Research boosting health policies

Breakfast tray 22 December 2011

By Simon Murphy

Public health policies have been hampered by the lack of good research evidence to design and implement effective initiatives. A House of Commons report found that there are many significant barriers to evaluating such policies.

To address this problem, the Public Health Improvement Research Network, part of the ESRC-funded DECIPHer (Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement), has facilitated a number of national policy experiments in Wales.

Free breakfasts for primary school pupils and an exercise referral scheme for chronic disease patients were two of the policy initiatives that were examined, in research projects led by Dr Simon Murphy at the Cardiff Institute of Society, Health and Ethics.

The Primary School Free Breakfast Initiative was a Welsh Government policy to provide the opportunity for all primary school children in Wales to have a free healthy breakfast. Dr Murphy’s initial evaluation of a number of pilot schools led to immediate modifications of the scheme, followed by a trial of 111 schools in order to evaluate the overall impact of the programme. Policymakers were given an estimate of the impact on pupils’ breakfast-eating behaviour, dietary intake, concentration and behaviour and also how the scheme could be modified.

A follow-up study funded by the ESRC-supported National Prevention Research Initiative assessed the impact of the scheme on social inequalities and other educational and social outcomes, for feedback to policymakers.

The National Exercise Referral Scheme (NERS) was set up by Welsh Government to target people at risk of chronic disease. DECIPHer undertook a randomised trial with 2000 of the participants, and the findings directly influenced the continued operation of the scheme.

Early evaluation results highlighted for example concerns about the quality of motivational interviewing consultations, resulting in additional support and training for practitioners across the scheme. In addition, the evaluation has already informed the content of the British Heart Foundation Exercise Referral Toolkit and will be considered in a forthcoming policy review of the service in Wales.

These research evaluations require close collaboration between academics, policymakers and practitioners - enabling researchers to influence policy content and structure at an early planning stage. DECIPHer’s approach to policy evaluation has been recognised by the National Centre for Social Research as good practice for policy evaluation, and appears as a case study in government guidance for rigorous policy evaluation in the HM Treasury’s Magenta Book 2011.