Projects and Publications

Inclusivity in Menopause Support

Funder: Hertfordshire and West Essex and Suffolk and Northeast Essex integrated care systems

Team lead: Samantha Chenery-Morris

Duration: 31.71 weeks

Brief description: Inclusivity in Menopause Transition Project. Background: The average age for menopause is 51, with many factors influencing the start of menopause, such as ethnicity, cultural beliefs, socioeconomic background, and general health issues. Therefore, the ICS wanted to explore these factors. Method: A concurrent, exploratory, mixed-method project using secondary data from the NHS Staff survey and focus group interviews with staff. Findings: Quantitative Phase: The NHS Staff survey of the two ICS included 41,353 staff. 64% of the workforce are aged 41-65, and most are female (77%). One in five staff (20%) is from an ethnic minority, and 4% identify as LGBTQ+. Qualitative phase: Four staff focus groups with a total of eight participants from mixed backgrounds were conducted. Five themes were identified and discussed. The two ICS were already undertaking a wide range of measures to support staff with the menopause transition. However, these initiatives were not always or widely known, and policies to support staff were not compassionately enacted or followed. There was differential access to reasonable adjustments in the workplace.


Diabetic evaluation

Funder: Suffolk GP Federation

Team lead: Valerie Gladwell

Duration: 50.1 weeks


North Essex Neighbourhood Evaluation

Funder: Northeast Health Alliance

Team lead: Valerie Gladwell

Team members: Chris Owens, Paul Freeman, Ellie Rossiter, Scott Danielsen, Oonagh Corrigan, Obinna Ejiogu

Duration: 52 weeks

Brief description: Using a collaborative approach, we aim to develop an evaluation framework and identify an appropriate and relevant evaluation plan that reflects the motivations, principles and context of the neighbourhood model and live well domain programme. A combination of methods has been used to capture early learning within the Colchester team, including focus groups, adapted ripple effects mapping (REM) workshops, and theory of change workshops. Data is being analysed at different time points to allow for timely feedback and elaboration on emerging themes. An initial REM workshop took place in November 2022, after which, outputs were digitised and analysed for impact pathways and emerging themes. A follow-up workshop is due to take place in May 2023.


Evaluation of Suffolk Mind's Emotional Needs Audit

Funder: Suffolk County council

Team lead: Colin R. Martin

Duration: 25.6 weeks


Develop a Self-report Measure to Assess Sleep Satisfaction through Community-based Participatory Research: The Suffolk Sleep Index (SuSi)

Funder: NHS Ipswich and East Suffolk CCG

Team lead: Valerie Gladwell

Team members: Colin R. Martin and Stephen Hunt

Duration: 65.1 weeks

Brief description: This research is based on the protocol described Protogerou, C., Gladwell, V., & Martin, C. (2022). Development of a self-report measure to assess sleep satisfaction: Protocol for the Suffolk Sleep Index (SuSI). Frontiers in Psychology, 13, 6803.

Good sleep is essential for health but there is no consensus on how to define and measure people’s understanding of good sleep. To date, people’s perceptions of a good night’s sleep have been, almost exclusively, conceptualized under the lens of sleep quality, which refers to objective characteristics of good sleep, such as such as ease and time needed to fall asleep, hours of sleep, and physical symptoms during sleep and upon awakening. This research focuses on sleep satisfaction, rather than sleep quality, and aims to develop a self-report measure to assess sleep satisfaction in an English adult population. To our knowledge, a valid and reliable sleep satisfaction self-report measure has not been developed in the United Kingdom previously.


How can agile working support mental wellbeing in SMEs?

Funder: NHS Norfolk and Waveney Integrated Care Board (Ipswich Borough Council)

Team lead: Valerie Gladwell

Team members: Clare Rigg, Laura Reeves, Adetola Adekunle, Warren Scott

Duration: 15 weeks

Brief description: In what ways do Agile working practices impact on Mental Health & Wellbeing in Small Medium Enterprises (SME’s), and what do SME’s currently do to address this? For this grant we had research capacity funding to explore the opportunity to bid for NIHR funding for the following project. A person’s workplace can improve their mental wellbeing, particularly when managers are supportive. However, it can be difficult to ensure that employees have good mental wellbeing when there are working arrangements that allow flexible working hours and location (known as agile working). More than half of the UK works for businesses with fewer than 250 employees (known as Small, Medium Enterprises or SMEs). Compared to big companies, SMEs tend to have fewer resources, specialists and systems in place to aid mental wellbeing. Furthermore, SMEs differ from larger companies in how they are set up, their structure and types of people. Managers are uniquely positioned to support the wellbeing of those they manage. However, they also need to look after their own well-being when trying to meet agile business objectives. In the long term, this research project aims to improve the wellbeing of managers and employees in SMEs engaged in agile working, by designing and implementing an effective intervention with the SME managers. This stage of the research investigates the current impact of Agile working on Mental Wellbeing within SME’s and then further to consider the feasibility, format and implementation of Action Learning (AL) as a way of enabling SME managers to engage effectively with Mental Wellbeing.


Advanced Clinical Practice roles across the Suffolk and North-East Essex (SNEE) Integrated Care System.

Funder: ESNEFT

Team lead: Noreen Cushen-Brewster

Duration: 181.71 weeks

Description: East Suffolk and North Essex NHS Foundation Trust (ESNEFT) have commissioned a programme of research to explore how the Advanced Clinical Practitioner (ACP) role has been deployed across Suffolk and Northeast Essex (SNEE). This will focus on clinical practise activities which are known to impact patient care, length of stay, and cost; this will enhance the Trust’s activities to focus improvements on those areas of care delivery which can have the greatest impact. Includes a literature review to identify the impact of advanced practice on clinical pathways at System level, a scoping exercise to identify the range of ACP roles currently deployed across SNEE and their adherence to national recommendations for this level of practice as defined by HEE, action research to explore the impact of the ACP role on the patient experience. Plus, a fully funded PhD to critically examine barriers and enablers to implementation of ACP roles in ICS.


Prevention Enablement Model continuation

Team lead: Valerie Gladwell

Duration: 41. 43 weeks


Securing and retaining a local workforce: An exploration of the elements that provide an environment for growth across two integrated health systems

Funder:  Health Education England

Team lead: Noreen Cushen-Brewster

Team members: Philip Anyanwu,Erkan Alkan

Duration: 12 Months

Brief description: This is a mixed-method study that is designed to address challenges and strategies for securing and retaining the future workforce in the Suffolk and North-East Essex regions of England. We will first conduct a systematic review to ascertain what evidence already exists relating to turnover and retention of staff as well as gain a greater understanding of the organisational practice environment. Following this review, we will disseminate a valaded questionnaire to newly qualified nurses/allied health professionals (AHPs) and other nurses and AHPs who have been employed in the same organisation for over a year to explore individuals' personal experiences of working in high pressured environments, we will then analyse the quantitative data from these questionnaires to test the relationship between turnover intention and organisational practice environment. Finally, we will conduct semi-structured interviews with newly qualified staff and retained staff (over a year in employment) to ascertain an in-depth understanding of this relationship.

Informing policy for Suffolk's physical activity strategy

Funder: Research England (internal allocation)

Team lead: Valerie Gladwell

Team members: Jane Black, Chris Owens, Nafiseh Javan, Obinna Ejiogu, Robert Southall-Edwards.

Duration: 73.71 weeks

Brief Description: The Physical Activity Strategy project aims to provide a high level of evidence to support and guide the development policy and strategy to make a difference in what is happening across Suffolk, especially in areas of high inequalities. It will work with underrepresented groups and those with long-term conditions, health care professionals, coaches, and providers who provide physical activity for underrepresented groups and those with long-term conditions.

The study will use the Ripple Effect mapping method, the GAPPA map (Global Action Plan on Physical Activity) and focus groups to interactively understand and explore the study aims. This qualitative research project will have four workstreams. Workstream, one includes providers, coaches who have provided the intervention/activity and those with lived experience who have participated in the activities/interventions. Workstream two are less heard communities with higher inequality and those with lived experience. Workstream three includes two groups of health care professionals, group 1: individuals who actively promote physical activity, and group two: individuals who do not actively promote physical activity. Workstream four: will includes coaches/ providers who provide activities for underrepresented groups. The study is proposed to start in February 2023 and end in June 2023 in the current phase.

Robert Southall-Edwards will join the team on the 13th of March 2023.


Flywheel application by Physios

Funder: Desmotec

Team lead: Marco Beato

Duration: 13 months

Brief description: Flywheel (isoinertial) resistance training is a valid strength training method that has been incorporated in sport for decades, yet little is known about how therapists working in sport apply flywheel resistance training. We aimed to describe and understand the current application and perception of flywheel resistance training amongst therapists working in sport. Seventy-three therapists (13.1 ± 10.0 years of experience) started part of this survey with 52 completing the entire electronic questionnaire. Nine multiple choice questions on application and perceptions of flywheel training (prerequisites, use of technology, barriers, and upper- and lower-body exercises) preceded two 6-point Likert scale statements on strength and reduction of injury likelihood. Most therapists (47/73) either used or intended to use flywheel training with their athletes and stated familiarisation would be a priority prior to initiating training. Although more than half suggested they were confident flywheel training could enhance strength (27/52) and muscular prehabilitation outcomes (40/52), many remained unsure. Nonetheless, it appears that therapists would mostly include flywheel training within prehabilitation (40/52) or during the later stages of rehabilitation (37/52). To monitor progress, therapists slightly prefer power (30/52) over velocity outputs, while few would not use them at all. Although therapists would prescribe most exercises - the squat, rotational exercise, and unilateral leg curl would be the most selected. Meanwhile, therapists reported remaining most unsure or would avoid prescribing the lateral squat and unilateral hip extension. The biggest perceived barriers to flywheel training are equipment cost/space, evidence, and scheduling.


Return to play after hamstring injuries

Funder: Brentford FC

Team lead: Marco Beato

Duration: 6 years

Brief description: Return to Play in professional football”. Football is the most played team sport in the world. Like most team sports, football is classified as a repeated sprint sport because of the repetition of high-intensity exercise bouts, followed by a shorter or longer rest period. The contact nature of the sport and the necessity to produce high forces and reach high speed expose players to several muscle, bone and joint injuries. In particular, the sprinting element exposes players to an increased risk of hamstring injuries. Thus, hamstring injury rates are particularly high in football: one-third of all muscle-related injuries, with a high recurrence rate of 12–33%. The research will focus on the Return to Play in professional football following a hamstring injury. The research will look at three aspects of this process, answering the following questions:

1) Is the player ready to return to play football? What are the specific criteria to safely return to performance?

2) Structure of gym-based rehabilitation. Design guidelines to prescribe the most appropriate hamstring exercises.

3) On-field rehabilitation. How can hamstring rehabilitation be structured? What are the milestones and the factors to include before returning to training and playing matches?"


The relationship between traffic related air pollution and airway inflammation in primary school children at school pick-up time.

Funder: UKRI Policy Support Fund

Team lead: Gavin Devereux

Team members: Scarlett Moloney

Duration: 6 months

Brief description: This project aims to investigate the relationship between traffic related air   pollution and fractional exhaled nitric oxide (FeNO) in children at school pick-up time. Using a within-subject crossover design, FeNO responses to 30 minutes of walking on the roadside at school pick-up time will be compared with the FeNO response to 30 minutes of walking in a tree-lined area at school pick-up time. The health benefits of exercise are well established and participating in active travel to and from school is encouraged as a flexible and accessible form of daily exercise to contribute towards meeting the World Health Organisations exercise guidelines for children. However, air pollution is the largest environmental cause of premature death and is detrimental for children’s lung development. Despite the growing focus of public policy and campaigns to reduce car idling and traffic density around schools, supporting evidence about the impact of this on children’s health is limited. Considering 99% of the world population now live in an area that exceeds the air pollution limits established by the World Health Organisation, comparing potential changes in airway inflammation following a walk along the roadside at school pick-up time to walking a tree-lined route in an urban environment is pertinent for (i) understanding how this may impact airway inflammation, and (ii) investigating realistic strategies to reduce pollution exposure and whether this could have a meaningful influence on airway inflammation.

Continuity of care in maternity services

Funder: ESNEFT

Team lead: Colin R. Martin

Duration: 181.7 weeks

Description: Improving outcomes and the integration of the care for adults with diabetes has been an NHS ambition for many years. In Northeast Essex, a local GP federation developed an innovative community-based diabetic service (Northeast Essex Diabetic service (NEEDS) to provide a single point of access providing continuity of care across an integrated care pathway. Aim: To gain a greater understanding of the implementation of NEEDS from the perspective of staff and those receiving care. Design and Setting: A mixed methods approach was used. Retrospective data from the GP surgeries involved in NEEDS was analysed to capture standard diabetic outcomes. Using online surveys and focus groups, data was collected from the workforce and a patient forum group. Results: The results demonstrated a clear pathway of diabetic care across an integrated care system. Standard care processes and patient outcomes were higher than those recorded for other GP surgeries across England. The patient forum group reported that the support they received enabled them to have more control over their care. The workforce reported that they were given autonomy to develop the service providing a holistic approach. The ‘virtual ward’ provided a true multidisciplinary team approach. The reduction in bureaucracy and blurring of professional boundaries enabled staff to work more effectively. Training and education for all was important. Conclusion: The implementation of the NEEDS service has demonstrated a holistic integrated approach to the delivery of patient care. Patients and workforce reported feeling more empowered improving the quality of care.


University of West Bohemia, Czech Republic, foreign scientist award for development of international research collaboration

Funder: University of West Bohemia

Team lead: Colin R. Martin

Duration: 17.29 weeks


The Tokophobia Severity Scale (TSS): measurement model, power and sample size considerations

Academics: Colin R. Martin, Catriona Jones, Chao Huang, Julie Jomeen, Laura Boubert, Claire A. Marshall.

Brief description: Fear of childbirth (FoC) and tokophobia represents an area of increasing concern within perinatal mental health research and clinical practice. Existing measures of the FoC have been criticised due to either measurement inconsistencies, difficulties in scoring or practical clinical application. Attempting to address these limitations, researchers developed the Tokophobia Severity Scale (TSS).

Takotsubo cardiomyopathy

Funder: ESNEFT

Team lead: Colin R. Martin

Duration: 130.57 weeks


Long covid- and mental health co-ordinator

Funder: Research England (internal HEIF allocation)

Team lead: Valerie Gladwell

Duration: 13 weeks