20/119 Public Health Interventions led by or Involving the police
Deadline for submission: 30 March 2021, 1pm
- What is the effectiveness and cost effectiveness of public health interventions led by or involving the police which impact on population health or health inequalities?
Population health outcomes are influenced by the complex interaction between the social, economic, cultural and physical environments in which we live, our lifestyles and our individual characteristics. Many of these determinants of health overlap with the determinants of crime. The links between deprivation, childhood adversity, poor mental and physical health, social isolation, health inequalities and contact with the criminal justice system, whether as a victim, perpetrator or both is well evidenced.
For a number of years, the police and the public health system have sought to work in partnership to achieve safety and security for populations across the UK. Policing involves the protection of individuals, groups and communities with vulnerabilities and at risk of crime through safeguarding, surveillance, community safety and protection. Evidence-based policy making has become increasingly recognised and valued within the police service and there has been a shift in focus from crime and disorder to one of prevention, vulnerability and early identification. Recent developments in the area include (i) a Policing, Health and Social Care Consensus driven by a mutual desire to shift focus towards prevention and early identification and a recognition of the opportunities and partnerships to achieve this and (ii) a discussion paper on Public Health Approaches in Policing which builds on police experiences of neighbourhood policing and problem solving. These developments support current strategic visions for policing in England & Wales, in Scotland and in Northern Ireland.
The PHR Programme recognises that there are many interventions led by or involving the police that could impact at an individual level. However, for this call, the Programme is interested specifically in interventions that are active at a group, community and population level and the impacts on wider system usage.
Research areas of interest include, but are not limited to:
- What impacts do public health approaches led by or involving the police have on improving health and health inequalities experienced by vulnerable populations? Examples of population groups or issues of interest include: geographical communities, adverse childhood experiences, hate crime, domestic abuse, substance misuse, county lines, missing persons, modern slavery, mental health and distress, suicidal behaviour, intoxication, road deaths, knife crime and other violence.
- How should police and public health resources be coordinated and deployed to achieve the greatest health gain and/or reduction in health inequalities. What is the whole system return on investment?
- What are the population health impacts of policing activities that seek early identification, prevention and assessment of vulnerabilities and risks?
- What are the impacts of trauma-informed approaches in policing?
- What makes collaboration between the police and others effective in a public health context?
- What impact can the Police Service have on public health in relation to community safety and community cohesion?
A range of study designs and outcome measures can be used. Current evidence has been criticised for being of poor quality. Researchers will need to identify and justify the most suitable methodological approach and will also need to specify key outcome measures and how these will be measured in the short, medium and long term. Primary outcomes must be health related (not health service related). Proxy measures for health outcomes will be accepted but the link between health and the chosen outcome measure must be clearly specified and justified. Crime related outcomes could be considered as secondary outcomes.
Researchers are encouraged to consider the health economic impacts to the whole system of public health interventions led by or involving the police that impact on population health or health inequalities. Researchers are encouraged to include experts from the police service in the study team. We will consider inclusion of experts as costed members of the study team if appropriately justified. Researchers are also encouraged to involve people who are experts by experience in their research. Researchers should demonstrate the relevance of their proposed research to evidence users including the police, public health and health and social care services and other relevant agencies. Researchers might want to consider how they will share their findings with police, public health and other relevant audiences. They will be expected to be aware of other studies in this area and ensure their proposed research is complementary.
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, evidence syntheses + modelling). 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 - is 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.
Remit of call
All proposals submitted under this call must fall within the remit of the NIHR Public Health Research (PHR) Programme. Please visit the PHR Programme page for details. For the evaluation of time sensitive, policy driven, interventions applicants may wish to consider the fast-track work stream.
Please refer to the PHR supporting information page for programme specific guidance and tips for success.
Applications more suited to the HS&DR Programme
In addition to the areas covered in this PHR call, the HS&DR programme is interested in how the involvement of health services can help to prevent at risk groups from entering the criminal justice system (CJS) or lead to improved outcomes for individuals after release from custody. E.g. understanding how different care pathways affect access to services or can help people experiencing mental health crisis navigate through the CJS.
The following issues are of interest to the HS&DR Programme, though other issues may be proposed. All applications should align with the existing and ongoing evidence base such as the SECURE STAIRS programme commissioned by NHS England and NHS Improvement, and should provide a careful justification of the importance of the proposed research and the potential impact it will have on health and social care services and a broad range of other services such as police, youth offending teams, education sector etc.
- Prevention: What interventions and approaches by health services are most effective in preventing ‘at risk’ children and young people from offending and reducing reoffending and improving access to prevention programmes?
- Care pathways and access to services: What are the most effective pathways for the assessment, intervention and management of mental health problems for people in contact with CJS? How do these pathways promote the delivery of integrated multi-agency care, and promote successful transitions within the CJS and mental health services?
- Rehabilitation and resettlement: What approaches to care planning facilitate engagement with vulnerable offenders e.g. people with mental health problems, learning disabilities or, substance misuse, and improve outcomes such as access to health services; provision of accommodation; education and employment to reduce cycling through the mental health and CJSs?
Applications to the HS&DR programme can be made through their Researcher-Led call.