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Introduction: Co‐production with communities is increasingly seen as best practice that can improve the quality, relevance and effectiveness of research and service delivery. Despite this promising position, there remains uncertainty around definitions of co‐production and how to operationalize it. The current paper describes the development of a co‐production strategy to guide the work of the ActEarly multistakeholder preventative research programme to improve children's health in Bradford and Tower Hamlets, UK. Methods: The strategy used Appreciative Inquiry (AI), an approach following a five‐step iterative process: to define (Step 1) scope and guide progress; to discover (Step 2) key issues through seven focus groups (N = 36) and eight in‐depth interviews with key stakeholders representing community groups, and the voluntary and statutory sectors; to dream (Step 3) best practice through two workshops with AI participants to review findings; to design (Step 4) a co‐production strategy building on AI findings and to deliver (Step 5) the practical guidance in the strategy. Results: Nine principles for how to do co‐production well were identified: power should be shared; embrace a wide range of perspectives and skills; respect and value the lived experience; benefits should be for all involved parties; go to communities and do not expect them to come to you; work flexibly; avoid jargon and ensure availability of the right information; relationships should be built for the long‐term; co‐production activities should be adequately resourced. These principles were based on three underlying values of equality, reciprocity and agency. Conclusion: The empirical insights of the paper highlight the crucial importance of adequate resources and infrastructure to deliver effective co‐production. This documentation of one approach to operationalizing co‐production serves to avert any misappropriations of the term 'co‐production' by listening to service users, stakeholders and other relevant groups, to develop trust and long‐term relationships, and build on the learning that already exists amongst such groups. Patient or Public Contribution: The work was overseen by a steering group (N = 17) of individuals, both professional and members of the public with experience in undertaking co‐production, and/or with some knowledge of the context of the two ActEarly field sites, who provided regular oversight and feedback on the AI process. [ABSTRACT FROM AUTHOR]

The article presents an introduction to the 2003 issue of the "Children & Society" journal. Leading researchers and policy advisors in the children's field have been invited to assess how well the government of Great Britain is doing in reaching their objectives and to what extent services for children and young people have improved. The papers in this issue reflect some of the tensions and ambiguities within government policy. Whereas there is no shortage of activities, it is still too early to assess the effectiveness of much of what has been put in place. The reduction and eventual elimination of child poverty is perhaps the government's over-riding commitment and Jonathan Bradshaw's paper assesses trends in child poverty in Great Britain over the last 25 years. Health and well-being are a central component of the social inclusion in the agenda. The paper of Zarrina Kurtz outlines the impact that the government policies may have on outcomes for the physical and mental health of children but acknowledges that it is difficult to assess changes in health status as it relies heavily on proxy measures. The national child care strategy, with its emphasis on enabling parents to return to work, is also central to the government's anti-poverty strategy. Gillian Pugh considers what progress has been made towards a coherent policy for children under eight and concludes that much has been achieved through additional funding leading to an expansion of services and through a more integrated approach to planning and providing services across the statutory, voluntary and independent sectors.

The number of children with mental health problems is ever-growing; as a result, nearly 850,000 children in the UK are believed to have clinically significant problems, and only a quarter show evidence of mental illness. Family members often have a hard time dealing with children with mental health problems. As a result, digital mental health interventions are becoming popular for people seeking professional mental health services. Previous studies in this area have also shown that parents who are divorced or working away from home struggle to maintain contact with their children. This lack of communication between the parents and their children can worsen the children's mental health conditions and prevent early diagnosis. Human-centred design thinking is applied step by step in this paper to provide an intuitive understanding of the design process. Five stages of the design thinking process were examined to follow a correct path. The results were promising, and the feedback received assured that the product helps parents to better monitor their children's mental health and provides support when needed. The design thinking process was followed in concordance with the user needs identified from previous studies in this area, which led to a working solution that benefits both parents and children in tackling these problems. [ABSTRACT FROM AUTHOR]

Background: This paper presents insight into the scale of mental health concerns for families who have a child or young person with a diagnosis of Juvenile Idiopathic Arthritis (JIA) living in any of the four nations of the United Kingdom (UK). The study's objective is to share the current experiences of those that responded to a charity survey and consider future work to improve mental health support. Methods: This work was initiated and led by five UK charity partner organisations working with families affected by JIA. Parents/carers of a child or young person with JIA, and young people with JIA, submitted self-completion online questionnaires. The questionnaire asked 19 core questions, with a focus on the mental health impact of having and living with a JIA diagnosis. Questionnaires were delivered via charity partner UK-wide mailing lists and social media. Results: Questionnaire were completed by 291 participants over a 3-week period in February 2022. The majority of respondents were parents (229, 79%), 103 children had been diagnosed for over six years (35%), and 131 (45%) received shared care between paediatric rheumatology centres. In total, 168 (59%) children and young people with JIA had received, were currently receiving or were waiting for mental health support. Parents reported that their child's diagnosis impacted their own mental health (218, 82%). Children and young people reported never being offered mental health support during appointments for JIA (157, 54%), and 71 (50%) of these had never received support. Conclusion: Children and young people with JIA have significant mental health sequelae from their diagnosis. Our findings found that nearly 60% of our respondents have had or are requiring mental health support, with significant numbers of parents/carers reporting difficulties in accessing care for their child's mental health or their own mental health, due to their child's diagnosis. This unique collaborative charity-led study, illustrates the importance of timely and accessible mental health support. Further work is needed to understand why best practice guidance for mental health support is not being met consistently and to identify how to embed it into standard rheumatology care. [ABSTRACT FROM AUTHOR]

Objective: Mental health problems are a leading and increasing cause of health-related burden in children across the world. Peer support interventions are increasingly used to meet this need using the lived experience of people with a history of mental health problems. However, much of the research underpinning this work has focused on adults, leaving a gap in knowledge about how these complex interventions may work for different children in different circumstances. Realist research may help us to understand how such complex interventions may trigger different mechanisms to produce different outcomes in children. This paper reports on an important first step in realist research, namely the construction of an embryonic initial programme theory to help 'focus' realist evaluation exploring how children's peer support services work in different contexts to produce different outcomes in the West Midlands (UK). Methods: A survey and preliminary semi-structured realist interviews were conducted with 10 people involved in the delivery of peer support services. Realist analysis was carried out to produce context-mechanism-outcome configurations (CMOC). Results: Analysis produced an initial programme theory of peer support for children's mental health. This included 12 CMOCs. Important outcomes identified by peer support staff included hope, service engagement, wellbeing, resilience, and confidence; each generated by different mechanisms including contextualisation of psychoeducation, navigating barriers to accessing services, validation, skill development, therapeutic relationship, empowerment, and reducing stigma. Conclusion: These data lay the groundwork for designing youth mental health realist research to evaluate with nuance the complexities of what components of peer support work for whom in varying circumstances. [ABSTRACT FROM AUTHOR]

Participatory research is an empowering process through which individuals can increase control over their lives, and allows researchers/clinicians to gain a clearer understanding of a child's needs. However, involving children in participatory research is still relatively novel, despite national and international mandates to engage children in decision making. This paper draws on the learnings from designing the Management and Intervention for Asthma (MIA) study, which used a collaborative participatory method to develop an intervention-planning framework for South Asian children with asthma. There are currently 1 million children in the UK receiving treatment for asthma, making it one of the most prevalent chronic childhood illnesses. Symptoms of asthma are often underrecognized in children from South Asian communities in the UK, contributing to increased disease severity and increased attendance at the emergency department compared to White British children. Despite this, ethnic minorities are often excluded from research and thus absent from the 'evidence base', making it essential to hear their perspectives if health inequalities are to be successfully addressed. We worked alongside healthcare professionals, community facilitators, parents, and children to identify the key concerns and priorities they had and then designed the framework around their needs. Reflecting on the process, we identified several key considerations that need to be addressed when co-developing interventions with children. These include the power dynamics between the parent/researcher and child; navigating the consent/assent process; how parental involvement might affect the research; establishing a convenient time and location; how to keep children engaged throughout the process; tailoring activities to different levels of ability; and accounting for cultural differences. These factors were considered by the researchers when designing the study, however, implementing them was not without its challenges and highlighted the need for researchers to develop expertise in this field. Tailoring existing research methods allowed us to explore children's perceptions, priorities, and experiences of illness more effectively. However, involving children in participatory research is a complex undertaking, and researchers need to ensure that they have the expertise, time, and resources necessary to be able to fully support the needs of child participants before deciding to commit to this approach. Plain English summary: Involving families in health research gives children the opportunity to have more control over their healthcare and can help researchers/clinicians to better understand a child's needs. However, involving children in research is still an uncommon practice despite international pressures to include children in decision making. This paper reflects on the development of the Management and Intervention for Asthma study, which worked with communities to develop a framework for planning health interventions for South Asian children with asthma. There are currently 1 million children in the UK being treated for asthma, making it one of the most common chronic childhood illnesses. Symptoms of asthma are overlooked in children from South Asian communities in the UK, leading to worse health outcomes and more visits to the emergency department. We worked with the community to identify the key concerns and priorities they had, and then jointly designed the framework around their needs. We identified several key things to consider when co-developing interventions with children: Power dynamics Consent/Assent Parental involvement Time and location Engagement Diversity of needs Ethnicity and Culture Adapting our research and engagement methods to suit children's needs enabled us to involve them in the study in a way that allowed us to effectively explore their views, priorities, and experiences of their illness. However, researchers need to make sure that they have the expertise, time, and resources to be able to support the needs of child participants. [ABSTRACT FROM AUTHOR]

Obesity, along with its associated health issues, is closely tied to lifestyle habits. While certain elements affecting childhood health, such as genetics and ethnicity, are beyond individuals' control, there exists modifiable lifestyle behaviours that can facilitate healthier living. This study employed multiple regression analysis to investigate the relationship between specific modifiable lifestyle behaviours and self-reported health. The independent variables considered included days of moderate to vigorous physical activity (MVPA), fruit and vegetable consumption, breakfast frequency, school night sleep duration, and non-school night sleep duration. These variables were chosen for their practical modifiability within participants' daily lives. The analysis revealed a highly significant overall model (F(13,11363) = 191.117, p <.001), explaining 17.9% of the variance in self-reported health. Notably, higher MVPA levels were associated with improved self-reported health (B = 0.136 to 0.730, p <.001). Additionally, regular breakfast consumption and increased fruit and vegetable intake exhibited positive associations with self-reported health (B = 0.113 to 0.377, p <.001), while girls reported lower self-reported health (B = -0.079, p <.001). School night sleep duration was positively linked to self-reported health (B = 0.071, p <.001). Furthermore, a dose-response relationship between MVPA, dietary habits, and health was identified. These findings hold substantial potential for public health campaigns to promote healthy behaviours and prevent chronic diseases in young individuals. It is imperative to emphasise that all the variables considered in this study are readily modifiable aspects of individuals' lives, offering a promising avenue for personal health and well-being enhancement. [ABSTRACT FROM AUTHOR]

Background: Engaging in regular physical activity requires continued complex decision-making in varied and dynamic individual, social and structural contexts. Widespread shortfalls of physical activity interventions suggests the complex underlying mechanisms of change are not yet fully understood. More insightful process evaluations are needed to design and implement more effective approaches. This paper describes the protocol for a process evaluation of the JU:MP programme, a whole systems approach to increasing physical activity in children and young people aged 5-14 years in North Bradford, UK.Methods: This process evaluation, underpinned by realist philosophy, aims to understand the development and implementation of the JU:MP programme and the mechanisms by which JU:MP influences physical activity in children and young people. It also aims to explore behaviour change across wider policy, strategy and neighbourhood systems. A mixed method data collection approach will include semi-structured interview, observation, documentary analysis, surveys, and participatory evaluation methods including reflections and ripple effect mapping.Discussion: This protocol offers an innovative approach on the use of process evaluation feeding into an iterative programme intended to generate evidence-based practice and deliver practice-based evidence. This paper advances knowledge regarding the development of process evaluations for evaluating systems interventions, and emphasises the importance of process evaluation. [ABSTRACT FROM AUTHOR]

Poor participant engagement threatens the potential impact and cost-effectiveness of public health programmes preventing meaningful evaluation and wider application. Although barriers and levers to engagement with public health programmes are well documented, there is a lack of proven strategies in the literature addressing these. This paper details the development of a participant engagement intervention aimed at promoting enrolment and attendance to a community-based pre-school obesity prevention programme delivered in UK children's centres; HENRY (Health, Exercise, Nutrition for the Really Young). The Behaviour Change Wheel framework was used to guide the development of the intervention. The findings of a coinciding focused ethnography study identified barriers and levers to engagement with HENRY that informed which behaviours should be targeted within the intervention to promote engagement. A COM-B behavioural analysis was undertaken to identify whether capability, opportunity or motivation would need to be influenced for the target behaviours to occur. APEASE criteria were used to agree on appropriate intervention functions and behaviour change techniques. A multi-level participant engagement intervention was developed to promote adoption of target behaviours that were proposed to promote engagement with HENRY, e.g. ensuring the programme is accurately portrayed when approaching individuals to attend and providing 'taster' sessions prior to each programme. At the local authority level, the intervention aimed to increase buy-in with HENRY to increase the level of resource dedicated to engagement efforts. At the centre level, managers were encouraged to widen promotion of the programme and ensure that staff promoted the programme accurately. HENRY facilitators received training to increase engagement during sessions, and parents that had attended HENRY were encouraged to recruit their peers. This paper describes one of the first attempts to develop a theory-based multi-level participant engagement intervention specifically designed to promote recruitment and retention to a community-based obesity prevention programme. Given the challenges to implementing public health programmes with sufficient reach, the process used to develop the intervention serves as an example of how programmes that are already widely commissioned could be optimised to enable greater impact. [ABSTRACT FROM AUTHOR]

This paper presents an overview of the importance of mental health services for unaccompanied asylum-seeking children in the United Kingdom. It reviews what mental health support appears to be available in the United Kingdom following an on-line search which took place in Spring 2021 and using information gathered through 22 interviews and focus groups with stakeholders. The latter group are defined as people working with asylum-seeking children. The primary stakeholders were local authority staff, although interviews were also conducted with local government associations (London Councils, the Local Government Association), NHS bodies and the voluntary sector. Often, further relevant stakeholders were identified during interviews. The report details the aims, methodology and context, before the findings are presented which is followed by recommendations for improving mental and social care provision for unaccompanied asylum-seeking children in the United Kingdom. [ABSTRACT FROM AUTHOR]

In recent decades, social housing in the UK has increasingly become the preserve of the poorest in society. This paper is the first to investigate how the child outcome penalties associated with social housing tenure have changed over time across UK cohorts. I compare the differences in the cognitive, mental health, and physical health outcomes of children in social housing with children in non-social housing and evaluate whether these tenure differences have changed between the 1970 British Cohort Study (BCS) and the 2000 Millennium Cohort Study (MCS). I find that in both cohorts, children in social housing exhibit worse outcomes across all three dimensions (cognitive, mental health, and physical health) than children in non-social housing. For cognitive and physical health outcomes, however, the tenure difference has narrowed between the two cohorts, while for mental health outcomes, the tenure difference has widened. These results suggest that children have experienced a relative worsening in their mental health outcomes across cohorts, but also a relative improvement in both their cognitive and physical health outcomes. The findings suggest that policies aimed at reducing tenure inequalities in child outcomes should focus on mental health development in the early years. [ABSTRACT FROM AUTHOR]

Despite an increased drive over the past two decades in Western societies to promote children's physically active play to improve their health, there are concerns that childhood has become less physically active. There are also fears that a previously naturally occurring aspect of childhood has become less authentically playful. Both trends highlight changes over time in the amount and type of play practiced by children and are often cited as consequences of generational shifts. Yet, research which analytically employs the concept of generation to connect changes to childhood with relevant social transformations is lacking. Inspired by Mannheim's conceptualisation of generations, this paper draws on life history interviews with 28 United Kingdom residents born between 1950 and 1994 to propose a fracturing of naturally occurring physical activity from childhood play. As shifts in childhood and parenting have become inextricably linked, this argument illustrates the impact of an intensification to parenting upon greater parental surveillance of increasingly organised forms of childhood physical activity at the expense of spontaneous play. Future physical activity policy should be sensitive to the social climate in which recommendations for children are made, as this places expectations upon parents due to how childhood is currently understood within neoliberal contexts. [ABSTRACT FROM AUTHOR]

This paper reviews 26 reports into deaths and serious abuse of children in families who were subject to the No Recourse to Public Funds (NRPF) rule. Our analysis illustrates vulnerabilities caused by exclusionary policies, exacerbating social deprivation and isolation experienced by the children and families and making it more difficult for professionals to respond in ways which safeguarded children's welfare. Drawing upon a social model for protecting children that requires recognition of the social determinants of harm and the economic, social and cultural barriers faced by families, we examine the experiences of children and families with NRPF who were the subject of a serious case review, and the responses of agencies responsible for safeguarding child welfare. We conclude with recommendations for practices aimed at promoting the rights and well‐being of children and families subject to NRPF rules. [ABSTRACT FROM AUTHOR]

This paper analyses the causal effects of different levels of mother's and father's education on child general and mental health, by applying a fixed effects instrumental variable panel data estimator with selection to nationally represented longitudinal data of over 13,000 observations in the United Kingdom from 2008 to 2019. The results reveal a negative association between mother's education and boys' mental health, potentially driven by relative rather than absolute levels of education between parents. Differences in educational attainment between parents signal unequal power and different values, which inhibits conflict resolution and commitment, leading to higher likelihood of breaking up, which in turn may negatively affect child mental health. On the contrary, no evidence is found of causal links between different levels of mother's and father's education on child health, indicating the relevance of potential environmental factors in the intergenerational transmission mechanism. This calls for more co-ordination of educational interventions with other economic policies, also taking economic cycle into account. [ABSTRACT FROM AUTHOR]

The publication of the fourth edition of Health for All Children (Hall 4) in 2003 marked a shift in health visiting towards a more targeted service. This paper aims to explore, through the accounts of health visitors, the impacts of this changed policy context for health visiting practice and for the health visiting profession. The study, upon which this paper is based, was a qualitative exploration carried out in one NHS locality with broad socio-economic diversity. Semi-structured interviews were undertaken with 16 health visitors. The data was analysed using thematic and narrative techniques. In the study health visitors expressed concerns about the impacts of Hall 4 on health visiting practice, particularly in relation to health visiting expertise and the increase focus on child protection work shaping health visiting practice. In conjunction, health visitors' accounts suggest low morale as a profession. The paper concludes that the impacts of future policy change on health visiting practice must be fully considered; and, measures taken to prepare and support health visitors through periods of policy change. [ABSTRACT FROM AUTHOR]

Background: Cluster randomised trials (CRTs) are increasingly used to evaluate non-pharmacological interventions for improving child health. Although methodological challenges of CRTs are well documented, the characteristics of school-based CRTs with pupil health outcomes have not been systematically described. Our objective was to describe methodological characteristics of these studies in the United Kingdom (UK).Methods: MEDLINE was systematically searched from inception to 30th June 2020. Included studies used the CRT design in schools and measured primary outcomes on pupils. Study characteristics were described using descriptive statistics.Results: Of 3138 articles identified, 64 were included. CRTs with pupil health outcomes have been increasingly used in the UK school setting since the earliest included paper was published in 1993; 37 (58%) studies were published after 2010. Of the 44 studies that reported information, 93% included state-funded schools. Thirty six (56%) were exclusively in primary schools and 24 (38%) exclusively in secondary schools. Schools were randomised in 56 studies, classrooms in 6 studies, and year groups in 2 studies. Eighty percent of studies used restricted randomisation to balance cluster-level characteristics between trial arms, but few provided justification for their choice of balancing factors. Interventions covered 11 different health areas; 53 (83%) included components that were necessarily administered to entire clusters. The median (interquartile range) number of clusters and pupils recruited was 31.5 (21 to 50) and 1308 (604 to 3201), respectively. In half the studies, at least one cluster dropped out. Only 26 (41%) studies reported the intra-cluster correlation coefficient (ICC) of the primary outcome from the analysis; this was often markedly different to the assumed ICC in the sample size calculation. The median (range) ICC for school clusters was 0.028 (0.0005 to 0.21).Conclusions: The increasing pool of school-based CRTs examining pupil health outcomes provides methodological knowledge and highlights design challenges. Data from these studies should be used to identify the best school-level characteristics for balancing the randomisation. Better information on the ICC of pupil health outcomes is required to aid the planning of future CRTs. Improved reporting of the recruitment process will help to identify barriers to obtaining representative samples of schools. [ABSTRACT FROM AUTHOR]

Purpose – This paper aims to examine, through a focus on the practice of child caring, how three qualities of childhood preciousness, vulnerability and unpredictability, are nurtured by being brought together as rationales for product re-design, innovation and diversification. The new parent of today is confronted with a myriad of products that are designed to “safeguard”, “guide” and “monitor” the young child and ensure its well-being. Design/methodology/approach – The paper draws on research into the organisation of encounter platforms that serve as communication forums for commercial practitioners and child carers, and includes insights derived from fieldwork and a cultural content analysis of the British retailer Mothercare, consumer exhibitions and brand–product websites. Findings – After providing a brief outline of the research on which this paper draws, the author present three ways in which child safety is present in the market that caters for young children and their care. This is followed by a discussion of two case studies, which respectively expand on how vulnerability and unpredictability are nurtured in commercial narratives. Originality/value – The author concludes by drawing out the implications of the risk-averse culture, which this creates. [ABSTRACT FROM AUTHOR]

The last two hundred years or so have seen the transformation of medical practice from a clinical art to the application of science to the diagnosis and treatment of disease. There has been a historical debate about how the use of technology and discoveries of the laboratory have become integrated within medical practice. In trying to understand the evolution of “scientific medicine,” this has generally focused on the tensions between the differing cultures, persons, and professions of the “laboratory” and “clinic” and sought to explain how they were resolved within specific institutions. This paper looks again at the “Glasgow School” (the subject of a number of seminal papers on this subject) and the forces that shaped it, by exploring the career of Leonard Findlay, whose training in Glasgow, and in Berlin (where he worked in a department in which science and medicine were integrated), defined a style of clinical medicine that formed the model for a new sort of university department of medicine in which clinicians and scientists worked side by side, albeit under the leadership of the former. As a clinician exposed in Berlin to the emerging new sciences of nutrition, microbiology, and immunology, which were particularly relevant to the care of sick children, Findlay created in Glasgow a department of medical pediatrics, which owed less to local factors, figures, and forces and more to his experience in Germany. [ABSTRACT FROM PUBLISHER]

Discusses the importance of building an evidence base in child public health and social welfare in Great Britain. Evidence-based research; Effects of income inequality and macro social policy on important health and welfare outcomes; Need for more work on the experience of childhood asthma.

Modern welfare regimes rest on a range of actors – state, market, family/households, employers and charities – but austerity programmes diminish the contribution of the state. While changes in this 'welfare mix' require support from the population, attitude studies have focused mainly on people's views on state responsibilities, using welfare regime theory to explain differences. This paper contributes to our understanding of the welfare mix by including other providers such as the market, the family or employers, and also introduces social risk theories, contrasting new and old risks. Regime theory implies differences will persist over time, but risk theory suggests that growing similarities in certain risks may tend to promote international convergence. This article examines attitudes to the roles of state, market, family, charity/community and employer for pension and childcare in Germany and the UK. We collected data using deliberative forums, a new method in social policy research that allows citizens space to pursue extended lightly moderated discussion and permits researchers to analyse people's justifications for their attitudes. Our research indicated patterns of convergence especially in preferences for childcare, but that regime predominates in people's justifications for their attitudes: regime differences in attitudes are resilient. [ABSTRACT FROM AUTHOR]

Title. Adequacy of health-related quality of life measures in children under 5 years old: systematic review Aim. This paper is a report of a systematic review to assess the adequacy of measures evaluating generic health-related quality of life outcomes in children less than 5 years old. Background. Evaluating generic health-related quality of life outcomes in children is important to assess the effectiveness of interventions, nursing care and services. Methods. A methodological systematic review was carried out for the period 1980–2005 in accord with the UK Centre of Reviews and Dissemination guidelines on systematic reviews. We searched multiple electronic databases, hand-searched key texts, and contacted investigators. We included all English language publications describing primary empirical research of generic health-related quality of life, health status, functional status or wellbeing measures, with published psychometric evidence. All measures (proxy and/or self-complete) for use in children under 5 years were included; single dimension measures were excluded. Results. Seventy-six papers (70 studies) referring to 16 generic health-related quality of life measures met our inclusion criteria. None of the 16 measures were adequate in terms of their conceptual content or psychometric criteria; quality scores were poor (0–8). No current, generic health-related quality of life measure is both psychometrically and conceptually robust, although the Health Utilities Index has the most comprehensive psychometric data published. However, not all dimensions of health are assessed, with little evidence of reliability in children under 5 years of age. Conclusion. There is a need to develop empirically robust and conceptually comprehensive health-related quality of life measures, particularly in the context of proxy-completion measures for very young children. [ABSTRACT FROM AUTHOR]

Purpose — To consolidate and review current literature that relates children's health to their housing and living environments. Design/methodology/approach — A range of published sources which review the relationship between children, housing and health. The sources consolidate research that applies specifically to children and their domestic situation. The paper also reviews literature around municipal tower block estates and the unique health/architecture relationship before turning to children living in temporary bed and breakfast accommodation. An overview of current public health policy that seeks to reintegrate housing and well-being is undertaken. Findings — Decent housing lies at the heart of health for all. Generally, the picture is more positive, but action remains slow. Children's needs must be given a higher priority in housing in future to promote physical and emotional well-being. Research limitations/implications — It is not an exhaustive list and the sources are mainly UK publications. Practical implications — The UK approach to children, housing and health may be of interest to a number of overseas countries in Eastern Europe, Africa and Asia. Originality/value — This paper fulfils an identified information/resources need and offers readers such as students, academics and practitioners an overview of the UK approach. [ABSTRACT FROM AUTHOR]

This paper explores the need for better links between research and practice in relation to work with children and health inequalities. Despite continuing discussion about the need to improve dissemination of research activity in general, study of this area remains largely neglected. As a result, despite the rhetoric, the research and practice gap continues to exist. An attempt to remedy this was undertaken through the support of a user fellowship as part of the UK Economic and Social Research Council Health Variations Programme. The paper describes a number of activities that were undertaken during the fellowship, and discusses the implications of these for improving connections and minimizing the research and practice 'gap'. It argues that a need exists for researchers to develop innovative dissemination strategies and suggests that potential exists for an interactive model of dissemination. Such a model implies a more active role for users of research in the shaping of research agendas. [ABSTRACT FROM AUTHOR]

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This paper is concerned with the impact on children's health and wellbeing resulting from the move from the Welfare State to welfare markets and explores the political trajectory that stimulated this sea change in U.K. welfare. Two services, child protection and children's day care, are examined to highlight how the separation of purchasing services from providing them have "commodified" children who have become objects with a use-value in commercial exchanges in internal or external markets. The paper concludes with an overview of the impact of "austerity" policies that exclude many children from welfare markets entirely and considers the consequences for the children of the U.K. [ABSTRACT FROM AUTHOR]

Introduction: Collaboration was legislated in the delivery of integrated care in the early 2000s in the UK. This research explored how the reality of practice met the rhetoric of collaboration. Theory: The paper is situated against a theoretical framework of structure, agency, identity and empowerment. Collectively and contextually these concepts inform the proposed model of 'collaborative agency' to sustain integrated care. The paper brings sociological theory on structure and agency to the dilemma of collaboration. Methods: Participative action research was carried out in collaborative teams that aspired to achieve integrated care for children, young people and families between 2009 and 2013. It was a part time, PhD study in collaborative practice. Results: The research established that people needed to be able to be jointly aware of their context, to make joint decisions, and jointly act in order to deliver integrated services, and proposes a model of collaborative agency derived from practitioner's experiences and integrated action research and literature on agency. The model reflects the effects of a range of structures in shaping professional identity, empowerment, and agency in a dynamic. The author proposes that the collaborative agency model will support integrated care, although this is, as yet, an untested hypothesis. [ABSTRACT FROM AUTHOR]

The purpose of this study was to gain a more cohesive understanding of the assets considered necessary to develop in young swimmers to ensure both individual and sport-specific development. This two-stage study involved (a) a content analysis of key papers to develop a list of both psychosocial skills for performance enhancement and assets associated with positive youth development, and (b) in-depth interviews involving 10 expert swim coaches, practitioners, and youth sport scholars. Five higher-order categories containing 17 individual assets emerged. These results are discussed in relation to both existing models of positive youth development and implications for coaches, practitioners and parents when considering the psychosocial development of young British swimmers. [ABSTRACT FROM PUBLISHER]

This paper provides an overview of the main sources of fluoride (F) in children and discusses the importance of assessing F exposure at an individual and community level. It describes some of the methods used to assess F exposure by estimating F intake and excretion, together with the development and use of biomarkers for F and their importance. The paper focuses on what recent F research has shown in terms of significant sources of dietary F intake in UK infants and young children and the proportion of F intake that derives from F ingestion of toothpaste. This information is considered in the context of clinical dental practice and the implications of this research for oral health discussed. [ABSTRACT FROM AUTHOR]

Large numbers of children and adolescents in Canada, UK and USA are not getting their recommended daily dose of moderate to vigorous physical activity, and are thus more prone to obesity and its ill health effects. Exergames (video games that require physical activity to play) are rapidly gaining user acceptance, and may have the potential to increase physical activity levels among young people. Mobile exergames for GPS (global positioning system)- enabled smartphones and mini-tablets take players outdoors, in the open air, unlike console exergames, e.g., Xbox 360 Kinect exergames, which limit players to playing indoors in front of a TV set. In this paper and its companion 'Additional file 1', we review different examples of GPS exergames and of gamified geosocial apps and gadgets (mobile, location-aware apps and devices with social and gamification features), and briefly discuss some of the issues surrounding their use. Further research is needed to document best practices in this area, quantify the exact health and fitness benefits of GPS exergames and apps (under different settings and scenarios), and find out what is needed to improve them and the best ways to promote their adoption by the public. [ABSTRACT FROM AUTHOR]

Aim: Counsellors who work with young people in a range of contexts know that they are not engaging with ‘mini‐adults’. The issues young people bring to counselling are often complex, challenging and wide‐ranging, as adolescents are experiencing times of turbulence and change in their physical, emotional, social and psychological development. This paper focuses on a research project undertaken with five counsellors who work with young people, and asks the question: ‘What works?’ Method: The research project is an in‐depth qualitative study into the counsellor's experience of counselling young people, using a narrative approach. Findings: Four key shared themes emerged: the significance of ‘safety’ in the relationship; building the therapeutic alliance; flexibility and integration relating to theoretical orientation; and the use of creativity. Outcomes: This paper offers counsellors the opportunity to reflect on ‘what works’ and consider the professional knowledge, which underpins their own counselling practice with young people. [ABSTRACT FROM AUTHOR]

Purpose – This paper aims to outline the duties placed upon public bodies towards children with acquired brain injuries. Design/methodology/approach – The paper outlines the key obligations owed to such children by local authority children's services and health bodies, dealing with the responsibilities of each and the duty to co-operate placed on them. It also discusses the avenues of redress open to families of children with brain injuries and the various ways they can ensure that public bodies comply with their obligations. Findings – The article summarises relevant law and avenues of redress that may be used where duties are not complied with. Originality/value – The paper provides an up-to-date summary of the relevant duties which includes reference to applicable case law and focuses particularly on how the law applies to children with acquired brain injuries. [ABSTRACT FROM AUTHOR]

More than half of all children entering care in the UK are infants and children under five. The emotional and mental health needs of this population tend to be overlooked. Research described in this paper aimed to find out about the experience of an infant or young child in care and to inform training and support for health and social care professionals. The study found that therapeutic observation with a looked-after infant was feasible and provided an in-depth perspective on the experiences of the baby and his foster carers. The paper outlines the clinical context, defines therapeutic observation, describes stages in the first year of life of the observed infant and his transition to adoption, discusses functions of the therapeutic observer, describes applications of the research and makes suggestions for further research. [ABSTRACT FROM PUBLISHER]

Child health promotion services in England have been revolutionised in the last decade, with a shift from a low-threshold universal service to a more highly targeted programme. This has affected health visitors' preventive healthcare work with families. This paper draws on findings from the qualitative arm of a mixed-methods study that aimed to explore how child health promotion reform has been implemented. The particular focus of this paper is on health visitors' experiences of the process of policy reform. In-depth semi-structured telephone interviews were conducted with 25 health visitors working in urban areas in England, and data were analysed thematically. Health visitors described policy change as being enforced, but views on the new programme were coloured by the extent to which practitioners retained the autonomy to offer a service according to their professional judgment. Where practitioners retained professional autonomy, services were adequately staffed and there was a functional working environment, then interviewees were positive about child health promotion reform. Where health visitors felt they could not offer an appropriate level of health promotion services, they had grave concerns about the impact on child public health. [ABSTRACT FROM AUTHOR]

This paper documents how health is storied into existence by 'obesity discourse' to become part of the 'natural attitude' towards the health of individuals or populations. We draw attention to some of the major policy documentation influencing thinking on 'health' and school health education in the UK over recent years, especially, every child matters (ECM) and subsequent, related measures, for example the National Healthy Schools Programme (NHSP). We suggest that these measures have helped shape and make a 'totally pedagogised society' and 'totally pedagogised schools' in which 'health', reduced to an issue of weight, exercise and diet, becomes everyone's concern, everywhere. The analyses highlight the socio-political and psychological leanings of such policy documentation and its potential effect on the identities of children and young people when institutionalised and 'authorised' through state policies and the body pedagogies of schools and multiple other agencies. [ABSTRACT FROM AUTHOR]

Food and drink are distributed via corporate institutions in categories, such as ready meals or carbonated drinks. Within these categories, a minority of brands advertise, capitalizing upon the popularity of the categories. The issue of childhood obesity and health has led to a focus upon these advertised brands in terms of their being targeted at children, but nothing has been done about the categories they represent. Furthermore, parents have an influence upon their children's diet, as their expenditure accounts for the majority of their children's consumption. This paper accounts for UK children's perceptions of the effect of advertising and marketing of food and drink upon their parents, and concludes that the children see advertising as having very little influence. Rather, they see that their parents' involvement with certain categories have become, over time, their norm. Children do not see that the regulation of advertising of food and drink to them will have any significant effect upon their diet, as their parents will continue to consume from within the categories supplied by the retail sector, which in their view constitutes the most influential aspect of food and drink marketing. Given the international focus upon the advertising of food brands, this paper draws attention to other, potentially more influential issues. [ABSTRACT FROM AUTHOR]

This paper considers the influences on children's eating habits in both school and home spaces in the UK. Since 2002 the UK government has been committed to halting the increase in child obesity rates, and has sanctioned particular parental and school based practices as more “healthy” than others. This study examines this through critically questioning, in particular, the classed discourses written into health education advice and advocates a new way of thinking about health education messages. Based on qualitative research with children from one secondary school and with eight families in the North of England the paper reveals that while parents and children make decisions about their lives with reference to dominant discourses about ideal “healthy” family eating practices, their ability to realise these practices is limited in numerous ways. Moreover, the influences on children's eating habits in both home and school spaces are intricately interrelated and children's practices are clearly influenced by the spaces they inhabit. Their decisions involve balancing health education knowledge with a range of other knowledges that are bound up in the socio-spatial relations of their everyday lives. A holistic approach to understanding children's eating habits therefore requires a critical understanding of class background, parental influences and contemporary parenting practices as well as the microgeographical relations found in the school dining room. [ABSTRACT FROM AUTHOR]

Background: Smoking in the home is the major cause of exposure to second-hand smoke in children in the UK, particularly those living in low income households which have fewer restrictions on smoking in the home. Reducing children's exposure to second-hand smoke is an important public health and inequalities issue. Drawing on findings from a qualitative Scottish study, this paper identifies key issues and challenges that need to be considered when developing action to promote smoke-free homes at the national and local level. Methods: Two panels of tobacco control experts (local and national) from Scotland considered the implications of the findings from a qualitative study of smokers and non-smokers (who were interviewed about smoking in the home), for future action on reducing smoking in the home. Results: Several key themes emerged through the expert panel discussions. These related to: improving knowledge about SHS among carers and professionals; the goal and approach of future interventions (incremental/harm reduction or total restrictions); the complexity of the interventions; and issues around protecting children. Conclusion: The expert panels were very aware of the sensitivities around the boundary between the 'private' home and public health interventions; but also the lack of evidence on the relative effectiveness of specific individual and community approaches on increasing restrictions on smoking in the home. Future action on smoke-free homes needs to consider and address these complexities. In particular health professionals and other key stakeholders need appropriate training on the issues around smoking in the home and how to address these, as well as for more research to evaluate interventions and develop a more robust evidence base to inform effective action on this issue. [ABSTRACT FROM AUTHOR]

Discusses the National Service Frameworks (NSF), one of Great Britain government's modernization program in health and welfare services. Aim of NSF to improve the lives of children and young people; Role of External Working Group (EWG) under NSF modules; Evidence-gathering of EWG.

Purpose The purpose of this paper is to assess the legacy of six pioneer child care researchers.Design/methodology/approach An assessment of the achievements of a generation of child care researchers.Findings The early researchers were not only highly innovative in terms of theory and methodologies but also left a set of studies that stimulated and informed subsequent studies.Originality/value A review of the work of six pioneering child care researchers. [ABSTRACT FROM AUTHOR]

This paper considers the merits of the school health service in England and Wales, viewed as a service for children of primary school age. The paper reports on data from a recent Economic and Social Research Council-funded study: Children's Health in Primary Schools. Data were collected through a randomly selected sample of 620 schools and through six case studies. The study found variation in the quantity and quality of the service; the service was not, in general, child-friendly. The paper argues, on grounds of efficiency, convenience and complementarity, that children should have access to a health service during their days at school, and one which is even in quality and quantity. © 1998 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This article analyses early years education policy in England from 1918 to 1972, applying the theoretical ideas of John Kingdon. Throughout this period, the educational needs of young children were a low political priority, but they did occasionally rise on the agenda. When the issue gained prominence, politicians considered two key policy alternatives for potential investment: the expensive, self-governing nursery school, orientated towards promoting children’s physical health, and the cheaper nursery class, attached to an infant school, perhaps better at easing transition to formal education. After an initial period of damaging indecisiveness, the choice fell first on nursery schools and then on nursery classes. The reason that such fundamental changes in approach were possible was that an underlying lack of political commitment meant policies were only ever partially implemented. This chaotic pattern of development has had a damaging effect on the coherence of early years services offered today. [ABSTRACT FROM PUBLISHER]

While many earlier studies have shown a positive correlation between parents' education and children health, little attempt has been made to address the possibility that unobserved characteristics underlie this intergenerational relationship. This paper explores the effect of additional schooling induced through compulsory schooling laws in Great Britain and Northern Ireland on child health as measured by long-term illness. Despite statistically significant ordinary least squares estimates, the instrumental variable estimates reveal little if any causal relationship between parental education and long-term illness in children. This is true for both two-parent and single-parent families. [ABSTRACT FROM AUTHOR]

Background Both the prevalence of childhood obesity and the consumption of sugar-sweetened beverages ( SSBs) have increased globally. The present review describes interventions that reduce the consumption of SSBs in children and determines whether this leads to subsequent changes in body fatness. Methods Three databases were searched from 2000 to August 2013. Only intervention control trials, ≥6 months in duration, which aimed to reduce the consumption of SSBs in >100 children aged 2-18 years, and reporting changes in body fatness, were included. The quality of selected papers was assessed. Results Eight studies met inclusion criteria. Six interventions achieved significant ( P < 0.05) reductions in SSB intake, although this was not always sustained. In the two interventions providing replacement drinks, significant differences in body mass index (12- or 18-month follow-up) were reported ( P = 0.001 and 0.045). The risk of being overweight/obesity was reduced ( P < 0.05) in three of the five education programmes but in one programme only for girls who were overweight at baseline and in one programme only for pupils perceived to be at greater risk at baseline. In the one study that included both provision of water and education, the risk of being overweight was reduced by 31% ( P = 0.04) in the intervention group. Conclusions The evidence suggests that school-based education programmes focusing on reducing SSB consumption, but including follow-up modules, offer opportunities for implementing effective, sustainable interventions. Peer support and changing the school environment (e.g. providing water or replacement drinks) to support educational programmes could improve their effectiveness. Home delivery of more suitable drinks has a big impact on reducing SSB consumption, with associated reductions in body weight. [ABSTRACT FROM AUTHOR]

Despite being largely preventable, dental caries is one of the most common diseases both in the UK and worldwide. Unmanaged dental caries may adversely impact a child and their quality of life. All healthcare professionals who have contact with children have an important role to play in improving the oral health of their patients. This can be achieved by delivering consistent, structured and supportive preventive messages and signposting to dental professionals when required. This paper outlines evidence-based guidance that should be followed to prevent dental caries, both on an individual and population basis. [ABSTRACT FROM AUTHOR]

The article explores the role of proactive schemes in schools in helping vulnerable children and preventing problems in later life. It references the green paper "Transforming Children and Young People's Mental Health Provision" published by the British Department for Health and Social Care and the Department for Education. Some skills that are important for children's future success are identified including self-awareness, self-regulation, relationship skills and self-efficacy.

Background: Teaching undergraduate medical students clinical skills in a child health setting is a particular challenge for clinical educators. Students spend less time with pediatric patients and have fewer opportunities to practice clinical skills. The coronavirus (COVID-19) pandemic further reduced students' opportunities to observe and practice skills in the workplace. This has necessitated a greater shift towards teaching skills in a "skills lab" setting, which allows for simulated practice in a safe environment. This study reports the design, implementation, and evaluation of a standardized course that utilizes the "skills lab" to train undergraduate medical students in five clinical skills important to child health. Objectives: This study aimed to implement and evaluate a standardized undergraduate clinical skills course for child health and improve students' confidence in performing child health clinical skills. Methods: Evaluations were carried out over approximately one academic year, with a total of 174 participants from a single medical school in the United Kingdom. Qualitative and quantitative data were collected, examining students' self-reported confidence (preand post-course) along with free-text course evaluations. A paired t-test was used to calculate the mean difference in students' preand post-course confidence scores. Qualitative evaluations were analyzed for themes using framework analysis. Results: The students had greater confidence in all measured learning outcomes following the course. Qualitative data, examined using framework analysis, suggested that the course was valued by students, who felt it was relevant to their future practice. Numerous written comments suggested particular content and teaching methods that were strengths of the course, including practical elements, small group teaching, and feedback from tutors. Conclusions: Implementing a child health clinical skills course in a skills lab setting is feasible and valued by students. The course increased the self-reported confidence of the studied cohort and might therefore support them in practicing these skills with actual patients. Further studies are required to determine whether these effects demonstrate longevity and whether they translate to increased competence in performing the taught skills. [ABSTRACT FROM AUTHOR]