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UOA 11 - Nursing and Midwifery
RA5a: Research environment and esteem
Napier University Edinburgh, a post-92 Higher Education establishment, conducts intensive research with an applied approach across a range of inter-connected specialities. A policy of selective research development is pursued which maps on to the University's strategic plan. Transfer of knowledge (KT) to the practice setting, informing policy and the enhancement of learning and teaching are key to the role of research. Recent restructuring of the management framework has streamlined procedures. In order to generate a critical mass of research, this is now co-ordinated by Associate Deans through Faculty-level research centres.
Napier University has supported the development of research activity within the disciplines of Nursing, Midwifery and Social Care over the past seven years. Staff in these disciplines belong primarily to the School of Nursing, Midwifery and Social Care (SNMSC), one of three Schools in the Faculty of Health, Life and Social Sciences. The University aspires to further develop excellence in nursing and health care research by 2010. This aspiration is evident in the University Strategic Plan (2001 – 2008) where the area of Health and the Environment is identified as one of five areas for strategic development. A new Faculty building is planned for completion in 2010 which will enhance teaching and research facilities. This first Napier University nursing submission to the RAE demonstrates the significant progress of the research infrastructure which has occurred since 2000. It has resulted in themed research outputs and the establishment of a sustainable research environment.
We aim to produce research that is aligned to current health and social care policy. This emphasises the importance of preventing enduring conditions as well as their long term management. Thus Public Health and the Management of Enduring Conditions are the two key themes underpinning the research contained in our submission. These priorities are complementary to the themes of the Centre for Integrated Healthcare Research (CIHR) which is funded by a strategic development grant provided by the Scottish Funding Council and the Scottish Executive Health Department, Chief Scientist Office. CIHR aims to increase research capacity and capability in Nursing and the Allied Health Professions in a consortium consisting of Napier University, Queen Margaret University, Edinburgh University, NHS Lothian, NHS Borders and NHS Lanarkshire.
Research development 2000 – 2007
Since 2000, targeted investment has supported research activity in the two main themes. This includes the appointment of key staff with expertise and potential to develop research, attract funding, and increase the numbers of staff with a PhD. In 2000 four staff members held PhDs. This has increased to twenty three staff by 2007 twelve of which have been awarded during the current census period. A further ten members of staff (two full time) are completing PhDs.
The commitment from the University to dedicate time for research active staff demonstrates long term strategic intent in research and knowledge transfer. Time has been allocated to established and early career researchers to develop research. Staff within the group have been commissioned to develop national policies within the Scottish Government ensuring that many of the recent studies are embedded in policy, involve clinical staff and promote user involvement.
In order to achieve critical mass and plan for sustainability, research is now coordinated by Associate Deans in Faculty-level research centres. Nursing is a key group in the Faculty’s Applied Research Centre for Health, Environment & Society (ARCHES). This is newly-formed (October 2006) and designed to promote sustainable interdisciplinary research, among researchers in the three Schools of the Faculty, and across the University. The Centre is a conduit for research knowledge, including dissemination of information on, and responses to, national strategies for research innovation and policy. ARCHES is also the financial and administrative hub for research in the Faculty.
The range of disciplines involved in ARCHES allows for synergy and collaboration between nurse researchers, scientists, psychologists, sociologists, exercise physiologists and allied health professionals. This cross fertilisation of expertise and knowledge has led to the development of a number of multidisciplinary proposals in areas such as the management of stroke and diabetes. The Nursing & Health group is made up of staff from the SNMSC, including those from the Centre of Integrated Healthcare Research. The group is coordinated by Kennedy (Director of Research and Knowledge Transfer). Research active staff are now allocated research time (35%) and Kennedy is allocated additional time (50%) to mentor early career researchers, develop interdisciplinary research, encourage research output, and actively promote collaboration internally and externally. Leading researchers Alder, Elliott, Kennedy and Raab, provide local mentoring practices to ensure experienced researchers work with professionally younger colleagues.
The association of ARCHES with the Centre for Integrated Healthcare Research provides nurses and allied health professionals with access to pump priming funds, research training, seminars, statistical support, research expertise, funding to present at national and international conferences, and funding for visiting academic research staff. To date, CIHR has invested (circa) £540,000 in Napier University to develop research capacity and capability. This investment has resulted in a Professorial Post (Elliott, Public Health Theme); a Post Doctoral Research Fellowship (Hanley); two full time studentships; nine pump priming studies (£15,000 each covering both Public Health and Managing Enduring Conditions) and funding for scientific presentations at international conferences.
The Wellcome Clinical Research Facility in Lothian has excellent facilities (equipment and staff) for carrying out research and this can be accessed nurses and allied health professionals working in ARCHES. ARCHES also supports staff, Research Fellows and Post Graduate students to attend and present at national and international conferences to disseminate their work widely. A number of staff are regularly invited by international and national collaborators to deliver key note speeches. For example, Alder is frequently invited to deliver key note addresses internationally in recognition of her expertise in infant feeding.
Napier University staff in the health disciplines aim to develop research that influences clinical practice and underpins our teaching. Research active staff are educators for pre-registration and post graduate programmes to ensure research is embedded in our programmes. International teaching collaborations will be established with the aim of enhancing collaborative research links. The importance of research that is closely linked to practice is evidenced in the creation of 12 joint appointment posts with the NHS and social services within SNMSC. More appointments are planned over 3 – 5 years.
Research students and research studentships
The establishment of a Graduate School and Faculty restructuring in September 2006 transformed research degree provision. Faculty Higher Degrees Committees and School-level Higher Degree Committees work closely with the Graduate School and central HDC on recruitment, progression, training, examination, to improve the student experience. A tailored study programme provides sessions on a range of generic skills and awareness of issues such as intellectual property, research ethics and data protection, coupled with discipline-based advanced training. This is backed by workshops, seminars and conferences provided in-house or externally, to meet various needs including training for teaching, advanced data analysis, IT skills, English language support and careers advice. A popular staff development programme exists for research degree supervisors, examiners and administrators.
Currently there are 21 PhD students (10 full time and 11 part time) attached to the Nursing & Health Group within ARCHES of which 19 are supervised by submitted staff. These are funded through Napier University Internal Research Studentships (4), Centre for Integrated Health Care Research (2), Scottish Government’s Chief Scientist’s Office (1) and other external research funding (2). Since 2000 six PhDs have been awarded.
There is an annual research student conference at which all postgraduate students present their work. Staff and students undertake research training together providing opportunities to share expertise, improve their skills and knowledge in research methodologies and approaches to data management and analyses. In this way we provide an academic community of post graduate researchers linked closely with research experts and clinicians.
Future vitality depends on managed renewal and the group has undergone a number of changes that reflect this. The establishment of ARCHES, the appointment of Kennedy in August 2007 to the role of Director, Research and Knowledge Transfer and Elliott’s leadership through CIHR will consolidate and build on existing collaborations. New researchers who are gaining experience as PIs through activities such as the CIHR pump prime grants and working with existing research teams will be supported and encouraged to develop their research expertise.
Over the next five years the Faculty and School plans to build on current progress and develop Research & Knowledge Transfer activities with particular emphasis on:
- Increasing sustainable activity in research, consultancy & knowledge transfer using local mentoring practices;
- Focussing research and KT activities on the management of enduring conditions and public health issues relevant to nursing;
- Building capacity and capability in mental health nursing research in order to address the identified knowledge gap in this area and to reflect current policy recommendations;
- Increasing the active involvement of service users in all stages of research;
- Increasing the numbers of PhD students linked to programmes of research such as cancer and palliative care, diabetes, stroke and mental health;
- Building PhD supervisory capacity and capability amongst staff;
- Working within ARCHES to capitalise on the opportunities for cross-University collaboration;
- Collaborating with CIHR to capitalise on the opportunities for interdisciplinary health and social care research across universities and the NHS;
- Establishing the Faculty as one of the leading centres for nursing research in Scotland;
- Developing a range of international partnerships in learning, teaching, research and knowledge transfer areas: this includes links with China, Hong Kong, Dubai, India and Jakarta.
In August 2007 the SNMSC embarked on a collaborative practice development project with NHS Lothian. Known as the Leadership in Compassionate Care Project it will focus on embedding compassionate care as an integral aspect of nursing practice. The project has four strands which focus on undergraduate nurses, newly qualified nurses, developing centres of clinical excellence and leadership in compassionate care. The aims of the project support and are consistent with national policies such as: Delivering Care, Enabling Health (2006) and Rights, Relationships and Recovery (2006). The project received funding of £1.138,000 (Private investment), £188,000 (Napier University), and £307,000 (NHS / Scottish Executive). Research will evaluate its impact on the nursing management of enduring conditions, and will become a focus of research activity for the Faculty. The project attracts national and international interest and opportunities for collaborative working and further research.
The next section contains an overview of the two research themes; nursing management of enduring conditions and public health.
Theme 1: Management of enduring conditions
Research in this theme covers the management of enduring conditions such as stroke and diabetes, cancer care, and care of the elderly. Crosscutting themes consist of systematic review and statistics, and nursing workforce development. Some research is focussed on acute episodes of chronic conditions. The team involved in this research grouping are Dr Roseanne Cetnarskyj (Early Career Researcher, ECR), Professor Morag Gray, Dr Lynn Kilbride (ECR), Karen Lockhart (ECR), Dr Catriona Kennedy, Dr Kay Penny, Professor Morag Prowse, Dr Anne Rowat and Anne Williams. Eighteen PhD students are conducting research in this theme.
The research and consultancy activities undertaken in this group, are highly relevant to health and social care policy and clinical practice, and include reviews which inform policy and knowledge transfer across the National Health Service. Examples include research synthesis using systematic review and original research using quantitative and qualitative methods.
Systematic Review and Statistics
The Scottish Executive commissioned Kennedy to undertake a literature review to inform the review of nursing in the community completed in Scotland in 2006 (£10,000). The aim of this review was to inform the implementation of Delivering for Health (Scottish Executive 2005) (Kennedy 4). She led a team from Napier University and Queen Margaret University (QMU) who contributed to the review http://www.scotland.gov.uk/Resource/Doc/153965/0041416.pdf. Plans are in place to publish the outcomes of the review in a peer reviewed journal. Research proposals have been developed and submitted for Health Services Research funding with colleagues at QMU and CIHR. This kind of research activity has a direct bearing on the experiences and outcomes of patients with enduring condition, and carers in primary care.
Kilbride and Lockhart are early career researchers who hold external grants from the CIHR. These are; a study of treatment of type 2 diabetes (with Wellcome Trust Clinical Research Facility, NHS Lothian) and a systematic review of ‘Methods of communicating a diagnosis of breast cancer’ (Lockhart 1). Another systematic review ‘Specialist breast care nurses for supportive care of women with breast cancer’ (Kennedy) was also funded by CIHR (£15,000 per award). CIHR have funded 9 pump prime grants which involve staff from SNMSC. Key publications and presentations have resulted from these grants which impact on care delivery and patient outcomes in clinical practice. Service users and providers have contributed to the development and peer review of both Cochrane systematic reviews and other CIHR funded grants.
Kilbride and Kennedy with the Edinburgh Centre for Neuro-oncology (NHS Lothian) have secured University funding (£20,000). This will provide the basis for future research and educational opportunities specifically in the area of malignant spinal cord compression. A research fellow has undertaken a literature review and the title has been registered with the Cochrane Collaboration. A jointly funded full time PhD studentship with NHS Lothian commenced in September 2007 (£15000 NHS Lothian & £36000 Napier University). Clinical staff in neuro-oncology in NHS Lothian identified developing an evidence base for the management of malignant spinal cord compression as a clinical priority to which we have responded. Kilbride, and colleagues from NHS Lothian, have registered a title with the Cochrane Collaboration to review the impact of usual care on menopausal women with type 1 diabetes mellitus.
Penny, a statistician, has undertaken collaborative research in various health-related areas including head-injury studies (Penny 3), chronic pain in the community, trauma injury outcomes, and symptoms and quality of life of irritable bowel syndrome patients. She is currently developing analytical techniques to determine factors associated with death following injury using routinely collected data (Penny 1 & Penny 4). She collaborates with researchers at Edinburgh University and the Western General Hospital, Edinburgh, who are investigating many aspects of irritable bowel syndrome including factors associated with health care utilisation and quality of life (Penny 2), and symptom subgroup classification of patients, and how this changes over time.
A major achievement in this theme is external funding for two full time Cancer Nursing PhD Research Fellowships (£220,000 Kennedy) in breast cancer and relevant to National policy (NHS QIS 2005). This focus on cancer nursing builds on a Chief Scientist’s Office (CSO) grant (Raab £150,000) investigating skin care following radiotherapy. This study has led to 5 publications and a proposal for a follow up study (Raab 2). The multi-professional research team included staff from the Universities of Dundee, St Andrews University and NHS Lothian, Scotland. Raab, as a statistician, works across the two themes in this submission.
Cetnarskyj, an early career researcher, has conducted research in cancer genetics including family history and risk assessment (Cetnarskyj 3). This research is multi-professional and collaborative with the University of Edinburgh. Some of this work has resulted in funding from the Scottish Government to establish a genetic nurse/counsellor led service in Scotland (Cetnarskyj 1 & 4). Cetnarskyj is a member of the Scottish Colorectal cancer research group who have completed a MRC funded case control study of colorectal cancer (Cetnarskyj 2).
A team led by Kennedy has undertaken the evaluation of a Children and Family Support Worker Service funded by Macmillan Cancer Support (£37,205). A part time research fellow was employed and a number of publications and conference presentations are in progress. Two papers from this study will be published in the International Journal for Palliative Nursing. This collaborative work with the University of Edinburgh is feeding into the current review of bereavement policy and services by the Scottish Government.
Williams is an experienced practitioner who has researched the experiences of people living with lymphoedema (Williams 1) and undertaken an RCT into the effects of manual lymph drainage in women with breast cancer related lymphoedema (Williams 2). Collaborative work with Thames Valley University, the Haven Trust and St George’s Hospital Medical School has estimated the prevalence of chronic lymphoedema in the community (Williams 3) and examined tools used to measure health related quality of life in patients with lymphoedema (Williams 4). Kilbride has also investigated anxiety and depression in patients with malignant brain tumours (Kilbride 1 & 2).
Rowat is an early career researcher with research into nursing care of stroke patients and older people (1, 2, 3 & 4). Rowat is engaged in long term research collaboration with Professor Warlow’s stroke research group at the Division of Clinical Neurosciences, University of Edinburgh. Since 2001, funding has been secured from the Health Foundation, Chest, Heart and Stroke Scotland and NHS Lothian R&D (Total = £77,445) to undertake projects that investigate nursing practice related to nutrition, hydration and hypoxia in acute stroke. A full time studentship is linked to this area of research.
Kilbride is working with colleagues in NHS Lothian on a study of diabetes and exercise. Internal funding (£22,000) and external funding, from ‘Sporting Chance Initiative’ (£15,000), have been secured to employ a research fellow to assist with this work.
Kennedy is involved in a collaborative project (£390,000) with Edinburgh University, NHS Lothian and the University of Ulster. The aim of this 3 year project (2007 – 2010) is to develop the ‘National Network Supporting Learning and Practice Development in the Care of Older People’ funded by NHS Quality Improvement Scotland Care Commission and NHS Education for Scotland. The ‘Connect in Care’ network will implement and evaluate learning and practice development initiatives to improve nursing care of older people. It will develop the knowledge of staff and improve the experiences of pre registration students in clinical areas particularly care homes. Other work in this theme relates to clarifying the nursing role in assessment, care and treatment within chronic and palliative non-malignant disease for patients and families (Kennedy 1, 2 & 3 Lockhart 2).
Nursing workforce development
Prowse has contributed to professional debates on the characteristics and achievements of nurse consultant posts established in the United Kingdom in 1999 (Prowse 1). She has also been involved in the exploration of nurses’ experiences of providing high dependency care in children’s wards (Prowse 4) and the influence of nurses’ bio-scientific knowledge on patient outcomes in perioperative care (Prowse 2 & 3). Work exploring the literature base for post operative pain management in older people contributes to debates about improving patient outcomes.
Also associated with this theme is the work of Gray which is applied nursing education research. Gray is a member of a collaborative research team working with colleagues from the Universities of Brighton, Plymouth and Teeside. This collaborative group has attracted £570,000 of funding from the Department of Health (Gray 1, 2, 3 & 4). Research relating to mentorship, preceptorship and the use of portfolios helps to enhance the pedagogical approaches used and facilitates evidence based practice in the SNMSC. Gray is also evaluating the Anaesthesia Practitioner project funded by NHS education for Scotland (£50,000).
Members of the group are involved in a number of scholarly groups and committees including the Scottish Intercollegiate Guidelines Network (Williams), NHS Quality Improvement Scotland (Lockhart) and the South East Scotland Cancer Network (Kennedy). Other activities include elected membership of the scientific committee for the Samantha Dickson Brain Tumour Trust (Kilbride) and Scottish NMAHP Research into Practice Conference Scientific Committee (Kennedy), Chair of the Research Action Group of the Scottish Stroke Nurse Forum and member for the Lothian Stroke Research Managed Clinical Network and the Prediction of Stroke Outcomes Collaboration (Rowat). Gray is on the Editorial Board for Nurse Education in Practice; The International Journal of Excellence in Health Care Management and an Executive Board member of the International Network for Doctoral education for nurses and a member of the Sigma Theta Tau International Honor society of nursing. Penny has also held the post of Statistical Editor for the Journal of Clinical Nursing. Kennedy has secured a grant from the Royal Society for Edinburgh International Programme (£1800) to visit the Peter Macallum Cancer Centre Melbourne Australia in April 2008
- Together this group has obtained around £772,205 in externally funded research grants which are held by Napier University.
- Research grants of around £1,237,445 are held by members with external collaborators.
- Together this group have published a total of 67 research papers, 10 book chapters, 6 reviews and 19 clinical papers.
- Members of this group have also established research links with other Higher Education Institutions:
- Queen Margaret University (Kennedy);
- Edinburgh University (Cetnarskjy, Kennedy, Kilbride Penny and Rowat);
- Stirling University (Kennedy);
- Glasgow University (Rowat);
- University of Ulster (Kennedy);
- Universities of Brighton, Plymouth and Teesside (Gray).
- Members of this group have established links and hold collaborative research grants with the NHS in the Lothians and Borders.
Theme 2: Public Health
Public Health is a key area of research and contributes to National Health Service policy and informs service provision. The group consists of Professor Beth Alder, Dr Sandra Bonellie, Professor Lawrie Elliott, Dr Janet Hanley (ECR) and Professor Gillian Raab plus 4 doctoral students, 2 research assistants, and a research administrator. The work of this group is focused on public health policy and public health interventions many of which include nurses and midwives, particularly those aimed at disadvantaged groups.
Alder was Faculty Director of Research from 2000 to 2004 and has provided leadership for this research theme. Her research is primarily focused on interventions by midwives and health visitors e.g. on infant feeding, (Alder 1, 2 & 4) and postnatal incontinence (Alder 3) and postnatal depression. She held a collaborative grant with colleagues in Coventry and Oxford to investigate early midwife interventions in breast feeding (DoH £226,000) and was Principal Investigator on a project looking at the implementation of guidelines on postnatal depression (NHS QIS, £128,000). Alder was instrumental in obtaining funding for the Centre for Integrated Healthcare Research and is a member of the Programme Management Group.
Elliott is lead for a program of research within the Centre for Integrated Healthcare Research entitled, ‘Improving the Management of Enduring Conditions’. His work in Public Health has contributed to national and international policy (Elliott 1 & 4). Published work includes a systematic review of public health nursing that helped inform Scotland’s policy ‘Nursing for Health: A review of the contribution of Nurses, Midwives and Health Visitors to improving the Public’s Health’ (2001). Further work examined the effectiveness of a nurse led intervention delivered in a community setting for drug addicts and demonstrates the contribution of nursing in this helping this highly disadvantaged group (Elliott 3). A second systematic review includes interventions for young drug users that are highly relevant to nurses working the field of addiction, including community and public health settings (Elliott 2). A third review consists of a synthesis of public health policies which was published by the World Health Organisation. It focuses on closing health inequalities gaps and proposes a radical change in health provision towards public health interventions (Elliott 4). Together this work urges public health nurses to adopt a stronger community role and is reflected in current nursing policy such as Delivering care and enabling health: Harnessing the nursing, midwifery, and allied health professions’ contribution to implementing Delivering for Health in Scotland (Nov 2006), and Visible, Accessible, and Integrated Care: Report of the Review of Nursing in Community in Scotland (Nov 2006).
Hanley is an early career post doctoral Research Fellow seconded from NHS Lothian 0.4 to the Centre for Integrated Healthcare Research and Napier University and working with Elliott. Her research is aligned to Improving the Management of Enduring Conditions in community settings and focuses on the self management of urinary incontinence (Hanley 1 & 2) and hypertension (Hanley 3). The Chief Scientist Office (£4462 & £14,605) and Royal College of General Practitioners (£9995) have funded research to explore blood pressure monitoring in primary care. Hanley has secured a grant from the BUPA Foundation(£200,000) to investigate self monitoring of hypertension in the community.
Elliot and Raab, along with partners who include the MRC Social and Public Health Sciences Unit and the National Centre for Social Research, have attracted funding of approximately £672,000 to investigate the impact of a National Demonstration Project (Healthy Respect) which aims to improve the sexual health of young people including those from socially disadvantaged areas. It is a complex public health intervention in which school and family planning nurses play a major role. It has attracted related funding (circa £60K) for an embedded RCT and has led to the creation a number of research posts at Napier including a post doctoral fellow, three researchers and a full time PhD Student.
Raab along with Bonellie and Penny brings expertise in research and survey design and in clinical trials to support both themes in this submission (Raab 3) and leads to joint publications (Raab 4). She has attracted ESRC funding (£50,000) to develop training for researchers in survey research. Her collaboration with members of the enduring conditions theme has led to funding for an RCT (£150,000) and subsequent papers (Raab 2). She has other research collaborations, several relating to interventions for vulnerable young people (Raab 1), leading to £106,000 in research income to Napier in the RAE period. During the RAE period Raab has successfully supervised 6 (4 registered at Napier University) PhD students to completion 3 of whom worked in the sexual health area.
Raab collaborates with Bonellie (Bonellie 1, 2, 3 & 4) on the Cerebral Palsy Register for Scotland (CPRS) which was set up as a joint project between Napier and the NHS with a grants of £135,000 from Cerebra, Foundation for Brain Injured Children in 2002. The CPRS is also part of the UKCP, a collaboration of research registers for CP. Bonellie was awarded a further £65,000 in 2005 for a project based on the CPRS and £46,000 from the CSO in the same year to investigate the changing influence of deprivation on perinatal outcomes
Work from this group has informed the following policies and expert groups: Elliott is co-author of a report published by the World Health Organisation in 2006 entitled ‘Closing the Health Inequalities Gap: An International Perspective. He was a member of the Nursing and Midwifery Research Strategy Task Force (Scotland) which lead to: ‘Choices and Challenges’ 2002 the Scottish Executive’s strategy for nursing research. He was also a member of the editorial committee and Task Force leading to: Nursing for Health ‘A review of the contribution of nurses, midwives and health visitors to improving the public’s health’ (2001). He is a member of the MRC College of Experts and sits on the editorial board for the Journal of Psychiatric and Mental Health Nursing.
Alder chaired the NHS Health Scotland Breast feeding Expert Group and has contributed to policy on post-natal depression. She is an adviser to NHS Health Scotland on parenting and women’s health. Since 2001 she has supervised seven PhD Theses by nurses since 2001 and has published 12 refereed journal papers. Alder has 50 additional publications comprising a range of book chapters, conference proceedings and other publications. Her expertise has been recognized internationally by being invited to present papers or keynote lectures in the UK, Spain, Italy, Germany, USA, Australia, Argentina, Japan, and Malaysia.
Raab is a member of the Review Teams for the Scottish Health Survey and the Scottish Household Survey and sits on the Chief Scientist Office Health Services Research Committee. During the Raab has been part of review panels for the ESRC and for the German Research Foundation and has published 17 refereed journal papers.
- Together the group has obtained around £1.4 million in externally funded research grants.
- Together this group have published a total of 44 research papers, 11 book chapters, 12 reviews and 3 technical/working papers have been published.
- Members of group also sit on prestigious committees and boards including:
- The MRC College of experts (Raab and Elliott);
- MREC-A for Scotland (Raab);
- Member British Psychological Society Scottish Branch Committee (Alder);
- Vice Chair and BPS representative Committee for Applied Psychologists in Health (CAPISH) (Alder);
- Chair British Psychological Society Division of Health Psychology Scotland (Alder);
- International Society of Psychosomatic Obstetrics and Gynecology (Alder President).
- External collaborations with internationally recognised partners include:
- The MRC Public Health and Social Policy Unit, Glasgow University (Raab and Elliott);
- Public Health Division, and School of Nursing and Midwifery, University of Dundee (Elliott and Alder);
- Research Centre for Health and Behaviour Change, Edinburgh University (Raab);
- Department of Nursing, Newcastle University (Elliott);
- Health Services Research Centre, University of Coventry (Alder);
- Division of Public Health, University of Glasgow (Alder);
- Health Services Research Centre, Coventry University (Alder).