Professor Kamlesh Khunti - Prevention of Chronic Disease

Prevention Theme

Theme Lead: Kamlesh Khunti

CLAHRC East Midlands is hosted by

Nottinghamshire Healthcare

Public Health England Priorities 2013/4

• Reducing preventable deaths• Reducing the burden of disease• Protecting the country's health• Giving children and young people the

best start in life• Improving health in the workplace

NHS Priorities

Health Survey for England 2010-2012

Adult (aged 16+) overweight and obesity: BMI ≥ 25kg/m2

More than 6 out of 10 men are overweight or obese (66.5%)

More than 5 out of 10 women are overweight or obese (57.8%)

Overweight and obesity among adults

National Child Measurement Programme 2012/13

Child overweight (including obesity)/ excess weight: BMI ≥ 85th centile of the UK90 growth reference

One in five children in Reception is overweight or obese (boys 23.2%, girls 21.2%)

One in three children in Year 6 is overweight or obese (boys 34.8%, girls 31.8%)

Prevalence of excess weight among children

References:1. ASH Factsheet, Smoking Statistics: illness & death, June 2011 (http://ash.org.uk/files/documents/ASH_107.pdf) NB area represents value

Obesity: 34,100

Smoking: 81,400

Alcohol: 6,541

Suicide:5,377

Drug misuse: 1,738

HIV: 529

Traffic:2,502

Causes of death

Wilmot E et al Diabetologia 2012 DOI 1007/soo125-012-2677-x, Edwardson C et al PLoS ONE 2012:7:4e34916

HR DM 2.12

HR CVD 2.47

HR CVD MORT 1.9

HR ALL CAUSE MORT 1.49

18 Studies incl 794,577

HR 1.73 for Metabolic Syndrome

Sedentary time and outcomes

Helping pregnant smokers to stop:integrating behavioural sciences evidence into NHS counselling

Tim Coleman, Kasia Campbell & Sue Cooper

Division of Primary Care



• NHS health professionals are trained to help pregnant smokers by the National Centre For Smoking Cessation Training, NCSCT

• Systematic reviews of behavioural sciences literature– Identify behaviour change techniques

(BCTs)

• Pregnant smoker focus groups– Add relevant BCTs to NCSCT training

• More effective UK ‘stop smoking’ counselling– Health professionals trained via enhanced

online and face to face training courses

Training: integrating evidence

Healthy Schools Programmes

Professor Stuart BiddleProfessor Cris Glazebrook



• Interventions aimed at reducing sitting and increasing overall movement have also been shown to be beneficial for young people’s health

• A wide scale translation of these findings into the curriculum and physical activity in schools is in need of development.

Healthy Schools Programme

• To develop and implement an integrated approach to:

– promoting health behaviour, including sitting less, moving more, and a healthy diet

– increasing knowledge and understanding of chronic disease within the school curriculum

– Resources: Teaching guides, student & parent booklets, website

• Main outcomes: whether teachers engage with the project; knowledge; behaviour change

Aim

• This project will be run in collaboration with NB Group which specialises in healthcare and retail marketing communications, including services in strategic consultancy, creative, design, copywriting, multimedia, production and deployment

Industry

Implementation of a type 2 diabetes prevention pathway in a South Asian population

Tom YatesJoe Kai



• Type 2 diabetes mellitus (T2DM) is one of the fastest growing LTC

• Cost NHS £15.1 billion by 2035, =17% of total health care expenditure

• Prevention is an NHS priority • The risk and prevalence of T2DM is

2-3X greater in South Asians• Urgent need to engage and embed

prevention strategies in South Asian communities

Background

• Embed a systematic EB approach to identifying at high risk people

• Embed within routine care a structured education programme for SAs

• Identify barriers and facilitators to implementation

• To explore and assess the acceptability, feasibility and impact of the approach

• To determine whether the programme promotes increases in health behaviour and quality of life

• To determine the cost-effectiveness of implementing the programme

Objectives

• Analysis and outcomes will be structured around the RE-AIM (Reach, Efficacy/Effectiveness, Adoption, Implementation, Maintenance) evaluation framework (http://www.re-aim.org/).

• Adoption and Implementation: Number of practices approached, number that take part and number actually implementing the diabetes prevention pathway. Number of educators trained and number of courses undertaken will also be recorded.

• Reach: Numbers of individuals identified at high risk, invited to attend, agree to attend and actually attend the programme will be recorded.

• Effectiveness: Do measures of health status change?

• Maintenance: Is the prevention pathway continued after the study period has finished?

Evaluation

http://www.re-aim.org/

Trial to investigate the effect of structured education on people at

risk of cardiovascular diseaseProfessor Stuart Biddle

Professor of Physical Activity and Health, University of Loughborough

Dr Stephen Rogers, Visiting Professor, University of Northampton;

Consultant in Public Health, Northamptonshire County Council



• To develop a structured education programme for individuals at high risk of CVD

• To determine (by randomised controlled trial) whether the programme can reduce total cholesterol and other modifiable risk factors

Objectives

• Individually randomised trial run in primary care• Eligibility criteria – modelled CVD risk > 20%

(Framingham or QRisk) in previous 24 months• Primary outcome is total cholesterol; secondary

outcomes include body weight, physical activity, diet and smoking status

• Intervention - Structured lifestyle intervention programme • Data collected at baseline with follow-up at 6 and 12

months

Study Design

Thank you for listening

[email protected]

www.clahrc-em.nihr.ac.uk

@CLAHRC_EM

This research was funded by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care East Midlands (NIHR CLAHRC EM). The views expressed in this presentation are

those of the speaker(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

Professor Kamlesh Khunti - Prevention of Chronic Disease

Health & Medicine

Transcript of Professor Kamlesh Khunti - Prevention of Chronic Disease