When Professor Frank Kee decided to become a doctor, he did not have general practice in mind.
‘Public health was a career choice from very early on, when I was a student. I was interested in the basic science of epidemiology. I was interested in being able to intervene in terms of whole populations rather than just single patients.’
Now, as Director of The UKCRC (UK Clinical Research Collaboration) Centre of Excellence for Public Health NI, he has that capacity. He explains, ‘There are five UKCRC Centres of Excellence across the UK and they were established in 2008 through multi-partner funding from a consortium of Research Councils and major charities – the Economic and Social Research Council, Medical Research Council (MRC) and the Wellcome Foundation among the biggest. We were set up to build capacity in public health research - but research that has an outward face and can have translational impact, so we have been engaged with practitioners and policy-makers from the start.’
Much of the impact is through specific projects. One of the biggest is known as the PARC study – Physical Activity Rejuvenating Connswater.
‘We’re in collaboration with the East Belfast Partnership who were awarded a Big Lottery grant to build the Connswater Community Greenway. We made an independent grant application to the MRC to evaluate its impact and were awarded almost £1m over a five-year period to do that.
‘So far the partnership with our stakeholders has been a real success. As we’ve been producing our early findings we’ve been able to relate them back to local people. For example, we recently carried out our first household survey and have been able to present the results to representatives of the local community."We’re trying to tilt the balance away from only looking at the causes of things – looking instead at what interventions will make things better." It’s good to have that direct link. In fact, in 2011 the Joseph Rowntree Foundation produced a report on the impact of local research and they chose the PARC study as one of their examples of good practice.’
Another workstream in the Centre involves the development of public health infrastructure. ‘That doesn’t mean bricks and mortar. It can be a resource such as record linkage of public health data. One of our researchers is leading many projects associated with the Northern Ireland longitudinal study based on the 2001 census. What’s emerging is quite powerful – such as how social circumstances affect mortality.’
As Professor Kee explains, the work of the Centre is carefully and closely managed by the Research Councils.
‘They look at the engagement we have with decision-makers and how our work influences policy and practice. Ultimately, our impact will be in the wellbeing of the community but senior researchers sit on a variety of regional policy advisory committees, such as those devising obesity prevention strategies and the multi-sectoral group updating the Investing for Health strategy.’
He believes in strengthening intervention research. ‘We’re trying to tilt the balance away from only looking at the causes of things – looking instead at what interventions will make things better. In the PARC study, it’s changing the built Environment. For example we have experimented with physical activity loyalty cards and carried out a trial with 400 civil servants at Stormont. When the civil servants went for a walk around the grounds at lunchtime they could swipe the card at sensors we’d set up at various locations around the estate. They could build up “points” according to how much walking they did and get rewarded with retail vouchers. This trial has gone well and so interventions like this will be part of our focus in the future.
‘The Government talks about trying to change what it calls the choice architecture of our lives. However, behavioural change isn’t solely down to personal decisions. People are affected by their circumstances. So I welcome things like the minimum price of alcohol and the smoking ban. Government and society as a whole have to complement individual choices.’
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