Current and future trends in chronic disease prevention research. Presented by Elly Howse.
I would like to start my presentation by acknowledging the traditional owners of the land on which I work, the Gadigal people of the Eora nation, and pay respects to elders past, present and emerging. I’m Elly Howse and I’m a Research Fellow with The Australian Prevention Partnership Centre.
The Prevention Centre is a national collaboration of researchers, practitioners and policymakers working to prevent chronic disease. Our funding partners include the NHMRC, Commonwealth, state and territory health departments, Cancer Council and VicHealth. We are hosted by the Sax Institute in Sydney.
The Centre recently completed a review about the current and future trends in chronic disease prevention research. I acknowledge the review’s co-authors Leah Marks, Lucie Rychetnik and Andrew Wilson. The purpose of this review was to start a conversation, to help inform our ideas for the next possible phase of funding for the Prevention Centre. We wanted to look back at what’s happened in prevention research in the last 5 years. In doing so, think about what might be next for prevention research.
Our research questions were:
- What are the current trends, major themes and topics of chronic disease prevention research in Australia and globally?
- What are the thematic synergies across the scientific and grey literature?
- What are the future trends anticipated for chronic disease prevention research?
We aimed to answer these questions through:
- A review of the grey and peer-reviewed literature that discussed or forecast the future of chronic disease prevention research
- A qualitative thematic analysis to identify topics, themes and synergies in the literature
- We only looked at what was published between 2014 and 2019
- Also, due to the nature of the research questions, this was not a systematic review.
- 147 publications in our review
- 45 grey literature publications, such as reports, policy briefs and factsheets
- 102 scientific publications, such as peer-reviewed commentary and opinion pieces, and the introductions to five Lancet Commissions.
We identified 26 topics within the grey and scientific literature, 18 of these topics we grouped into five major themes of prevention research:
- Food production and consumption – food systems, agriculture, diet and nutrition and malnutrition in all its forms (which included obesity and food security)
- Place and spaces – physical activity, built environment, urban health and cities, and transport
- Environment and health – air pollution, planetary health and climate change
- Expanded determinants of health – social, economic, corporate and legal determinants of health
- Personalised prevention – digital health, precision medicine and big data.
We also identified 8 additional topics that we didn’t group into the major themes:
- Tobacco and alcohol
- Mental health
- Life-course approach
- Multisectoral approach
- Systems thinking
- Low and middle-income countries
- Evidence gaps
- Implementation and /or evaluation challenges.
So, what might the future of prevention research look like? In this review, we identified five main opportunities and challenges for the future of prevention research:
- The first one was expanding the scope of prevention and thinking more holistically about chronic disease prevention and its relationship with other areas, such as environmental and planetary health
- The second opportunity identified was the need for increasing the use of systems thinking – particularly in terms of working with other sectors and disciplines to address those ‘causes of the causes’ of chronic disease
- We did find discussed in the literature a challenge for prevention research is moving beyond the ‘what’ to the ‘how’ – so less describing of the problem of chronic disease and more applied research that identifies how we might develop and apply solutions. For example, lots of publications discussed the need for multisectoral approaches to prevention, but very few actually showed the implementation or evaluation of such approaches.
- Another main challenge for the future of prevention research is how to address persistent inequities in health and chronic disease.
- And finally, acknowledging the politics of prevention was identified as a challenge for the future of prevention research. the systems change needed for prevention is politically contested. We have to acknowledge and work with that as researchers.