Reducing health inequalities: Marmot indicators 2017

This briefing provides an update on progress since the 2008 Marmot Review into the most effective evidence-based strategies for reducing health inequalities in England. | The Institute of Health Equity 

This update finds that improvements on life expectancy at birth and remaining life expectancy at 65 have slowed since 2010. The analysis also finds that inequalities within and between local authorities have persisted.

Full document: Marmot Indicators Briefing 2017 – updated

Additional links: BBC News report | AgeUK

Measuring the public health impact of healthcare professionals

The Royal Society for Public Health has published Everyday interactions: measuring the public health impact of healthcare professionals.

This toolkit seeks to provide a straightforward way for health care professionals to record and measure their public health impact in a uniform and comparable way.  It is to support healthcare professionals in the prevention and health improvement interventions that they do as part of routine clinical practice.  It is particularly aimed at nurses and midwives, dentists, allied health professionals and pharmacists.

Adult weight management

Public Health England has published guidance to support the commissioning and delivery of tier 2 adult weight management services.

This guidance supports commissioners and providers of tier 2 adult weight management services, including:

  • local authorities (LAs)
  • clinical commissioning groups (CCGs)
  • NHS institutions

The guidance is published under the following categories: following categories:

Commission and provide

Adult weight management services: commission and provide

Weight management services: insights into user experiences

Interventions

Data collection

Behaviour change interventions for primary prevention of cardiovascular disease

It is uncertain whether multiple health behaviour change (MHBC) interventions are effective for the primary prevention of cardiovascular disease (CVD) in primary care | BMJ Open

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Background: A systematic review and a meta-analysis were performed to evaluate the effectiveness of MHBC interventions on CVD risk and CVD risk factors; the study also evaluated associations of theoretical frameworks and intervention components with intervention effectiveness.

Conclusions: MHBC interventions delivered to CVD-free participants in primary care did not appear to have quantitatively important effects on CVD risk factors. Better reporting of interventions’ rationale, content and delivery is essential to understanding their effectiveness.

Full reference: Alageel, S. et al. (2017) Multiple health behaviour change interventions for primary prevention of cardiovascular disease in primary care: systematic review and meta-analysis. BMJ Open. 7:e015375. 

Community-based gardening interventions to prevent overweight and obesity

Protocol for systematic review exploring the efficacy and cost-effectiveness of community gardening to prevent overweight/obesity | BMJ Open

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Introduction: The worldwide prevalence of overweight/obesity has continued to rise over the last decades. To reverse this trend, public health authorities are exploring cost-effective interventions, especially in high-income and middle-income countries. Community gardening offers a unique opportunity for individuals to enhance physical activity levels and improve their diet. However, synthesised evidence on the short-term or long-term effectiveness and on the costs of community gardening interventions to prevent overweight/obesity remains limited. Therefore, this review will investigate: (1) the effectiveness of voluntary participation in community gardening compared with no or a control intervention on overweight/obesity and associated health outcomes, (2) effects on different subgroups of populations and (3) the costs of community gardening interventions.

Methods and analysis: We will conduct a systematic review, limited to evaluations of community gardening interventions with controlled quantitative and interrupted time series designs. To identify relevant articles, we will systematically search 12 academic and 5 grey literature databases, as well as 2 trial registers and 6 websites. Articles will then be assessed for eligibility based on a predefined set of criteria. At least two independent reviewers will assess each article for relevance, before evaluating the methodological quality and potential bias of the studies. Data relevant to the objectives of this review will be extracted and cross-validated. Any disagreements will be mediated by a third reviewer. If feasible, meta-analyses of primary outcomes (overweight/obesity, physical activity, food intake, energy intake) will be conducted. We will use the Grading of Recommendations Assessment, Development and Evaluation method to assess the overall quality of evidence.

Ethics and dissemination: For this review, no ethical approval is required as we will only extract and analyse secondary data. We aim to submit the final review manuscript to an open access journal for publication and disseminate results via conferences and social media.

Full reference: Heise TL, Romppel M, Molnar S, et al. (2017) Community gardening, community farming and other local community-based gardening interventions to prevent overweight and obesity in high-income and middle-income countries: protocol for a systematic review. BMJ Open. 7:e016237.

Workplace health promotion

Report suggests that effective investment in health and wellbeing can save a company more than it spends on the interventions | RAND

The importance of the workplace as a setting for health promotion is increasingly recognised by employers and policymakers. As a result, workplace health promotion programmes are growing in numbers and scope around the world.  Such programmes have the potential to generate returns on investments and can reduce overall health costs.

Image source: www.rand.org

The RAND Corporation has published The return of investment for preventive healthcare programmes.  This report outlines the divers of successful workplace health promotion programmes, provides an overview of health and wellbeing interventions offered by pharmaceutical companies, and develops a framework to analyse the return on investment of such projects, applying it to GSK’s P4P programme

Supported web-based programme helps people lose weight in the short term

A web-based programme (POWeR) with nurse support helped about 30% of people lose at least 5% of their body weight, maintained for at least 12 months. By comparison, twenty percent of people achieved this with an online information sheet only.  | National Institute for Health Research (NIHR)

weights-1501439_1920POWer+ helped more people achieve short-term weight loss but the average weight loss of about 3-4 kg after 12 months was statistically similar for those given information only. The healthy eating online materials tested had previously been shown to help people to control their weight, without expert advice.

This NIHR research showed that the web programme, with phone or email support from nurses, had a modest benefit and was probably cost-effective.  It represents one option that could be offered to patients.

Full reference: Little P, Stuart B, Hobbs FR, et al. Randomised controlled trial and economic analysis of an internet-based weight management programme: POWeR+ (PositiveOnline Weight Reduction). Health Technol Assess. 2017;21(4):1-62.