This is a collaboration with the Public Health Team of the London Triborough Authorities (Hammersmith and Fulham, Kensington and Chelsea and City of Westminster) on the design and delivery of a research evaluation of a new pilot project aimed at preventing obesity in childhood. The project forms part of a wider programme in the three boroughs to halt and reverse levels of childhood obesity and improve associated outcomes for children and their families. ‘Go Golborne: eat happy, move and play’ was launched in May 2015. With many schools, preschools, youth clubs and parks, Golborne - one of London’s most deprived wards – offers potential to reach large numbers of children and young people and explore the environment’s role in supporting healthy behaviours. This pilot takes a ‘whole place’ community approach through a local network of individuals and organisations. Using training opportunities, environmental improvements, consistent messages, community development and a series of social marketing campaigns, Go Golborne encourages children and their families to ‘eat happy, move and play’ by helping to create supportive environments that make healthier choices around eating and physical activity easier.  Their themed campaigns will focus on simple messages such as sugar swaps, snack checks, active travel, and reduced screen time. CHSS is taking a ‘theory of change’ approach to the four-year evaluation, which will study the links between activities, outcomes and contexts of the initiative.  It will incorporate a detailed process evaluation, as well as evaluating outcomes on healthy weight, changes in behaviour, awareness of and attitudes to physical activity and healthy eating, and changes in home, school and community environments. Evidence suggests that healthy lifestyles initiatives work best when targeted at a local level to respond to the unique needs of communities. Learning from other areas also highlights the importance of taking a ‘whole system’ approach where everyone who lives and works in a community plays their part to make it a healthier place for children to grow up.  This pilot, as part of a multi-agency approach to tackling child obesity, will test the feasibility of replicating the intervention in other areas. The research team will: Assess impact and costs of the pilot at child and family, community and local authority level, Identify the least and most effective elements of the project - for who, in what contexts, and how. Inform the progress of the project over the three years to maximize the likelihood of greatest impact. Make recommendations on whether and how the intervention could be rolled out in or adapted for other wards.   Start date: 25/05/2015 End date: 31/03/2019 Funder: Royal Borough of Kensington and Chelsea Funding: £189, 653

This is a joint project with the Kyiv Economics Institute at the Kyiv School of Economics www.kse.org.ua  It is a 12-month development study to assess the feasibility of implementing a full-scale evaluation of the Public Health programmes and policies in Ukraine over the period 1990-2014. Ukraine has long faced a significant health crisis exacerbated by growing health inequalities.  It is one of five countries in the World Health Organisation European region with life expectancy 11 years lower than EU average and a 10 year gap between males and females. Since independence in 1992 Ukraine’s health care and public health systems have become inadequate to deal with growing epidemics of non-communicable diseases and TB/HIV/AIDs.  The Ukraine government has stated its commitment to reform and to evidence-based decision-making.  However, the dire state of population health and economic and political difficulties make it likely to opt instead for rapid implementation of ready-made examples from other countries.  This allows for no fundamental analysis of what does/did and does not/did not work in the Ukrainian context. This 12-month development study funded by the Medical Research Council will examine how Ukraine’s national public health programmes and policies evolved from 1990-2014, mapping their implementation across regions and over time.  Professor of Health Economics, Olena Nizalova leads the CHSS team which also includes Prof Stephen Peckham and Dr Erica Gadsby. Start date: 15/06/2015 End date: 31/12/2016 Funder: Medical Research Council Funding: £100,590   Project Publications: Working Paper 1: Importance of Process and Impact Evaluation of Public Health Programmes/Policies Overall and Especially in Financially Deprived Settings (David J Hunter, Stephen Peckham, Erica W Gadsby) This paper sets the scene for subsequent papers by discussing the importance of research evidence in public health policy and practice, and the role it plays, alongside other influences, in decision-making processes.  The paper outlines the meaning and challenges of ‘evidence-informed public health’, and discusses the role of governments (and others) in developing public health policies and programmes based on good evidence.  It then explores the UK experience of supporting evidence for public health policy, and looks at the way in which public health research has developed there, before discussing the need for greater commitment to, and investment in, research and knowledge exchange in Ukraine. Working Paper 2: Current Population Health Needs and Their Regional Distribution in Ukraine (Olena Nizalova,Nataliia Shapoval, Olga Nikolaieva) This working paper describes briefly the situation in Ukraine in terms of population health over the past decade, starting from the analysis of the national level data on mortality and comparison of its levels and the last decade’s dynamics to that in the UK, Estonia, and Russia. Further comparison is made between avoidable/non-avoidable mortality as a more appropriate measure of the effectiveness of the Public Health system. To complete the description of the situation with population health, we analyse the available information on morbidity across various conditions linked to high mortality. Working Paper 3: Public health programmes and policies in Ukraine: development, design and implementation (Erica Gadsby, Stephen Peckham, Anna Kvit, Kateryna Ruskykh) This working paper describes our analysis of the evaluability (in principle) of public health programmes/policies in Ukraine. To do this, we analysed programme and policy documents, and our telephone survey and in-depth interviews, to explore the logic models of programmes/policies and to describe their (intended and actual) implementation. We sought to identify and explain programme aims, objectives, outcomes/targets and mechanisms by which outcomes are expected to be achieved. The following sections include some general conclusions resulting from our analysis of a range of programmes/policies, and give explicit examples of specific programmes/policies where relevant. Working Paper 4: Existing Elements of Public Health System in Ukraine: Current State and Historical Developments (Erica Gadsby, Olena Nizalova, Olga Nikolaieva, Nataliia Shapoval, Oleksandra Betliy, Anastasiya Salnykova) This working paper describes the historical developments and current state of the various elements that might together make up the public health function in Ukraine. To do this, we have drawn on the structure used by the European Observatory on Health Systems and Policies in their analyses of health systems in Europe (Rechel and McKee 2014), and the World Health Organization’s self-assessment tool for the evaluation of the essential public health operations in the WHO European region (WHO, 2015). We focus on a number of essential public health operations, as identified by the WHO Regional Office for Europe that guide our assessment of public health capacities and services. They are key issues for health policy-making, and look across the whole political and administrative spectrum, rather than focusing on the activities of specific institutions. For each key issue described in this working paper, we define the issue, briefly discuss the international context, and describe the situation in Ukraine, with reference to policies and regulations, organization and infrastructure, and operations and activities specific to the issue. The first key issue we address relates to the surveillance of population health and wellbeing. We then go on to explore issues of health protection, including emergency response, occupational health, environmental health and food safety. Next, we explore disease prevention and early detection of disease by examining screening in Ukraine. We then examine health promotion in the Ukrainian context, including action to address non-communicable diseases and social determinants of health. Finally, we look at the organization and financing of public health, and the state of the public health workforce in Ukraine.

Public Health Collaboration. CHSS has been commissioned to conduct an external evaluation of Medway Public Health Department’s weight management projects. This collaborative project will assess how Medway’s initiatives and programmes could be built on and improved. In 2014 Medway Council hosted an Obesity Summit attended by private, public and voluntary sector partners, to help develop a framework for tackling obesity. Medway Council’s dedicated ‘Supporting Healthy Weight’ team (SHW) works with adults, families, children and young people to help them in achieving healthy weight. Within the National Child Measurement Programme (NCMP) classification, 23.3% of 4-5 year olds and 32.7% of 10-11 year olds in Medway are overweight or obese. The SHW team provide and commission a diverse range of interventions across Medway to help prevent and manage overweight.  These include four MEND programmes (2-4, 5-7, 7-13 and Graduates) and Fit Fix, a programme for 13 – 17 year olds. The team work across the Council to maximise opportunities to support obesity prevention in all aspects of the Council’s work, and in the revised Medway Local Plan. The evaluation will also focus on raising awareness of the SHW portfolio and developing its media profile to get the message out to a wide audience about obesity and public health initiatives in Medway.  Start date: 15/01/2015 End date: 14/01/2017 Funder: Medway Council Funding: £67,187 Poster presentation: Evaluability assessments as part of a ‘whole systems approach’ to evaluating Medway Council’s interventions to tackle obesity.