By Moritz P Herle, on 8 August 2017
by Anna Roberts
Over 14 million people are diagnosed with cancer worldwide each year, and this is expected to rise to 22 million over the next two decades. Thankfully, due to improvements in early diagnosis and treatment, the number of people who are surviving longer after cancer is also increasing.
However, many people diagnosed with cancer experience long-lasting and debilitating side effects (e.g. fatigue, pain, sleep difficulties, anxiety and depression), all of which can substantially reduce quality of life. Health behaviours, such as physical activity and diet could prolong survival, reduce the risk of cancer returning and have been shown to reduce many of these common side effects. However, it is many of these side effects which make physical activity more difficult to do following a cancer diagnosis, and the number of cancer survivors who meet the recommended 150 minutes of moderate-vigorous physical activity per week is lower than for people who have never had cancer. Therefore, there is a need for interventions which can help support cancer survivors’ to take part in physical activity following their diagnosis.
Digital interventions use technologies such as text messaging, email, mobile apps, social media, websites and patient portals can be used to support health behaviours such as physical activity and diet. Digital interventions have increased in popularity as they are easy to access, tend to cost less than face-to-face support and therefore have the ability to reach a large number of people. This is especially true given the ever increasing number of UK adults who access the internet and own a smartphone.
In the last few years, the number of studies which have looked at how effective these types of technologies are at improving cancer survivors’ physical activity participation and diet quality has rapidly increased. In our new study, we reviewed all of the published literature to see how effective digital technologies are at increasing physical activity or improving dietary quality among people diagnosed with cancer. We also looked at the effect of these types of interventions on body mass index (BMI) and other cancer-relevant outcomes measured in the studies, such as fatigue, sleep quality, anxiety and depression and quality of life.
15 studies were included in the review, all of which evaluated the effect of a digital technology on physical activity and five studies also evaluated the effect on dietary quality. By statistically combining the data from the studies (also known as a meta-analysis), we were able to estimate that digital technologies can increase cancer survivors’ moderate-vigorous physical activity by approximately 40 minutes per week. This technique also allowed us to show that digital technologies can significantly reduce BMI, however there was no evidence of an improvement in cancer survivors’ quality of life. While there was evidence for a reduction in fatigue, this was not large enough to be deemed statistically significant. Meta-analysis was not possible for all of the outcomes we were interested in (either due to the variation between studies in the way in which they were measured or because of the small number of studies which assessed these outcomes). Of the 5 studies which assessed the effect of digital interventions on diet, only 2 showed an improvement in dietary quality. There was no evidence of any improvement in anxiety or depression and while only 2 studies evaluated the effect on sleep quality, both showed a significant improvement in sleep outcomes.
However, as this is an emerging field of research, the quality of the included studies was varied. For instance, all of the studies asked participants to report their own physical activity participation using questionnaires. These types of questionnaires are notorious for overestimating actual physical activity levels. Furthermore, the length of follow-up in these studies was relatively short which makes it difficult to understand the longer-term impact of these types of interventions. There was also large variation between the studies in terms of the types of digital interventions, the types of cancer and the way in which the outcomes were measured. This makes it very difficult to ascertain what types of intervention are most effective, for which outcomes, among which groups of cancer survivors. While the results of this review show that the use of digital technologies in this context appears promising, we also call for larger, high-quality studies with objective measures of physical activity and longer follow-up periods.
Article link: Roberts AL, Fisher A, Smith L, Heinrich M, Potts HWW. Digital health behaviour change interventions targeting physical activity and diet in cancer survivors: a systematic review and meta-analysis. Journal of Cancer Survivorship, 2017.
By Laura Marlow, on 3 July 2017
Authors: Amanda Chorley, Laura Marlow, Jo Waller
One of our previous blogs discussed how rates of cervical screening (aka the smear test, or pap test) have been declining in the UK. Last year, screening uptake rates fell to 72.7%, meaning that over a quarter of women had not been screened as recommended (1). A better understanding of why women are not being screened is vital. If women are making informed decisions not to attend this is perfectly acceptable, but if women do not understand cervical screening or find it difficult to attend for other reasons (e.g. inconvenient appointment times), interventions to address this are important. Treating women who do not attend screening as a single group of “non-participants” means those with very different screening experiences and intentions are considered to be the same. Unsurprisingly this means that “one size fits all” interventions to increase screening participation do not have large effects, as they are unlikely to be suited to individual women’s differing needs.
In our latest study published in the European Journal of Cancer last week, we used the Precaution Adoption Process Model (PAPM)(2) to try and improve our understanding of the ways in which women who do not attend screening may differ. The PAPM is a model from behavioural science which states that before carrying out a health behaviour (in this case cervical screening), a person must move through a number of stages. A person must first be aware of the health behaviour and engaged with it before they can make a decision whether or not to carry it out. If they do decide to carry out the behaviour, they must then overcome any barriers which may be in the way of this (e.g. getting to the screening appointment). Importantly, the PAPM also includes the possibility for people to make an active decision to not participate in the behaviour. By classifying women according to the PAPM we hoped to identify what the most common type of screening non-participant is, and whether women within a particular group tend to have shared characteristics.
793 (27%) of the 3113 women we surveyed were either overdue for screening (including those who had never had a smear test) or said they did not plan to go for screening when next invited. Of these non-participating women, just over half said that they do intend to go. These women tended to be younger than women who were up to date with screening, and were more likely to be single and from less affluent backgrounds. Perhaps more surprisingly, given the fact that all should have received an invitation and leaflet about screening as part of the NHS programme, 28% of non-participating women said that they had never heard of cervical screening, smear or pap tests, even after being shown a photo of the procedure. These women were more likely to be younger and from ethnic minority and less affluent backgrounds, and to have English as a second language. Finally, 15% of non-participating women said that they had made a decision not to be screened in the future. These women tended to be older, and most had been screened before. As with the other two groups, they were also more likely to be from less affluent backgrounds.
The differences between these groups of non-participants show how important it is to consider the different reasons for non-participation. Changes such as more flexible clinic hours or text message reminders may help women who do want to go for screening but have found it hard to get around to it. However, for women who are unaware of cervical screening, more accessible information about the programme is a vital first step towards making an informed choice about whether to participate or not. As we found that unaware women were more likely to be from ethnic minority backgrounds and less likely to speak English as their first language, it may be helpful to provide information in more languages and through TV or radio advertisements rather than just using written materials. Choosing not to be screened is a legitimate choice, and one that needs to be respected by medical professionals. However, in order for women to make an informed choice it is important that they have access to relevant information, including the benefits, risks, and limitations of screening. For some of the women who have decided not to go in the future, it may be the case that they have sought out this information. For other women the decision not to go for further screening may be due to a previous bad experience.
Our survey goes some way to showing that there is not just one type of cervical screening non-participant, but different groups of women with different experiences, choices, and needs. In the future we hope to look further into these differences, both between and within the different groups described in this post.
1. Screening and Immunisations team ND. Cervical screening programme: England, 2015-16. Health and Social Care Information Centre, 2016, p. 1 – 76.
2. Weinstein N. The Precaution Adoption Process. Health Psychology. 1988; 7: 31.
By Moritz P Herle, on 23 May 2017
by Amanda Chorley and Jo Waller
Cancer screening programmes, such as breast, cervical, and bowel, are an important tool in the fight against cancer. Many people are aware of the value of early detection of cancer, which breast screening and the Faecal Occult Blood test (FOBt) part of bowel screening offer, which allows for treatment at an earlier stage when it is more likely to be effective. But are people aware that cervical screening and bowel scope screening (also known as flexible sigmoidoscopy, or FS) primarily aim to prevent cancer by identifying and removing abnormalities which may progress into cancer at a later date? This is the question we looked to answer in our recently published paper1 in the Journal of Medical Screening.
As part of a larger survey on attitudes and behaviours surrounding cancer, we asked 1433 middle aged and older adults what they thought the main purpose of each of these screening programmes was. We found that while the majority of respondents were aware that breast screening (77.9%) and FOBt (73.2%) aimed to detect cancer early, only 17.6% knew that cervical screening primarily aimed to prevent cancer. For bowel scope screening the figure was only 13.8%. Overall only 13 people correctly identified the purpose of all four screening programmes, which is just under 1% of respondents.
We also looked at whether people had participated in each programme in the past to see whether that had any effect on awareness of the purpose of the programme. People who had been sent a test kit, and those who had completed and returned the kit were more likely to know that FOBt is designed to detect cancer early. For breast screening, only those having participated in screening were more likely to know that it was aimed at early detection. Having received an invitation did not seem to have an effect on knowledge of the purpose of the test.
However for both cervical screening and bowel scope screening neither those who had received an invitation nor those who had actually participated in the programme were any more likely to be aware of the preventive nature of the programme than respondents who hadn’t been invited or participated. This is despite the leaflets accompanying invitations clearly stating prevention as the main purpose.
On the one hand it is positive that public health messages on the importance of the early detection of cancer have been so effective, and that the majority of people recognise this to be the purpose of breast screening and FOBt. However, for people to make an informed choice about whether to participate in a screening programme they need an understanding about what the screening test aims to do, as well as any risks and benefits. Our survey suggests that this is not the case for cervical screening and bowel scope. As well as this lack of awareness being an issue for informed choice, it could also have consequences for how people engage with the screening programmes. People may end up avoiding screening tests if they are afraid they might be told they have cancer2, 3. Knowing that some programmes can prevent cancer by finding and removing abnormalities may help to reduce these fears. Other studies have shown that women invited to colposcopy after having an abnormal result from their smear test sometimes mistakenly believe they have cancer4, 5. A better awareness that cervical screening mainly looks for cell abnormalities which can be removed before they have a chance to turn into cancer may help in reducing stress and worry about the abnormal result.
If leaflets aren’t getting these messages across effectively, one of the priorities for the future will be finding different ways to communicate about cancer screening so that everyone understands what the tests are trying to do.
- Chorley AJ, Hirst Y, Vrinten C, Wagner Cv, Wardle J and Waller J. Public understanding of the purpose of cancer screening: A population-based survey. J Med Screen. 2017; 0: 0969141317699440.
- Vrinten C, Waller J, von Wagner C and Wardle J. Cancer fear: facilitator and deterrent to participation in colorectal cancer screening. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. 2015; 24: 400-5.
- Andersen MR, Smith R, Meischke H, Bowen D and Urban N. Breast cancer worry and mammography use by women with and without a family history in a population-based sample. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. 2003; 12: 314-20.
- Kavanagh AM and Broom DH. Women’s understanding of abnormal cervical smear test results: a qualitative interview study. BMJ (Clinical research ed). 1997; 314: 1388.
- Gray NM, Sharp L, Cotton SC, et al. Psychological effects of a low-grade abnormal cervical smear test result: anxiety and associated factors. British journal of cancer. 2006; 94: 1253-62.
By Lauren Rockliffe, on 16 March 2017
What is HPV?
Human papillomavirus, also known as HPV, is a common virus that affects the skin and moist areas that line the body, such as the cervix. It is spread by skin-to-skin contact and can be transmitted through sexual activity. Most people will come into contact with HPV at some point in their life, and in most cases the body will get rid of the virus on its own. However, in some cases the virus can cause cell changes which can increase the risk of some cancers, such as cervical cancer. There are over 100 different types of HPV, but two types in particular (types 16 and 18) cause 70% of cases.
In 2008 a vaccination was introduced which protects against these two types of HPV. It also protects against two other types of HPV that don’t cause cancer, but do cause genital warts. The vaccination is mainly given through schools to girls aged 12-13 (in school year 8). The vaccine is given in two separate injections.
Why was this study done?
Most girls get the vaccination but as we’ve written before, there are some girls who do not. Research has shown that girls from ethnic minority backgrounds are less likely to have the vaccination than White British girls. In our new study, published this week, we investigated why this might be the case.
What did we do?
We did thirty-three face-to-face interviews with parents from ethnic minority backgrounds, whose daughters both had and had not got the vaccine. We also did interviews with parents from White British backgrounds, whose daughters had not got the vaccine, so that we could see whether there were any differences between what parents from different ethnic backgrounds were saying. All but one of the people we interviewed were mothers.
What did we find?
Parents have concerns about the vaccine
Parents had concerns about side effects of the vaccine and its effectiveness, despite the vaccine being recognised as safe by the UK government and World Health Organisation. Some parents were worried that the benefits of having the vaccination might not outweigh the risks. Other parents worried that it might encourage girls to be more sexually active.
Other people’s opinions and experiences are important
Some parents’ vaccination decisions were affected by things they had heard from other people about the vaccination. A number of parents had got information from others about the vaccine and some parents had heard about girls who happened to become unwell after having the vaccine and whose parents thought this must have been caused by the vaccine.
Parents need more information
Many parents had not heard about the vaccine before their daughter was invited to have it. Some parents felt like they had not been provided with enough information about the vaccine and others chose to research it themselves.
Some parents prefer to protect their daughters using other methods
Although there isn’t any evidence that complementary medicines can prevent HPV, some parents preferred to use them instead of vaccination and some encouraged a healthy lifestyle to prevent illness. Others thought that better ways to prevent their daughter from getting an HPV infection would be to encourage them to have safe sex, to educate them about sex or for their daughters to not have sex before marriage. A few parents believed illness was caused by things outside their control, such as God.
Some parents don’t trust authorities
A number of parents believed that the introduction of the vaccine was driven by pharmaceutical companies wanting to make money. Some of these parents lacked faith in the government and why it had chosen to introduce the vaccine.
Emotions influence vaccination decisions
Some parents felt that they might regret the decision if they vaccinated, whilst others felt they might regret their decision if they did not.
What did we conclude?
In general, many of the things parents spoke to us about were said by parents from all different ethnic backgrounds. However, there were some issues that were only brought up by parents from ethnic minority backgrounds. These included preferring their daughters to wait until marriage before having sex and believing that cervical cancer is caused by things that are out of their control.
The results of this study suggest to us that any future attempts to try and increase uptake of the vaccination need to consider issues that are important to parents from ethnic minority backgrounds. It may be helpful to involve community group leaders and religious leaders when designing future interventions, to ensure that it is appropriate and well considered.
By Sarah Jackson, on 8 March 2017
Rises in obesity prevalence over recent decades have corresponded with increasing stigmatisation of, and discrimination against, individuals living with obesity. Weight stigma is often justified on the basis that it might encourage people to lose weight, but a growing evidence base indicates that experiences of weight-related stigmatisation may in fact encourage behaviours that promote obesity.
A few small studies have indicated that people who face weight stigma are more inclined to avoid physical activity, but none have been able to clearly establish what effect experiencing stigma has on actual exercise behaviour.
In a new study published today in BMJ Open we explored the relationship between weight discrimination and physical activity. The research involved 5,480 men and women aged 50 years and older taking part in the English Longitudinal Study of Ageing, a large population-based cohort of middle-aged and older adults living in England.
Overall, one in twenty people said they had been discriminated against because of their weight, ranging from lack of respect or courtesy to being threatened or harassed. Rates of weight discrimination varied considerably according to how overweight a person was, from 0.9% of people with a body mass index (BMI) in the overweight range (25-29.9) to 13.4% of people with obesity (BMI greater than 30).
Importantly, we found that people who had experienced weight-related discrimination had almost 60% higher odds of being inactive and 30% lower odds of engaging in moderate or vigorous exercise once a week than their peers.
Interestingly, a person’s BMI in itself did not affect the relationship between weight discrimination and exercise, indicating that people who experience weight-related discrimination are likely to be less physically active, regardless of their weight.
There could be several reasons for our findings. People who feel stigmatised may be more self-conscious about exercising in front of others for fear they will attract undesirable attention, leading to embarrassment or teasing. They may also begin to believe the negative stereotypes against themselves as lazy and worthless, leaving them wondering why they should bother trying to be active.
Given the substantial benefits of being physically active for both physical and mental health, interventions that aim to reduce weight bias at a population level – for example through schools, local communities or national campaigns – may have greater impact on health than those that encourage people to lose weight. A Health at Every Size approach may be helpful in encouraging people to develop and maintain healthy habits, including regular physical activity, for the sake of health and wellbeing as opposed to weight control.
Jackson SE, Steptoe A. Association between perceived weight discrimination and physical activity: a population-based study in English middle-aged and older adults. BMJ Open. 2017;7:e014592.
By Lauren Rockliffe, on 28 February 2017
Mobile phone apps are commonplace in today’s society and for millions of people they are a part of everyday life. In 2016 alone, worldwide downloads exceeded 90 billion1. Apps tracking calorie consumption, exercise, steps, food points and so on, have become increasing popular. Physical activity apps in particular, have been shown to be effective in increasing people’s levels of physical activity2-3. However, most physical activity apps are tailored towards those who enjoy recording information about their performance and/or enjoy the competitive element offered by most fitness apps. Currently there are no physical activity apps which focus on the pleasure that someone might experience from doing the activity itself.
In our new study, published this week, we aimed to develop a physical activity app that would allow users to record positive images and feelings about the activity they performed, whether that was walking the dog or going to the gym, as well as encouraging them to make it a habit. We reasoned that linking positive feelings to a particular activity would increase the likelihood that the user would perform the activity more frequently, which would make it more likely to become a habit.
The app (‘Haptivity’) allowed users to take a photo every time they carried out an activity, to remind them of any positive feelings they had. Then, at a specific time each day the user would receive a reminder to be active, coupled with a photo that the user had previously uploaded. Each time users were active they would be prompted to take another photo. Users were able to look at these photos any time they liked and could receive positive feedback from other app users who they had connected with.
The app was developed along with a group of participants who helped to design and test it. Participants were aged 35-55 and said that they didn’t do any exercise at the moment, but would like to be more active. Participants initially attended a meeting to discuss what they wanted and needed in apps in general and in physical activity apps specifically. A few months later participants attended a second meeting where they were asked to download the app and to discuss their initial thoughts. At this point they were asked to complete a questionnaire about how much physical activity they were currently doing and other psychological factors related to physical activity. Participants then went away and tested the app in their own time before returning for a final meeting where their experience of using the app was discussed and they were asked to complete the same questionnaire again. This was to assess whether there had been any change in their physical activity levels whilst they were using the app, although it is important to point out that the aim of the study was to develop the app, not to increase physical activity levels at this point.
The feedback provided by participants was generally positive and suggested that it motivated them to be more active, although they had suggestions as to how to improve the app, such as being able to quantify the activities performed (e.g. recording time spent doing an activity) and being able to make the photos more interesting using photo editing, for example. Small improvements were seen in the amount of time people spent walking, although there were also reductions in the amount of time spent performing activities at a moderate and vigorous level of exertion. Overall, participants thought that the app was acceptable although it will need to be developed and tested further, with a larger number of participants, to incorporate their suggested changes.
1 App Annie 2016 Retrospective – Mobile’s Continued Momentum. https://www.appannie.com/insights/market-data/app-annie-2016-retrospective/
2 Foster, C., J. Richards, et al. (2013). Remote and web 2.0 interventions for promoting physical activity. Cochrane Database of Systematic Reviews, 9, CD010395.
3 Richards, J., M. Hillsdon, et al. (2013). Face-to-face interventions for promoting physical activity. Cochrane Database of Systematic Reviews, 9, CD010392.
By Moritz P Herle, on 23 January 2017
Today marks an exciting new chapter in the history of the Health Behaviour Research Centre. Since its inception as the Health Behaviour Unit at the Institute of Psychiatry in 1996, the group has grown into the world class Health Behaviour Research Centre at UCL and now merges with the Psychobiology group to form the Research Department of Behavioural Science and Health.
The mission of the Research Department of Behavioural Science and Health is to apply the whole range of behavioural sciences (including health, social and cognitive psychology, aetiological and health care epidemiology, psychobiology, exercise science, behaviour genetics, dietetics, communication sciences, and health services research) to a better understanding of disease prevention, early detection, and prognosis.
Our vision is to carry out cutting-edge research and provide high quality teaching on the impact of behavioural and emotional processes on disease aetiology and health outcomes, and to implement this knowledge to reduce disease risk and improve the health of the population.
More information about the Department can be found on our brand new website.
You can also follow us on Twitter via @ucl_bsh.
The official launch of the new Department will be celebrated at a later date (invitation only).
By Moritz P Herle, on 16 January 2017
Regular readers of this blog post have already heard the exciting news: next week, the HBRC will merge with the Psychobiology group to form the new Research Department of Behavioural Science and Health. More information about the new Department can be found in our previous blog post about it.
By Moritz P Herle, on 9 January 2017
Pssst, have you heard the news?? The Health Behaviour Research Centre is soon to become its own department! After many months of preparations, we finally get to share this exciting news with you: on the 23rd of January, the Health Behaviour Research Centre will merge with the Psychobiology Group. Both are currently located in UCL’s Research Department of Epidemiology and Public Health, but together they will form the new Research Department of Behavioural Science and Health.
What will change?
The head of the new Research Department of Behavioural Science and Health will be Professor Andrew Steptoe, who will be stepping down as Director of the Institute of Epidemiology and Public Health. Andrew has led the Psychobiology group since its formation in 2000. Professor Robert West, who currently leads the HBRC’s Tobacco and Alcohol Research Group, will become deputy head of the new Department. Both will continue to lead their respective research groups within the new Department.
The HRBC’s “Cancer Screening and Communication” and “Energy Balance” groups will undergo some transformations. The former will be split into two new research groups: the Cancer Communication & Screening research group, which will be led by Dr Jo Waller and Dr Christian von Wagner, and the Epidemiology of Cancer Healthcare and Outcomes (ECHO) research group, which will be led by Dr Yoryos Lyratzopoulos.
Similarly, the Energy Balance group will be split into two: the Obesity research group, led by Dr Clare Llewellyn and Dr Helen Croker, and the Energy Balance and Cancer research group, which will be led by Dr Becca Beeken and Dr Abi Fisher.
The HBRC and Psychobiology have always had a common interest in understanding how demographic, psychosocial and behavioural factors influence physical illness. Historically, the HBRC has focused on cancer while much of the work of the Psychobiology group has been in the area of cardiovascular disease and ageing. There are considerable overlaps and synergies in the theoretical and methodological approaches taken, and we hope that the new Department will facilitate even closer links than ever. Last July, the two groups spent a joint “Away Day” learning about each other’s research at the beautiful London City Hall, where the photo below was taken.
As part of the transition process, this blog will shortly be renamed “UCL Health Chatter: the Research Department of Behavioural Science and Health blog”.
In addition, if you follow us on Twitter, look out for the new name of our Twitter account (currently @hbrc_ucl). From 23 January onwards, you can find us on Twitter as @ucl_bsh. If you’re already following us, the name of our account will be automatically updated in your Following list.
What will stay the same?
Some things will never change, however. We will continue our world-class research into the behavioural determinants of health and illness, as well as our education of the next generation of excellent behavioural health scientists via our doctoral research students and the MSc Health Psychology course. Our visiting address will also remain the same, at 1-19 Torrington Place, London.
Why this change?
The creation of a new department is a demonstration of UCL’s ongoing commitment to outstanding research in behavioural science and health, and a recognition of the strengths we have in behavioural aspects of disease prevention, early detection, and prognosis. While some of our work is epidemiological, other research involves clinical and experimental paradigms, so is distinct from that of the Research Department of Epidemiology and Public Health.
We look forward to welcoming you to our new Department and website from 23 January onwards.
Remember, you heard it here first!
By Alice Forster, on 7 November 2016
Alice Forster and Laura Marlow
Today at the NCRI Cancer Conference in Liverpool, the inaugural Jane Wardle prize was awarded to our very own Dr Jo Waller to recognise her world-leading contribution in cervical cancer prevention. The prize was set up by Cancer Research UK in memory of Professor Jane Wardle who died last year. Jo has been at the Health Behaviour Research Centre for 15 years and was herself mentored by Jane Wardle. In this blog we highlight some of Jo’s key research in cervical cancer prevention during this time.
In 2005, Jo completed a PhD exploring psychosocial issues surrounding the viral aetiology of cervical cancer. These early studies explored the emotional and social consequences of a HPV diagnosis and how women make sense of a HPV positive result at cervical screening. The findings highlighted extremely low awareness of HPV and poor understanding about how cervical cancer develops. This work also showed the importance of providing good information to ensure minimal anxiety when receiving a HPV positive result at screening and to avoid stigmatising cervical cancer.
Jo and her colleagues went on to explore psychosocial issues surrounding HPV vaccination before and after its introduction in 2008. This research helped identify the most appropriate age for the vaccine and contributed to the content of the information materials provided. In addition, this work offered reassurance that vaccination against a sexually transmitted infection (the HPV vaccine) did not result in changes to girls’ sexual behaviour as some media reports had suggested. Jo’s work has also explored why certain sub-groups of the population, such as young women and ethnic minority women are less likely to participate in cervical screening.
In 2014, Jo was awarded a prestigious Cancer Research UK Career Development Fellowship to continue her research in cervical cancer prevention. Jo now formally manages a team of researchers and her current research activities include understanding non-participation in cervical cancer screening and HPV vaccination, developing interventions to improve uptake of these cervical cancer control interventions, and evaluating the psychological impact of primary HPV testing within cervical screening.
Jo has also been involved in numerous other bodies of work over the last 10 years including development of the Cancer Awareness Measure and studies exploring informed choice about screening. She is also an informal mentor to many students and colleagues. We are all very proud of Jo’s achievement today. Well done Jo!
You can read more about our current work in cervical cancer prevention on our website.