Other Projects

(Funded by Gamble Aware)

There had been a dramatic increase in recent years in the amount of gambling marketing and advertising, and growing concern about its potential effects, particularly on children, young people and vulnerable adults.  Although advertising codes of conduct existed to regulate the content and placement of gambling advertising, it had been argued that these had not kept pace with changes in recent years. A better understanding was needed regarding the nature of gambling advertising and how it may influence behaviour. This project, funded by Gamble Aware, aimed to understand the content,  reach  and  effect  of  gambling marketing and advertising on children, young people and vulnerable people. This aim was addressed through three research objectives: 

1. Explored whether  gambling  marketing  and  advertising  influenced  children  and  young people’s, attitudes towards gambling, in what ways and the impact of this.
2. Examined the tone and content of gambling marketing and advertising across all media, including  social  media  affiliates,  and  explored  the  potential  impact  of  this on children, young people, and vulnerable people.
3. Identified specific  themes  and  features  of  gambling  advertising  that  children, young people and vulnerable groups were particularly susceptible to.
4. Literature review of recent studies into the nature and effects of gambling advertising.

 Five work packages were conducted:

1. Content analysis of paid-for advertising across all forms of media, including broadcast, press, online, outdoor and direct mail. Three hundred advertising ‘creatives’ (examples of actual advertising) from two one-week periods in 2018 were analysed in-depth using a detailed codebook.  The analysis provided an in-depth insight into the features and characteristics of gambling advertising including analysis of whether advertising used elements which potentially increased the appeal of gambling or run counter to existing codes of conduct.
2. Analysis of sports sponsorship. A sample of football, rugby, boxing, tennis and Formula One fixtures broadcast in 2018 were analysed in terms of the frequency and nature of gambling marketing references (eg. sponsor logos on shirts, adverts, pitch side borders) shown during the duration of the broadcast.  The analysis provided insight into the extent of routine exposure to gambling references during broadcast sport.
3. Focus group research with young people and vulnerable adults (conducted by ScotCen Social Research). These explored in-depth how young people and vulnerable adults perceived and responded to gambling advertising in terms of awareness, knowledge of different brands, perceptions of the messages and themes conveyed in advertising about gambling and gambling outcomes, the emotional and other responses evoked by gambling advertising, and perceived effects on behaviour. 
4. Survey of children and young people aged 11-24 years olds (conducted by ScotCen Social Research). This examined the extent of awareness of, and exposure to, gambling advertising in the population, and the relationship between exposure and outcomes such as susceptibility, self-reported gambling behaviour, knowledge of gambling brands, and attitudes towards gambling.

ISM Staff: Nathan Critchlow, Martine Stead, Kathryn Angus, Crawford Moodie, Richard Purves and Amber Morgan

External: Fiona Dobbie, University of Edinburgh; Philip Newall, Gerda Reith and ScotCen Social Research

(Funded by Medical Research Council)

Almost half of the world's population, including 700 million people in Africa, rely on biomass fuels (animal dung, crop residues, wood) for their everyday fuel-energy requirements. These fuels are typically burned in open fires, often indoors, that emit smoke into the household environment and lead to high levels of household air pollution. Women and children, especially young children, experience high exposures to air pollution in the home; this has been linked to a range of adverse health outcomes including non communicable lung diseases like chronic obstructive pulmonary disease (COPD) and lung cancer in adults and asthma in children. It is now recognised that household air pollution from biomass smoke is the third leading cause of global disability and death with 4 million deaths attributed to this exposure annually. This burden, much of which is represented by non-communicable respiratory disease, falls hardest on poor populations around the world and in countries in sub-Saharan Africa in particular.

To build the foundations for work to tackle this issue we brought together a network of investigators from ten African countries (Cameroon, Ethiopia, Ghana, Kenya, Malawi, Nigeria, South Africa, Sudan, The Gambia and Uganda) underpinned by support from the Pan African Thoracic Society (PATS), American Thoracic Society (ATS) Methods in Epidemiologic, Clinical and Operations Research (MECOR) programme, MRC BREATHE-Africa partnership, Malawi Liverpool Wellcome Trust (MLW), Burden of Obstructive Lung Disease (BOLD) Centre, Spirometry Training Services Africa, Global Asthma Network (GAN), and Collaboration for Applied Health Research and Delivery (CAHRD). This proposal offered an unprecedented opportunity to create a multi-site multi-disciplinary pan-African platform for clinical, epidemiological and applied health research underpinned by regional and international collaborative research and delivery networks that allowed us to conduct research into the causes, prevention and treatment of non-communicable respiratory disease across the life course. By addressing a major cause of morbidity and mortality across the life course of children and adults living in low or middle-income countries in Africa the proposal aligned with the overall principle of Official Development Assistance (ODA) to promote welfare of developing countries.

Within the two years of this foundations-building grant we worked hard to create a thriving partnership whilst delivering on two specific research aims: to 1) develop and share methodology for the measurement of non-communicable respiratory disease exposures and outcomes tailored to the challenges of conducting research in resource-constrained African environments and 2) use this methodology to generate and share high quality preliminary data from multiple African sites.

ISM Staff: Sean Semple

External: Led by The Liverpool School of Tropical Medicine

Changing behaviours such as inactivity and poor diet, and so improving obesity and other related outcomes can be difficult as these behaviours are influenced by several factors including family circumstances. Efforts to improve family health usually focus on mothers, not fathers, even though men are more often overweight and less likely to take part in weight loss or healthy living programs.

We previously developed and evaluated a highly successful weight loss/healthy living program for men who were overweight or obese (Football Fans in Training, FFIT). FFIT was delivered by trained community coaches in professional football clubs and proved very popular with the men who took part (Hunt et al 2014a).  FFIT helped men to make positive changes to their weight and lifestyles and our studies had shown that these changes could be long-lasting in some men (Hunt et al 2014b; Gray et al 2018).

FFIT was delivered at professional football clubs throughout Scotland, and in England and Germany. Similar programs have been delivered in Australia (Quested et al 2018), New Zealand (Maddison et al 2019), England, the Netherlands, Norway and Portugal (Wyke et al 2019) and Canada (Capercione et al 2018, Petrella et al 2017).

Feedback from FFIT participants, family members and participating clubs suggested that there was widespread interest in developing a family component for FFIT and similar programs. We developed and evaluated a 4-week extension to these programs (‘FITter Families’) which aimed to: encourage children (and families) to adopt healthy lifestyles; promote positive parent-child communication about diet, physical activity and wellbeing; and improve long term weight loss and positive behaviour changes in men.

The aim of this study was to deliver and evaluate a 4-week family extension to FFIT and similar programmes (FITter Families). We would:

• test whether FITter Families was feasible to deliver;
• investigate whether short- and medium-term benefits of FFIT for participating men were likely to be at least maintained or improved;
• investigate whether there was evidence of likely benefit for key health behaviours in children and wider families;
• make changes to the programme, if needed, using feedback from coaches, clubs, participating men and their families.

References

Caperchione C et al (2017). The HAT TRICK program for improving physical activity, healthy eating and connectedness among overweight, inactive men: Study protocol of a pragmatic feasibility trial. BMJ Open, 7(9): e016940.

Gray C et al (2018). Long-term weight loss trajectories following participation in a randomised controlled trial of a weight management programme for men delivered through professional football clubs: a longitudinal cohort study and economic evaluation. International Journal of Behavioral Nutrition and Physical Activity, 15: 60.

Hunt K et al (2014). Do weight management programmes delivered at professional football clubs attract and engage high risk men? A mixed-methods study. BMC Public Health, 14: 50.

Hunt K et al (2014). Football Fans in Training (FFIT): a pragmatic randomised controlled trial and cost effectiveness analysis of a gender-sensitised weight loss and healthy living programme delivered to overweight and obese men aged 35-65 by Scottish Premier League football clubs. Lancet, 383: 1211-21.

Maddison R et al (2019). Rugby Fans in Training New Zealand (RUFIT-NZ): a pilot randomized controlled trial of a healthy lifestyle program for overweight men delivered through professional rugby clubs in New Zealand. BMC Public Health.

Petrella RJ et al (2017). Hockey Fans in Training: A Pilot Pragmatic Randomized Controlled Trial. Medicine & Science in Sports & Exercise, 49: 2506-2516.

Quested E et al (2018). Protocol for a gender-sensitised weight loss and healthy living programme for overweight and obese men delivered in Australian Football League settings (Aussie-FIT): A feasibility and pilot randomised controlled trial. BMJ Open, 8: e022663.

Wyke S et al (2019). The effect of a program for men to reduce sedentary time and increase physical activity delivered in professional football clubs across four countries: The European Fans in Training (EuroFIT) randomized controlled trial. PLOS Medicine, 16(2): e1002736.

Wyke S et al (2015). Football Fans in Training (FFIT): a randomised controlled trial of a gender-sensitised weight loss and healthy living programme for men - end of study report. Public Health Research, 3.

ISM Staff: Professor Kate Hunt (PI), Matthew McDonald (left), Alice Maclean

External: Professor Russ Jago and Dr Simon Sebire, University of Bristol; Dr Craig Donnachie, Dr Stephanie Chambers, MRC/CSO Social and Public Health Sciences Unit, University of Glasgow; Dr Cindy Gray, University of Glasgow

This study involved the development of a school-based, peer lead, social network intervention to delay the onset of gambling experimentation. In this early phase study, development of the intervention would be grounded in diffusion and network intervention theory, and modelled on an existing intervention called ASSIST, which was a smoking prevention programme that encouraged the dissemination of non-smoking messages among 12-13 year olds in the UK.

ISM Staff: Michael Ussher and Catherine Best

External: Led by Fiona Dobbie, University of Edinburgh

(Funded by the Chief Scientist Office)

Out-of-hospital cardiac arrest (OHCA) was a significant health problem in Scotland with approximately 3,000 resuscitation attempts each year. Survival was only 6.4%, with those in the more deprived quintile of the population (SIMD 1) twice as likely to suffer an OHCA, but 43% less likely to survive compared with those who were least deprived. The most important modifiable factor affecting survival was cardiopulmonary resuscitation (CPR) by a bystander. Bystander CPR more than doubles the likelihood of survival, but occurs only around 40% of the time, and least often in the SIMD 1 quintile. In 2015 the Scottish Government launched Scotland’s OHCA strategy with a key aim to improve survival by increasing rates of bystander CPR. This study contributed to that aim by developing a strategy to ensure that communities who most need increased CPR rates would be targeted. We accomplished this by designing an evidence-based intervention to improve the rate of bystander CPR in deprived areas using a social marketing framework and social network theory. Our research design included a systematic review and a range of qualitative methods with key partners and stakeholders. 

ISM Staff: Fiona Dobbie (PI), Martine Stead, Douglas Eadie, Kathryn Angus and Nathan Critchlow

External: Edward Duncan, University of Stirling; Gareth Clegg, Lisa MacInnes and Liz Hasseld, The University of Edinburgh

Publications:
Dobbie F, Angus K, Uny I, Duncan E, MacInnes L, Hasseld L and Clegg G (2018). Protocol for a systematic review to identify the barriers and facilitators to deliver bystander cardiopulmonary resuscitation (CPR) in disadvantaged communities. Systematic Reviews, 7: 143. doi:10.1186/s13643-018-0807-5

(Funded by the Medical Research Council)

The majority of UK adults do not meet physical activity guidelines. Some workplaces have tried to encourage physical activity at work to keep employees happy and healthy, but it has proved difficult to interest employees and to keep them involved. A new approach could be to provide opportunities for physical activity during paid working hours.

This exploratory project investigated attitudes relevant to such interventions in the workplace. To achieve this we collected the views of people within the organisations (employees, line managers, senior managers and supervisors, HR departments) and explored their thoughts on how such an approach might work. Focus group meetings and interviews were held to discuss how the workplace could provide physical activity during paid working hours, what type of physical activity people were interested in doing, and how this could be delivered. As part of this, we held a workshop for each workplace to generate ideas for addressing potential problems, and how to make the workplace culture and environment more favourable to physical activity.

ISM Staff: Martine Stead

External Department: Led by Josie Evans, Faculty of Health Sciences and Sport

(Funded by Keep Scotland Beautiful)

A ‘nudge’ is the manipulation of any aspect of ‘choice architecture’ that alters people’s behaviour in a predictable way without forbidding any options or significantly changing their economic incentives. This project aimed to encourage better use of street litter bins by enhancing bin salience. It did this by painting the bins in a bright colour to make them more visible and easier for people to find, and by painting footprints on the ground leading up to the bins as a prompt to infer the intended correct action, ie. to use the bin. The project built on an anti-littering nudge intervention carried out in Copenhagen in 2011 by applying a rigorous experimental design, and extending the original work to examine the impact of longer term exposure on bin use. The study used a before and after design implemented in a single site to comparing intervention against a normal state baseline over four stages: baseline, one week, four week and eight week follow-up. Impact on littering was assessed by distributing free, single items of wrapped confectionery to people as they moved across the study site and measured numbers of items correctly binned or discarded on the ground within a designated study area. The study was undertaken with our collaboration partner Keep Scotland Beautiful and was funded by Zero Waste Scotland. 

ISM Staff: Douglas Eadie and Martine Stead