20/06 Reducing health inequalities in coastal towns and communities
Deadline for submission: 28 July 2020, 1.00pm
Which interventions are effective in improving health and reducing health inequalities for deprived populations living in coastal towns/communities?
Approximately 17 per cent of the UK population lives in coastal towns and communities (CTCs). Many contain prosperous and commercially successful areas, with other areas experiencing socio-economic decline and having unusual demographic profiles. Evidence suggests that there are growing risks for the health and wellbeing of CTCs. CTCs can suffer from a set of issues that have their roots in the decline of their core industries, this includes tourism, fishing, ship building and port activities. These areas can be affected by the combination of industrial decline, geography and the 180 degree context, which brings a unique set of economic and social challenges.
The PHR Programme is interested in the effectiveness of interventions (outside of the NHS) to improve health and reduce inequalities in CTCs. Research may address health issues, or wider determinants of health, for CTCs, or area-based interventions. Changes in health outcomes related to coastal initiatives, such as asset-based approaches, coastal development or regeneration, may also be studied. ‘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. There is particular interest in addressing need for those at higher risk of poor health outcomes. Researchers should specify and justify their choice of intervention and geography. The Programme is not interested in interventions that operate at an individual level and is particularly interested in findings that will be applicable to other deprived coastal areas.
Researchers will need to identify and justify the most suitable methodological approach. Researchers will need to specify how short, medium and long term impacts will be evaluated.
Relevant populations or sub-groups may be studied, based on factors such as ethnicity, socioeconomic status, gender or other social markers. Researchers are to specify and justify their choice of intervention to evaluate, the relevance to the population being studied and the outcomes being measured. Researchers should demonstrate the relevance of their proposed research to policy makers and other evidence-users. Researchers are encouraged to consider wider economic impacts across whole systems. Researchers are encouraged to involve relevant subject-matter experts in their research, including as fully funded members of the research team.
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.
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. Applications received in response to this NIHR PHR commissioned call may be eligible for a contribution towards intervention costs if Local Authorities (LA’s) or other commissioner organisations are unable to fund the intervention costs. Researchers are expected to work closely with the commissioning organisations to explore and secure intervention cost requirements but in exceptional circumstances where it has not been possible to secure funding, researchers may be eligible to access funding. This is a UK-wide pilot initiative and intervention costs can be covered within England, Wales, Scotland and Northern Ireland. For the Stage 1 application, if you think you are may need to make a case for accessing intervention costs, please enter the amount being requested in the ‘Estimated non-NHS intervention costs’ section of the form and also highlight in writing at the start of the Research Plan section of the form that you may wish to access these funds and the likely amount. Please note that there is an expectation that throughout the commissioning process applicants will continue to try and source these costs from partnering organisations. Please note that these costs are not intended for the development of new interventions. Please visit the PHR remit for more information on eligibility. Proposals applying for intervention costs will be assessed via the standard PHR funding process.
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 email@example.com 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.
In line with the government’s transparency agenda, any contract resulting from this tender may be published in its entirety to the general public.