Alice Burnand, Associate Researcher, Centre for Ageing Population Studies (CAPS) shares her experience hosting a dementia workshop. 

Introduction

On October 11^th, 2023 I hosted a workshop to share results from our research project, which brought together a variety of individuals such as clinicians, caregivers, and researchers. Our research project involved evaluating the current literature on the non-pharmacological interventions to manage psychosis symptoms in dementia, such as hallucinations and delusions. I wanted to share the take-home messages of this research, to improve the quality of care that is delivered to people living with dementia. The workshop, however, was not just about sharing knowledge but also about rich interactions, meeting individuals who have unfortunately been affected by dementia-related psychosis, the exchange of ideas, and invaluable feedback about this important research topic.

The Workshop’s Concept

The workshop was titled “non-pharmacological interventions in the management of dementia-related psychosis”. It aimed to educate the audience on the symptoms and causes of psychosis in dementia, how to optimise physical health and the environment for someone, and to share the current literature to best support individuals without the need for medication. It also aimed to inform the audience of the risk of bias in research, to enable them to make informed decisions about the quality of the papers that we discussed. The aim was to empower caregivers and healthcare professionals, and to share valuable tools that can be used to support people living with dementia.

Planning and Preparation

It all began with meticulous planning and inviting a guest speaker to collaborate and join. In the months leading up to the event, I outlined my goals, determined my target audience, and designed the content to be engaging and informative. I originally wanted the workshop to be help in person, with 20 attendees, however, I quickly gained a vast amount of interest following circulation of the information, with nearly 100 people signing up asking to join. I chose to do the workshop hybrid, to make it as accessible as possible and so that everyone who wanted to join, could. For those coming in person, I chose a venue in a central London location, and ensured I provided all the necessary supplies, including printouts, drinks, and importantly, chocolate biscuits.

The Workshop Experience

Learning and content

The workshop started with educating the audience on psychosis in dementia and how to prevent it by ensuring physical health is optimised. It was led by myself and the guest speaker, Dr Stephen Orleans-Foli, who is a consultant psychiatrist working in the Cognitive Impairment and Dementia Service, West London NHS Trust. We then discussed the current research that aims to support individuals living with dementia without medication, and whether these are effective or not. Examples of these therapies include music therapy and aromatherapy and we discussed how to “trial” these. The aim was for the audience to apply the knowledge learnt in the first half to the content and the activities in the second half.

Group Discussions

After the teaching took place and in the second half of the workshop, we invited individuals to join “break-out rooms” on Zoom, and those in person were in groups sat round tables. We had 3 vignettes for groups to discuss for 5 minutes, about how they would best manage a situation, applying the knowledge they had just learnt. We then invited individuals to share their ideas and perceptions. It was incredible to see how different perspectives and life stories enriched the discussion and inspired others. An example of a vignette is below.

How would you manage?

86-year-old widow lives with her daughter. She has a 3-year history 3 of Alzheimer’s disease dementia (ADD). She is currently on Donepezil for her ADD. She spends the day looking for certain clothes in her wardrobe and leaves some of these strewn around the bedroom and lounge. She accuses her daughter of theft as some of her clothes are missing. She repeatedly calls the police on her daughter.  Her daughter repeatedly challenges her mother that she has no need of her mother’s clothes as they don’t fit and not her style.

Post-Workshop Reflection

A supportive environment

It was great to have such an interactive audience and individuals who were keen to get involved to raise points of interest and ask questions. It can always be a worry when asking the audience to get involved – but we had some great feedback and interaction from the audience which I was very grateful for!

Personal and Professional Growth

As the facilitator, witnessing the resilience of caregivers and healthcare professionals as they shared personal experiences was inspiring, and the huge interest in the workshop demonstrated how dementia-related psychosis affects so many people. For me, this has reaffirmed the importance of researching this topic.

Participant Feedback

The feedback received from participants following the workshop was incredibly rewarding. Many expressed how the experience had helped shape their approach to caregiving and had provided useful information in their supportive roles for people with dementia.

Conclusion

Hosting the workshop was an experience I thoroughly enjoyed. It was great to know the work you have put into researching receives appreciation from people who are directly impacted by the condition. It has helped me to understand the need for further research in this area, and I look forward to more opportunities to contribute to research and make a difference.

If you would like a copy of the recording or the slides of the workshop, please email Alice Burnand – a.burnand@ucl.ac.uk.

Acknowledgement

This research project and workshop were funded by the School of Primary Care Research at UCL. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

A blog from Community Researcher Sean Chou in his own words. 

‘It’s important to get feelers out there and really get to know the community.’

At the beginning, I felt nervous about being a community researcher. It was a role that I was keen to get stuck into – having studied Anthropology as an undergraduate, I felt equipped with the curiosity and listening skills needed to glean insights from residents. But it was also one that I really didn’t want to get wrong. What if I said something offensive? What if I came off so keen to chat that it came across as awkward?

All of these doubts were soothed by the words from my research supervisor, Tamsin. I had regular weekly catch up meetings, as well as one-to-ones, where I had a safe space to share feedback on research and how I felt during research. It felt humanising to acknowledge that research has a person-centred approach, that the researcher themselves could have fears or internal doubts to reckon with.

But it was Tamsin’s personal touch that lit a flame in me. Tamsin had a keen interest in sustainability and building resilient communities with environmental solutions, and I was impressed to see how an interest in helping the local community in Brent could be knitted together with one’s own vision for what a better society could look like.

For me, that was about the community helping to lead change. Our research project looked at health inequalities in Brent, as well as how residents used community assets to tackle these inequalities. These went beyond just the ‘obvious’ physical assets – libraries, parks, civic buildings, to include the ones the communities valued themselves. Partnerships, mutual aid groups, classes, all of these are relationships that tie us together and ultimately make up who we are as holistic, social beings, rather than atomised, individual units.

This is especially the case [for our?] health. I attended community events organised by Brent Health Matters (BHM) which aimed to promote positive health outcomes, healthy living as well as register and signpost attendees to health and medical services such as GP registration.

I was able to see how attendees were tied together – or sometimes not, and sometimes made vulnerable, by their health: a mother with two children attended an event, not speaking English, but helped by my fellow researcher to translate her symptoms so the GP could make the right diagnosis. A woman who attended a floristry class saying that she attended because this helped with her mental health and make friends; if she wasn’t here today, she didn’t know what she would be doing. A night shift worker opening up to a BHM health worker about diabetes in her family, before breaking down crying about her family in Bangladesh. As I watched her be taken away by the health worker to talk somewhere more private, away from prying eyes, I was reminded of how health is a sensitive, emotionally charged experience for people. When we’re told by someone we love that we’re unhealthy, it often comes off as judgement – ‘You’re not doing enough to get healthy, you’re slacking’. But our physical health is often entangled with work, family, caring responsibilities that make it difficult to recentre our lives around living healthily.

But it also reminded me that some groups are more susceptible to poor health outcomes than others – those with low incomes, women, community groups, those from migrant backgrounds. BHM targeted these groups by bringing events to them. Community centres, places of worship, football pitches, food halls – all of these were places used to bring health services and awareness to communities, and ultimately bring communities together.

I was fortunate enough to be able to connect with the Chinese community. As a British Taiwanese person myself, I felt well placed to strike up rapport with those active in the community working across many different charities and local venues. I had conversations in Mandarin Chinese and bonded with members of the community over shared cultural festivals and cuisine. But I could also make sure that research was done for and by us, not just about us – in interactions and interviews, I made sure to emphasise the importance of residents’ views and ensure that research was led by residents’ interests from the ground up.

I am proud then to call myself a community researcher. From my experience, I have been able to connect my personal background with relationships that structure people’s wider access to healthcare. It remains vitally important that such work, centred on lived experiences, recognising others, listening to in-depth stories, continues through participant observation and interview research methods. Throughout my time as a community researcher, I’ve learned how to approach residents with empathy and curiosity, learned to tap into their views with interviews and produce data that represents the multi-dimensional, complex lived experiences residents have. Such data underpins ultimately why it’s so important to conduct community research, to see the people we study as holistic beings made up of different commitments and relationships, but ultimately brought together to be with others and lead a good life.

Want to find out more about the experience of our Community Researchers? Take a look at this zine by Sarah Al-Halfi.

Written by Camilla Rossi, Jo Blodgett, Chandrika Kaviraj, and Aradhna Kaushal 

The way we research health matters. Despite a growing awareness of stark health inequities across the UK, most health research does not involve people from ethnic minority groups. This under-representation not only hides the experiences of those who are often most at risk of poor health, but it also prevents appropriate solutions from being developed. Through a UCL Research Culture Award, we organised a co-production workshop in London to better understand what might prevent equitable participation in health research and how to start addressing these barriers.

The workshop was held in June 2022 at UCL and brought together a group of six participants who identify as ethnic minorities. The activities developed around two main sessions: in the morning, the group brainstormed potential barriers to participation and discussed when they might emerge; the afternoon was dedicated to considering how they could be addressed, discussing the practicalities of involving people from different ethnic minority communities.

The project was informed by the notion of ‘knowledge co-production’. Through this approach, the researchers step back from their traditional role as ‘experts’ to make space for lived experiences as central forms of expertise. One of the ways we did this was by designing the workshop in collaboration with a member of the public, Chandrika Kaviraj. Chandrika reviewed and informed our initial proposal and is now overseeing the analysis and communication of the findings.

What is preventing equitable participation in health research?

Drawing from their families and their personal experiences, the participants identified a variety of potential barriers which we grouped under three main categories.

Lack of trust in institutions and their representatives emerged as a key underlying theme.  Participants discussed the effects of “previous negative experiences”, “fear” of institutions and of the repercussions of getting involved, and shared a general perception that medical professionals and researchers are not trained to engage with racism and the trauma it causes:

“My mom would have so much to add to and learn about health research, but she is so deeply scared of institutions because of how she has been treated in the past.” (British Asian, male, 18-29)

Language and socio-cultural obstacles experienced within the health sector were identified as often concurrent, leading to a difficulty in communicating and being heard from both a linguistic and cultural point of view. This can contribute to a sense of “being invalid”, “incorrect”, and “uneducated”:

“Due to language barriers, due to feeling like it is something we’re not a part of, and due to doctors not understanding the cultural context … this leads to an inability to express.” (Black British, female, 40-49)

Practical barriers contribute to people perceiving health research as “not doable” or “relevant”. These can include lack of time and childcare needs, as well as the use of technology and the location of the study.

It is important to stress that the term ‘ethnic minorities’ includes a highly varied population, with ethnicity being only one of the many social categories shaping personal and social identity: different barriers might be more or less relevant to certain individuals or communities depending on factors such as gender, age, disability, or socioeconomic status. Engaging with this diversity and fluidity of experience is essential to avoid simplistic representations which may end up reinforcing the very barriers we are trying to dismantle.

What are the possible solutions?

Participants agreed that all barriers are exacerbated by researchers’ lack of knowledge and engagement with communities. This leads to research methods that do not fit with people’s lived experiences and needs.

The group developed four main recommendations.

1. Tap into existing community structures

Researchers need to go beyond “traditional means” to make the research meaningful and relatable to people. Engaging with existing community structures and “physically going out there” was highlighted as essential. When the researcher has no existing links with a particular group, the involvement of a community member in the design and development of the project was recommended.

“You need more of a ‘community development mindset’: use the local authorities and look for places where people are already involved. Go out there.” (Black British, female, 40-49)

2. Be transparent about the research aims, objectives, and challenges

The aims and objectives of the research needs to be communicated with clarity and transparency from the beginning: how can the research add value to their communities, families, society? What impact could it have and what are the limitations? Participants agreed that being transparent about the potential challenges involved might help to build trust, making researchers easier to relate and resonate with:

“These communities can smell fraud from miles: be honest about the barriers involved, we can relate to your constraints! If you manage people’s expectations, they will respect you more.” (Black British, male, 50-59)

3. One size does not fit all: make the project flexible and adaptable 

Investing time and resources into tailoring the research process was highlighted as essential both to encourage people to participate and ensure that they are not forced to drop out. Participants recommended advertising the study through different means of communication, both online and offline, hosting the study in safe and inclusive spaces, dedicating ample space for questions, and being ready to allow time, space, and support for participants struggling to commit for personal reasons:

“Show support and availability, the whole process needs to be more adaptable, flexible, and caring… which also means labour intensive!” (British Asian, male, 18-29)

4. Bring the results back to the communities

Confining the research findings to academia can widen the gap between participants and the researcher, discouraging people from taking part in future studies. Instead, diversifying how research is communicated, including accessible reports and in-person presentations within community settings, could contribute to strengthening trust and generate new opportunities for engagement:

“The research needs to get back to the public who participated, they cannot be forgotten. Otherwise, they won’t participate again, and mistrust will continue.” (Black British, female, 40-49)

Next steps

The results of this project will be written up for publication in the coming months with plans to disseminate the findings widely across UCL, and beyond and to embed the learnings into relevant courses and teaching practices.

If you are interested in finding out more about this project or would like to be kept informed about future development – please email research.involvement@ucl.ac.uk

Claire Grant, first year PhD student at University College London’s Institute of Epidemiology and Health Care, provides tips for starting doctoral studies in unusual times.  

I found out that I’d been awarded an Economic and Social Research Council (ESRC) studentship to complete a PhD in Epidemiology and Public Health in March 2020. In the following months, the situation in the UK and around the world unfolded into what we now describe as “unprecedented” times, and the world has since changed. Completing a PhD in any time is known to be an overwhelming, challenging and sometimes stressful experience – but there are some unique challenges in the wake of COVID-19.

This blog post offers an insight into my personal experience of starting a PhD at UCL in 2020, with the aim of sharing some tips for navigating the specific challenges of home working and remote learning. It goes without saying that this list is by no means exhaustive, and that each student will face unique challenges and opportunities as they embark on their studies. This is simply a reflection of my past year and a message of hope to new starters.

1) Ask questions

Starting anything new can be daunting. Understanding how things work, making sense of departmental norms and university culture is difficult, especially when you are working from home. My advice is to ask questions from the start.

The reality is, there are many questions you will not know the answer to and a lot of these can be easily answered by friendly and knowledgeable staff/students at the university. Knowing who to ask for what will become clearer the more communication you have. Asking peers, supervisors and departmental staff for ‘best contacts’ to deal with concerns will help orientate you and your position in the university.

2) Create a good home working environment

If you are working from home, you will need the appropriate equipment and environment to do so. Funding bodies and even departmental funds might be able to support you to buy the software, equipment, and resources you need to work. I assumed that being a student meant that I wouldn’t be entitled to support – but this was not the case (see point 1 – ask questions).

From the beginning, try to create a working environment that is separate from your home life. This can be challenging, especially if you’re living in a place with limited space. If possible, try to work in a separate room to where you sleep, and if this is not possible, set-up a separate working station within the ro om. As tempting as it is to sit in bed all day, the environment you create to work in will impact on your motivation more than you might think.

That said, I will admit that in an effort to create my ‘ideal working from home environment’ earlier this year, I purchased a cheap computer desk from Facebook marketplace. The questionable instructions (see pictures) and my lack of craftsmanship mean that the unassembled planks of wood are still lying in my kitchen.

3) Network

A PhD is a solo venture, but nobody can complete it alone. In the absence of happen-chance meetings on campus, it is important to remember to opt-in to networking opportunities. Sign up to mailing lists on topics and methods that interest you. Email peers in your cohort and arrange Zoom coffee breaks. Download Twitter and follow accounts that relate to your work. Attend departmental seminars, and if you’re feeling brave, even ask questions! The more virtual rooms you enter – the more people and opportunities you will be exposed to.

Networking doesn’t just have to be PhD related. The Department of Epidemiology and Public Health did a great job at organising informal catch-up sessions for students over the past year, and the conversations were mainly structured around Netflix recommendations and lockdown recipes. The Students’ Union at UCL also have a wide range of clubs and societies for postgraduate students to get involved with. Building a social network of likeminded people with similar interests will help you find your place.

4) Set boundaries

               Your working day

Structure a day that suits your project and working style. Nobody is productive all day, yet we can feel guilty for taking breaks, particularly when working from home. I’ve learnt that a long lunchtime walk listening to a podcast (usually the Guardian’s Today in Focus) makes me feel brighter and more ready for the afternoon than if I eat lunch slumped over my laptop. If you’re required to do a lot of reading on your computer – make an active effort to schedule time away from your screen throughout the day. Your eyes and mind will thank you for the rest.

Being online makes us more accessible than ever. This is exciting as we can attend more events, seminars, and trainings than ever before. However, be realistic and thoughtful about how much you can do. For example, don’t try to complete other work tasks while attending online seminars or training. You wouldn’t do that in person. Allow yourself the same time and energy you would offline. This is much easier said than done.

Your personal life

Set boundaries with ‘PhD life’ and ‘regular life’ as you would any other job. Your research will be more important to you than it is to most people, and it might feel all consuming. It’s also likely that you’ve chosen a topic of particular interest to you, making it difficult to switch off. There’s always more work to do, more papers to read and more ideas to talk through. It can feel as though you should be doing something all the time. At the beginning, I found this difficult to manage.

I also found it strange not having the same sense of completing a task as I did when I submitted course work in previous taught courses. At undergraduate level, I remember the feeling of relief after sitting exams, knowing I’d be enjoying some well-deserved time off before being informed of a definitive result – ‘pass’ or ‘fail’. From my experience, this is not the case in a PhD. Feedback from supervisors usually leads to more work. Good project management will account for the much-needed breaks in this academic marathon. When you do take time off, try to detach completely. Let your supervisors know you won’t be available, turn off email notifications on your phone and wait until you return to reply to messages.

Importantly, life continues as you study. Make sure to carve out room for friends and family. Make time for hobbies and interests. A PhD is only one part of your identity.

5) Trust your abilities

You are probably already doing better than you’re giving yourself credit for. It takes time to get used to this new way of working and the beginning of such a mammoth task can feel daunting. Remember that every project is different, so try not to spend time comparing your progress to your peers. Your supervisors will help guide you and there are various UCL check-ins along the way to make sure you’re on track (such as Thesis Committee reviews).

One of the most common anxieties among new doctoral students is ‘imposter syndrome’ – the overwhelming feeling that you’re a fraud. Take note: you have started on a training programme and that is merited on the basis that you have the abilities required to succeed. Trust the process and know that everyone else is probably thinking the same about themselves.

6) Be flexible with your project

Due to COVID-19 restrictions, your project might have to be adapted or changed completely. You are not alone if this is the case. Over the past year many students have faced dilemmas with methodologies and research topics that are not easily modifiable to the world of online learning. Be open to potential alternatives and listen to the experiences of others in your field. There are many learnings from the past year which will be useful to consider when thinking of alternative approaches to your research.

7) Be kind

To yourself, to your peers, and to staff.

Students and staff at UCL have worked tirelessly to adapt to new ways of learning over the past 18-months. It has been a tough time for everyone, and we have all been impacted in some way. Try to acknowledge this and be compassionate to yourself and others. Remember that staff are also facing some of the same challenges as students and will appreciate your understanding.

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Enjoy the journey & best of luck with your studies!

by Katie Gilchrist

I am an MSc Health Psychology student at UCL. As part of the programme, we are required to attend a clinic for observation. As a brain tumour survivor, a natural choice for me was the Neurosurgery clinic at The Unit of Functional Neurosurgery at The National Hospital for Neurology and Neurosurgery, London.

My sense of tumour

In December 2017 I was diagnosed with a benign brain tumour called acoustic neuroma and in February 2019 I underwent surgery at The Royal Randwick hospital in Sydney, Australia to have the tumour removed. A consequence of the surgery was being left with grade 6 House-Brackman facial paralysis, single sided deafness and one less vestibular nerve. I spent the first month recuperating from the surgery, practicing walking with one balance nerve and adjusting to losing the hearing in one ear and the loss of facial movement on one side of my face. Seven months after the surgery my husband and I packed up our lives after spending seven years in Australia and moved back to the UK where I started my MSc in Health Psychology at UCL. Following my experience, naturally, I was really excited about spending a morning in a hospital clinic (a mandatory part of the course) and even more excited when I saw there was a neuro clinic!

Feeling empathy for patients

So, recently I attended the clinic at The Unit of Functional Neurosurgery at The National Hospital for Neurology and Neurosurgery, London with Prof Ludvic Zrinzo. The clinic specialises in cranial nerve disorders such as hemifacial spasm (involuntary facial twitch) and trigeminal neuralgia (chronic facial pain). What I didn’t realise, when I made my selection, was that the conditions Prof Ludvic Zrinzo works with can present with facial droop or weakness and that for some of the conditions the surgical approach, risks and recovery are very similar to what I had. There were a lot of patients with facial movement issues and their faces looked like mine, asymmetrical smiles and one eye looking frozen open, foreheads not able to move and I felt such empathy for them. It was difficult not to run after them and comfort them but at the same time it was like hearing my own diagnosis over and over again. There were several moments where my eye (only one produces tears) glazed over and I had to concentrate not to show too much emotion as that would have been unprofessional. While it may help the patient to see we are human, it is not good for them to feel our burden which may accidentally transfer to them if we overshare.

Learning from the best

Having met a few surgeons through my own health experience, I was really blown away by Prof Ludvic Zrinzo’s approach to patient care. It was great to see a surgeon putting into practice all the psychology aspects we have learned in class this term; building rapport, explaining in clear language, allowing time for the patient to ask questions as well as all the additional points he covered like asking who was at home to help with care, reminding them to bring partners into appointments and explaining all the options available to them and really emphasising that it was the patients decision. Before each consultation, he explained to the patient who we were (there were three students observing) and he asked if it was ok if we stayed and listened. Only one patient decided at that time it was not ok for us to stay for that appointment and Prof Zrinzo kindly asked us to wait outside. On our return we didn’t ask about the patient and nor did he offer any information. The appointment had taken longer than some and we were playing catch up. I also felt there was an understanding between us that in this instance any discussion was to stay between patient and health professional.

What will I take from this into my future roles?

1. The importance of asking the patient what they want
   • Did they mind having students in the room?
   • What were their thoughts on which treatment?

2. The benefits of open dialog
   • Encouraging patients to include family and friends in the conversation
   • Explaining risks and benefits in layman’s terms without provoking fear
   • Asking about family, other health issues, home/work environment
   • Having open discussion with empathy and patience, even if it has been discussed several times previously

Overall, Prof Ludvic Zrinzo had such a great approach and I am so grateful to be able to have observed this. While it was emotional for me it really reaffirmed my desire to help people with health issues and I just wanted to say thank you to UCL and The National Hospital for Neurology and Neurosurgery for arranging such a great experience.

 

World Health Organisation and United States guidelines say adolescents should do at least an hour’s moderate-to-vigorous physical activity each day. But a new global study shows eight out of 10 fail to meet that standard – and there is a widening gender gap. Professor Yvonne Kelly and Fran Abrams outline new research revealing worrying trends which demonstrate the need for political and social choices that will help young people enjoy the social, physical and mental benefits of being active.

Physical activity has many health benefits for young people – and globally,  four in every five adolescents do not benefit from regular physical activity.

 In 2018, the WHO launched a global action plan called More Active People for a Healthier World. It aimed to reduce the proportion of people doing insufficient physical activity by 15 per cent by 2030 among both adolescents and adults. 

Now in a major new study WHO researchers have analysed information on 1.6 million school students aged 11-17 in 146 countries. They found some positive trends but argued much still needed to be done to encourage young people to exercise more.

There was a small reduction over 15 years in the proportion of boys not doing enough, though this still fell well short of the WHO’s target. But the proportion of girls meeting the target remained static and this led to a widening gender gap. 

As has been shown in the UK such gender differences start early with lower levels of physical activity in girls emerging before they become teenagers. 

The authors of a separate investigation using the Millennium Cohort Study (MCS) suggest the main reason for young people not exercising or sleeping enough is the amount of time they spend using screens. This is a hotly contested area, intuitively, ‘too much screen time’ and ‘too little exercise’ might appear to sit side by side.  However, in this kind of study, it is not possible to infer that one causes the other. 

The WHO study showed the majority of adolescents did not meet physical activity guidelines, putting their current and future health at risk. Although there were small reductions in insufficient activity among boys, the prevalence of insufficient physical activity in girls had remained unchanged since 2001.

 

Huge dataset

The dataset used in the WHO study was huge – the young people studied had provided information for at least three years and the analysis covered four World Bank income groups, nine regions, and the globe as a whole for the years 2001–16. Saying that, although  the research data covered more than 80 per cent of the global population, it still didn’t cover every county and region. And the estimates for low-income countries need to be treated with caution as the coverage there was much lower – only 36 per cent.

The overall analysis showed that more than eight out of 10 school-going adolescents aged 11–17 did not meet the recommendations for daily physical activity. The small improvements in boys’ activity levels, combined with the static position in girls’ activity, suggested a target of more than 30 per cent of adolescents meeting the recommended level by 2030 will not be met.

Globally, across all income groups and regions and in nearly all the countries analysed, girls were less active than boys.

And perhaps surprisingly, the research did not find that the problem was worse in higher-income countries. However, this was not the case for girls, for whom there was no clear pattern in relation to country income.

Differences in activity levels

In addition to variations related to gender and affluence, there were also differences in activity levels between different parts of the world. The boys least likely to meet activity targets were in the high-income Asia Pacific region, but the second-least likely were in lower-income Sub-Saharan Africa and particularly in Sudan and Zambia. 

The boys most likely to meet the targets were found in high-income western and south Asian countries with large populations such as the USA, Bangladesh, and India.

These variations might be driven by specific characteristics of particular countries – for example, as the research looked at school children the picture might be skewed in countries where disadvantaged children often do not attend school, or in places where the tradition of school or community sport is strong.

For girls, the largest proportions failing to meet the targets were in Asia Pacific and particularly in South Korea- though in some of those countries girls’ participation in education is low and that might have affected the study’s sample.

The recent MCS study by academics from Loughborough University and University College London used data from 3899 adolescents. This study, in which young people were fitted with activity monitors, found that while nine out of 10 were getting the recommended amount of sleep, just four in ten met exercise targets and a quarter were keeping to the recommended screen time. These figures were higher than those in the WHO study, which could be explained by the different methods used to measure activity and which show just how important it is to consider HOW activity is measured.

The study looked at  some correlates of physical activity and showed that adolescent girls who had depressive symptoms were less likely to meet all three of these recommendations (8-10 hours of sleep, no more than two hours of screen time and at least an hour a day of physical activity), while those from better-off backgrounds were more likely to meet them. Among boys, those who were obese and those who had depressive symptoms were less likely to meet the recommendations. However, it is not possible to rule out the potential for cyclical associations to be at play here as low levels of physical activity could lead to depressed mood and to weight gain.

What can be done? 

• More research is needed to understand the causes of non-participation in exercise – social, economic, cultural, environmental and technological. 
• Policy change should be prioritised and should encourage all forms of physical education – sport, active play, and recreation as well as safe walking and cycling.
• Social marketing campaigns such as the National Lottery funded #thisgirlcan campaign combined with community-based interventions could be starting points to increase physical activity levels in girls, particularly in countries with wide gender differences. This approach has been identified as cost-effective.
• Schools, families, sport and recreation providers, urban planners, and city and community leaders all need to become involved.

That four in every five adolescents do not experience the enjoyment and social, physical, and mental health benefits of regular physical activity is not a chance thing – it is the consequence of political  choices. 

Young people have the right to play and should be provided with the opportunities to realise their right to physical and mental health and wellbeing. Urgent action is needed, particularly through targeted interventions to promote and retain girls’ participation in physical activity. Policymakers and stakeholders should be encouraged to act now for the health of this young generation and of future ones.

Yvonne Kelly is Professor of Lifecourse Epidemiology and Director of the ESRC International Centre for Lifecourse Studies at UCL. She is editor of the Child of our Time blog.

Fran Abrams is CEO of the Education Media Centre and freelance journalist who writes for the Child of our Time blog.

Global trends in insufficient physical activity among adolescents: a pooled analysis of 298 population-based surveys with 1·6 million participants, by Regina Guthold, Leanne Riley, Fiona Bull and Gretchen Stevens, is published in The Lancet Child and Adolescent Health.

Regina Guthold, Leanne Riley and Fiona Bull are based at the Department for Prevention of Noncommunicable Diseases, WHO, Geneva, Switzerland and Gretchen Stevens is at the Department for Information, Evidence and Research, WHO, Geneva, Switzerland.  Fiona Bull is also affiliated with the Department of Sport and Exercise Science, University of Western Australia, Perth.

Prevalence and Correlates of Meeting Sleep, Screen-Time, and Physical Activity Guidelines Among Adolescents in the United Kingdom, by Natalie Pearson, Lauren B Sherar and Mark Hamer, is published in JAMA Paediatrics: 

Natalie Pearson and Lauren Sherar are at the School of Sport, Exercise & Health Sciences, Loughborough University, United Kingdom, and Mark Hamer is at the Institute of Sport Exercise & Health, Division of Surgery & Interventional Science, Faculty of Medical Sciences, University College London, United Kingdom.

This blog article is courtesy of the Child of our Time blog, which is a blog about the health and happiness of children living in the UK. led by the ESRC International Centre for Lifecourse Studies, University College London

Emma Walker, second year BBSRC-ESRC funded Centre for Doctoral Training in Biosocial Research PhD student at University College London’s Institute for Epidemiology and Health Care, describes how getting involved with research on social media helped her to reflect on her own usage. 

It’s 00.23 and I should be in bed. I’ve got lots on tomorrow but I’ve spent the last 45 minutes scrolling. Scrolling through the profiles of Instagram “life style coaches”, yogis, models; each collection of photos perfectly curated to appeal to my desire for millennial aesthetic.

Everything feels so much better than anything I have. And actually, in the world of Instagram, I know that everything is much better than what I have. Number of followers or number of likes on each post has conveniently quantified this for me.

The next evening, as part of my public health PhD work, I’m reading Professor Yvonne Kelly’s paper laying out the effects of social media use on the mental health of girls. I diligently make notes “.. greater social media use related to online harassment, poor sleep, low self-esteem and poor body image .. ” “..girls affected more than boys..” and pause periodically to check my phone.

All my friends are at the pub having a great time, another friend just put up a post where she looks amazing, it already has 50 likes. I get to the methods section of the paper “how many times in the last 2 weeks have you felt miserable or unhappy; found it hard to think properly or concentrate; felt lonely; thought you could never be as good as other kids…”.

Then the penny drops. Why do I think I’m immune? I’m like the lifelong smoker who’s confused by their cancer diagnosis: “I never thought it would happen to me.” The idea starts to filter in: I don’t need this in my life. In fact, I need this to not be a part of my life.

The next day I deactivate my Instagram account. That day I meet a friend for coffee in a hipster café and don’t take a picture of my coffee. That night I get to sleep by 11pm. The next day I work more productively than I’ve worked in weeks.

An opportunity to get involved comes up: the National Literacy Trust are really interested in Yvonne’s work and are keen to put together an event for young people. A great group of undergraduates and I devise a series of activities to find out what young people think about the research.

The first section would involve 4 zones at the front of the Renaissance Learning centre room for Strongly Disagree, Disagree, Agree and Strongly Disagree we put a series of statements on the board and ask the pupils to move to a zone and explain why. We include statements on a range of topics including cyber bullying, sleep deprivation, self-esteem and body image and parents and social media.

On the day, the 50 enthusiastic 11-14 year olds from 3 schools across London jostle about, keen to share their opinions and to hear one another’s. I’m amazed at the diversity of ideas, overall willingness to get involved and the mental health literacy of many of the students.

Some responses are predictable; the boys happy to appear less concerned about body image, many keen to state in front of their teachers that social media does not in any way disrupt their studies. Some are surprising; only a handful of pupils had been on social media before arriving at the event that day (a significantly lower proportion than the adults running it!) Other responses are hard to read; were the gaggle of girls laughing at the very idea of social media posts making you feel left out, honest or desperate to seem not to care?

A clear feeling was the young people’s frustration at their parents use of phones and social media. Many expressed irritation at the rules their parents have established – no phones at the table, in bedrooms, after 8pm – that they, themselves constantly break.

One boy described having to ask the same question 3 times before his dad will look up from his phone. The idea that our event should be run for parents was cheered.

Next we presented them with the evidence base for the possible impact of social media and mental health then asked them to make public health campaign like posters with top tips that could go up in their schools. We were presented with a beautiful collection of posters with thoughtful advice, carefully put together information, clever slogans and eye catching drawings. Audio recordings from the day gave further insights from the young who readily offered tips and advice for younger children.

Overall, I think the event was a success. My main impression was that these young people are actually very well equipped to protect themselves from the potential mental health impact of social media. That in fact it may be people in their 20s, who have grown up in the full glare of social media and its pressures, who are at the greatest risk.

It was a real privilege being able to discuss this topic with young people and the message that stood out the most from them is the opportunity parents have to make a difference by practicing what they preach.  Chances are they’ll benefit from switching off!

As for me, it’s now been 6 months since I deleted Instagram and whilst it hasn’t been plain sailing – I have got this itch for the buzz of an influx of likes –  for the time being I’m happy and I would wholeheartedly recommend it!

We have a fantastic post below from Vennie an A-level student aspiring to study Medicine at university. She visited the Research Department of Primary Care and  and shadowed some of our academics in their various projects in July. In this post talks about her experience and what she took away from it. 

Dementia is an increasing problem especially with the growing older population in the UK. The awareness of dementia is rising, especially through the use of media and organised events such as Memory Walks. However, how much do we know about dementia?

Well, in simple words, dementia is the ongoing decline in the brain. This is only an umbrella term for 200+ different sub-types of dementia that exists, some of which you may have heard off. For example the most common two are Alzheimer’s disease and vascular dementia.

During my placement in the Research Department of Primary Care and Population Health at the Royal Free Hospital, I was able to shadow members of the team that are involved at different levels of research projects.

I discovered that there are many stages which make up the process of a research project. Starting with the planning and design of the research project, ethics, and recruitment through to finally analysing and presenting the results produced. Alongside all this and integrated throughout are processes to ensure the results are implemented into clinical practice and policy, to make a difference. I learnt about the different types of studies such as qualitative studies and large clinical trials. Due to the involvement of human participants including often patients from the NHS in the studies the department runs, a major part of the research process is the ethical application and review. The purpose of the review is to establish if the project has more benefit than risk to the person and their family as well as is the project being conducted sensitively. For all of this to happen, it may take 5 to 20 years to see a difference in practice and policy.

In order for, this project to be successful, a range of people are required to take part, which in turns bring a variety of skills into the mix. These individuals may include designers, programmers, clinicians, psychologists, sociologists, statisticians, qualitative researchers, and importantly patients and their family themselves. A few of the most prominent skills are communication, teamwork, determination and resilience. For example, a project with Dr Davies and Prof Rait I observed on producing a support package for people with dementia and their families, communication has a massive role to play. The project uses workshops with people with dementia, their family and professionals to develop the support package. There is a need for clear communication between the ranges of people for this project to progress smoothly. The communication may come in the form of discussion-based in meetings, emails and many other ways. Therefore, teamwork is essential as each person will have a special role in the project. Finally, determination and resilience are required from every member of the team as there will be challenges along the way, which could be out of your control that must be overcome. For example, if the project does not meet the criteria of the ethics committee it may be returned to the researcher, and his or her team must go back and amend the plan.

In conclusion, research of any kind similar to this project requires a range of people to be involved with a variety of skills that are vital for the research to work. This work experience has been a fascinating and exciting opportunity for me to experience what goes on behind the scenes of a research project.

With the help of a Researcher-Led Initiative award, PhD students Fran Harkness and Jo Blodgett, and Research Fellow Aradhna Kaushal organised a day of podcast training for early career researchers to learn how to beam their findings straight into the ears of the general public. Here they explain what a podcast is and how you can get started making your own.

Why podcast?

Do you want to learn how to share your research discoveries beyond academic community (and pay-) walls? It would be unusual for a non-academic to read a journal, and as researchers, it’s not possible control how findings make headlines. But 6 million people in the UK listen to a podcast every week. And with people almost entirely listening to episodes as a lone activity- often on their phones whilst driving or travelling- the podcast has their full attention. Podcasts such as ‘All in the Mind’, ‘The Infinite Monkey Cage’, and our own Institute’s ‘The Lifecourse Podcast’ are easy to access (freely available online), and able to build a relationship with audiences through regular episodes. They disseminate new research in an informal style, often by chatting about new research with a fellow host, or interviewing academics.

Researcher-led initiative

We knew we wanted to make a podcast, but we didn’t know how. That’s where the Researcher-Led Initiative awards came in. We successfully applied for £1000 from the UCL Organisational Development to invite an experienced podcast trainer, Chris Garrington, and fellow academic and journalist Jen Allan to teach us everything we needed to make our own episodes.

Along with 13 other early career researchers, we learnt about the practical aspects of making a podcast such as how to conduct an interview, choosing recording equipment, incorporating jingles, editing audio files and disseminating podcasts online. We practiced recording and editing our recordings. It was such a buzz hearing our voices “introducing” our own podcast after the jingle. Of course 10, 000 more practice hours are needed before any Poddies are won but it was much easier than we thought it would be.

Recording a podcast series

We learnt that before you make your podcast, it’s important to consider the ideal format for the topic. For example, will a monologue or interview work best? Is the role of the presenter to ask questions on behalf of the audience or to offer their own opinions and thoughts? We also considered how many episodes are feasible to make, how often and how long should they be. Who are the audience and what kind of tone and style will appeal to them?

We experimented with sound quality between recording straight onto our laptops or enhancing it with different microphones, and received sage advice such as not to record in a coffee shop and to record some background sound separately when on you are on location in case you need to loop it in behind new recordings back in your studio (ahem bedroom). Jen then gave us a session of how to get the information you need from your interviewees, including to learn to soundlessly agree with them so to not cut them off (as qualitative researchers probably already know), and how to get around difficult questions.

What kit do you need?

You don’t need highly specialised equipment to make a podcast. An investment in a good microphone will ensure the quality of the audio recording. You may also consider different types of microphones (such as lapel microphones or hand-held) for different needs. You can also record interviews via Skype or Zoom using an Ecamm Call Recorder. Once you have your audio file, you can edit this using freely available software such as GarageBand (Mac) or Audacity (Windows). When you are ready to share your podcast with the world, you can share this using a podcast hosting website such as Libsyn: A podcast host simplifies and automates both the RSS feed and file hosting and delivery to your subscribers. But a good host does more than that by providing useful stats, tutorials, and support.

Thanks to Chris and Jen, we somehow finished the day with a mini episode and many big plans for the future! Watch this space.