Faculty of Health and Life Sciences PhD studentships 2013

Closing Date: 21st June

List of suggested PhD studentship topics and the main PhD supervisor for that study

Dr Katherine Brown: Factors affecting safer sex decision-making: Exploring the potential contribution of attentional bias, sexual promiscuity and emotional promiscuity on the impact of affective outcome expectancy manipulation for condom use intentions and behaviour

Dr Carol Grant-Pearce: Identifying the self management needs of palliative care patients to inform the development of a support programme

Dr Andy Turner: Development and evaluation of a cancer survivors self-management programme: ehope

Dr Andy Turner: Establishing the long term self reported outcomes of the dementia self-management programme from the viewpoint of patients and their carers.

Prof Louise Wallace: Developing an intervention within an acculturation framework to meet the needs of Muslim women of Pakistani origin living in Birmingham regarding their breastfeeding intentions and practices.

TITLE:Factors affecting safer sex decision-making: Exploring the potential contribution of attentional bias, sexual promiscuity and emotional promiscuity on the impact of affective outcome expectancy manipulation for condom use intentions and behaviour
Prospective applicants can contact
Dr Katherine Brown
Sexual promiscuity is a known risk factor for unprotected sex (Hoyle, Fejfar & Miller, 2000). It has been found that women who score highly on measures of both sexual promiscuity (SP) and a related measure; emotional promiscuity (EP; easily prone to feelings of falling in love) are more likely than male counterparts to engage in sex without condoms (Jones & Paulhus, 2012).
Research exploring attitudes to condom use indicates that affective outcome expectancies (e.g. expecting condom use will reduce pleasure) are stronger predictors of condom use than cognitive outcome expectancies (e.g. knowing they provide protection from STI) (Newby et al., 2013). Affective outcome expectancies are therefore better targets for intervention. Little is yet known however, about how sexual and emotional promiscuity interact with affective outcome expectancies about condom use in safer sex decision-making. Exploring this will provide important evidence for improving health promotion and school sex education interventions.
Furthermore, Johnson et al. (in prep) found that women with higher scores on SP have a greater attentional bias for safer sex images than males. This suggests that safe sex is more emotionally salient to high SP females, relative to high SP males. However, it is unknown to what extent this bias is predictive of safe sex decision making and how this bias is mediated by the related construct of EP. Therefore, in order to develop health promotion messages targeted at women higher in SP, we need a better understanding of the relationships between attentional bias for safer sex images, emotional and sexual promiscuity, and outcome expectancies for safer sex behaviour including condom use.
This thesis would aim to examine whether the same bias for safer sex images exist for women with high levels of EP as it does for high levels of SP
It would assess which outcome expectancies are most predictive of condom use intention and behaviour in high and low sexual and emotionally promiscuous populations
It would address the questions: Do higher levels of sexual and emotional promiscuity moderate the relationship between affective outcome expectancies and condom use? And does this differ by gender?
Finally it would explore whether intervention messages designed to address findings in studies 1 and 2 (e.g. using images likely to attract attention of those at risk and targeting identified predictive affective condom beliefs) have a stronger impact on intention to engage in safer sex and self-reported condom use compared to controls? And whether such messages moderate the attentional bias; suggesting an increased emotional salience.
Study 1 – Questionnaire based identification of a sample of males and females drawn from student populations with high and low levels of sexual and emotional promiscuity.Laboratory experimental assessment of attentional bias for safer sex images. This visual probe task involves reaction times (RT) for a target probe that follows the presentation of two adjacent images (one safe-sex image and one matched control). The attentional bias score comprises the difference in RTs for the target response when the probe was positioned where the preceding safe-sex image was located relative to the control image.
Study 2 – A questionnaire based study (incorporating appropriate piloting of measures) to assess outcome expectancy predictors of condom intention and use and explore differences by promiscuity levels and gender.
Study 3 – Development and beta level experimental evaluation of a brief (possibly on-line) intervention manipulating safer sex imagery stimuli and outcome expectancy beliefs to assess impact on condom use intentions and behaviour among populations at low and high risk of unprotected sex.
Reference list
Hoyle, R.H., Fejfar, M.C., & Miller, J.D. (2000) Personality and sexual risk taking: a quantitative review. Journal of Personality, 68, 1203-1231. doi:10.1111/1467-6494.00132
Johnson, A., Price, S. & Brown K. E. (in prep). Attentional bias for sexual and safe sex stimuli in individuals high and low on measures of sexual promiscuity.
Jones, D.N. & Paulhus, D.L. (2012) The role of emotional promiscuity in unprotected sex, Psychology & Health, 27:9, 1021-1035. doi:10.1080/08870446.2011.647819
Newby, K. V., Brown, K. E., French, D., & Wallace, L. (2013). Which outcome expectancies are important in determining young adults’ intentions to use condoms with casual sexual partners?: A cross-sectional study. BMC Public Health, 13, 133. doi:10.1186/1471-2458-13-133
TITLE:Identifying the self management needs of palliative care patients to inform the development of a support programme
prospective applicants can contact
Dr Carol Grant-Pearce,
Around half a million people die in England each year. The majority of deaths follow a period of chronic illness such as heart disease, stroke, cancer, dementia, respiratory or neurological disease. The support for people in the final phase of life can be provided in different settings including: hospital inpatients, outpatients, day-care, homecare and hospice-at-home.
Palliative care patients, those with progressive life limiting disease, confront complex challenges to their physical health, psychosocial identity and emotional wellbeing, while living with the dual states of survivorship and limited mortality[i], as do their families.
Despite the introduction of various policy initiatives, such as the Gold Standards Framework, which aim to ensure a more holistic approach to support and care for palliative patients, such patients and their relatives are often left to navigate a health system which offers bifurcated support. The self-management paradigm offer strategies which aim to empower patients through knowledge, skills and self efficacy, to navigate though the web of options offered to them (e.g. hospice-at-home) and those that are not (e.g. assisted suicide), in various settings.
ARC HLI self-management interventions (e.g. HOPEand Healthy Essentials for Life after Testicular and Colorectal Cancer) have been cited as examples of innovative support, by the National Cancer Survivorship Initiative (2013).
Questions to be addressed by this research:
  • What are the self-management support needs of patients with life limiting illness and their carers?
  • How could addressing these influence their approach to the end of life options that are on offer to them and those that are not?
  • What does the literature tell us about evidence based palliative care self-management interventions?
  • What should be the content and format of a palliative care self-management support programme?

Year 1 Systematic review of self management support interventions for palliative care patients asserting their desires for end of life for options on offer and not on offer.
Year 2 A qualitative approach using focus groups and interviews will be utilised to elicit and understand the needs, cognitions and behaviours of patients in the palliative phase. Stakeholders such as palliative patients and their carers, palliative care staff and relevant third sector advocates will be the target population. A grounded theory approach will be used to analyse this data.
Year 3A systematic development process will be used to ensure that the components of a palliative self-management programme will be developed to address the specific needs of palliative care patients and carers and a proposed causal pathway for change is elucidated, as supported by theory and evidence (Michie, Fixsen, Grimshaw, & Eccles, 2009).
The Coventry Intervention Development Method, which combines elements from other methods (Bartholomew, Parcel, Kok, & Gottlieb, 2006; Renger & Hurley, 2006), has the advantage of leading to the mapping of intervention components and measures for success based on both primary data from the stakeholders mentioned above and the supporting evidence base from existing research literature to develop the content of each programme.
The entire process will be guided by a steering group made up of key stakeholders’ perceptions of need and priorities. The resulting intervention will have a clear logic underlying the inclusion of every component, rendering areas for refinements to intervention during the development cycle (Craig et al., 2008) easy to locate as each component has a clear and specific purpose.
Reference list
Baily DE, Steinhauser K, Hendrix C, Tulsky JA, (2011) Editorial: pairing self-managing self-management with palliative care: intervening in life- limiting illness. J Nurs Health Chronic Illn, 2011 Mar: 3(1): 1-3
Bartholomew, L. K., Parcel, G. S., Kok, G., & Gottlieb, N. H. (2006). Planning health promotion programs: An intervention mapping approach. San Francisco: Jossey-Bass
Bradley SA, Frizelle D and Johnson M (2011) Patients’ psychosocial experiences of attending specialist palliative day care: a systematic review. Palliative Medicine 25 (3) 2010-228
M.A. Branthwaite, “Time for change,” British Medical Journal, vol. 331 (Sept. 24, 2005), p. 681.
Craig, P. (2008) 'Developing and Evaluating Complex Interventions the New Medical Research Council Guidance.'. British Medical Journal 337 (a1655)
Department of Health, Macmillan Cancer Support & NHS Improvement .Living With and Beyond Cancer: Taking Action to Improve Outcomes Guidance on improving quality of life for cancer survivors. March 2013. Website Accessed 24 April 2013
Dickinson, G.E., Lancaster, C.J., Clark, D., Ahmedzai, S.H. & Noble W. (2002). U.K. physicians' attitudes toward active voluntary euthanasia and physician-assisted suicide. Death Studies, 26(6), 479 – 490.
Michie, S., Fixsen, D., Grimshaw, J., & Eccles, M. (2009). Specifying and reporting complex behaviour change interventions: the need for a scientific method. Implementation Science, 4(1), 40. doi: 10.1186/1748-5908-4-40
Renger, R., & Hurley, C. (2006). From theory to practice: Lessons learned in the application of the ATM approach to developing logic models. Evaluation and Program Planning, 29(2), 106-119. doi: 10.1016/j.evalprogplan.2006.01.004
Turner, A., Batehup, L., & Surendranath, S. (2011). Hope is the Key. Researchers and support organisations that have developed self-management courses for cancer survivors explain their positive results. Nursing Standard, January, 5-11.
TITLE:Identifying the self management needs of palliative care patients to inform the development of a support programme
prospective applicants can contact
Dr Carol Grant-Pearce,
Around half a million people die in England each year. The majority of deaths follow a period of chronic illness such as heart disease, stroke, cancer, dementia, respiratory or neurological disease. The support for people in the final phase of life can be provided in different settings including: hospital inpatients, outpatients, day-care, homecare and hospice-at-home.
Palliative care patients, those with progressive life limiting disease, confront complex challenges to their physical health, psychosocial identity and emotional wellbeing, while living with the dual states of survivorship and limited mortality[ii], as do their families.
Despite the introduction of various policy initiatives, such as the Gold Standards Framework, which aim to ensure a more holistic approach to support and care for palliative patients, such patients and their relatives are often left to navigate a health system which offers bifurcated support. The self-management paradigm offer strategies which aim to empower patients through knowledge, skills and self efficacy, to navigate though the web of options offered to them (e.g. hospice-at-home) and those that are not (e.g. assisted suicide), in various settings.
ARC HLI self-management interventions (e.g. HOPEand Healthy Essentials for Life after Testicular and Colorectal Cancer) have been cited as examples of innovative support, by the National Cancer Survivorship Initiative (2013).
Questions to be addressed by this research:
  • What are the self-management support needs of patients with life limiting illness and their carers?
  • How could addressing these influence their approach to the end of life options that are on offer to them and those that are not?
  • What does the literature tell us about evidence based palliative care self-management interventions?
  • What should be the content and format of a palliative care self-management support programme?

Year 1 Systematic review of self management support interventions for palliative care patients asserting their desires for end of life for options on offer and not on offer.
Year 2 A qualitative approach using focus groups and interviews will be utilised to elicit and understand the needs, cognitions and behaviours of patients in the palliative phase. Stakeholders such as palliative patients and their carers, palliative care staff and relevant third sector advocates will be the target population. A grounded theory approach will be used to analyse this data.
Year 3A systematic development process will be used to ensure that the components of a palliative self-management programme will be developed to address the specific needs of palliative care patients and carers and a proposed causal pathway for change is elucidated, as supported by theory and evidence (Michie, Fixsen, Grimshaw, & Eccles, 2009).
The Coventry Intervention Development Method, which combines elements from other methods (Bartholomew, Parcel, Kok, & Gottlieb, 2006; Renger & Hurley, 2006), has the advantage of leading to the mapping of intervention components and measures for success based on both primary data from the stakeholders mentioned above and the supporting evidence base from existing research literature to develop the content of each programme.
The entire process will be guided by a steering group made up of key stakeholders’ perceptions of need and priorities. The resulting intervention will have a clear logic underlying the inclusion of every component, rendering areas for refinements to intervention during the development cycle (Craig et al., 2008) easy to locate as each component has a clear and specific purpose.
Reference list
Baily DE, Steinhauser K, Hendrix C, Tulsky JA, (2011) Editorial: pairing self-managing self-management with palliative care: intervening in life- limiting illness. J Nurs Health Chronic Illn, 2011 Mar: 3(1): 1-3
Bartholomew, L. K., Parcel, G. S., Kok, G., & Gottlieb, N. H. (2006). Planning health promotion programs: An intervention mapping approach. San Francisco: Jossey-Bass
Bradley SA, Frizelle D and Johnson M (2011) Patients’ psychosocial experiences of attending specialist palliative day care: a systematic review. Palliative Medicine 25 (3) 2010-228
M.A. Branthwaite, “Time for change,” British Medical Journal, vol. 331 (Sept. 24, 2005), p. 681.
Craig, P. (2008) 'Developing and Evaluating Complex Interventions the New Medical Research Council Guidance.'. British Medical Journal 337 (a1655)
Department of Health, Macmillan Cancer Support & NHS Improvement .Living With and Beyond Cancer: Taking Action to Improve Outcomes Guidance on improving quality of life for cancer survivors. March 2013. Website Accessed 24 April 2013
Dickinson, G.E., Lancaster, C.J., Clark, D., Ahmedzai, S.H. & Noble W. (2002). U.K. physicians' attitudes toward active voluntary euthanasia and physician-assisted suicide. Death Studies, 26(6), 479 – 490.
Michie, S., Fixsen, D., Grimshaw, J., & Eccles, M. (2009). Specifying and reporting complex behaviour change interventions: the need for a scientific method. Implementation Science, 4(1), 40. doi: 10.1186/1748-5908-4-40
Renger, R., & Hurley, C. (2006). From theory to practice: Lessons learned in the application of the ATM approach to developing logic models. Evaluation and Program Planning, 29(2), 106-119. doi: 10.1016/j.evalprogplan.2006.01.004
Turner, A., Batehup, L., & Surendranath, S. (2011). Hope is the Key. Researchers and support organisations that have developed self-management courses for cancer survivors explain their positive results. Nursing Standard, January, 5-11.
TITLE:Development and evaluation of a cancer survivors self-management programme: ehope
prospective applicants can contact
Dr Andy Turner,
Background to project: There are 2 million cancer survivors in the UK and this figure is expected to grow annually by 3%. ARC HLI have developed and pilot tested several group-based, face-to-face, self-management programmes for cancer survivors at the end of curative treatment ( Martin et al, 2010a, 2010b). Preliminary results are extremely encouraging and show that quality of life is significantly improved at 6 months follow up (Turner et al. 2011). Two of ARC HLI’s interventions (HOPE and Healthy Essentials for Life after Testicular and Colorectal Cancer) are cited as examples of innovative and cost-effective self-management support in the recent to the National Cancer Survivorship Initiative 2010 Vision document update (DH, Macmillan Cancer Support & NHS Improvement, March 2013). We are currently applying for NIHR funding to conduct a randomised controlled feasibility and cost-effectiveness trial (250k) of the HOPE Programme. Macmillan Cancer Support deliver the HOPE under licence from CU across the UK.
Despite the benefits of attending group-based self-management programmes many cancer survivors do not attend. Some cancer survivors would prefer to access web-based self-management support. We have recently had confirmation from Macmillan Cancer Support that they intend to fund the development of a web-based version of the HOPE Programme: ehope and the PhD will be linked to this project
Aims and objectives of the project
The overall aim of the PhD is to develop and evaluate the ehope programme for cancer survivors.
  1. Establish the evidence for web-based self-management support for cancer survivors
  2. Identify the web-based self-management support needs of cancer survivors
  3. Develop a pilot web-based self-management programme cancer survivors ehope
  4. Testing the pilot version of the web-based self-management programme

Proposed methodology
Year 1
Systematic review of the evidence for web-based self-management support for cancer survivors