Preventing Multiple Morbidities

Oxford with the Universities of Liverpool and Sheffield.

Work aims to reduce premature morbidity and mortality and narrow health inequalities by: 1. Co-designing and testing policy interventions for the general population to prevent non-communicable diseases (NCD) and 2. Designing interventions to help people with mental illness reduce behavioural risk factors for NCDs by addressing the underlying social and neuropsychological difficulties that cause both mental illness and adverse health behaviours.

The NHS Long-Term Plan has committed to improving life expectancy by five years and reducing health inequalities by tackling smoking, obesity and excess alcohol consumption which account for a quarter of UK hospital admission and deaths. Social scientists study the environmental influences on smoking, unhealth alcohol and food consumption and researchers study policies after implementation but there is little research linking basic behavioural science with the co-design of novel policy options and testing them in rigorous early phase experiments to inform future policy.

People with mental illness are much more likely to smoke, drink hazardously, be inactive, or overweight and this shortens healthy life expectancy. The causes of the co-occurrence of mental illness and adverse health behaviour are complex but increasingly understood. We aim to co-design interventions that address the common social and neuropsychological roots of mental illness and adverse health behaviour to reduce the incidence of NCDs.

Two work packages (WP) will progress this work.

WP1– Focuses on co-designed population interventions to prevent NCDs equitably across the population, reducing net exchequer costs.

WP2– Focuses on co-designing interventions to address behavioural risk factors for NCDs in people with mental illness. This new generation of interventions will address the neuropsychological deficits and social underpinnings of both mental illness and adverse health behaviour.

Collaborative work with Oxford Brookes University and the Universities of Sheffield and Liverpool will focus both in whole populations and individuals.

Whole population -work will involve leading a prevention policy development collaborative to test policies addressing tobacco, diet, obesity and alcohol in increasingly realistic settings as evidence develops. It employs a multistate life table model called PRIMEtime to appraise policy candidates. Other tools include the developed ‘Woods’ online supermarket to measure public preferences plus taste laboratories for reformulated products. Food/drinks companies will be involved in later stage experiments.

Individuals– work will develop practicable and effective preventative interventions for use in clinical practice, co-designed and focused on people with mental illness.  It will include modelling and virtual reality to enhance cognitive behavioural therapy approaches to enhancing emotional regulation and other neuropsychological difficulties. It will aim to address social adversity, including socioeconomic disadvantage and is more common in migrants that makes behaviour change more difficult.

This whole Theme is centred around co-production with a commitment to finding innovative ways to engage, and secure the involvement of, those with mental illness in research.

Building on successful work to date, the Theme will provide pre-Fellowship support and opportunities to grow a generation of researchers focused on population health interventions and preventing NCDs in people with mental illness.