Potential Graduate Research Projects 2020/21
Please note that these are simply potential project ideas - no specific funding is attached unless otherwise stated in the project description. For information on funding please see here. Applicants are also welcome to submit their own project ideas.
Those wishing to apply for one the below projects will still need to submit their own research proposal. Your proposal should expand on the basic outline published below and should demonstrate: your knowledge and skills in the area; your ideas of how to approach the topic; any areas of your specific interest within the broader area specified and how you see the project developing during the course of your DPhil.
Producing your own, more detailed, research proposal gives you the opportunity to demonstrate your strengths more extensively than on a CV or application form and is a good way for you to make a strong impression on the selection panel.
Please check our course pages here for entry requirements and details on how to apply. If you have any questions about the process, please contact our Postgraduate Training Officer, Daniel Long (firstname.lastname@example.org); for questions about the projects, please contact supervisors directly.
Supervisor: Andrew Farmer
Data from low-cost wearables and other monitoring devices can be used to track the health and health behaviours of people with long-term health conditions (including diabetes and cardiovascular disease). Using such devices to help guide patients in self-management, and alerting clinicians to changes in their patient's health or health behaviour is a promising approach to better health and health care.
Work in my group, based at the Nuffield Department for Primary Care Health Sciences (NDPCHS) in collaboration with the Department of Engineering Science, aims to explore how digital technologies are used by people with a long-term health conditions. We are particularly interested in developing research that can identify the ways in which data from such devices is clinically relevant, how people use them, and how health care might change as a result of their use. Current studies include monitoring recovery after hospital admission for a range of conditions and supporting better use of medicines. There are opportunities to work with an interdisciplinary team bringing together clinical academics, engineers, industry, social scientists and patient representatives to produce world-leading research into digital health.
The student will have the opportunity to develop skills in quantitative, qualitative or mixed methods research, including planning a protocol for a study, collecting and analysing data, and preparing reports for publication. This will require critical appraisal of relevant literature from the field, analysis of data previously collected, as well as collecting and analysing original data.
Supervision in the Nuffield Department of Primary Care Health Sciences is a collaborative process between the student and supervisor. Both need to agree on an interesting project. DPhil projects with me are likely to include an evaluation of the theoretical underpinning and evidence for a new treatment (usually in the form of a systematic review); establishing the best ways to measure its impact; and carrying out a study, for example a small-scale randomised trial, to evaluate its feasibility and impact. The project might also include analysis of data collected in previous studies. In most cases, supervision will take the form of a formal supervision meeting once a month (with more frequent meetings early on in the project) at which progress with the research is discussed and plans made for the next month’s research. In practice, however, additional informal meetings occur more often - once or twice a month - and the NDPCHS has an active group of graduate students and postgraduate researchers able to offer advice. Working as a doctoral student in the clinical trials unit provides access to informal advice from staff with skills and experience using a wide range of research methodologies.
1. Farmer, A. et al. Self-Management Support Using a Digital Health System Compared With Usual Care for Chronic Obstructive Pulmonary Disease: Randomized Controlled Trial. J Med Internet Res 19, e144–15 (2017).
2. Bobrow, K. Farmer A et al. Mobile Phone Text Messages to Support Treatment Adherence in Adults With High Blood Pressure (SMS-Text Adherence Support [StAR]): A Single-Blind, Randomized Trial. Circulation 133, 592–600 (2016).
3. Farmer, A. J. et al. Adherence to Oral Glucose-Lowering Therapies and Associations With 1-Year HbA1c: A Retrospective Cohort Analysis in a Large Primary Care Database. 39, 258–263 (2016).
4. Farmer, A. & Tarassenko, L. Use of wearable monitoring devices to change health behavior. JAMA : the journal of the American Medical Association 313, 1864–1865 (2015).
Supervisor: James Sheppard
For patients with multi-morbidity, increasing frailty and polypharmacy, deprescribing of medications which no longer hold benefit is now encouraged in routine clinical practice. However, clinical guidelines advocating deprescribing are often based on expert opinion rather than robust scientific evidence. Candidates are invited to join the Stratified Treatments Research Group to undertake a DPhil aiming to better inform deprescribing practice in routine primary care. Potential projects will involve systematic reviews and analysis electronic health records to better understand the extent of deprescribing in routine practice and the impact of such approaches to care on patient outcomes. This work will aim to develop evidence based deprescribing interventions which can inform future clinical guidelines for the care of older adults.
Pre-eclampsia is a disease of pregnancy, marked by high blood pressure (hypertension) and protein in the urine. It affects around 5% of pregnancies in the UK. Early diagnosis of pre-eclampsia can reduce complications for both mother and baby.
Self-monitoring of blood pressure and urine self-testing, over and above usual antenatal visits, could allow pre-eclampsia to be picked up earlier so that we can help control a woman’s blood pressure and avoid complications. Our work has shown that women are willing to self-monitor their blood pressure during pregnancy and that following hypertensive pregnancy, women are able to make medication changes based on their home readings. Initial work suggests pregnant women would find self-testing of their urine equally feasible and acceptable.
The research project would involve:
- Working with pregnant women and health care professionals to further develop a combined home monitoring in pregnancy intervention including telemonitoring guided care.
- A pilot trial to examine whether combining self-management of blood pressure and self-testing for protein is feasible and acceptable to hypertensive pregnant women and their health professionals.
- While the overarching topic for study has been identified there is scope for specific questions to be identified by the candidate. We would welcome anyone interested to approach us to discuss this.
The research team
The student will join the supportive hypertension team based in the Nuffield Department of Primary Care Health Sciences.
Who should apply?
The project will suit a student with a background in medical or biological sciences, or equally medical, nursing or midwifery graduates wishing to pursue research in women’s reproductive health.
Candidates will be expected to hold a good undergraduate degree (or Masters) in a relevant subject (such as medical sciences, biological sciences, evidence-based health care, communications science, behavioural science).
For more information please contact Dr Katherine Tucker.
In the month of Ramadan, Muslims abstain from eating, drinking and tobacco use during daylight hours. Observing a period of temporary tobacco abstinence each day could mean that tobacco users naturally reduce their consumption, making this a potential opportunity to intervene and enhance the likelihood of complete cessation. The aim of this DPhil will be to explore faith-based interventions for tobacco use cessation and potential ways to harness short-term naturalistic behaviour change to maximise the chances of enduring change.
It will include a systematic review of faith-based tobacco cessation interventions; an observational study investigating changes in tobacco-use among Muslim smokers during Ramadan and their associations with nicotine dependence and quitting; and a qualitative exploration of smokers’ perceptions of smoking and quitting during and following Ramadan. This work will inform the design and implementation of faith-based tobacco cessation methods.
Brief advice from medical professionals on smoking cessation is effective and can lead to dramatic improvements in population health. However, UK medical undergraduate teaching of smoking cessation advice varies greatly by medical school, and in practice many opportunities to deliver brief cessation advice in clinical practice are missed. This DPhil project aims to investigate current provision of training on delivering smoking cessation advice, with the aim to then inform a future intervention. It will include a survey of how, if at all, the delivery of smoking cessation advice and treatment is taught in UK medical schools, as well as qualitative work with medical school staff and pre-clinical and clinical students regarding delivery and implementation of smoking cessation guidance, and ways to motivate students to use the skills learned in practice. This information will then be used to develop, test and evaluate a new short module on smoking cessation aimed at undergraduate medical students.
Smoking is a key driver of health inequalities in the UK and abroad, and a common concern regarding smoking cessation interventions is that they risk exacerbating existing disparities. This project would aim to explore this concern to identify ways in which smoking cessation treatments and services could be improved to reduce health inequalities, particularly in relation to socioeconomic status (SES). We anticipate this would include a Cochrane systematic review on the impact of smoking cessation interventions on health inequalities, secondary data analysis from RCTs evaluating differences in effects by socioeconomic status, investigation of current disparities in smoking cessation behaviours using a nationally representative dataset, and qualitative research to investigate barriers and facilitators to smoking cessation interventions in lower SES groups.
18% of people with incident heart disease smoke tobacco and less than half manage to stop. Clinicians intervene actively to support cessation for a small minority, when we know that continued smoking is a matter of addiction, not choice, for most of this group. This doctoral proposal aims to address this by:
- Updating the Cochrane review of the effect of cessation on recurrence of cardiovascular disease (CVD) in those with incident CVD, for the first time including risk of stroke in those with incident stroke;
- Producing novel estimates of association of smoking with CVD recurrence, using data from a large primary care record database and incorporating novel methods to assess the causal effect of active support for cessation on recurrence; and
- 3) Creating a way to reframe the management of offering smoking cessation support, to trigger doctors to view smoking as an addiction to be treated and not a matter of choice. This reframing will then be tested in online experiments to produce early evidence that we can change the way doctors treat people who smoke by providing active support for cessation. The student will work with patients with CVD who smoke to incorporate the outcomes that matter to them.
The rise in popularity of e-cigarettes in recent years has been accompanied by a growth in the number of virtual ‘vaper’ communities, with people sharing their advice and experiences of e-cigarettes with peers on internet support groups and discussion forums, many of which address ways of reducing or stopping smoking. The rise of peer to peer support is unique to e-cigarettes; no other means of stopping or reducing smoking attracts such passionate engagement from members of the public. This raises the possibility that we could better harness this peer support to enable more people to reduce or stop smoking using e-cigarettes and this project examines this. The first project will explore how different vaping communities communicate with one another, specifically examining online content and forums. The second study will be a content-driven analysis of data from an on-going randomised controlled trial that enlisted the support of experienced vapers in providing telephone support to smokers who were offered an e-cigarette by their GP. The audio-recordings between the experienced vapers and smokers will be analysed to identify what concerns new vapers have, how they respond to reassurances offered by peer supporters, and to understand which components of support are effective and how this can be maximised. Building on the first and second study, the third study will involve developing and testing a peer-led intervention for new vapers and will assess the value of peer support in encouraging smokers to switch to vaping.
Non-alcoholic fatty liver disease (NAFLD) increase the risk for morbidity and mortality and is strongly associated with obesity. No licenced medication exist for NAFLD. Clinical guidelines around the world recommend clinicians offer advice on lifestyle modification, which mostly includes weight loss through hypo-energetic diets and increased physical activity. However, whether clinicians provide advice and the type of advice they give may vary greatly, and guidelines rarely specifically recommend treatment programs to support weight loss. The aims of this project are to
- Estimate the association between various stages of NAFLD and disease outcomes and survival and quantify the lifestyle advice provided to people with NAFLD in primary care utilising big data.
- Explore the attitudes of primary care professionals towards providing lifestyle advice to people with NAFLD using qualitative methodology.
- Develop and pilot an intervention to prompt GPs to refer people with NAFLD to weight management programmes by drawing on the current literature and using a mixed-methods approach.
The successful candidate will develop their skills in quantitative and qualitative analysis and intervention development and evaluation.
Primary supervisor: Susan Jebb
One in ten children in reception classes are already defined as obese, rising to one in five leaving primary school and excess weight often tracks into later life. Alongside public health efforts to prevent obesity in children there is an urgent need to develop ways to support children and their families to achieve and maintain a healthy weight.
We have an extensive programme of research on adult weight management and we are looking to extend this to children. It will include how to engage health professionals in conversations about obesity in children and develop and/or evaluate interventions which may be effective, particularly a new app based programme.
The project is likely to include the following elements:
- (i) A systematic review of behavioural interventions to treat obesity in children with a focus on routine healthcare settings
- Qualitative research with practitioners and parents to explore their attitudes and beliefs regarding health professional involvement in obesity management in children
- A feasibility study and process evaluation of a new intervention, including engagement with the programme and impacts on diet, physical activity and weight
The project will suit a student with an excellent academic track record, training in nutrition, physical activity, behaviour change or health sciences and knowledge of both quantitative and qualitative research methods. Prior experience in working with patients or the public would be an advantage.
The student will join other obesity researchers in the thriving Health Behaviours team in the Nuffield Department of Primary Care Health Sciences. We are currently working on range of interventions in primary care and in the community to support adults who are trying to lose weight along with population-level interventions to change dietary behaviours.
This studentship will be funded by the Wolfson-Marriott scholarship and the NIHR Applied Research Collaboration Oxford and Thames Valley.
Poor diet is one of the major contributors to preventable morbidity and premature mortality in the UK. Food and drink purchases from grocery stores are a crucial antecedent of household consumption and interventions which change food purchasing have the potential to encourage healthier food choices at a scale to bring public health benefits. We have recently published a systematic review of interventions to change food purchasing in grocery stores, we have already developed a virtual online supermarket which can be used to conduct early phase testing and we have an ongoing trials with a major retailer.
There are three potential aspects to this project. First to develop methods and tools to monitor the healthfulness of in-store and online grocery stores, to assess current practices and monitor changes over time. Second to develop interventions to encourage healthier food purchases. Finally to conduct a feasibility field trial in real online or physical stores or other food environments.
The project will suit a student with some knowledge of both nutrition and behaviour change and with strong quantitative research skills. It is likely to involve direct collaborations with the food industry.
The student will join the thriving Health Behaviours team in the Nuffield Department of Primary Care Health Sciences. We are currently working on range of interventions in primary care and in the community to support people to change their food consumption, including behavioural interventions for weight loss and reductions in saturated fat or salt to reduce cardiovascular risk.
The NHS in England is under considerable pressure to respond to the changes in our society's health. New ways of preventing illness, managing disease and delivering care are needed. This has been recognised by NHS England who have published the NHS Long Term Plan.
Significantly, this plan recognises that to meet many of the challenges that the NHS faces, an influential and prominent primary care and community-based health service is needed. In recognition of this, at least £4.5 billion a year in real terms is being promised to enhance and integrate these services by 2023/24. Also, the plan is set to run over ten years, thus potentially providing a period of stability for any change to take place.
A range of changes and initiatives are planned. These include, for example, new service models (such as Primary Care Networks), new working relationships (such as Sustainability and Transformation Partnerships) and extended roles and recruitment of non-medical practitioners (such as pharmacists, nurses, paramedics, link workers and allied health professionals).
However, evidence is needed to support the optimal implementation of the various aspects of the NHS Long Term Plan into current NHS structures and practice.
The work will build on an existing programme of work to support the evidence base for primary care redesign, including work within the NIHR SPCR Evidence Synthesis Working Group, Centre for Evidence Based Medicine and Interdisciplinary Research in Health Sciences (IRIHS) group.
The proposal may use a variety of research designs including evidence synthesis, qualitative and realist methods. Training and supervision will be provided, and there will be opportunities to form national and international collaborations as the work develops.
Stakeholder involvement will be a critical feature of the proposed DPhil work. Stakeholders will include patients and members of the public, as well as clinicians and those working at a local and national policy level. The department offers several ways in which to support PPI and stakeholder work.
We would welcome anyone interested to approach us to discuss your plans for your DPhil, outlining what your plans are and why this area of focus is important. We are particularly keen to hear from NHS primary care health care professionals.
For more information contact Dr Geoff Wong.
Supervisor(s): Geoff Wong (Nuffield Department of Primary Care Health Sciences) & Mike English (Centre for Tropical Medicine & Global Health and Oxford Health Systems Collaboration, Nuffield Department of Medicine; in partnership with Dr. Jacinta Nzinga at the KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya.
Progress has been made in reducing child mortality in Kenya and other African countries but levels of neonatal mortality still remains high. Reducing neonatal mortality will in part require significant improvements in the quality of care provided to sick newborns in Kenyan hospitals. A major programme of work to improve the care provided on Kenyan hospital newborn units (NBU) is beginning in 2019 led by an Oxford and Kenyan team, it is linked to work by a wider set of international partners focused on implementing a bundle of low-cost technologies. The purpose of this DPhil is to conduct an ‘external evaluation’ of this major programme of work in the form a Realist Evaluation.
The major project will deliver a set of interventions through a network of 10 to 12 hospitals including: training, outreach from a central coordinator, regular performance feedback, peer to peer learning and in some a bundle of supportive care technologies – the NEST package. Over the course of the project and for each hospital the characteristics of NBU admissions, process measures of the care they receive and their health outcomes will be continuously measured. The major project already has some planned evaluation activities in addition to this NBU performance tracking including qualitative studies of the experiences of senior and frontline health workers in the target NBUs and more specific implementation research around specific technologies (eg. CPAP).
The DPhil proposed will complement and advance the planned research by developing an evaluation approach that draws on systems thinking and complexity theory to help distil lessons that can guide and optimise large scale intervention strategies in Low and Middle Income Country’s health systems. The research approach is likely to take the form of in-depth, mixed-method case studies and contribute to efforts to link complexity theory and Realist Evaluation.
Realist Evaluation is informed by established theories from social science but is especially focused on developing middle range theories that explain how programmes achieve their effects as a result of the interaction of contexts that triggers (often multiple) mechanisms to produce outcomes. The overall aim or realist evaluations is therefore to address the question “What works, for whom, in what respects, to what extent, in what contexts, and how?” as a means of offering transferable lessons to guide later intervention approaches. This DPhil will aim to develop an initial programme theory encompassing the entire intervention approach drawing on literature and the experience and reasoning of those conducting the intervention. The initial programme theory developed with the Kenyan team delivering the intervention. We envisage the evaluation design will use a case study approach of hospital sites and use realist interviews, with data analysis using a realist logic of analysis to further develop, confirm, refute or refine the programme theory.
The purpose of this DPhil is enable the successful candidate to develop their understanding of large scale global health service change interventions and introduce them to bodies of theory that can be used to understand the reasons for success (or failure) of change efforts. The successful candidate will also have the additional benefit of being able to develop their knowledge and skills in the Realist Evaluation approach. There will likely be opportunities for specific training in Realist Evaluation. Skills in proposal writing to satisfy the requirements of scientific and ethical review will also be developed. Training in qualitative and quantitative research methods will also be provided as needed. It is anticipated that during the course of the DPhil and linked to the collection of interview data approximately 6 months may be spent in Kenya based at the Nairobi offices of the KEMRI-Wellcome Trust Research Programme.
Start date: Anticipated start in October 2020 (Michaelmas Term 2020)