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Playwork is a recognised profession in the United Kingdom (UK) and is currently a growing area of interest internationally. However, debates about the nature and purpose of playwork have raged in the playwork field since the profession was invented in the early adventure playgrounds. This study is the first to capture data about what the now international playwork workforce understands to be the purpose of playwork. The International Playwork Census (IPC) was an online survey which asked participants from 19 different countries about their knowledge and experience of playwork. This paper reports on one question from the IPC: what is the purpose of playwork? A thematic analysis was undertaken from 193 responses on what was considered "the purpose of playwork" and three themes emerged: Facilitate and Provide for children's play; Support and Advocate. This paper describes how these three themes reflect both the historical change in understandings of the purpose of playwork and how different understandings of playwork are developed through the experience of practitioners working in range of different contexts.

Objective: This study examined the inter-rater agreement between child-self and parental proxy health-related quality of life (HRQoL) ratings (overall and domain level) using two different generic child-specific measures, the Child Health Utility 9D (CHU9D) and the Pediatric Quality of Life Inventory (PedsQL TM ), in a community-based sample of Australian children. A secondary objective was to investigate the impact of age on child-parent agreement across the dimensions of the two measures., Methods: A total of 85 child-parent dyads (children aged 6-12 years) recruited from the community completed the self and proxy versions of the CHU9D and the PedsQL TM , respectively. The inter-rater agreement was estimated using Concordance Correlation Coefficients (CCC) and Gwet's Agreement Coefficient (AC 1 ) for the overall sample and across age-groups., Results: Agreement was low for overall HRQoL for both the CHU9D (CCC = 0.28) and the PedsQL TM (CCC = 0.39). Across the CHU9D dimensions, agreement was the highest for 'sad' (AC 1 = 0.83) and lowest for 'tired' (AC 1 = 0.31). The PedsQL TM demonstrated stronger agreement (AC 1 = 0.41-0.6) for the physical health dimension but weaker for the psychosocial dimensions (AC 1 < 0.4). Except for the 'tired' dimension, agreement was consistent across age-groups with the CHU9D, whilst the PedsQL TM showed poor agreement for most of the psychosocial health items among the older age-groups only (8-10 and 11-12 years)., Conclusion: This study highlights that the agreement between child and parent proxy reported HRQoL may be influenced by both the measure used and the age of the child. These findings may have implications for the economic evaluation of healthcare interventions and services in child populations when both child and proxy perspectives are considered in the assessment of child HRQoL., (© 2023. The Author(s).)

We evaluate the role of behavioral attributes in predicting engagement in an intervention program. Distinct from the previous studies, we investigate how parental preferences influence their engagement behavior in a health program when the targeted outcomes relate to the health of their children, as opposed to their own. We use an artifactual field experiment where the participants were former parent enrollees in a child health management program in Australia. Our findings suggest that parents' time preference and risk tolerance are robust predictors of engagement, measured by program attendance. Attendance is positively associated with patience and risk tolerance in the health domain, after controlling for a host of personality traits and socioeconomic factors. By improving our understanding of the behavioral risk factors for attrition, these findings offer important insights for enhancing participant engagement in intervention programs that are beset with the problem of high attrition., (© 2021 John Wiley & Sons Ltd.)

Objective: Patient-reported outcomes of health-related quality-of-life (HRQoL) are important descriptors of population health. A recent Australian adolescent population survey provided a unique opportunity to derive preference-based HRQoL., Methods: Data from 2967 adolescents aged 11-17 years were analysed. An interviewer-led parent/carer questionnaire was administered for demographic variables and mental disorders of adolescents during previous 12 months using the Diagnostic Interview Schedule for Children. A self-report survey was administered to derive HRQoL using the child health utility nine-dimensions instrument (CHU-9D). Weighted HRQoL was derived for several demographic groups, mental disorder diagnosis, and youth risk behaviours., Results: The total population had a mean utility of 0.78 [standard deviation (SD): 0.20]. Males had a significantly higher mean utility (0.81, SD 0.18) than females (0.76, SD: 0.21) (Cohen's d = 0.23, p < 0.001), and utility decreased with age for both males and females (p < 0.001). Family type and some parent/carer variables were associated with significant lower HRQoL scores with small effect size. Youth risk behaviours were associated with reduced HRQoL with moderate effect sizes. Adolescents who self-harmed, had suicidal ideation, or had a mental disorder had significantly lower utilities scores with moderate to large effect sizes compared to those who did not have such conditions., Conclusions: This study has provided contemporary Australian population norms for HRQoL in adolescents that may be used as cross comparison between studies as well as indicators allowing estimation of population health (e.g. estimation of the burden of disease) and can be used to populate future economic models., (© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: Parents' play a proactive role in seeking health information to ensure optimal growth and development for their children. To date, very little is known about the differences between information seeking behaviour for child health and engagement with resources between culturally and linguistically diverse (CALD) and non-CALD parents., Objective: To investigate the differences in resources used and trusted for information related to child health behaviours and engagement with online features among CALD and non-CALD respondents in Australia., Methods: An analysis of a theory informed online cross-sectional survey was conducted using data from 122 CALD and 399 non-CALD parents who had a child younger than 24 months or were currently pregnant in Australia. Descriptive statistics and chi-squared were used to compare the differences, and logistic regression models were used to identify factors associated with using health resources., Results: The most trusted sources for information reported by respondents were health professionals (76.2 %), websites run by health professionals (59.5 %), and government websites (53.2 %). Social media was significantly more trusted as a source of information for child health behaviours among CALD respondents than non-CALD respondents (odds ratio (OR) 1.92, P = 0.01). In contrast, booklets/ pamphlets and friends were significantly more trusted by non-CALD parents than for CALD parents (OR 0.54, P = 0.02). General search engines were used very frequently among CALD respondents for child health information (39.3 % vs 24.1 %, p = 0.013). Overall, the most common features respondents enjoyed on websites were images (81 %), videos (40.1 %), and discussion forums (39.9 %). CALD respondents significantly favoured videos (p = 0.003) while non-CALD respondents preferred obtaining information through attachments (p < 0.001)., Conclusions: Despite parents' reporting health professionals, websites run by health professionals, and government websites as trustworthy, general search engines and social media were still the most frequently used information source for parents with young children. Credible resources parents deem as trustworthy should take into account effective and engaging means of disseminating information that are accessible to both CALD and non-CALD communities., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

The article describes a quality improvement project aimed at reducing the incidence of pressure injuries in children caused by peripheral intravenous cannulaes (PIVC), conducted at a general children's ward in a hospital in Far North Queensland. Topics discussed are pressure injuries specific to PIVC, modification of PIVC audit tool to observe the effect of the changes made to PIVC care, staff education and adoption of practice changes, and ethical considerations for conducting the project.

Objectives: To identify features of mental health services that affect the uptake of services among parents of children with chronic medical conditions, to inform the design of pathways into mental health care. Methods: A discrete choice experiment in which participants made choices between hypothetical mental health services described in terms of service features: cost, wait time, provider knowledge of chronic medical conditions, recommendations, opening hours, and travel time. Participants were parents of children attending The Royal Children's Hospital outpatient clinics for the management of a chronic medical condition who completed the online survey between August 2020 and January 2021. The uptake of mental health services with differing features was predicted based on regression models examining the relationship between choice and service features, and accounting for participant characteristics and unobserved heterogeneity. Results: The sample comprised 112 parents, of whom 52% reported unmet needs. The most influential service features were wait times, cost, recommendation from medical specialists, and mental health provider knowledge of chronic medical conditions. Predicted uptake of a realistic service showed inequalities across income, parental education, and single parent status. A service comprising preferred features was predicted to eliminate these inequalities. Conclusions: Reducing cost and wait time for mental health services could reduce unmet need among children with chronic medical conditions. Specific approaches to tackle the high levels of unmet needs in this group include equipping medical specialists to recommend mental health providers and training mental health providers on the impacts of chronic medical conditions on children. Offering preferred services could increase uptake and reduce inequalities in mental health care. What is known about the topic? Children with chronic medical conditions have high rates of unmet need for mental healthcare. Qualitative research has indicated features of mental health services that may be important to consider in service design to address these unmet needs. What does this paper add? A detailed understanding of parents' preferences for features of mental health services for children with chronic medical conditions, including their importance and prediction of uptake under different scenarios. What are the implications for practitioners? Parents preferred services with recommendation from specialists, mental health providers who understand the impact of chronic conditions, lower cost, and shorter wait time. Offering preferred mental health services is predicted to significantly reduce unmet needs and reduce inequalities in care. [ABSTRACT FROM AUTHOR]

Objective: We aim to reflect on the introduction of risk-based approaches to public health, driven by legislation outlining the expected local government public health functions and roles by identifying factors that most influenced organisational change within the Western Australia local government sector when developing and submitting child and young people's health and social policy to an annual Awards program., Methods: This paper uses 10 years of data from a WA-based Local Government Policy Awards scheme to identify planned organisational change within the local government sector by applying a tangible organisational change model to develop a change narrative to describe factors that influenced local governments to address public health. Semi-structured interviews of 83 local government officers over the 10 years since implementation were used to create the narrative and identify factors that strengthened or hindered policy development and implementation at the local organisational level., Results: Participant interviews highlighted that the Policy Award Scheme contributed to steps outlined in the Pettigrew et al. (1992) stepped model of organisational change theory to support policy development. Implications for public health: Few studies have explored these elements in their own right. We argue that advocacy for structured policy development is continually needed to support and promote internal policy prioritisation and implementation in practice., (© 2021 The Authors.)

Preference weights are widely used to score generic health states into utility indexes for estimation of quality adjusted life years (QALYs) and to aid health care funding decisions. To date, health state utilities are predominantly derived using stated preference methods based on decision utility. This paper tests an alternative and generates preference weights using experienced utility for children based on the Child Health Utility 9D (CHU9D) descriptive system. We estimate the relative values of the CHU9D health states with regard to experienced utility, where experienced utility is approximated by self-reported happiness. A nationally-representative longitudinal survey was used including 6090 Australian children aged 12–17 years surveyed over 2014–2018. The derived weights were then applied to calculate the utility decrements for a few common child health conditions. We found that the estimated utility decrements are largely similar to those estimated using the published CHU9D Australian adolescent weights based on decision utility, except for pain and depression. A smaller utility decrement for pain and a larger utility decrement for depression were indicated by experienced utility. We contribute to the literature by showing that using experienced utility methods to generate preference weights for health states is possible, and we discuss some important methodological challenges for future studies such as the impracticability of anchoring to 'dead' when utilizing experienced utility. • Established methods of valuing health states rely on decision utility. • We use experienced utility to generate preference weights for children. • The estimated decrements for health conditions are similar to published weights. • We see smaller impact for pain, larger for depression compared to published weights. • Feasibility is demonstrated using child experienced utility for preference weights. [ABSTRACT FROM AUTHOR]

Background: Evidence on the relationship between air pollution and allergic sensitisation in childhood is inconsistent, and this relationship has not been investigated in the context of smoke events that are predicted to increase with climate change. Thus, we aimed to evaluate associations between exposure in two early life periods to severe levels of particulate matter with an aerodynamic diameter < 2.5 μm (PM2.5) from a mine fire, background PM2.5, and allergic sensitisation later in childhood. Methods: We measured specific immunoglobulin E (IgE) levels for seven common aeroallergens as well as total IgE levels in a cohort of children who had been exposed to the Hazelwood coal mine fire, either in utero or during their first two years of life, in a regional area of Australia where ambient levels of PM2.5 are generally low. We estimated personal exposure to fire-specific emissions of PM2.5 based on a high-resolution meteorological and pollutant dispersion model and detailed reported movements of pregnant mothers and young children during the fire. We also estimated the usual background exposure to PM2.5 at the residential address at birth using a national satellite-based land-use regression model. Associations between both sources of PM2.5 and sensitisation to dust, cat, fungi, and grass seven years after the fire were estimated with logistic regression, while associations with total IgE levels were estimated with linear regression. Results: No association was found between the levels of exposure at either developmental stage to fire-related PM2.5 and allergic sensitisation seven years after the event. However, levels of background exposure were positively associated with sensitisation to dust (OR = 1.90, 95%CI = 1.12,3.21 per 1 μg/m3). Conclusions: Chronic but low exposure to PM2.5 in early life could be more strongly associated with allergic sensitisation in childhood than time-limited high exposure levels, such as the ones experienced during landscape fires. [ABSTRACT FROM AUTHOR]

Background: Parents' Evaluation of Developmental Status, (PEDS), is a validated screening tool designed for primary health care clinicians to assess child development. Despite widespread use by local government child-nurse services, PEDS has not been tested in Australian general practice. We examined the effect of an intervention that aimed to use PEDS to improve documented assessment of child developmental status during routine general practice consultations. Methods: The study took place in a single general practice in Melbourne, Australia. The intervention included training of all general practice staff regarding PEDS processes and provision of PEDS questionnaires, scoring and interpretation forms. Mixed methods incorporated audits of clinical records of young children (1 to ≤ 5 years) before and after the intervention, and written questionnaires and a focus group (informed by the Theoretical Domains Framework and COM-B model) with receptionists, practice nurses and general practitioners. Results: Documented developmental status more than doubled after the intervention with almost one in three (30.4%) records documenting the PEDS tool. Overall, staff responses to questionnaires indicated that PEDS processes had been successfully implemented, half of the staff felt PEDS had developed their professional skills and clinicians expressed confidence using the tool (71%). Thematic analysis of the focus group transcript revealed divided reactions to PEDS screening with most barriers arising from general practitioners' motivation to use PEDS tools and perceptions of environmental constraints. Conclusions: A team-practice intervention that applied PEDS training and implementation, more than doubled documented rates of child developmental status during routine visits. Solutions to underlying barriers could be incorporated into a revised training module. Future studies need to test the tool in more methodologically robust studies that include analysis of the outcomes of developmental surveillance and long-term sustainability of PEDS use in practices. [ABSTRACT FROM AUTHOR]

Background: Parents' beliefs and behaviours affect children's nutrition, eating behaviours, and health outcomes; however, little is known about parents' experiences and perspectives on establishing a healthy diet with young children. Methods: A community‐recruited sample of 391 parents of young children (under age 5) completed an anonymous cross‐sectional online survey assessing the degree to which their children met recommendations outlined in Australian nutrition guidelines, perceived barriers to establishing a healthy diet with their child, and interest in receiving tips/information about establishing healthy eating habits with their children. Descriptive statistics illustrated proportions of children adhering to recommendations. Thematic analysis was used to analyse qualitative data. Results: Adherence to recommended nutrition guidelines varied across age groups. Most children across all age groups had water as their main drink, routinely consumed a variety of fruit, and consumed sweet drinks or fast foods only rarely. In contrast, less than half of 2‐ and 3‐year‐olds regularly consumed a variety of vegetables. The proportion of children consuming discretionary "treat" foods increased sharply over the first 2 years of life, and two thirds of 2‐, 3‐, and 4‐year‐olds consumed treat foods a few days per week or more. Parent‐reported barriers to establishing a healthy diet with young children included child behavioural factors (e.g., dislike of vegetables), parental influences (e.g., lack of time), family dynamics (e.g., influence of extended family) and external influences (e.g., external environment). Parents were most often interested in ways to modify child behaviour and information about child nutrition. Conclusions: Parents cite child behavioural issues as a major barrier to establishing a healthy diet with young children. Behavioural interventions that provide parents with information and support on how to establish a healthy diet with young children, as opposed to educational interventions focusing mainly on what children should be eating, may better meet families' needs. [ABSTRACT FROM AUTHOR]

Aim: The aim was to discover longitudinal trajectories and patterns of events preceding adolescent‐to‐mother family violence in a geographic locale in Australia. Design: This was a retrospective case series. Methods: Routinely collected administrative data were sourced and linked from police and health service electronic records for adolescents born between 1994 and 2006 who had been issued a legal action for a family violence‐related offence (n = 775). A time‐stamped log of events from birth (where available) was created. Process mining was employed to discover dominant events and trajectories in the log from birth until adolescents' first recorded offence against their mother. Results/Findings Most adolescents in the case series offended against mothers (63%, n = 486). Trajectory analysis confirmed dominant early childhood events were repeated exposure to parental intimate partner violence (P‐IPV), parental drug and/or alcohol use and neglect. During early adolescence, pathways towards adolescent‐to‐mother violence involved other offending, drug and/or alcohol use and mental health service contact. Conclusion: The trajectories evidenced provide a complex picture of the emergence of adolescent‐to‐mother violence. From an early intervention perspective, it was found that many children and mothers were identifiable from police records in early childhood, at an average age of 35 months. Responses to adolescent family violence need to acknowledge the impact of childhood trauma and emerging mental health problems, along with strategies to mitigate the effect of P‐IPV on mother‐to‐child relationships. Impact This is the first large‐scale study to specifically examine trajectories from birth for adolescents who engage in violence towards mothers. The findings have important implications for the design and delivery of early intervention childhood services and interagency collaboration in nursing and midwifery services. In early adolescence, contact with mental health services represents an opportunity for screening and support interventions. This is an important preventive timepoint for family violence, adolescent drug and alcohol use and other offences. [ABSTRACT FROM AUTHOR]

This study investigated parent-reported barriers and enablers to establishing sun safety practices with young children (0–4 years; N = 423) living in Australia. An online survey examined parent/child adherence to recommended sun safety practices and barriers and enablers to establishing sun safety practices. Adherence to different sun safety practices varied across age groups. Lack of child cooperation was the most commonly-endorsed barrier while child compliance was the most commonly-endorsed facilitator. Young children's lack of cooperation with sun safety practices represents a major obstacle for parents. In conclusion, the development and testing of family-based intervention approaches to reduce child resistance and promote cooperation is warranted. [ABSTRACT FROM AUTHOR]

The Child Dental Benefits Schedule (CDBS) is an ongoing scheme administered through the Australian Government providing eligible children funding for clinical dental treatment. This study aimed to investigate the access of dental services across children's early childhood and examine whether the CDBS has improved access to dental care. The longitudinal study of Australian children is an ongoing cross‐sequential cohort study with a representative sample of Australian children recruited in 2004. Birth (0–1 year) and kindergarten (4–5 years) cohorts were recruited through Medicare enrolment information at baseline and were representative of the Australian child population. Population‐weighted longitudinal mixed effects Poisson models with individual identifiers as a random effect were used to assess the effect of Medicare dental schedules on reported dental attendance. Prior to the implementation of the CDBS for both cohorts, the birth cohort reported the lowest attendance rate at age 4–5. The introduction of the CDBS increased the rate of dental attendance for the low household income group by 8% (95% CI: 1%, 15%) after adjusting for confounders. The model provides evidence that dental attendance increased with age and the Indigenous population have 31% (95% CI: 4%, 55%) lower attendance rate after adjustment. The increase in reported access to dental services and favourable visiting patterns in low‐income households during the operation of the CDBS provides some evidence that the schedule's primary aims to improve access to care in the child population are being met. Access to healthcare is multifaceted and the underutilisation of the schedule in the population warrants review of the schedule performance using other patient‐centred indicators. [ABSTRACT FROM AUTHOR]

Summary: ▪In this narrative review, we summarise the vast and burgeoning research on the potential and established indirect impacts on children of the COVID‐19 pandemic. We used a community child health lens to organise our findings and to consider how Australia might best respond to the needs of children (aged 0–12 years).▪We synthesised the literature on previous pandemics, epidemics and natural disasters, and the current COVID‐19 pandemic. We found clear evidence of adverse impacts of the COVID‐19 pandemic on children that either repeated or extended the findings from previous pandemics.▪We identified 11 impact areas, under three broad categories: child‐level factors (poorer mental health, poorer child health and development, poorer academic achievement); family‐level factors that affect children (poorer parent mental health, reduced family income and job losses, increased household stress, increased abuse and neglect, poorer maternal and newborn health); and service‐level factors that affect children (school closures, reduced access to health care, increased use of technology for learning, connection and health care).▪There is increasing global concern about the likely disproportionate impact of the current pandemic on children experiencing adversity, widening existing disparities in child health and developmental outcomes.▪We suggest five potential strategy areas that could begin to address these inequities: addressing financial instability through parent financial supplements; expanding the role of schools to address learning gaps and wellbeing; rethinking health care delivery to address reduced access; focusing on prevention and early intervention for mental health; and using digital solutions to address inequitable service delivery. [ABSTRACT FROM AUTHOR]

Background: Dire forecasts predict that an increasingly hostile environment globally will increase the threats to human health. Infants and young children are especially at risk because children are particularly vulnerable to climate-related stressors. The childhood diseases most affected, the breadth and magnitude of future health problems and the time frame over which these problems will manifest remain largely unknown.Objectives: To review the possibility that spacially explicit analyses can be used to determine how climate change has affected children's health to date and whether these analyses can be used for future projections.Methods: As an example of whether these objectives can be achieved, all available Australian environmental and health databases were reviewed.Results: Environmental and health data in Australia have been collected for up to 30 years for the same spatial areas at 'Statistical Area level 1' (SA1) scale. SA1s are defined as having a population of between 200 and 800 people and collectively they cover the whole of Australia without gaps or overlap. Although the SA1 environmental and health data have been collected separately, they can be merged to allow detailed statistical analyses that can determine how climate change has affected the health of children.Conclusions: The availability of environmental and health datasets that share the same precise spatial coordinates provides a pathway whereby past and emerging effects on child health can be measured and predicted into the future. Given that the future health and well-being of children is one of society's greatest concerns, this information is urgently needed. [ABSTRACT FROM AUTHOR]