/families they were supporting. A potential barrier to the use of both tools is lack of wi-fi/internet connectivity. What difference can this make? Using the obesity prediction tool could provide the opportunity for health promotion and facilitate discussions by giving an objective result and removing the perception of professional judgement. This could encourage conversations on healthy weight and potentially influence health visitor practice by increasing provision of anticipatory support on feeding. Using the tool antenatally, or with a younger infant may allow for an easier conversation, allowing the healthcare professional to focus on prevention, as opposed to ‘correcting’ a parent’s current behaviour. Health visitors felt that parents were more likely to be receptive to a preventative approach. The refined area-based measures provide improved tools for better planning and targeting of services by the local councils. Network mapping using Genie made people realise what they have and what they need and help staff start the conversation to find out what was going on in the lives of individuals/families they were supporting. Why in this important? The Childhood Obesity Risk Estimation Tool has the potential to focus targeted intervention for the early prevention of childhood obesity. The updated food insecurity risk index has enabled local government to target available resources to those with greatest need. It has been included in the Joint Strategic Needs Assessment (JSNA) for Hampshire County Council. It has also contributed to food aid planning in Dorset, Hampshire and further resource planning in districts across the country. What’s next? The SLOPE CORE tool combined with the area based measures will require further testing to establish how it can be best used in practice, and any impact it may have on childhood obesity. This could be as part of a new or existing pathway which includes interventions designed to reduce risk of childhood obesity. Healthcare professionals using the tool should be trained in risk commination, be able to advise the parent on next steps, and have time to discuss what can be a sensitive topic. As SLOPE CORE only requires routinely collected data, it may be possible to build the tool into existing systems - such as healthy weight pathways, routine health visiting contacts and relevant GP consultations, which could save time and support existing work rather than further adding to workload for healthcare professionals. If internet access is unreliable, then a paper data collection sheet could be used to capture data required to use the tool at another time. After determining optimum timing and setting for tool use, a longer term evaluation is necessary to explore the impact of the tool on parents and healthcare professionals behaviours in the short term, and childhood obesity in the longer term. Publications: Ziauddeen, N., Roderick, P., Santorelli, G., Wright, J., & Alwan, N.A. (2022). Childhood overweight and obesity at the start of primary school: external validation of pregnancy and early-life prediction models. PLOS Glob Public Health. 2(6): e0000258. Ziauddeen, N., Roderick, P., Santorelli, G., Wright, J., & Alwan, N.A. (2020). OP55 Childhood overweight and obesity at the start of primary school: external validation of pregnancy and early-life prediction models. Journal of Epidemiology & Community Health, 74(Supplement 1), A26. https://doi.org/10.1136/jech-2020-SSMabstracts.54 Smith, D.M., Rixson, L., Grove, G., Ziauddeen, N., Vassilev, I., Taheem, R., Roderick, P., & Alwan, N.A. Household food insecurity risk indices for English neighbourhoods: measures to support local policy decisions. MedRxiv 2022:22273530. https://doi.org/10.1101/2022.04.06.22273530 (preprint and minor revisions requested at PLOS ONE) Smith, D. and Thompson, C. (2022) Food Deserts and Food Insecurity in the UK. Routledge. Further funding because of this research: ARC Wessex - Wessex DIET: Determining the Impact of covid-19 on food sEcurity in young families and Testing interventions MRC Clinical Research Fellowship (Dr Grace Grove) - Investigating the impact of food vouchers on diet composition and the prevention of childhood obesity Other impacts: The food security risk index has been included in the JSNA for Hampshire and has contributed to JSNAs and food aid planning in Dorset, Hampshire and further resource planning in Lancaster, Hull Hertfordshire and Greater Manchester to name a selection of Local Authorities, demonstrating the wider reach beyond Wessex.

c1c3e509-fcbe-4039-a8f6-143f962aecbd COMPLETED: Improving community health care planning Improving community health care logistics using Operational Research Principal Investigator: Dr Carlos Lamas-Fernandez Team members: Dr Carlos Lamas-Fernandez, (Research Fellow in Operational Research, University of Southampton), Professor Peter Griffiths (Chair of Health Services Research. University of Southampton), Dr Antonio Martinez-Sykora (Associate Prof of Business Analytics. Southampton Business School, University of Southampton), Dr Tom Monks (Associate Professor of Health Data Science, University of Exeter) Start: 1 October 2019 Ended: 30 September 2021 Partners: University of Southampton, Solent NHS Trust and Abicare Lay summary Operational Research (OR) is the application of computer and mathematical modelling to support decision making. In health services research, OR aims to improve patient outcomes, increase efficiency and enhance health professionals and citizens understanding of how an NHS service achieves good performance. In this study, we will use OR to improve the quality of patient care by supporting community nursing teams organise how they visit people in their own home. What did we acheive? We found that it is possible to develop algorithms that create routes and schedules automatically for district nurses. These algorithms can incorporate many practical constraints that nurses encounter during planning, and produce solutions that are optimised to use their time efficiently. We found out that, with minor modifications, the algorithm can also support social care workers in a similar manner. What difference can this new knowledge make? These algorithms are a stepping stone that bring closer the academic research (typically on idealized problems that do not work on practice) to the reality of nurses that currently organise their workload on a laborious manual process. Both their planning time and the extra time spent on the road (e.g. by doing a route larger than it could have been) can be saved and utilized to care for patients. Why is this important? Patients will benefit from a more efficient workforce, who can as a result have more time to care for them. Further, they might also benefit from better planned visits which might include their preferences. Care providers can use these kind of tools to plan their workload more efficiently, save costs on their operations and reduce the burnout of the nurses in charge of doing manual planning. Policy makers can run these kind of tools to test hypothetical scenarios (e.g. how does service delivery change with an increase of the demand, when we hire more district nurses or if we train part of our staff?). Care providers can also assess What's next? We continue working to improve our algorithms and liaise with social care companies to explore how they can be used in practice. We are looking into integrating them as demand estimation tools in other relevant problems, such as complex discharge from hospital. Publications https://www.nursingtimes.net/news/community/home-healthcare-are-nurses-wasting-their-time-on-the-road-26-04-2021/ A flexible mathematical model for Home Health Care Problems - ScienceDirect Useful Models (Open source): Reproduced exact models from the literature: https://github.com/c-lamas/hhcrsp Our own contribution: https://github.com/miguelreula/MILP_HHCRSP Synthetic Datasets: https://github.com/c-lamas/instances_hhcrsp

Home > About us Case studies Dr Dominique Mylods Journey to becoming a researcher Dr Dominique Mylod, is a lecturer in Midwifery at Bournemouth University. In an interview with Jamie Stevenson she talks openly, passionately and with great humour about her journey from Teaching English as a Foreign Language to qualifying ad a midwife at 40, then making a start on her research career. Anna Badley Community nursing to PhD I love research and I always have done, but my journey to being awarded an ARC Wessex PhD Scholarship has been far from traditional. Read more

Public and Community Involvement, Engagement and Participation Resources Why involve patients and the public? PPI in research is expected for many funding streams (including the NIHR) and is a consideration made by the National Research Ethics Service when assessing applications. If PPI is not incorporated into your work, you will have to give a clear explanation of why not. It could benefit your research through: Additional expertise – this could come from having experience of the illness or simply relate to their age or demographic Ensuring the research questions are relevant and the priorities reflect the needs of those affected Improving patient experience and influencing trial recruitment and retention Assessing ethics/acceptability – helping ensure your research is conducted in a way that is sensitive to the needs and preferences of your participants Assisting with writing in lay language How could PPI help my research? Patients and the public involved in your research could: Help write and design patient literature for your participants, so they are more suitable for the reader. Comment on ethical issues associated with studies, and how they can be addressed Ensure your study is appropriately designed Get advice on how to share your findings to a wide audience, in a way the public can understand Guide the design of questionnaires to get reliable, honest data from trial participants, particularly when questions are about sensitive topics Sit on your steering committee, to provide input based on their direct experience of the topic being investigated Please see our Standard documents, templates and procedures to download the guidelines for researchers accessing any of the PPI groups and feedback form for PPI activities (for completion at the end of your PPI activity). NIHR resource links below and other helpful organisations Tips on writing a PLAIN ENGLISH SUMMARY Briefing notes for researchers - public involvement in NHS, health and social care research Payment guidance for researchers and professionals UK Standards for Public Involvement Connect with expertise Raising Voices in Research RViR (Hampshire and Isle of Wight) Public Involvement front Door You can also search for advice and tips using the NIHR Learning for Involvement search page The NIHR has a series of PPI in Action Webinars which you can watch below Aimed at researchers and public members alike, each section gives a short introduction to all elements needed to be considered for good quality PCIEP, with additional resources available for those needing more detailed information. UK Standards for Public Involvement Produced by the NIHR, this is a framework for what good public involvement in research looks like and designed to help researchers and organisations improve the quality and consistency of public involvement in health and care research. Reaching Out: Building relationships to increase research impact A report written about an online event where community groups, researchers and NIHR organisations from Kent, Surrey and Sussex came together to explore the barriers to ethnic minority group involvement in research and to consider what could be done to address these through partnership working. Learning for Involvement NIHR web pages offering Training and Resources for Public Involvement in Research. If you have any queries please email the PCIEP Team ppiesupport@uhs.nhs.uk

78e6cc7b-5ff9-411b-b288-1d82a03f0414 COMPLETED: Testing the effects of food product placement on customers’ visual attention and intended product purchases: a randomised trial in a virtual supermarket setting (Phase I) Does supermarket placement affect intention to buy healthy and unhealthy foods? Principal Investigator: Janis Baird and Christina Vogel, Professor of Public Health and Epidemiology and Principal Research Fellow in Public Health Nutrition respectively, MRC Lifecourse Epidemiology Centre, University of Southampton Team: Dr Sarah Crozier, Senior Statistician, MRC Lifecourse Epidemiology Centre, University of Southampton Sarah Jenner, Senior Research Assistant at University of Southampton Dr Sarah Muir, Senior Research Fellow, University of Southampton Professor Marcus Munafo and Dr Olivia Maynard, Bristol University Ravita Taheem, Southampton City Council, Sure Start Children’s Centres Megan Brook, Public Contributor Tiana Chadwick, Public Contributo Start date: 1 October 2019 End date: 28 February 2022 Background Poor diet has been recognised as a major contributor to the burden of non- communicable diseases in the UK and costs the NHS approximately £6 Billion annually. Most adults in England consume too much salt, saturated fat and free sugar, and do not eat the recommended five daily portions of fruit and vegetables. Among low-income groups these trends are more extreme. Almost 90% of UK grocery sales occur within supermarkets4 and their subtle use of marketing techniques influences the food choices of an almost captive market. Women of childbearing age are an important target group to study because they remain primarily responsible for domestic food tasks such as shopping and cooking and their nutrition status influences the short and long-term health of their children. Our prior work in Hampshire showed that the diets of women with low educational attainment were more affected by less healthy supermarket environments than women with higher attainment. Shopping at less healthy discount and small supermarkets, with poorer availability, pricing and placement of healthy foods, was associated with poor dietary quality among women who left school aged 16 years but not among those with degree qualifications. UK government policy recognises that more effort is needed to develop interventions to improve health equitably and is introducing legislation on product placement initiatives to support families to make healthier food choices in supermarkets. Research using adequately powered clustered randomised controlled trials in supermarkets is limited, largely due to the complexity and large number of stores required. Evaluating changes in supermarket layout is notoriously challenging due to differing health and business agendas and randomisation at the store level requires commitment that is problematic in this highly competitive, commercial setting. Virtual supermarkets offer a viable alternative to investigate the likely impact of supermarket-based, healthy eating policy options using robust trial designs. Additionally, neuroscience techniques, such as eye-tracking, offer objective evidence that complements self-report behaviours, and facilitate a deeper understanding of the cognitive mechanisms underlying health-related behaviours. Such techniques have been used to examine how product placement facilitates customers’ visual attention, however there is a gap in understanding of how visual attention differs according to the healthfulness of products, particularly while placed in prominent in-store locations and whether visual attention differs according to customer’s socioeconomic position. This study aims to use experimental randomised trials and a virtual supermarket setting to determine differences in visual attention and intended purchase of healthy, unhealthy and non-food products placed in prominent in-store locations such as checkouts. It will also assess effect modification by educational attainment on these relationships to explore potential effects on inequalities. This is the first of two phases of research assessing visual responses to product placement. In this phase, heat mapping technology using Qualtrics software determined whether interest in and intended purchase of products in prominent in-store locations differed if the products were healthy, unhealthy or non-food items. We assessed effect modification by educational attainment to explore potential effects on inequalities. Women with young children (n=230), recruited through Sure Start Children’s Centres, early years setting and other community groups in Hampshire, undertook shopping trips in a virtual supermarket to assess whether their purchasing intentions differ if unhealthy foods, healthy foods or non-food items are placed in prominent positions (store entrances, checkouts and end of aisle). Preliminary findings indicated differences in women’s intention to buy certain types of products according to their educational attainment. Women with no educational qualifications beyond aged 16 years were intent on purchasing fewer healthy products when they were placed in prominent locations whereas those with higher educational attainment were intent on buying significantly more healthy products. A total of 230 women participated in phase I, exceeding our target sample size of 52. The study Women were shown a series of pictures representing six journeys through a supermarket. Pictures focused on the areas in a store where most shoppers usually pass through including the store entrance, end-of-aisles and checkouts. In the first three journeys, women needed to click all items they were interested in. In the last three journeys they needed to click all the items they would intend to buy if this was a real shop. Each set of journeys included a healthy journey, unhealthy journey and a non-food journey. What were the results? 201 women took part in a virtual supermarket survey. Overall, women in the study showed more interest in unhealthy products than healthy or non-food items. At checkouts, however, they did show more interest in non-food items. Women intended to buy more healthy and non-food items than unhealthy food items. On average they wanted to buy 12.9 healthy products per shop compared to 11.5 unhealthy products. What difference will this make? Unhealthy products can be interesting to women who shop at supermarkets but they have higher intentions to buy healthy and non-food items in noticeable places in stores. Supermarkets usually place unhealthy foods in noticeable places to make profits. Replacing these unhealthy foods with healthy or non-food items will just as likely, if not more successfully, lead to purchases. This can help families lead healthier lives. Why is this important for patients, health and care providers and policy makers ? Placing unhealthy foods in noticeable places can lead to impulse purchases of foods that can lead to obesity. Our study shows that women do not intend to buy these foods but may show interest in them. Since 2022, UK policy has banned the placement of some unhealthy foods at noticeable places in supermarkets. This research provides evidence that customers likely support this policy as they would like to buy healthy and non-food items from these locations. What we are going to be doing next? We wanted to further understand how attention to healthy, unhealthy and non-food items differ in noticeable places in supermarkets. We therefore ran eye-tracking experiments with 70 women in Hampshire. Data are being analysed. We plan to report the results of our survey and eye-tracking studies to policymakers (e.g. Department of Health and Social Care and Public Health England) via a policy brief. We also aim to share our results with families via Sure Start Children’s Centres, Facebook and Local Schools. We have plans to share our findings at public health conferences and in an academic journal.

f1f73a06-b3fc-4e9d-b46d-0ecc2e946c91 PARIEDA - Prediction of Acute Respiratory Infection outcomes prior to Emergency Department Attendance Principal Investigator: Dr Daniel Burns, Senior Research Engineer, University of Southampton, d.burns@soton.ac.uk Team: Professor Michael Boniface, Professorial Fellow of Information Systems, University of Southampton, m.j.boniface@soton.ac.uk Professor Matthew Inada-Kim, National Clinical Director-Infection, AMR & Deterioration-NHS England & Improvement, National Clinical Lead COVID NHS@home Visiting Professor, University of Southampton Chair COVID pathways group, matthew.inada-kim@nhs.net Dr Stephen Kidd, Lead Healthcare Scientist, Hampshire Hospitals Foundation Trust, stephen.kidd@hhft.nhs.uk Starts: 1/4/2023 Ends: 30/9/2024 Aim: We will help community doctors and nurses decide how best to care for patients with serious respiratory illness. The right care depends on how ill a patient is and if they will get worse. Care may include home monitoring or hospital visits. We aim to use computer algorithms to help doctors and nurses make these decisions. We expect patients to avoid unnecessary trips to hospital and to feel more supported. Background: Hospitals have had record number of emergency departments visits. Respiratory infections are almost half of the visits. Many of these patients were not admitted to hospital. This means that some patients could be cared outside of the hospital in the community. COVID-19 is a serious respiratory illness. During the COVID-19 pandemic a new way to care for patients was created. Instead of patients going straight to hospital, they were assessed in the community. Only the most serious cases were then sent to hospital. Community care and assessment is now being considered for other respiratory illnesses. Approach: We will use computer algorithms to help community doctors and nurses decide which patients are at most risk of serious respiratory illness. Risk assessment will be done using machine learning. Machine learning is a way to train a computer to categorise patients into groups using data about patients and services they use. We will use historical hospital data to identify patients in high-risk groups. The patient categories will then be used to inform community decisions before attendance at hospital. Patient and Public Involvement: Patients and public have helped develop the research through evaluation pilots for community assessment hubs. PPI will influence data usage and the use of risk groupings within care pathways. Two public members will participant in a Steering Committee. A PPI Committee will organise three workshops involving ten patients and public in the research. Dissemination: Communication will engage the public and decision makers. We will work with patients and the public to design engaging communication and seek acceptance. Our results will be published and will inform national policy.

eb290c7e-cd77-4244-9d45-322994af9f69 COMPLETED ADOPTED PROJECT: Comparing pharmacological and non-pharmacological interventions for adults with Attention-Deficit/Hyperactivity Disorder (ADHD): systematic review and network meta-analysis Chief Investigator: Professor Samuele Cortese – University of Southampton Project Team Members: Professor Andrea Cipriani – University of Oxford, Associate Professor Corentin Gosling – University of Paris Nanterre, France, Dr Luis Faraht – University of São Paulo, Brazil / Yale University Child Study Center, USA, Dr Cinzia Del Giovane – University of Modena and Reggio, Italy Project partners: Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK; Oxford Precision Psychiatry Lab, National Institute for Health and Care Research Oxford Health Biomedical Research Centre, Oxford, UK; Oxford Health National Health Service (NHS) Foundation Trust, Warneford Hospital, Oxford, UK. Electronic address: edoardo.ostinelli@psych.ox.ac.uk . Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany. Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK; Oxford Precision Psychiatry Lab, National Institute for Health and Care Research Oxford Health Biomedical Research Centre, Oxford, UK; Oxford Health National Health Service (NHS) Foundation Trust, Warneford Hospital, Oxford, UK. Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil. Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK; Oxford Precision Psychiatry Lab, National Institute for Health and Care Research Oxford Health Biomedical Research Centre, Oxford, UK. Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy; Institute of Primary Health Care, University of Bern, Bern, Switzerland. Hampshire and Isle of Wight NHS Foundation Trust, Southampton, UK; Department of Psychiatry, Faculty of Medicine, University of Southampton, Southampton, UK. Psychology Services, London, UK; Department of Psychology, Reykjavik University, Reykjavik, Iceland. Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK; Oxford Health National Health Service (NHS) Foundation Trust, Warneford Hospital, Oxford, UK. The National Attention Deficit Disorder Information and Support Services, Edgware, UK. Hampshire and Isle of Wight NHS Foundation Trust, Southampton, UK Full team listing including PPI :O stinelli EG, Schulze M, Zangani C, Farhat LC, Tomlinson A, Del Giovane C, Chamberlain SR, Philipsen A, Young S, Cowen PJ, Bilbow A (PPI), Cipriani A, Cortese S Ended: 28th February 2024 Background: It is currently unclear how different treatment options for preschool children with ADHD compare with each other in terms of efficacy and safety. We will use data from available randomised controlled trials (RCTs) and apply an advanced and innovative statistical approach (network meta-analysis) to answer this question. What did we find out? We found that Stimulant medications and atomoxetine are the only treatments that clearly help reduce the main symptoms of ADHD in the short term, based on both what patients say and what doctors observe. However, people were less likely to stick with atomoxetine than with a placebo (a dummy pill). There was no evidence available other important things like improving quality of life, and we don’t know much about how well they work in the long run. Non-medication treatments had mixed results depending on who was doing the rating. This study gives the most complete picture so far of how different treatments for adult ADHD compare to each other. It can help guide treatment choices, but those choices should always be based on a careful look at both the benefits and risks — and on what matters most to the individual. The study is already informing clinical guidelines, e.g., the ongoing guidelines from APOSARD (USA). The study has informed a freely available platform ( https://ebiadhd-database.org/ ) that has been utilised by 15,000 colleagues around the world and improved through feedback from 1,000 stakeholders worldwide See medication and treatment ratings Next Steps To test the impact of the platform on knowledge and clinical practice To contact guideline bodies in the UK (eg NICE) and abroad to bring the network meta-analysis and the related platform to their attention. Publications Comparative efficacy and acceptability of pharmacological, psychological, and neurostimulatory interventions for ADHD in adults: a systematic review and component network meta-analysis - ScienceDirect

af50ff28-5b02-41fa-bc1f-f9689464860e EnTech (Enabling Technology): Investigating the enabling and inhibiting factors to the use of internet-based support tools for caregivers of people with dementia, and how to promote engagement. Chief investigator: Prof Chris Kipps Neurologist, Clinical Director R&D University Hospital Southampton Dr Sarah Fearn Senior Research Fellow NIHR ARC Wessex (Ageing & Dementia) University of Southampton Team: Prof Cathy Murphy, Professorial Fellow Research, School of Health Sciences University of Southampton Prof Eneida Mioshi Professor in Dementia Care Research University of East Anglia NIHR ARC East of England Jane Ward Dementia Friendly Hampshire Amanda Wollam Public contributor with personal and professional (social care) experience of caregiving to people with dementia Start: 1 October 2024 End: 31 March 2026 Partners: Do rset HealthCare University NHS Foundation Trust, University Hospital Southampton NHS Foundation Trust, University of Southampton, University of East Anglia / NIHR ARC East of England, Dementia Friendly Hampshire, My Dementia Support. Our research This research aims to identify the factors that help or hinder caregivers of people with dementia to use online support tools. It also aims to create strategies to support caregivers to use them. We will use two internet-based resources as examples in our work: the DemCon website, which provides advice on dementia and continence, and FTDToolkit, which will be a psychoeducational intervention to support management of behavioural symptoms in people with frontotemporal dementia (FTD) and FTD with Motor Neurone Disease (FTDMND). Whilst some previous research in this area exists, it has been based mostly on surveys and has not included caregivers who do not go online. We will use interviews and focus groups so that caregivers can discuss all of the factors that affect their use of online support tools. This could include their personal situation and attitude towards online support tools, as well as thoughts about the tool itself. We will ensure that caregivers who are less confident or less able to use online websites are also included. We will also investigate the factors that help or hinder caregivers of people with a specific type of dementia – young onset dementia or frontotemporal lobar degeneration, which includes, but is not limited to, FTD. These sub-types of dementia often affect people at a younger age and can have different symptoms to other, more common types of dementia. This specific group of caregivers has not previously been discussed in existing research on this topic. We will use our findings on the factors that help or hinder caregivers of people with dementia to use online support tools to create strategies to support them. We will do this in workshops with caregivers so that we create them together. Managing continence issues and behavioural changes can be difficult topics for caregivers to discuss. This project will provide insight into how online support tools can help support conversations about challenging topics. Public involvement We are working with caregivers of people with dementia and local dementia charities in this project. On our team, we have two public contributors who both have lived experience of caring for someone with dementia. They will help us to design and carry out the research, to make sure it is relevant to caregivers and benefits them. 60 caregivers will participate in the research in interviews, focus groups or workshops. Outcomes This research will inform the roll-out of DemCon and development of FTDToolKit, to promote their successful adoption by caregivers. Our findings will also be relevant to the development and roll-out of other online support tools for caregivers of people with dementia. We will share our findings with caregivers, academics, support tool developers and others involved in the care of people with dementia. We will produce reports, write scientific articles, present at conferences, and work with national and local dementia organisations to share our findings. Email lead researcher

1810d0c8-e9bb-4a7c-9947-bbac48f4dd69 Mental Health, Workforce and Well-being Research Framework - ARC Collaboration More details on ARC Greater Manchester website What are we trying to do? The purpose of the document is to propose a pan National Insititue of Health Research (NIHR) Applied Research Collaboration (ARC) workforce focused mental health and well-being research framework. The aim is for the research framework to serve as a reference point to: Create coherence and comparability across the research carried out by NIHR ARCs Reduce duplication of work to reduce workforce burden. Adopting a coherent approach with an agreed purpose and broad aims will maximise the potential for cross-ARC collaboration, synergy and impact. While the focus of this research has a COVID-19 focus, the ambition is that this framework should facilitate research beyond the current pandemic, ensuring programme sustainability and longevity across the lifetime of this 5-year NIHR ARC funding cycle. This framework is not intended to be prescriptive, rather, it is a call to colleagues doing research under the NIHR ARC umbrella to use the framework as a point of reference in the development of research projects and programmes. It is a modular approach which allows flexibility to fit the scientific questions and data collection to the needs of the specific workforce and context being studied. Why is it important? The NIHR has invested £135 million to support 15 collaboratives covering every region within England. The NIHR ARC collaborative provides a framework within which key stakeholders are brought together locally and nationally with a mandate to tackle difficult issues facing our health and care system including: patient outcomes, effectiveness of our health and care system, system sustainability, and carrying out research with an applied focus to facilitate the rapid translation of research into practice. Moreover, the designation of ARC South London and ARC East of England as national leads for mental health and the establishment of a National Mental Health Priorities Network provides a further opportunity for effective collaboration. The NIHR ARC network presents a unique opportunity to develop a coherent and consistent approach to workforce mental health and well-being research which embodies these principles. What will we do? The framework is available for any NIHR ARC to review and align with, to guide the development of work that aligns to the fundamental principles of the NIHR ARC programme. Who are we working with? The NIHR ARCs and their research themes are set out in a table included in the document. In line with the framework, colleagues are encouraged to work collaboratively to maximise synergy, impact, and reduce duplication and burden. The origins of this framework arose out of conversation with colleagues from across NIHR ARC sites between April 2020-June 2020. The framework has been developed by: Kirsten Windfuhr (ARC Greater Manchester), Jane Ball (ARC Wessex), Karina Lovell (ARC Greater Manchester) Penny Bee (ARC Greater Manchester). Additional contributions and comments were gratefully received from ARC colleagues, and in particular Kristy Sanderson (ARC East of England). More information For further information about this work, please contact Alison Littlewood (Programme Manager). (ARC GM) Download - Mental Health, Workforce and Well-being Research Framework

Dr Preeti Dhuria (University of Southampton) and Professor Christina Vogel (The Centre for Food Policy, City St George’s, University of London) discuss how weak enforcement lets retailers bypass UK obesity regulations < Back Chocolate at the checkout Weak enforcement of obesity regulations is undermining public health Dr Preeti Dhuria (University of Southampton) and Professor Christina Vogel (The Centre for Food Policy, City St George’s, University of London) discuss how weak enforcement lets retailers bypass UK obesity regulations It’s far too easy to choose unhealthy options in retail stores in the UK. This isn’t just a personal challenge for citizens, it’s a public health crisis. The places we shop shape our food choices and quite frankly, the odds are stacked against us in selecting healthy food. There is a growing momentum for strong policies to rein in the aggressive promotion of unhealthy foods, and that’s a positive step. In fact, the UK government introduced a ban on placing unhealthy foods at checkouts, aisle-ends and store entrances in 2022. But you wouldn’t necessarily know it as a shopper. Our research shows there is a significant lack of resources for adequate enforcement. This situation means we still see chocolate at checkouts in some stores and alcohol at the aisle-ends in others because stores are either breaking the rules or using loopholes to continue making money at the expense of the country’s health. Regulating the food retail environment is an important part of the solution to lower levels of obesity but weak enforcement can undermine health goals. The Food (Promotion and Placement) Regulations 2021 are designed to limit the promotion of unhealthy foods in most retail stores and online equivalents in England. When 22 local government officers were asked about their approach to enforcement before the regulations came into effect, the clear narrative was that these regulations would not be robustly enforced because of a lack of staff and training. Our research showed the key obstacles to enforcing these regulations include: Staffing Constraints : There is limited capacity within local authority enforcement teams to enforce these regulations. Their scarce resources are used for immediate threats to life like knife crime rather than assessing breaches, issuing notices and processing fines for these anti-obesity regulations. Inadequate financial support: Funding constraints further hinder enforcement because only £281k in funding has been allocated across the 317 local authorities in England to support these enforcement tasks, leading to inconsistencies across regions. Minimal training: Enforcement officers are likely to rely on personal judgment and experience due to limited training and guidance on how to interpret the definitions in the regulations, leading to significant variations in the interpretation and enforcement of the rules across regions. Despite the regulations’ long-term health goals, it is clear that they are ranked as a low priority and the process of issuing infringement notices is cumbersome. This situation is leading to patchy enforcement, and businesses not being held accountable uniformly. The processes for reporting breaches are also unclear meaning even action by the public is usually difficult. A freedom of information request covering a three-month period showed that no improvement notices had been issued despite instances of non-compliance being observed. A Call for Stronger Enforcement Our research outlines actions at the national and local levels that could help to improve the level of enforcement being undertaken. National-level actions Provide adequate and dedicated funding to local authorities to recruit and allocate staff specifically for compliance assessment of these regulations. Provide centralised training and detailed guidelines for enforcement officers to ensure consistency and build confidence among enforcement teams. Streamline compliance assessments by requiring manufacturers to disclose nutrient profile scores for their products and retailers to provide key details, such as store square footage and employee count, to their local authorities. Local-level actions Instigate linkages within local authorities by supporting cross departmental activity between trading standards, environmental health and public health officers to make enforcement efficient. Raise regulations’ priority by incorporating into joint strategic needs assessment within local authorities to increase buy-ins from councillors and Directors of Public Health. Lack of enforcement compromises impact Investing in enforcement is essential to securing regulation compliance and achieving the level playing field that food businesses and public health advocates called for. Early enforcement ensures that businesses fully understand their obligations, comply with the rules, and help build a precedent for healthier retail environments. Proactive enforcement sends a clear message- the regulations are here to stay, and compliance is non-negotiable. But local authorities cannot achieve strong compliance without adequate funding and the right tools. A lack of enforcement risks being misinterpreted as a sign of regulatory failure and withdrawal of the regulations. This outcome would be detrimental to the health of British children and families. Here are a few instances recently where our research team have spotted non-compliance but do not know how to effectively report the instances, and even approaching the store manager has not led to an immediate removal of products from restricted areas. To truly make an impact, future food policies must incorporate robust enforcement strategies and dedicated funding from the outset to maximise the regulations’ impact and safeguard public health. Previous Next