17/55 Promoting independence in older and disabled people
The National Falls Prevention Coordination Group has identified a number of research priorities on the prevention and reduction of falls. The PHR Programme welcomes applications on the evaluation of population level interventions to prevent and reduce falls for older people and disabled people. The HS&DR Programme is also interested in receiving applications evaluating how the NHS and social care might improve the quality, accessibility and delivery of services for falls prevention. Applications within the remit of the HS&DR programme should be directed to current or future HS&DR Researcher-led calls. Please see the following link for information on the current call 20/02 Researcher-led call.
Applications should complement the existing evidence base and avoid duplication of ongoing research. Applicants should clearly state how their proposed research addresses an explicit evidence gap and how the research adds value to the existing NIHR research portfolio
- What are the most effective* interventions which support (or create the conditions for) independence* in the everyday lives of older people, or disabled people** of any age?
*Independence has been defined as “the ability to make choices and to exercise control over your life. This includes being able to live independently with or without support” (1).
**“Disabled people” have been defined as people with impairments who are disabled by society
The Public Health Research programme is particularly interested in evaluations of interventions to support practical everyday living and therefore contribute to independence in:
- Older people
- Disabled people (people with impairments who are disabled by barriers in society)
Whilst these populations are different, there may be overlapping needs, and there may be interventions or groups of interventions that meet the independence support needs of various population groups and therefore offer efficiencies in systems of delivery.
Aspects of everyday living are important, and include:
- the ability to remain at home in clean, warm, affordable accommodation
- remaining socially engaged
- continuing with activities that give life meaning
- contributing to family or community
- feeling safe
- maintaining choice, control, personal appearance and dignity
- being free from discrimination
- not feeling ‘burdensome’ to their families
- and continuing the role as caregiver
The Public Health Research Programme wishes to commission research on the effectiveness* of interventions outside the NHS in the following areas:
- Studies that assess the effectiveness of community-based interventions or programmes of interventions that are designed to support independence in the populations of interest. A wide range of interventions are currently in use throughout the UK, research may evaluate one or more interventions appropriate to the target group.
- Studies that shed light on how community-based interventions can be scaled-up successfully, including across population groups.
In considering interventions to be evaluated, interventions delivered ‘at scale’ should be prioritised, given these are likely to produce greater impact. Interventions evaluated may include (but are not restricted to) those relating to the built environment and/or the digital environment. Effectiveness may be considered from the perspective of the person themselves, their family or carers or the provider of the initiative. Outcomes of interventions across different groups according to gender, ethnicity, sexual orientation or socioeconomic status, for example, may be explored. Research which includes collaboration with local authorities and/or relevant third sector organisations would be welcome.
Researchers should identify underlying theory and should include a logic model to help explain underlying context, theory and mechanisms. Research should consider the impact of the intervention on health inequalities. Proposals should ensure adequate public involvement in the research.
*‘Effectiveness’ in this context relates not only to the size of the effect, but it also takes into account any harmful or negative side effects, including inequitable outcomes.
Studies should generate evidence to inform the implementation of single or multi-component interventions. Studies may include evidence syntheses, studies evaluating interventions, including trials, quasi- and natural experimental evaluations, and feasibility and pilot studies for these. We welcome applications for linked studies (e.g. pilot + main evaluation). Secondary analyses of existing epidemiological data and/or impact modelling studies may also be funded. We encourage the adoption of a systems perspective where appropriate to the study context. In all cases a strong justification for the chosen design and methods must be made.
The primary outcome measure of the research, if not necessarily the intervention itself, must be health-related. The positive or negative impacts of the intervention, including inequitable outcomes should be considered. Researchers are asked to indicate how long-term impacts will be assessed. All applications should identify underlying theory and include a logic model (or equivalent) to help explain underlying context, theory and mechanisms. Proposals should ensure adequate public involvement in the research.
The impacts of public health interventions are often complex and wide-reaching. Studies should acknowledge this by adopting a broad perspective, taking account of costs and benefits to all relevant sectors of society. An appropriate health economic analysis to inform cost effectiveness, affordability or return on investment should be included where appropriate. Sustainability - health, economic and environmental - are also of interest.
For all proposals, applicants should clearly state the public health utility of the outcomes and the mechanisms by which they will inform future public health policy and practice. Details about the potential pathway to impact and scalability of interventions, if shown to have an effect, should be provided, including an indication of which organisation(s) might fund the relevant intervention(s) if widely implemented.
Representatives of policy or practice communities relevant to the project should be directly engaged or involved with the development and delivery of PHR research because this produces research that is more closely grounded in, and reflective of, their concerns and makes the subsequent uptake and application of research findings more likely. By policy or practice, we mean any organisation that is involved in shaping policy or delivering public health services relevant to the research, whether at local or national levels. This might include local authorities, charities, voluntary organisations, professional bodies, commercial organisations, governmental and arms-length bodies.
We welcome proposals in which appropriate professionals (e.g. a director of public health or chief executive of a charity) are formally part of the project team as a co-applicant, and in which they play a defined role in the project. Their contribution may be to facilitate or enable research access to organisations, to be directly involved in research fieldwork, to contribute to interpretation of emerging findings, and to be involved in dissemination activity. The time of policy or practice representatives as co-applicants can be costed into the proposal, as part of the Research Costs. As with all members of a project team, an individual's equipoise should be considered before they are proposed as co-applicant of a research project. Their involvement and associated costs should be fully justified, in the same way as for academic applicants.
There are other ways in which policy or practice representative support for the proposed research can be demonstrated, such as co-opting on to a project advisory or steering group, or the inclusion of a letter or statement of support from a senior policy or practice partner from relevant organisations.
Remit of Call
All proposals submitted under this call must fall within the remit of the NIHR Public Health Research (PHR) programme. For the evaluation of time sensitive, policy driven, interventions applicants may wish to consider the fast-track work stream.
For the evaluation of time sensitive, policy driven, interventions applicants may wish to consider the fast-track work stream.
Notes about NIHR and the PHR Programme
The PHR Programme funds research to generate evidence to inform the delivery of non-NHS interventions intended to improve the health of the public and reduce inequalities in health. Our scope is multi-disciplinary and broad, covering a wide range of interventions that improve public health.
The primary aim of the programme is the evaluation of practical interventions. We will fund both primary research (mainly evaluative, but also some preparatory research) and secondary research (evidence synthesis); precise methods will need to be appropriate to the question being asked and the feasibility of the research.
Our research serves a variety of key stakeholders including: decision-makers in local government; primary care organisations and other local public services; third sector organisations; relevant national agencies (e.g. NICE) concerned with improving public health and reducing health inequalities; researchers; public health practitioners and the public.
Applicants should consider how their findings will impact upon decision making in public health practice, whether results are generalisable to other populations and affordable, setting out a clear pathway to impact. The NIHR PHR programme recognises that there is a need for an evidence base for disinvestment and that the removal of an intervention from a population can be worthy of evaluation.
The affordability of the intervention, and at least an indication of the stakeholder(s) willing to fund the intervention, should be referenced within the stage 1 application. At the stage 2 application point, statements of support confirming stakeholder commitments to funding will be required. Applicants should be aware that the NIHR PHR programme is unable to fund intervention costs.
The NIHR PHR programme is open to the joint funding of research projects with other organisations such as those in the third sector. If you would like to explore the potential for joint funding, please contact us at firstname.lastname@example.org with details of your proposal and the other funder prior to submission.
All of our funded projects are eligible for publication in the NIHR Journals Library. This open access resource is freely available online, and provides a full and permanent record of NIHR-funded research.
Notes to Applicants
The NIHR PHR programme is funded by the NIHR, with contributions from the CSO in Scotland, Health and Care Research Wales, and HSC R&D, Public Health Agency, Northern Ireland. Researchers in England, Scotland, Wales and Northern Ireland are eligible to apply for funding under this programme.
Applicants are recommended to seek advice from suitable methodological support services, at an early stage in the development of their research idea and application. The NIHR Research Design Service can advise on appropriate NIHR programme choice, and developing and designing high quality research grant applications.
The NIHR Clinical Research Network (CRN) supports health and social care research taking place in NHS and non-NHS settings. The CRN provides expert advice and support to plan, set up and deliver research efficiently.
Clinical Trials Units are regarded as an important component of many trial applications however, they are not essential for all types of studies to the PHR programme. The CTUs can advise and participate throughout the process from initial idea development through to project delivery and reporting. NIHR CTU Support Funding provides information on units receiving funding from the NIHR to collaborate on research applications to NIHR programmes and funded projects. In addition, the UKCRC CTU Network provides a searchable information resource on all registered units in the UK, and lists key interest areas and contact information.
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