areas of expertise
Geoff Bates is currently completing a PhD with the Public Health Institute (PHI) under the supervision of Dr Conan Leavey (PHI), Dr David Tod (School of Sport and Exercise Sciences, LJMU) and Lisa Jones (PHI).
The research entitled ‘Exploring decision making regarding the use of drugs used for muscular enhancement to inform engagement and behaviour change interventions’ will investigate determinants for decision making regarding the use of drugs for muscular enhancement and the processes through which these decisions are made. The research comprises four studies utilising systematic review methods, Q methodology and in depth interviews. Together they will generate a body of evidence regarding decision making relating to drugs used for muscular enhancement and opportunities for intervention informed by the context of theories of decision making and behaviour change. It is proposed that the evidence emerging from this research will inform the development of a behaviour change intervention following completion of this project.
Before starting his PhD research Geoff was employed as a researcher at the Public Health Institute in the Evidence Review team and was responsible for producing systematic reviews and other evidence reviews on a broad range of public health topics. Geoff worked on a range of research projects including a national survey of performance enhancing drug users and systematic reviews around the effectiveness of interventions relating to illicit drug use. Geoff’s main areas of interest are in harm reduction and prevention relating to substance misuse and in particular performance enhancing drug use. In addition he is interested in the application of evidence to the development of policy, and the development of effective public health guidance.
Geoff Bates's Publications
A rapid evidence assessment of the published evidence on drug treatment and recovery outcomes and international comparators: Full evidence report
In March 2015, Public Health England (PHE) were asked by the Department of Health to “review the evidence on: what can be expected of the drug treatment and recovery system and provide advice to inform future policy”. This rapid review of drug treatment and recovery outcomes was commissioned by PHE to support this process. The rapid review adopted a review of reviews approach to examine the effectiveness of interventions and services delivered within the framework of structured drug treatment.
Image and Performance Enhancing Drugs 2015 Survey Results
This report presents findings from the third year of the National IPED INFO Survey (formerly the Steroids and Image Enhancing Drugs Survey), the largest survey carried out with people who use image and performance enhancing drugs (IPEDs). The survey explores IPED use in Wales, England and Scotland and investigates the experiences of people who use IPEDs including their substance use, health and injecting behaviours. This work continues to add to the limited evidence base around the use of IPEDs, which is vital to support the design and implementation of services to this population.
Visit www.ipedinfo.co.uk for more information on the National IPED INFO survey and image and performance enhancing drugs.
Evaluation of the Liverpool Rehabilitation, Education, Support & Treatment (REST) Centre – Executive Summary
The Rehabilitation, Education, Support & Treatment (REST) Centre was developed as a means to diffuse the anti-social behaviour associated with street drinking in the city area of Liverpool, as well as being set up to provide support and pathways for alcohol treatment for street drinkers. The Centre for Public Health, Liverpool John Moores University was commissioned by Safer and Stronger Communities, Liverpool City Council to undertake an evaluation of the pilot of the REST Centre. The evaluation aimed to examine the impact of the REST Centre on street drinkers in Liverpool and of the broader effects within the wider community.
Geoff Bates's Papers
BMJ-British Medical Journal, 2016.
We welcome the news item on the role of harm reduction in the ‘fight’ against HIV1 and we broadly agree with the findings of the report The Case for a Harm Reduction Decade: Progress, Potential and Paradigm Shifts.2 Clearly harm reduction for people who inject drugs (PWID) is having a positive impact on HIV in places such as the Ukraine, Nepal and parts of China and Kenya. This is supported by evidence of the long term impact of harm reduction approaches in controlling HIV among PWID in the United Kingdom, Switzerland and Australia. The increased benefits of even a modest proportional shift in resource from the so called ‘War on Drugs’ to evidence based harm reduction policies is a compelling argument. However, in addition to addressing the needs of established drug injecting populations such as heroin and stimulant injectors, we must also get ahead of the curve in relation to emerging patterns of injecting drug use to reduce the number of new cases of HIV. The injection of image and performance enhancing drugs (IPEDs) has been largely overlooked in relation to blood borne virus risks. IPEDs are a collective term for anabolic steroids, growth hormones, other drugs to increase musculature and associated ancillary drugs, together with peptide hormones such as melanotan II (a synthetic melanocortin analogue) and other drugs that are used for enhancement purposes. A recent meta-analysis and meta-regression of 187 studies on anabolic steroid use indicated a global lifetime prevalence of 3.3%.3 IPED users are growing as a client group in many countries with long standing provision of needle and syringe programmes, such as Australia4 and the United Kingdom where many services now report that over half of their clients inject IPEDs.5 Furthermore, in the United Kingdom there is conclusive evidence of HIV being present within this group of PWID, with an HIV prevalence of 1.5%6 amongst men injecting IPEDs, a level that is comparable to that among those injecting opioids and/or stimulants in the UK. Finally, there is evidence that people using IPED are a very sexually active population with low rates of condom use suggesting a risk of HIV transmission through their sexual networks.6 The use of IPEDs and in particular the injection of anabolic steroids by men, must be viewed as a serious public health concern requiring the attention of policy makers. Addressing the needs of emerging and often hidden populations of PWID should be part of the focus for harm reduction interventions. 1 BMJ 2016;352:i1479 2 Harm Reduction International. The case for a harm reduction decade: progress, potential and paradigm shifts. 2016. www.ihra.net/harm-reduction-decade 3 Sagoe D, Molde H, Andreassen CS, et al. The global epidemiology of anabolic-androgenic steroid use: a meta-analysis and meta-regression analysis. Ann Epidemiol 2014;24:383-98. 4 Iversen J, Topp L, Wand H, et al. Are people who inject performance and image-enhancing drugs an increasing population of Needle and Syringe Program attendees? Drug Alcohol Rev. 2013;32:205-7. 5 Kimergård A, McVeigh J. Variability and dilemmas in harm reduction for anabolic steroid users in the UK: a multi-area interview study. Harm Reduct J 2014;11:19. 6 Hope VD, McVeigh J, Marongiu A, et al. Prevalence of, and risk factors for, HIV, hepatitis B and C infections among men who inject image and performance enhancing drugs: a cross-sectional study. BMJ Open 2013;3:e003207.
Relationship between alcohol-attributable disease and socioeconomic status, and the role of alcohol consumption in this relationship: a systematic review and meta-analysis
BMC Public Health, 15:400, 2015.
Abstract: Background: Studies show that alcohol consumption appears to have a disproportionate impact on people of low socioeconomic status. Further exploration of the relationship between alcohol consumption, socioeconomic status and the development of chronic alcohol-attributable diseases is therefore important to inform the development of effective public health programmes. Methods: We used systematic review methodology to identify published studies of the association between socioeconomic factors and mortality and morbidity for alcohol-attributable conditions. To attempt to quantify differences in the impact of alcohol consumption for each condition, stratified by SES, we (i) investigated the relationship between SES and risk of mortality or morbidity for each alcohol-attributable condition, and (ii) where, feasible explored alcohol consumption as a mediating or interacting variable in this relationship. Results: We identified differing relationships between a range of alcohol-attributable conditions and socioeconomic indicators. Pooled analyses showed that low, relative to high socioeconomic status, was associated with an increased risk of head and neck cancer and stroke, and in individual studies, with hypertension and liver disease. Conversely, risk of female breast cancer tended to be associated with higher socioeconomic status. These findings were attenuated but held when adjusted for a number of known risk factors and other potential confounding factors. A key finding was the lack of studies that have explored the interaction between alcohol-attributable disease, socioeconomic status and alcohol use. Conclusions: Despite some limitations to our review, we have described relationships between socioeconomic status and a range of alcohol-attributable conditions, and explored the mediating and interacting effects of alcohol consumption where feasible. However, further research is needed to better characterise the relationship between socioeconomic status alcohol consumption and alcohol-attributable disease risk so as to gain a greater understanding of the mechanisms and pathways that influence the differential risk in harm between people of low and high socioeconomic status.
Views and experiences of hepatitis C testing and diagnosis among people who inject drugs: Systematic review of qualitative research
Int J Drug Policy., 21st November, 2013.
Abstract: Background: Many developed countries are facing a major challenge to improve identification of individuals acutely and chronically infected with hepatitis C virus (HCV) infection. We explored the views and experiences of people who inject drugs (PWID) in relation to HCV testing, and diagnosis through a review and synthesis of qualitative research. Methods: Based on the thematic synthesis of qualitative research. Searches were conducted in 14 databases and supplemented by reference checking, hand searching of selected journals, and searches of relevant websites. Studies of any qualitative design that examined the views and experiences of, and attitudes towards, HCV testing and diagnosis among PWID or practitioners involved in their care were included. Key themes and sub-themes were systematically coded according to the meaning and content of the findings of each study which proceeded to the preparation of a narrative account of the synthesis. Results: 28 qualitative studies were identified. We identified a number of overarching descriptive themes in the literature, finding overall that PWID hold complex and differing views and experiences of testing and diagnosis. Three major themes emerged: missed opportunities for the provision of information and knowledge; shifting priorities between HCV testing and other needs; and testing as unexpected and routine. Evidence of missed opportunities for the provision of knowledge and information about HCV were clear, contributing to delays in seeking testing and providing a context to poor experiences of diagnosis. Influenced by the nature of their personal circumstances, perceptions of the risk associated with HCV and the prioritisation of other needs acted both to encourage and discourage the uptake of HCV testing. Undergoing HCV testing as part of routine health assessment, and an unawareness of being testing was common. An unexpected positive diagnosis exacerbated anxiety and confusion. Conclusion: This review has identified that there are modifiable factors that affect the uptake of HCV testing and experiences of HCV diagnosis among PWID. Intervention development should focus on addressing these factors. There is a need for further research that engages PWID from a diverse range of populations to identify interventions, strategies and approaches that they consider valuable.