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This report shares findings from a Nesta-funded rapid knowledge synthesis conducted by researchers at the University of Edinburgh's Centre for Biomedicine, Self & Society. We were asked to review innovative participatory approaches to public engagement that can be used by the Scottish Government to move beyond conventional engagement methods in the area of digital health and care. We conducted scoping conversations with key people inside the Scottish Government, in stakeholder organisations, and experts with experience of advising on or implementing engagement approaches. We also reviewed academic and 'grey' literature on a) participatory approaches to public engagement and b) approaches to public engagement that have been applied in the field of digital health and care.

The conditions in which we are born, grow, live, work and age are key drivers of health and inequalities in life chances. To maximise health and wellbeing across the whole population, we need well-coordinated action across government sectors, in areas including economic, education, welfare, labour market and housing policy. Current research struggles to offer effective decision support on the cross-sector strategic alignment of policies, and to generate evidence that gives budget holders the confidence to change the way major investment decisions are made. This open letter introduces a new research initiative in this space. The SIPHER (Systems Science in Public Health and Health Economics Research) Consortium brings together a multi-disciplinary group of scientists from across six universities, three government partners at local, regional and national level, and ten practice partner organisations. The Consortium’s vision is a shift from health policy to healthy public policy, where the wellbeing impacts of policies are a core consideration across government sectors. Researchers and policy makers will jointly tackle fundamental questions about: a) the complex causal relationships between upstream policies and wellbeing, economic and equality outcomes; b) the multi-sectoral appraisal of costs and benefits of alternative investment options; c) public values and preferences for different outcomes, and how necessary trade-offs can be negotiated; and d) creating the conditions for intelligence-led adaptive policy design that maximises progress against economic, social and health goals. Whilst our methods will be adaptable across policy topics and jurisdictions, we will initially focus on four policy areas: Inclusive Economic Growth, Adverse Childhood Experiences, Mental Wellbeing and Housing.

The role of ‘advocacy’ within public health attracts considerable debate but is rarely the subject of empirical research. This paper reviews the available literature and presents data from qualitative research (interviews and focus groups conducted in the UK in 2011–2013) involving 147 professionals (working in academia, the public sector, the third sector and policy settings) concerned with public health in the UK. It seeks to address the following questions: (i) What is public health advocacy and how does it relate to research?; (ii) What role (if any) do professionals concerned with public health feel researchers ought to play in advocacy?; and (iii) For those researchers who do engage in advocacy, what are the risks and challenges and to what extent can these be managed/mitigated? In answering these questions, we argue that two deeply contrasting conceptualisations of ‘advocacy’ exist within public health, the most dominant of which (‘representational’) centres on strategies for ‘selling’ public health goals to decision-makers and the wider public. This contrasts with an alternative (less widely employed) conceptualisation of advocacy as ‘facilitational’. This approach focuses on working with communities whose voices are often unheard/ignored in policy to enable their views to contribute to debates. We argue that these divergent ways of thinking about advocacy speak to a more fundamental challenge regarding the role of the public in research, policy and practice and the activities that connect these various strands of public health research.

Of all the social sciences, social policy is one of the most obviously policy-orientated. One might, therefore, expect a research and funding agenda which prioritises and rewards policy relevance to garner an enthusiastic response among social policy scholars. Yet, the social policy response to the way in which major funders and the Research Excellence Framework (REF) are now prioritising ‘impact’ has been remarkably muted. Elsewhere in the social sciences, ‘research impact’ is being widely debated and a wealth of concerns about the way in which this agenda is being pursued are being articulated. Here, we argue there is an urgent need for social policy academics to join this debate. First, we employ interviews with academics involved in health inequalities research, undertaken between 2004-2015, to explore perceptions, and experiences, of the ‘impact agenda’ (an analysis which is informed by a review of guidelines for assessing ‘impact’ and relevant academic literature). Next, we analyse high and low scoring REF2014 impact case studies to assess whether these concerns appear justified. We conclude by outlining how social policy expertise might usefully contribute to efforts to encourage, measure and reward research ‘impact’.

Policy researchers face a range of pressures to incorporate the perspectives of ‘hard-to-reach’ groups in their research. In the specific case of public involvement policy in health (one example of the growing field of citizen participation initiatives in administrative contexts), researchers have struggled to accomplish this without compelling research participants to enter into a policy discourse that is unfamiliar and may be at odds with their self-understood roles as patients and citizens. This paper presents findings from an interpretive project which sought to understand the perspectives of young adults on local practices of public involvement in a socio-economically deprived area of Scotland. It recounts the researcher’s shifting standpoint in response to silences and absences within young adults’ reaction to the project, and argues that the everyday ‘tactics’ young adults described using in their interactions with health services be reimagined as relevant, albeit challenging forms of citizen participation.