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Public Health and Prevention Economics Research

The Public Health and Prevention Economics Research Group (PHERG) is part of the Centre for Health Economics and Medicines Evaluation (CHEME) within the School of Medical and Health Sciences and part of the multidisciplinary Bangor Institute for Health and Medical Research (BIHMR) group. Our research adopts a life-course model applying methods of health economics evaluation to trials and other study designs in the evaluation of public health and psychosocial interventions at both programme and system level. Our research has applications within the NHS, third sector organisations, and Government. Much of our research is funded by NIHR,, HTA, charities, and Welsh Government.

PHERG is led by Rhiannon Tudor Edwards BSc. Econ, M.A., D.Phil., Hon. MFPH, Professor of Health Economics.

Our Skill Set

With a research and policy lens, we apply health economics to public health and prevention, well-being and well-becoming.

Our expertise and the methods we use are displayed in this infographic:

This is a spider graph detailing the methods we use. The categories are Social Value, Reviewing, Economic Evaluation, Participant-Centred and Prioritisation.

International evidence points towards the greatest return on investment coming from investment in the first three years of life. Our research shows that positive preventive actions during child development are the most important ways to intervene and yield the greatest return on investment to society.

The CHEME Transforming Young Lives across Wales report can be found here.

This new infographic shows how factors impact on wellbeing through life course.

Well-being and well-becoming through the life-course in public health economics research and policy: A new infographic

infographic showing how factors impact on wellbeing through life course.

Our Impact

This is a spider graph demonstrating our impact. Categories include publications, influencing policy, teaching and informative resources, and identifying preventative health measures.

Research and policy support activities

Methodology of public health economics

Handbooks in Health Economic Evaluation, Applied Health Economics for Public Health Practice and Research, edited by Rhiannon Tudor Edwards and Emma McIntosh, published by Oxford University Press.

applied health book cover image

Our publications

PHERG publications 2023

  • Anthony, B. F., Disbeschl, S., Goulden, N., Hendry, A., Hiscock, J., Hoare, Z., Roberts, J., Rose, J., Surgey, A., Williams, N. H., Walker, D., Neal, R., Wilkinson, C., & Edwards, R. T. (2023). Earlier cancer diagnosis in primary care: a feasibility economic analysis of ThinkCancer! https://doi.org/10.3399/BJGPO.2022.0130
  • Casswell, E. J., Cro, S., Cornelius, V. R., Banerjee, P. J., Zvobgo, T. M., Edwards, R. T., Ezeofor, V., Anthony, B., Shahid, S. M., Bunce, C., Kelly, J., Murphy, C., Robertson, E., & Charteris, D. (2023). Clinical science Randomised controlled trial of adjunctive triamcinolone acetonide in eyes undergoing vitreoretinal surgery following open globe trauma: The ASCOT study. Br J Ophthalmol, 0, 1–9. https://doi.org/10.1136/bjo-2022-322787
  • Doungsong, K., Hartfiel, N., Gladman, J., Harwood, R. H., & Tudor Edwards, R. (2023). RCT-based Social Return on Investment (SROI) of a home exercise programme for people with early dementia comparing in-person and blended delivery before and during the COVID-19 pandemic. https://doi.org/10.1101/2023.08.25.23294408
  • Edwards, R. T., Ezeofor, V., Bryning, L., Anthony, B. F., Charles, J. M., & Weeks, A. (2023). Prevention of postpartum haemorrhage: Economic evaluation of the novel butterfly device in a UK setting. European Journal of Obstetrics and Gynecology, 283, 301–2115. https://doi.org/10.1016/j.ejogrb.2023.02.020
  • England, C., Jarrom, D., Washington, J., Hasler, E., Batten, L., Lewis, R., Edwards, R. T., Davies, J., Collins, B., Cooper, A., & Edwards, A. (2023). Measuring Mental Health in a Cost-of-Living Crisis: Rapid review RR0006 Measuring Mental Health in a Cost-of-Living Crisis: a rapid review. https://doi.org/10.1101/2023.07.24.23293078
  • Edwards, D., Csontos, J., Gillen, E., Hutchinson, G., Sha’aban, A., Carrier, J., Lewis, R., Edwards, R. T., Davies, J., Collins, B., Cooper, A., & Edwards, A. (2023). What is the forecasted prevalence and incidence of long-term conditions in Wales: a rapid evidence map. https://doi.org/10.1101/2023.06.23.23291814
  • Granger, R., & Kubis, H. P. (2023). Too much is too much: Influence of former stress levels on food craving and weight gain during the COVID-19 period. PLoS ONE, 18(4 April). https://doi.org/10.1371/journal.pone.0277856
  • Harwood, R. H., Goldberg, S. E., Brand, A., Wardt, V. van Der, Booth, V., Lorito, C. Di, Hoare, Z., Hancox, J., Bajwa, R., Burgon, C., Howe, L., Cowley, A., Bramley, T., Long, A., Lock, J., Tucker, R., Adams, E. J., O’Brien, R., Kearney, F., … Masud, T. (2023). Promoting Activity, Independence, and Stability in Early Dementia and mild cognitive impairment (PrAISED): randomised controlled trial. BMJ, 382, e074787. https://doi.org/10.1136/BMJ-2023-074787
  • Hartfiel, N., Gittins, H., Morrison, V., Wynne-Jones, S., Dandy, N., & Edwards, R. T. (2023). Social Return on Investment of Nature-Based Activities for Adults with Mental Wellbeing Challenges. International Journal of Environmental Research and Public Health, 20(15). https://doi.org/10.3390/ijerph20156500
  • O’toole, S., Moazzez, R., Wojewodka, G., Zeki, S., Jafari, J., Hope, K., Brand, A., Hoare, Z., Scott, S., Doungsong, K., Ezeofor, V., Edwards, R. T., Drakatos, P., & Steier, J. (2023). Single-centre, single-blinded, randomised, parallel group, feasibility study protocol investigating if mandibular advancement device treatment for obstructive sleep apnoea can reduce nocturnal gastro-oesophageal reflux (MAD-Reflux trial). https://doi.org/10.1136/bmjopen-2023-076661
  • Makanjuola, A., Granger, R., Pisavadia, K., & Edwards, R. T. (2023). Is lifestyle coaching a potential cost-effective intervention to address the backlog for mental health counselling? A Rapid Review. MedRxiv, 2023.01.20.23284835. https://doi.org/10.1101/2023.01.20.23284835
  • Makanjuola, A., Lynch, M., Hartfiel, N., Cuthbert, A., & Edwards, R. (2023). Prevention of Poor Physical and Mental Health through the Green Social Prescribing Opening Doors to the Outdoors Programme: A Social Return on Investment Analysis. International Journal of Environmental Research and Public Health, 20(12), 6111. https://doi.org/10.3390/ijerph20126111
  • Makanjuola, A., Lynch, M., Spencer, L. H., & Edwards, R. T. (2023). Prospects and Aspirations for Workforce Training and Education in Social Prescribing. International Journal of Environmental Research and Public Health, 20(16), 6549. https://doi.org/10.3390/ijerph20166549
  • Prendergast, L. M., Toms, G., Seddon, D., Jones, C., Anthony, B. F., & Edwards, R. T. (2023). Supporting social connection for people living with dementia: lessons from the findings of the TRIO study. Working with Older People. https://doi.org/10.1108/WWOP-10-2022-0050
  • Skinner, A., Hartfiel, N., Lynch, M., Jones, A. W., & Edwards, R. T. (2023). Social Return on Investment of Social Prescribing via a Diabetes Technician for Preventing Type 2 Diabetes Progression. International Journal of Environmental Research and Public Health, 20(12), 6074. https://doi.org/10.3390/ijerph20126074
  • Spencer, L. H., Albustami, M., Khanom, A., Porter, A., Naha, G., Thomas, R. L., … Edwards, R. T. (2023). CYMELL Study: rapid review of the evidence. Retrieved February 15, 2023, from PROSPERO website: https://www.crd.york.ac.uk/prospero/#recordDetails
  • Spencer, L. H., Hendry, A., Makanjuola, A., Anthony, B., Davies, J., Pisavadia, K., … Edwards, A. (2023). What interventions or best practice are there to support people with Long COVID, or similar post-viral conditions or conditions characterised by fatigue, to return to normal activities: a rapid review. Retrieved February 2, 2023, from medRxiv preprint website: https://www.medrxiv.org/content/10.1101/2023.01.24.23284947v1
  • Spencer, L. H., Lynch, M., Thomas, G. M., & Edwards, R. T. (2023). Intergenerational Deliberations for Long Term Sustainability. Retrieved February 12, 2023, from Challenges website: https://www.mdpi.com/2078-1547/14/1/11?fbclid=IwAR039SCJmhvW5csmgs0eZbP3jSJ9xi511IdH4E5ac4BXcq87yEpFPRft-4w
  • Spencer, L., Hendry, A., Makanjuola, A., Anthony, B. F., Davies, J., Pisavadia, K., Hughes, D., Fitzsimmons, D., Wilkinson, C., Edwards, R. T., Lewis, R., Cooper, A., & Edwards, A. (2023). Supporting people with long COVID What interventions or best practice are there to support people with Long COVID, or similar post-viral conditions or conditions characterised by fatigue, to return to normal activities: a rapid review. https://doi.org/10.1101/2023.01.24.23284947
  • Spencer, L. ;, Hendry, A. ;, Makanjuola, A. ;, Pisavadia, K. ;, Davies, J. ;, Albustami, M. ;, Anthony, B. ;, Wilkinson, C. ;, Fitzsimmons, D. ;, Hughes, D. ;, Edwards, R., Tudor, ;, Lewis, R. ;, Cooper, A. ;, Edwards, A., Spencer, L., Makanjuola, A., Albustami, J., & Anthony, M. (2023). What is the effectiveness and cost-effectiveness of interventions in reducing the harms for children and young people who have been exposed to domestic violence or abuse: a rapid review.
  • Spencer, L. H., Lynch, M., Thomas, G. M., & Edwards, R. T. (2023). Intergenerational Deliberations for Long Term Sustainability. Challenges, 14(1), 11. https://doi.org/10.3390/challe14010011
  • Toms, G. R., Stringer, C. L., Prendergast, L. M., Seddon, D., Anthony, B. F., & Edwards, R. T. (2023). A Study to Explore the Feasibility of Using a Social Return on Investment Approach to Evaluate Short Breaks. https://doi.org/10.1155/2023/4699751
  • Weeks, A. D., Cunningham, C., Taylor, W., Rosala-Hallas, A., Watt, P., Bryning, L., Cregan, L., Hayden, E., Lambert, D., Bedwell, C., Lane, S., Fisher, T., Edwards, R. T., & Lavender, T. (2023). A mixed method, phase 2 clinical evaluation of a novel device to treat postpartum haemorrhage. European Journal of Obstetrics and Gynecology, 283, 142–148. https://doi.org/10.1016/j.ejogrb.2023.01.018

PHERG publications 2022

  • Cooledge, B., & Spencer, L. (2022). Siaradwyr Cymraeg mewn ymchwil iechyd a gofal yng Nghymru – Golwg360. https://golwg.360.cymru/gwerddon/2105428-siaradwyr-cymraeg-mewn-ymchwil-iechyd-gofal
  • Edwards, R. (2022). Through the life-course in public health economics research and policy: A new infographic. Frontiers in Public Health, 10, 5147. Retrieved fromhttps://www.frontiersin.org/articles/10.3389/fpubh.2022.1035260/full
  • Ezeofor, V. ‘Segun, Spencer, L. H., Rogers, S. N., Kanatas, A., Lowe, D., Semple, C. J., Hanna, J. R., Yeo, S. T., & Edwards, R. T. (2022). An Economic Evaluation Supported by Qualitative Data About the Patient Concerns Inventory (PCI) versus Standard Treatment Pathway in the Management of Patients with Head and Neck Cancer. PharmacoEconomics - Open, 6(3), 389–403. https://doi.org/10.1007/s41669-021-00320-4
  • Granger, R., Genn, H., & Tudor Edwards, R. (2022). Health economics of health justice partnerships: A rapid review of the economic returns to society of promoting access to legal advice. https://doi.org/10.3389/fpubh.2022.1009964
  • Hartfiel, N., Gladman, J., Harwood, R., & Tudor Edwards, R. (2022). Social Return on Investment of Home Exercise and Community Referral for People With Early Dementia. Gerontology and Geriatric Medicine, 8. https://doi.org/10.1177/23337214221106839
  • Makanjuola, A., Lynch, M., Hartfiel, N., Cuthbert, A., Wheeler, H. T., & Edwards, R. T. (2022). A Social Return on Investment Evaluation of the Pilot Social Prescribing EmotionMind Dynamic Coaching Programme to Improve Mental Wellbeing and Self-Confidence. Public Health, 19. https://doi.org/10.3390/ijerph191710658
  • Roberts, G., Holmes, J., Williams, G., Chess, J., Hartfiel, N., Charles, J. M., McLauglin, L., Noyes, J., & Edwards, R. T. (2022). Current costs of dialysis modalities: A comprehensive analysis within the United Kingdom. Peritoneal Dialysis International, 42(6), 578–584. https://doi.org/10.1177/08968608211061126
  • Spencer, L., Hendry, A., Makanjuola, A., Davies, J., Pisavadia, K., Hughes, D., Fitzsimmons, D., Wilkinson, C., Edwards, R. T., Lewis, R., Cooper, A., & Edwards, A. (2022). What is the long-term impact of COVID-19 on the Health-Related Quality of Life of individuals with mild symptoms (or non-hospitalised): A rapid review. https://doi.org/10.1101/2022.09.09.22279642
  • Spencer, L., Hartfiel, N., Hendry, A., Anthony, B., Makanjuola, A., Pisavadia, K., Davies, J., Bray, N., Hughes, D., Wilkinson, C., Fitzsimmons, D., Edwards, R. T., Edwards, A., Gal, M., Cooper, A., & Lewis, R. (2022). What innovations can address inequalities experienced by women and girls due to the COVID-19 pandemic across the different areas of life/domains: work, health, living standards, personal security, participation and education?http://www.primecentre.wales/resources/RR/Clean/RR00027_Wales_COVID-19_Evidence_Centre-
  • Whiteley, H., Lynch, M., Hartfiel, N., Beharrell, W., Cuthbert, A., & Edwards, R. T. (2022). A social Return on Investment (SROI) evaluation of the Fathom trust 'Making well' programme. https://fathomtrust.com/stories/making-well-a-social-return-on-investment-report/

 

Our Funders

This is a spider graph showing our funding sources, including UKRI, Welsh Government, NHS health boards, Horizon Europe and Charities.

 

Current Projectsinvest 4 health logo

Horizon Europe Invest4Health

The Centre for Health Economics and Medicines Evaluation (CHEME) are key partners in the EU Invest4Health project. This Horizon Europe collaboration across eight countries has been funded as one of the four large research programmes on the HORIZON-HLTH-2022-CARE-08-04 — Better financing models for health systems call. CHEME’s key contribution to this project include exploring what is meant by Smart Capacitating Investment (SCI), across the public, private and voluntary sectors at a macro, meso and micro level, and testing and evaluating proposed SCI models that aim to provide sustainable funding for preventive health measures in the post-COVID-19 healthcare landscape.

Advice on Prescription

Citizens Advice on Prescription (CAP) is a welfare and social prescribing intervention provided by Citizens Advice LCAP Liverpool logoiverpool Health Programme | Citizens Advice (citizensadviceliverpool.org.uk). The aim of CAP is to provide a single ‘gateway’ from health services in Liverpool into a holistic social and welfare support offer. A key element of the CAP service is that it is designed both to improve the lives of individuals, but also provide support for the health care system, with the aim to reduce the pressures from non-health issues on the health service.

The public health economics team, in conjunction with The University of Liverpool, are currently evaluating the effectiveness and cost-effectiveness of the CAP program. For the health economic analyses, we will be using health related quality of life (HRQOL) utility values as well as changes in health service usage (e.g., number of GP and hospital visits), and program costings to carry out a cost effectiveness analysis (CEA) and social return on investment (SROI) on the intervention.

KiVa

The Centre for Health Economics and Medicines Evaluation (CHEME), Bangor University, are delivering the health econoKiVa logomic evaluation of the universal KiVa anti-bullying programme as part of the UK Stand Together trial. Over 25% of UK children are bullied on a regular basis and bullying in school can impact absenteeism, academic achievement and result in bullied children accessing more mental health services compared to non-bullied children. The potential detrimental life course health and social care consequences highlight the importance of a preventative public health approach to reducing childhood bullying. The UK Stand Together trial is providing the first large-scale randomised control trial evaluation of the KiVa programme in England and Wales, investigating if KiVa is more effective and cost-effective in reducing bullying in UK primary schools compared to schools’ usual approach to addressing bullying. KiVa is a complex, multicomponent intervention delivered within a complex education system. We are applying a broad evaluative lens to deliver comprehensive and relevant cost-effectiveness evidence for decision-makers.

Our core staff working with Professor Edwards  

Alumni

PGR students

Postgraduate research opportunities/scholarship

MRes Health Economics

We offer a Master by Research in Public Health and Prevention Economics.

Teaching

  • Medical students at North Wales Medical School, Bangor University.
    • Rhiannon offers student selected component (SSC; 2nd to 4th year) a ‘Public health and prevention economics research across the life-course’ experience project.
    • Students will have an opportunity to join the Public Health and Prevention Economics Research network at CHEME.
  • Rhiannon offers bespoke lectures on public health economics and related topics:

Health economics of well-being and well-becomingTransforming Young Lives across Wales book cover

Research projects and collaborations through the life-course

Early years and childhood

Adolescents and young people

Working age

Older age – living well for longer

Where and how we die well

Evaluation of medical devices and technologies

Economic evaluation of sight loss and sight preserving surgery