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A Stop Smoking in Schools Trial: A process evaluation of the implementation of ASSIST in Scotland

44628469 - cigarettes

In 2014 the Institute for Social Marketing and a team of collaborators were appointed to conduct a process evaluation of ASSIST (A Stop Smoking in Schools Trial). ASSIST is a peer-led, school-based smoking prevention programme that encourages the dissemination of non-smoking norms by training students aged 12-14 to work as peer supporters. ASSIST was previously evaluated via a large cluster randomised trial of 59 schools in South Wales and Avon, England. Results from this trial showed that ASSIST was effective and cost effective at reducing smoking prevalence in young people (Campbell et al 2008), (Hollingworth et al 2012). This led to the wider roll out of ASSIST in parts of England and Wales and more recently in Scotland.

The overall aim of the study was to evaluate the process of implementing ASSIST in Scotland.

Three different delivery models were piloted in three NHS boards. This did not impact on fidelity or acceptability which was rated highly. Partnership working, from the onset, was viewed as being key to successful delivery and securing school participation. Feedback was overwhelmingly positive regarding the wider benefits of taking part in ASSIST for peer supporters (i.e. personal and communication skills) but also for the school and communities. There was less certainty regarding the extent of message diffusion and the impact this may have an adolescence smoking prevalence. Student survey results showed no significant change in self-reported smoking prevalence between baseline (1.6%) and follow-up (1.8%) and conversation recall with a peer supporter was low at 9%.

However, it is important that the current context (where regular smoking prevalence is 2% overall in 13 year olds in Scotland (SALSUS, 2015 http://www.gov.scot/Resource/0050/00508401.pdf) is taken into account. Opportunities to have informal conversations about smoking with peers may now be limited due to the ongoing decline in adolescent smoking since ASSIST was first developed. In addition, the data collection mode was a self-complete survey, so there is a possibility that by follow-up (12 weeks after baseline) young people may simply not remember conversation(s) with a peer supporter or may not have known that they had spoken with a peer supporter.

Overall, this study has demonstrated that it is feasible and acceptable to deliver the ASSIST programme in Scottish schools, although questions remain about the extent of message diffusion. Further consideration is required to assess whether delivery of ASSIST still offers a suitable return on investment and what role it may play in schools in areas of deprivation where smoking rates are higher. Now may be the time to consider whether, 13 years on from the original Randomised Control Trial, an implementation trial of ASSIST is warranted to determine if it is still effective and cost effective.

For more information see:  http://www.gov.scot/Publications/2017/03/6523 or contact fiona.dobbie@stir.ac.uk

Fiona Dobbie
24 March 2017

Photo Copyright: tum2282 / 123RF Stock Photo

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How Stirling research is fighting cancer | World Cancer Day

Saturday 4th February 2017 is World Cancer Day – a day where the world comes together in unity in the fight against cancer. Here’s how Stirling research is helping to accelerate progress in the fight against cancer. Investigating carcinogens in astro football pitches In 2016, Professor Andrew Watterson identified cancer-causing chemicals in rubber crumb samples from 3G astro football…

via How Stirling research is fighting cancer | World Cancer Day — University of Stirling

Research with Impact: Investing in Tobacco, Alcohol and Substance Use Research

researchwithimpact_bannergreenThe University of Stirling Impact Research Studentships support outstanding novel research projects that can demonstrate a link to the Universities strategic priorities and be high impact. Researchers in Health Sciences were successful in gaining three of these awards in spring 2016.

Dr Crawford Moodie, Dr Niamh Fitzgerald and Dr Tessa Parkes appointed three excellent researchers to these studentships in summer 2016 and all three started their studies in October.   Our new colleagues will be contributing to the globally-recognised work of the Tobacco, Alcohol and Substance Use Research Group.

andriana

Andriana Manta

Andriana Manta will be working on a comparative analysis between Scotland and Greece. She aims to examine various genres of representations of the ‘drug problem’, how these representations are being reflected in the governance of the ‘drug problem’, as well as to explore possible associations with concerning changes in key indicators of public health among people who inject drugs for contributing to the wider community. The study will use a “what’s the problem represented to be” (WPR) approach to follow the construction of the drug problem, involving discourse analysis and visual analysis. The studentship is funded by the University of Stirling.

Andriana has a background in mental health research, having worked for the programme Anti-Stigma at the Athens University Mental Health Research Institute, where she was involved with both qualitative and quantitative methods of research on the stigma surrounding mental health conditions. Moreover, Andriana has an educational background in drugs and alcohol studies; she has also worked variously in the field of drugs and alcohol treatment, in Scotland and Greece, having gained a good grasp of the ‘drug problem’ realities faced by both countries.

danielle

Danielle Mitchell

Danielle Mitchell will be working in the Institute for Social Marketing on the use of innovative tobacco packaging to deter smoking. The study will use both qualitative and quantitative methods to explore beyond the recent implemented plain packaging in the UK, in order to discover innovative methods to further deter smoking both in terms of encouraging cessation and the onset of smoking in youth.

Danielle has a background in marketing with both a BA Honours Marketing degree and an MSc in International Fashion Marketing.  Having gained knowledge and experience from carrying out mixed methods research in both her undergraduate and masters dissertations, her interest for continuous research grew and the prospect of using marketing and research techniques to impact upon the behaviour of individuals in a positive manner whilst also contributing to valuable social research.

claresharp

Clare Sharp

Clare Sharp will be working in the Institute for Social Marketing on a study which aims to understand how Nalmefene, a drug treatment for alcohol dependence, has been used in the UK, and the factors which have influenced prescribing for this drug. The study will used a mixed methods approach, involving quantitative analysis of prescribing data and qualitative methods to explore perceptions around the role of Nalmefene in treating alcohol dependence, key influences on prescribing behaviour and views about how the regulations and marketing of the drug have been handled.  The studentship is part-funded by Alcohol Research UK and the University of Stirling.

Clare has a background in social research, having worked in ScotCen Social Research for a number of years. Here, she gained considerable experience as a survey researcher, having been involved in the development, management and analysis of some of Scotland’s flagship surveys including Scottish Health Survey, Scottish Social Attitudes Survey, Growing Up in Scotland and the Scottish Crime Survey. Clare has also worked on mixed methods studies involving alcohol and tobacco, including the evaluation of the Alcohol Licensing Act and the DISPLAY project to evaluate the tobacco point of sale promotions ban.

Dr Tessa Parkes, Senior Lecturer, commented “We are delighted to welcome Danielle, Clare and Andriana to our Faculty and Research Group and wish them all well as they embark on their exciting projects.”

20 October 2016

Children’s choices influenced by dominance of junk food marketing

The extent to which Scotland’s children are being directly influenced by junk food marketing is uncovered in a report for the Scottish Government by researchers at the University of Stirling.

Stirling’s Institute of Social Marketing was commissioned to investigate the impact of food and drink marketing on Scotland’s young people.

In a study of school children, researchers were able to measure just how much the marketing landscape is dominated by promotions for junk food – food and drinks high in fat, salt and sugar. Young people aged 11 to 18 years old were asked about the marketing and promotions they had been exposed to in the preceding seven days and how they had responded to them.

They were asked if they had seen food and drink marketing involving broadcast, print, outdoor or digital adverts, sponsorship, price promotions and social media activity.

Three quarters of the marketing seen was for junk food, with visibility of healthy food and drinks’ marketing reported at only ten percent. Almost two thirds of the 2285 children questioned recalled one or more food or drink promotion with nearly half buying more than one or more item of food or drink in response.

Report author Georgina Cairns, senior researcher in dietary public health and behaviour change at the University of Stirling said: “Although we knew the visibility of marketing for food and drinks high in fat, salt and sugar was high, the strength of our results was nevertheless surprising. Retailer and marketer’s food and drink promotional investments are clearly heavily skewed towards these products. As a consequence, our young people are not getting the cues they need to encourage them to make healthier choices.”

High sugar foods dominated till based promotions – sweets, chocolate and sugary drinks accounted for 84 percent of all products picked up at the till area for purchase. Offers also featured highly in decisions to purchase – over half of respondents made a purchase related to a price promotion. Just over a third of purchases in this group included sugar sweetened soft drinks, chocolate or sugar based confectionery.

Cairns summarised her recommendations saying: “It’s clear that marketing is affecting the purchasing behaviour of young people. The majority of young people are aware of the food and drink marketing that surrounds them in their daily life and there is an opportunity for marketers to use this is a positive way.

“The extent of sweets, chocolate and sugary drinks being purchased at the till is concerning. Reducing the number or indeed completely eliminating these products from till areas could have a really positive impact on the buying behaviour and in turn the health of young people.

“The research indicates that the most urgent priority is to take positive steps to reduce promotions for sugary food and drinks with reductions in promotions for high fat and salt products important targets also.”

The Scottish Government has used the research to renew calls for junk food advertising to be banned before 9pm. Powers over broadcasting are reserved to the UK Government. The advertising is banned during children’s programmes, but permitted during prime-time early evening shows, which are watched by large numbers of under 16s.

Media enquiries to Corrinne Gallagher, Communications Officer, on 01786 466 687 orcorrinne.gallagher@stir.ac.uk

UK Government’s alcohol policies weaker than devolved nations – new research

Image of alcoholic drinksThe UK Government’s alcohol policies are weaker than those implemented by the devolved nations, a landmark report from the Universities of Stirling and Sheffield has found.

Alcohol policies across the four UK nations vary widely in the extent to which they are grounded in scientific evidence, with political considerations appearing to have significant bearing, the research shows.

Policies from the UK Government and devolved administrations were reviewed against recommendations from Health First, the independent expert-devised UK alcohol strategy, in the first such audit of its kind.  Overall strategy, pricing, marketing and availability of alcohol were amongst the areas examined.

Scotland had the strongest approach overall, seeking to implement the most evidence-based policies, working to clear outcomes, and with a taskforce in place to monitor and evaluate the Scottish Government’s alcohol strategy.

By contrast, the UK Government did not support the most effective policies, made inconsistent use of evidence, and was the most engaged with the alcohol industry.

While Wales and Northern Ireland took strong positions in areas such as taxation and restrictions on young drivers, they have fewer legislative powers than the Scottish Parliament.

The report was co-authored by Dr Niamh Fitzgerald, at the University of Stirling and Colin Angus at the University of Sheffield.

Dr Niamh Fitzgerald, Lecturer in Alcohol Studies, said: “Alcohol policy at UK Government level is in disarray, with it choosing to reduce taxation despite evidence that consumption and alcohol-related harms will increase as a result, putting even greater pressure on NHS and emergency services.

“In contrast to the UK Government, the devolved administrations – especially Scotland – are taking steps to address the widespread harms due to alcohol, recognising that they are a ‘whole population’ issue. All four nations, however, engage in partnership with the alcohol industry, despite clear conflicts of interest and its history of failure to support those policies most likely to work.”

Colin Angus, from the Sheffield Alcohol Research Group, said: “A clear illustration of the gap in effective policy across the UK relates to the marketing of alcohol. The devolved administrations have indicated support for mandatory action on product labelling, but the UK government has favoured self-regulation which has proven ineffective, with over 40 percent of products on the shelf still failing to meet the industry’s own best practice guidelines.

“On alcohol advertising, a reserved matter, the devolved administrations have called for stronger regulation to protect children, but this approach has been rejected by the former UK coalition government. The Scottish Government is currently updating its alcohol strategy while the other devolved nations continue to progress evidence-based policies to reduce alcohol harms. It may be that they will call for greater powers to go it alone in bringing in effective policy options, if Westminster is not prepared to act.”

Peter O’Neill, Evidence Exchange Manager at the Alliance for Useful Evidence, which commissioned the report, said: “Devolution in the UK provides opportunities for exchange of evidence and learning about what works through experimentation with different policies across the four nations. This report calls on administrations to support such learning, by engaging openly and maturely with the alcohol policy evidence, being honest about reasons for policy decisions, and robustly evaluating policy initiatives. Unfortunately, the report also suggests that alcohol policy may sometimes be underpinned by ideology more than by evidence, and is likely to be less effective as a result.”

Four Nations: How Evidence-based are Alcohol Policies and Programmes Across the UK? has been presented to representatives of the four administrations as part of the work of the British-Irish Council, which meets later this month.

Media enquiries to David Christie, Senior Communications Officer, on 01786 466 653 ordavid.christie1@stir.ac.uk.

Background information

  • The report was co-authored by Dr Niamh Fitzgerald, Lecturer in Alcohol Studies at the University of Stirling’s Institute for Social Marketing, and Research Fellow Colin Angus of the Sheffield Alcohol Research Group, at the University of Sheffield. Both Universities are members of the UK Centre for Tobacco and Alcohol Studies.
  • The Report design was funded by the Alcohol Health Alliance.

UK Centre for Tobacco & Alcohol Studies
The UK Centre for Tobacco & Alcohol Studies (UKCTAS) is one of the six UK Clinical Research Collaboration (UKCRC) Public Health Research Centres of Excellence. The UKCTAS is a collaborative network of 13 universities (12 in the UK, 1 in New Zealand) and receives funding from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council and the National Institute for Health Research under the auspices of the UK Clinical Research Collaboration. www.ukctas.net

Health First
The report Health First: An evidence-based alcohol strategy for the UK was published in March 2013 by the University of Stirling setting out for the first time a series of  recommendations to tackle the harm caused by excess drinking across the UK. The strategy was developed by a group of experts independent from government and the alcohol industry, under the auspices of the Alcohol Health Alliance and is supported by over 70 organisations.

The Alliance for Useful Evidence
The Alliance for Useful Evidence is an open network which champions the use of evidence in decision making for social policy and practice.  The Evidence Exchange project aims to increase the use of and demand for evidence between the four UK jurisdictions
www.alliance4usefulevidence.org

FOI + tobacco = sleepless nights: We got an FOI request from Big Tobacco – here’s how it went

Istitute of Social Marketing logoProf Gerard Hastings, Emeritus Professor at the University of Stirling, writes in The Conversation:

“In a world where knowledge is power, information is the antidote to oppression. We citizens must know what those at the top are doing if we’re going to hold them to account. That’s why freedom of information (FOI) legislation is a vital element of any functioning democracy; it helps rebalance power.”

The full article can be seen here in The Conversation: http://ow.ly/i/cHOFw

1 September 2015

Just how useful are licensing laws for improving public health?

Dr Niamh Fitzgerald

Dr Niamh Fitzgerald

Despite legal changes in Scotland, councils are struggling to use public health as an argument against new pubs and off-licences.

We need to reconsider the role of licensing in the context of other ways to achieve the same ends, suggests Dr Niamh Fitzgerald in this London School of Hygiene and Tropical Medicine blog post.