One of the strengths of DECIPHer is the range of skills and knowledge that staff bring to projects. Dr. Ruth Kipping spends half her week working as a public health consultant for the NHS and half her week at DECIPHer and demonstrates that having one foot in practice and the other in academia is possible – and enjoyable.
Ruth worked in NHS management for a number of years. Her interest in research started then and she worked for Professor Chris Ham (now head of The King’s Fund) at Birmingham’s renowned Health Services Management Centre. At this stage a career as a public health consultant was only open to those who had a medical degree. When the Faculty of Public Health opened its doors to those who did not attend medical school, Ruth swiftly joined the South West regional Public Health specialist team.
At the end of her training Ruth set out to get two jobs – one in the NHS and one in research; ‘If I didn’t do both, I would get frustrated. If I just did research it would feel too distant from practice and if I just did service-based work I would want to apply a research agenda to all of my work. I aimed to have the best of both worlds and by doing so to facilitate bringing research into practice and practice into research.’
In her NHS job Ruth covers the breadth of public health for all age groups including health improvement, health protection and health services, but her research is focussed on DECIPHer’s research agendas.
Bridging practice and research
One of Ruth’s first jobs as a public health trainee was part of the team that brought the Planet Health and Eat Well Keep Moving programmes to the UK (from Harvard School of Public Health). A RCT had demonstrated Planet Health reduced obesity in girls in the USA and Ruth suggested they also carry out a RCT to evaluate the programme’s effectiveness in the UK, where the programme is known as Active for Life Year 5. “At the time, in 2005, there was an urgency to address obesity but systematic reviews provided little evidence of effective interventions”.
Would staff without a research background have suggested a RCT? Ruth suggests “most public health people would have got hold of the programme materials, implemented it and maybe undertake a local evaluation”. These small evaluations, so ubiquitous in the NHS, often do not provide robust evidence of effectiveness.
Ruth and staff from the DECIPHer team developed a RCT of Active for Life Year 5 at the beginning of the programme to develop the UK evidence base on school-aged obesity programmes. Their research found:
- The odds of eating healthy amounts of fruit and vegetables and snacks were greater in children from the intervention compared to control schools. However, there was no difference in mean body mass index or the odds of obesity.
- US school-based intervention may be effective in reducing the time children spend on screen-based activities.
The programmes continues to be evaluated and has recently received NIHR funding for a full scale RCT in 60 schools.
Creating and delivering evidence-based medicine
Ruth’s recent work evaluating men’s slimming programmes also demonstrates the bridges her role can create between research and practice. In an effort to reduce obesity in adults, many PCTs buy vouchers from organisations such as Weight Watchers or Slimmer’s World. There is limited research on the longterm effectiveness of these programmes. Ruth, together with public health colleagues in Bristol who were also commissioning these programmes, identified a problem and applied a research frame to it. Ruth convened a group of academics and public health professionals to examine where there were gaps in research – gaps between what practitioners wanted to know and what the evidence showed. One gap identified was that most patients referred to slimming on referral were women, men only account for about 15% of slimming referrals, yet men are more likely to be overweight or obese. As a result, Ruth and colleagues are developing a research application based on what they are delivering – a study to increase the engagement of men in weight management.
With a foot on either side of the bridge, Ruth aims to create stronger links to benefit both the NHS and practice.
Image credit: Ronan Moriarty