In the beginning
“The B3 strand provided a hub for those undertaking health-related research in the fields of bioethics, biolaw and biosociety,” said Professor Cameron, “but it was also aimed at external collaborators, and colleagues whose work could be enriched by input from B3 researchers in other disciplines,”
Initially, the idea behind the strand was to foster projects with the potential to have impact at a variety of different levels - from altering community outreach initiatives to informing policy and practice debates. The loose framework around which the strand would be woven amounted to four key research themes.
- Health, children and parents
- Health, ageing and dying well
- Health, populations and participants
- Health, uncertainty and complexity
The University of Bristol has strengths particularly in themes 1-3. Theme 4 aimed to consolidate disparate expertise into a more cohesive whole, focused on challenges resulting from Brexit, Austerity, the climate crisis and beyond.
Supported by Esther Kissane-Webb, the strand was overseen by the invaluable contributions of a multidisciplinary, cross-career Advisory Board. The members were drawn from across the University’s faculties, and thus were able to act as conduits to a wide variety of disciplines and research groups across the University and beyond.
Professor Huxtable: “We looked upon the whole strand essentially as a seeding exercise - from acorns into oak trees, if you will! The strand has helped plant many acorns, and we're seeing some sprouting, but over the longer term we hope to see more as a result of what we’ve done.”
The strand also organised guest lectures from such leading national figures as Sally Cheshire CBE, previous chair of the Human Fertilisation and Embryo Authority, and Baroness Finlay of Llandaff, one-time president of the Royal Society of Medicine, consultant in palliative medicine and an Independent Crossbench member of the House of Lords.
During the last quarter of the strand’s time, COVID-19 associated lockdowns and closures affected how the strand operated. However, the fact B3 had been up and running for some time enabled a certain amount of flexibility in its approach, allowing established projects to complete and newer ones to thrive. Here is a far from exhaustive set of projects the strand has supported, and the potential impacts of their work upon the university, the healthcare professions, and the community at large.
Mental health
Mental health and wellbeing has been a problem attracting increasing concern and consequent scrutiny for some time. While there are many factors involved, strong predictors for changes in mental wellbeing are poorly understood. Of course, COVID-19 increased the urgency for research in this area.
As part of the B3 strand, a group of researchers headed by Drs Hannah Sallis, Robyn Wootton and Adele Wang held a symposium in January 2020 on causal predictors of mental wellbeing. The attending researchers, non-academic collaborators and advocacy groups focused on three ESRC (Economic and Social Research Council) strategic priority areas - education, social isolation and health behaviours - such as smoking, drinking or exercise.
“The symposium was directly off the back of the Elizabeth Blackwell Institute funding, and the team organised an event with various stakeholders. I think that many came away with lots to work with. The team had also gathered many ideas for future research, including some on substance use, which fed into a grant that Dr Sallis recently won. They are also sharing ideas with other groups around the university on topics such as social inequality, parenting, help seeking behaviours and social media - they are planting the seeds of a large amount of new work in these areas. And this is clearly hugely important from a COVID-19 perspective - mental health is almost ‘pandemic number two’, following on from 2020," Professor Huxtable said.
Good grief
The pandemic also encouraged flexibility within the networks that had previously been established. The Palliative and End Of Life Care Research Group established by Dr Lucy Pocock, Dr Lucy Selman and Dr Charlotte Chamberlain, facilitated collaborations across University of Bristol and with external collaborators and members of the public. As well as generating grant applications, it also aimed to increase public engagement about palliative and end-of-life care, and to improve the impact of University of Bristol research.
Pre-COVID-19, the Group hosted three meetings of the wider research network and facilitated a popular public event with Dr Kathryn Mannix (author of the book, With The End In Mind). Following this event, 15 members of the local community were recruited to form a Patient and Public Involvement (PPI) panel to work alongside the research network.
“Based broadly within health sciences, this Group has membership from across the University and far beyond,” commented Professor Huxtable. “One of the co-leads, Dr Selman, went on to become the founding director of the Good Grief festival. It was so successful that they went on to run a second. This feels to me like one of the projects that's going to become part of the landscape in the future.”
The Wellcome Trust funded festival included participants from the Group alongside other small grant holders from the strand, a wide range of external collaborators and an extensive roster of high-profile speakers. The festival moved online due to COVID-19 and ran in October 2020 and then again in March 2021.
Dr Lucy Selman, festival founder and director: “We have used the strand’s Research Network as a way of strengthening our own network of collaborators and disseminating information about our research and public engagement activities,” she said.
Death and loss talk
This is not the only example of the possibilities of collaborative flexibility, however, nor of the B3 strand’s impact in the wider communities’ interaction with grief.
“One of the projects I was involved in was called ‘Investigating Death and Loss Talk in an Age of Longevity’”, said Professor Cameron. “Building on contacts made through the strand and existing work led by Professor Karen West, our work developed with the pandemic into a very specific piece of work about bereavement and bereavement support within extra care housing during the pandemic.”
The project then pooled its resources with colleagues in the Bristol Medical School in an event called ‘Compassionate Communities’ - aiming to address loneliness and related-health issues, by putting compassion and kindness at the centre of healthcare.
Active motherhood
The beginning of life can also pose challenges to society and individuals - specifically mothers. Led by Dr Fiona Spotswood with Drs Miranda Armstrong and James Noble, ‘Mothering and physical activity: an exploratory project for public health’ examined the relationship between motherhood, activity levels and the cultural, community and individual expectations of physical activity in deprived areas. The original study went on to feed into a variety of new and extant projects which are still ongoing, as Dr Spotswood explains: “I applied for funding for the Mothering project - a small study, which aimed to develop ideas around mothering, physical activity and social practice theory. I’d been speaking to Bristol City Council about it, and I was invited onto their bid to Sport England for their successful Bristol Girls Can (BGC) project.”
Part of the funding from the Elizabeth Blackwell Institute was used to disseminate the research findings to Children’s Centre stakeholders to form the foundation of the collaboration underpinning the Bristol Girls Can project.
“The project focused on motherhood, rather than on barriers, opportunities at an individual level,” said Dr Spotswood. “But the temporal perspective of motherhood that we assessed very much informed how we thought more broadly about the BGC project.”
They interviewed 15 mothers from deprived areas of Bristol about their perspectives on physical activity; their lives, histories and daily routines.
“We found that the concept of physical activity for these mothers was really emotionally fraught. But if you understand their lives and routines, it becomes clear that physical activity is often made impossible by the practices of mothering.”
The strand-funded study resulted in a paper published in the Sociology of Health & Illness “We’re just stuck in a daily routine”: Implications of the temporal dimensions, demands and dispositions of mothering for leisure time physical activity. It has also resulted in further projects with UK-wide implications.
“I’ve been invited on an advisory group for Public Health England,” said Dr Spotswood. “Social practice theory opens up different perspectives and has informed a number of different projects that I'm working on to do with mothering, physical activity and social marketing with a much broader impact.”
Infants over time
A more overarching view of child-rearing in the past, and its implications, was the focus of a project headed by Dr Francesca Fulminante, of the Department of Anthropology and Archaeology.
The project, ’Inter-discipIinary Approaches to the Lives of Infant and Children in Past and Present Urban Communities: Promoting Debate to Shape Current Policies in Health and Education’, included cross collaborations with ALSPAC (the Avon Longitudinal Study of Parents and Children) researchers, on grants to compare the link between breastfeeding, child health and development and economic growth, and the how these relationships have changed over time.
Dr Fulminante has also liaised with midwifery and human milk organisations for future work. She said, “The idea is to do some events and to ascertain how my project and its results could be more useful for their work. COVID-19 has interrupted this aspect, but we have many plans in place.”
The strand has also funded other projects related to breast feeding. The interdisciplinary project ‘Human Milk: Bodies, Boundaries and Barriers’, led by the team of Dr Suzanne Doyle Guilloud of the Bristol Law School and Drs Anna Pease and Roxanne Parslow of the Bristol Medical School, focused on facilitating partnerships and collaborations in the field of human milk exchange for the future.
Looking forward
The B3 strand may have finished, but the collaborations it has engendered have not. Perhaps the most valuable component of all the strands is not the papers generated, nor the funding acquired, but the introductions made, and the sheer potential that these have for novel research in the future.
Professor Huxtable: “Bristol has huge expertise and strengths in this area, from numerous disciplines - and although some of us have contacts in other disciplines, others might not know who to approach and how to approach them.
“I suppose we were particularly mindful of those who might not have had those interdisciplinary conversations before, so I was delighted that some of the strand was not purely impact driven. For example, we’ve got a group who are studying silence - the Capturing Intangibles group, in the School of Geographical Sciences. The co-leads are from English (Dr Arthur Rose), Law (Dr Colin Nolden) and Geography (Dr Eleni Michalopoulou). That collaboration wouldn't have happened without the B3 strand’s backing. I don't know what the outcome will be; in a way, it doesn't matter as long as those conversations are happening. And it means that colleagues across those different school structures are talking.”
“So even with COVID-19, we have links now that didn't exist before. How we build on that will be the next challenge - thanks to the pandemic the last year has just intensified everything - so it’ll be great to shift our attentions on to nurturing these new connections and taking these possibilities forward.”