Steph Taylor is trained and accredited in both Public Heath and Primary Care. She continues in clinical practice as a salaried general practitioner and has an honorary appointment in Public Health Medicine at Barts NHS Trust. Her doctorate was epidemiological, examining the early antecedents of childhood blood pressure, and she retains a research interest in adolescents’ well-being. However following her epidemiological training she made a conscious decision to work in applied health research and to try to address the clinical areas that most troubled her in clinical practice – principally patients struggling with the day to day issues involved in living with intractable, unglamorous long term conditions such as heart failure, chronic obstructive pulmonary disease and chronic pain.
Leading early systematic reviews she attempted to identify models of care which might benefit these patients. Her early, influential systematic reviews suggested that early discharge/ hospital at home schemes were a much better way to deploy respiratory nurse specialists rather than the (then prevalent model) whereby respiratory nurses carried a long term “caseload” of COPD patients in the community.
Combining considerable experience in systematic reviewing and clinical trials Prof Taylor now leads a programme of work looking at complex interventions for chronic conditions, particularly respiratory conditions; she retains an interest in behavioural interventions to improve the quality of life of older people in residential care and in adolescent well being. Her research falls under three broad headings.
1.Self-management support for long term conditions, including novel, more effective interventions to support people living with long term conditions and their carers. Prof Taylor’s group regard self management as the way people deal with the medical, role and emotional aspects of their long term conditions and that supporting and promoting effective self-management is inseparable from, and commonly underpins, good quality healthcare. Sub-optimal self-management not only impairs quality of life - in many long term conditions it also shortens life. Current strands of work range from: work understanding and improving participation in proven self-management support interventions; new work around self management support in dementia (for patients and their carers); and a novel behavioural intervention for cancer survivors; and (as a collaborator) to studying how people value self management support. Jointly with Pinnock (Edinburgh), she has led the development of a taxonomy of self-management support components which will be of use to researchers, commissioners and providers, and an extensive series of meta-reviews looking at the evidence to support self management across a 14 different long term conditions. She has also led a review of the evidence behind the implementation of successful self-management initiatives which has exposed the paucity of implementation research in this area and led to work on standards for reporting implementation studies.
2. Complex interventions to address the psychological co-morbidity associated with long term conditions:
One of the major co-morbidities associated with many long term conditions is psychological distress, namely anxiety and/or depression. Prof Taylor led a programme grant which culminated in a large trial of a self-management support intervention for people with chronic musculoskeletal pain (46 per cent of whom at baseline had possible depression, with an even higher prevalence of possible anxiety) which had a large and sustained effect on depression. She will build on his, and on her work on depression in elderly frail care home populations (led by Underwood, Warwick), to develop, evaluate and implement interventions directed at psychological distress in long term conditions, in particular respiratory conditions.
3. Adolescent well being Building on her contribution to three longitudinal studies of physical and mental well being in adolescents in east London (RELACHS) Prof Taylor suggested an evaluation of the impacts of the Olyimpics, and the urban regeneration associated with the Olympics, which is based around adolescent health and the health of adolescents families The ORiEL study is led by Cummins at LSH&TM.
3. Adolescent well being
Building on her contribution to three longitudinal studies of physical and mental well being in adolescents in east London (RELACHS) Prof Taylor suggested an evaluation of the impacts of the Olyimpics, and the urban regeneration associated with the Olympics, which is based around adolescent health and the health of adolescents families The ORiEL study is led by Cummins at LSH&TM.