Creating dialogue is key to developing new health innovations

Professor Simon Coulton explains why engaging with different audiences at every stage of the research cycle ensures health research addresses the needs of those who access treatment, those delivering it and those commissioning services. Written by Dr Ann Kinzer.

Simon Coulton is Professor of Health Research at the University of Kent. He specialises in designing, conducting, and assessing clinical trials of new health innovations and has a particular interest in psychosocial interventions to promote behaviour change, especially with regards to alcohol and substance abuse.

Professor Coulton explains: ‘While my research involves clinical trials it is very focussed on answering important questions in real-life clinical practice’.

Most of Professor Coulton’s work involves randomised control trials, particularly pragmatic trials. This approach deals with key clinical questions in real clinical settings rather than tightly controlled laboratory environments, and addresses the question of whether new interventions are effective in the real world. In addition, an evaluation of effectiveness is usually accompanied with an evaluation of cost-effectiveness exploring the economic impact of a new intervention.

A classic example of his work is the ‘Screening and Intervention Programme for Sensible Drinkers’ (SIPS), where he and his collaborators explored different intensities of interventions to address problem drinking in primary care, emergency departments and criminal justice settings. Staff in these settings were trained in how to identify and intervene with problem drinkers. Participants were followed-up some months after being identified to explore how effective each of the different intensities had been in changing drinking behaviour. As a pragmatic study the approach allowed us to explore the effectiveness and cost-effectiveness but also to explore how acceptable and practical the different intensities were to deliver in different settings.

The trials that Professor Coulton designs combine scientific rigor with real-life application and provide the best evidence of whether a new intervention or treatment is effective. Developing and conducting this type of randomised control trials can be challenging. They are by their nature complex and often require multiple sites across the country or in some cases across the world. Measurements need to be valid and reliable, and analysis is often very detailed. A key aspect of these studies is interpreting and presenting the results in a way that is useful and understandable to the target audience, whether that is the clinical community, key policy makers and commissioners, or the general public.

It’s quite an art to sit down and communicate your findings to different audiences and this is helped by including stakeholders in the entire process, from the conceptual idea, to design, conduct, analysis and interpretation of trial results

Professor Coulton.

Professor Coulton and collaborators always include stakeholders and members of the public in the initial stages of applying for research funds. This ensures the research addresses the needs of those who may access treatment, those delivering it and those commissioning services.

Professor Coulton has worked with commissioners locally (Kent County Council, the Public Health Department), nationally (Public Health England, Department of Health) and internationally (across Europe, Australia and the US). His research has had a significant and sustained impact on UK policy and practice on addressing alcohol-related harm. It has shaped national guidelines, the commissioning of services, and screening and treatment intervention practice across a wide range of social care and clinical settings in. The Alcohol Programme Manager of Public Health England described his research as being instrumental in informing policy ‘guidelines for the identification and management of alcohol use disorders published by NHS England and the National Institute of Health and Social Care Excellence’. Public Health England further highlighted that Professor Coulton’s research has made a significant contribution to screening for alcohol-use disorders being ‘embedded in primary and secondary care practice through the inclusion in NHS Commissioning for Quality and Innovation Schemes (NHS CQUIN)’.