Analysis of Multiple Health Risky Behaviours and Associated Disease Outcomes Using Scottish Linked Hospitalisation Data.

Background: Disease incidence and premature deaths tend to be influenced by multiple health risky behaviours, including smoking, excessive alcohol consumption and unhealthy diet. Risky behaviours tend not to be independent and may have a multiplicative effect on disease incidence and healthcare cost. Thus, understanding the interrelationship between health behaviours and their effect on health outcomes is crucial in designing behavioural intervention programmes.

The effects of minimum unit pricing for alcohol on food purchases: Evaluation of a natural experiment.

Background: On the 1st of May 2018 Scotland became the first country to introduce minimum unit pricing (MUP) for alcohol sales. The objective of this study is to identify the effects of this policy instrument on food purchasing by evaluating a natural experiment.

Methods: Longitudinal analysis compares regions with similar characteristics but differing exposure to MUP (Scotland and the north of England).

Longitudinal study of the effects of price and promotion incentives on purchases of unhealthy foods: evidence for restricting food promotions.

Objectives: Taxes and restrictions on promotions have recently been proposed as policy instruments to reduce consumption of unhealthy foods. The objective of this study is to add to the limited evidence on the comparative effectiveness of price changes, price promotions and volume promotions in changing household purchasing of unhealthy foods, using biscuits, crisps and savoury snacks as examples.

Design: Longitudinal regression analysis of consumer microdata.

Evaluating possible intended and unintended consequences of the implementation of alcohol minimum unit pricing (MUP) in Scotland: a natural experiment protocol.

Introduction: Scotland is the first country to carry out a national implementation of minimum unit pricing (MUP) for alcohol. MUP aims to reduce alcohol-related harms, which are high in Scotland compared with Western Europe, and to improve health equalities. MUP is a minimum retail price per unit of alcohol.

What can Secondary Data Tell Us about Household Food Insecurity in a High-Income Country Context?

In the absence of routinely collected household food insecurity data, this study investigated what could be determined about the nature and prevalence of household food insecurity in Scotland from secondary data. Secondary analysis of the Living Costs and Food Survey (2007⁻2012) was conducted to calculate weekly food expenditure and its ratio to equivalised income for households below average income (HBAI) and above average income (non-HBAI). Diet Quality Index (DQI) scores were calculated for this survey and the Scottish Health Survey (SHeS, 2008 and 2012).

"A Lot of People Are Struggling Privately. They Don't Know Where to Go or They're Not Sure of What to Do": Frontline Service Provider Perspectives of the Nature of Household Food Insecurity in Scotland.

This qualitative study explored frontline service providers' perceptions of the nature of food insecurity in Scotland in 2015 to inform national policy and the provision of locally-based support for 'at risk' groups. A country-wide in-depth interview study was undertaken with informants from 25 health, social care, and third sector organisations. The study investigated informants' perspectives associated with how food insecurity was manifesting itself locally, and what was happening at the local level in response to the existence of food insecurity.

Benefits of Incentives for Breastfeeding and Smoking cessation in pregnancy (BIBS): a mixed-methods study to inform trial design.

Background: Smoking in pregnancy and/or not breastfeeding have considerable negative health outcomes for mother and baby.

Aim: To understand incentive mechanisms of action for smoking cessation in pregnancy and breastfeeding, develop a taxonomy and identify promising, acceptable and feasible interventions to inform trial design.

Design: Evidence syntheses, primary qualitative survey, and discrete choice experiment (DCE) research using multidisciplinary, mixed methods.

Unintended consequences of incentive provision for behaviour change and maintenance around childbirth.

Financial (positive or negative) and non-financial incentives or rewards are increasingly used in attempts to influence health behaviours. While unintended consequences of incentive provision are discussed in the literature, evidence syntheses did not identify any primary research with the aim of investigating unintended consequences of incentive interventions for lifestyle behaviour change. Our objective was to investigate perceived positive and negative unintended consequences of incentive provision for a shortlist of seven promising incentive strategies for smoking cessation in pregnancy and breastfeeding.

Public acceptability of financial incentives for smoking cessation in pregnancy and breast feeding: a survey of the British public.

Objective: To survey public attitudes about incentives for smoking cessation in pregnancy and for breast feeding to inform trial design.

Design: Cross-sectional survey.

Setting And Participants: British general public.

Active travel intervention and physical activity behaviour: an evaluation.

A physically active lifestyle is an important contributor to individual health and well-being. The evidence linking higher physical activity levels with better levels of morbidity and mortality is well understood. Despite this, physical inactivity remains a major global risk factor for mortality and, consequently, encouraging individuals to pursue physically active lifestyles has been an integral part of public health policy in many countries.

The impact of a bodyweight and physical activity intervention (BeWEL) initiated through a national colorectal cancer screening programme: randomised controlled trial.

Objective: To evaluate the impact of a diet and physical activity intervention (BeWEL) on weight change in people with a body mass index >25 weight (kg)/height (m)(2) at increased risk of colorectal cancer and other obesity related comorbidities.

Design: Multicentre, parallel group, randomised controlled trial.

Setting: Four Scottish National Health Service health boards.

Services just for men? Insights from a national study of the Well Men Services Pilots.

Background: Men continue to have a lower life expectancy in most countries compared to women. Explanations of this gendered health inequality tend to focus on male risk taking, unhealthy lifestyle choices and resistance to seeking help from health services. In the period 2005-2008 the Scottish Government funded a nationwide community health promotion programme aimed at improving men's health, called Well Men Service Pilots (henceforth WMS).

Smoking-related disease risk, area deprivation and health behaviours.

Background: Smokers and ex-smokers are at risk of many chronic diseases. However, never smokers and never smokers exposed to environmental tobacco smoke (ETS) are also at risk. Additionally, smoking behaviours and their associated disease risk are socially patterned and positively associated with health inequalities.

Inequalities in the distribution of the costs of alcohol misuse in Scotland: a cost of illness study.

Aims: To examine the distribution of the costs of alcohol misuse across Scotland in 2009/2010, in relation to deprivation.

Methods: A cost of illness approach was used. Alcohol-related harmful effects were assessed for inclusion using a literature review.

Tackling alcohol misuse: purchasing patterns affected by minimum pricing for alcohol.

Background: Alcohol consumption is associated with a range of health and social harms that increase with the level of consumption. Policy makers are interested in effective and cost-effective interventions to reduce alcohol consumption and associated harms. Economic theory and research evidence demonstrate that increasing price is effective at the population level.

Study protocol for BeWEL: the impact of a BodyWEight and physicaL activity intervention on adults at risk of developing colorectal adenomas.

Background: Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the second highest cause of cancer death in the UK. Most cases occur in people over 50 years and CRC often co-exists with other lifestyle related disorders including obesity, type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). These diseases share risk factors related to the metabolic syndrome including large body size, abnormal lipids and markers of insulin resistance indicating common aetiological pathways.

On measurement of avoidable and unavoidable cost of alcohol: an application of method for estimating costs due to prior consumption.

This study estimates the avoidable and unavoidable costs of alcohol-related, liver cirrhosis inpatient care, controlling for the lag structure and period of decline in disease risk. Lag structures with different lengths are applied to the exposure to risk from alcohol consumption, which allows for differentiation between avoidable and unavoidable cases due to prior consumption. A lag length of 20 (men) and 23 (women) years (expected remaining life years) gives a total cost of 592 million SEK.

Developing a timeline for evaluating public health nutrition policy interventions. What are the outcomes and when should we expect to see them?

Objective: To develop a timeline for evaluating public health nutrition policy interventions.

Design: Concept mapping, a stakeholder-driven approach for developing an evaluation framework to estimate the 'time to impact' for policy interventions. The Schools (Health Promotion and Nutrition) (Scotland) Act 2007 was used as the model to develop the evaluation timeline as it had typical characteristics of government policy.

Effectiveness of policy to provide breastfeeding groups (BIG) for pregnant and breastfeeding mothers in primary care: cluster randomised controlled trial.

Objective: To assess the clinical effectiveness and cost effectiveness of a policy to provide breastfeeding groups for pregnant and breastfeeding women.

Design: Cluster randomised controlled trial with prospective mixed method embedded case studies to evaluate implementation processes.

Setting: Primary care in Scotland.

What works with men? A systematic review of health promoting interventions targeting men.

Background: Encouraging men to make more effective use of (preventive) health services is considered one way of improving their health. The aim of this study was to appraise the available evidence of effective interventions aimed at improving men's health.

Methods: Systematic review of relevant studies identified through 14 electronic databases and other information resources.