There are a growing number of school-based interventions designed to promote children's social and emotional learning. One such intervention, PATHS (Promoting Alternative Thinking Strategies), was evaluated in a randomised controlled trial involving 5,074 pupils aged 4-6 years at baseline in 56 primary schools across a large city in the UK. The programme was implemented for two academic years. The primary outcome measure was the teacher-rated Strengths and Difficulties Questionnaire (SDQ). A secondary measure was the PATHS Teacher Rating Scale (PTRS). Observations of child and teacher behaviours were undertaken in a third of intervention and control schools using the Teacher-Pupil Observation Tool (T-POT). Regarding fidelity, dose and adherence were measured via weekly logs completed by teachers, and a semi-structured questionnaire completed by PATHS coaches was used as a global measure of fidelity (capturing adherence, dose and quality). A cost-consequence analysis examined programme costs from a multi-agency public sector perspective. At one year post-baseline there were no statistically significant differences between the programme and control groups on the SDQ subscales or the SDQ total difficulties and impact scores. There were statistically significant differences favouring the programme group for six out of 11 sub-scales on the secondary outcome measure (PTRS). At two years post-baseline, there were no statistically significant differences between the groups on either measure. Fidelity, according to the global measure, was relatively strong, and there was no relationship between fidelity and treatment effects. The average cost of PATHS was £12,666 per school or £139 per child. The study, which was fully powered and independent of the programme developer, shows no statistically significant effect of the programme on child behaviour or emotional well-being.3
The effectiveness of the Incredible Years preschool parenting programme in the United Kingdom: a pragmatic randomised controlled trial. Child Care in Practice, 23(2), pp. 141-161.
Over recent years there has been increased recognition of the importance of hearing the views of children and young people in and from care about the services and decisions that affect their lives. T give weight to and raise awareness of their experiences and outcomes and the need for policy and practice improvements. This paper discusses the development of methodologies for hearing and acting upon the voices of children and young people in care. It charts the journey towards increased levels of active involvement, from research participation and consultation to peer research and co-production. Using examples from our own empirical studies, the paper outlines key features of these different techniques and the opportunities, challenges and impact they engender. In early studies, views tended to be gathered via research interviews and analysed and presented by researchers. Consultation followed whereby children and young people were consulted on key decisions that might affect them. In more recent years there has been a transition towards greater participation through peer research and co-production in which children and young people are active and equal agents in the production of services designed to address their needs and in the design and production of research aiming to evaluate those services. Finally, we provide our reflections and those of some of the young people we have worked with to offer recommendations for meaningful and authentic engagement with the voices of care-experienced children and young people.
Parenting programs are effective in the early intervention and treatment of children’s social, emotional and behavioural difficulties. However, inconsistency in the use of outcome measures limits the comparability of programs and creates challenges for practitioners seeking to monitor progress of families in their care. A systematic review was conducted to identify measures, appraise their psychometric properties and ease of implementation, with the overall objective of recommending a small battery of measures for use by researchers and practitioners. This article provides an overview of the most commonly used measures in experimental evaluations of parenting programs delivered to parents of children up to, and including, the age of 5 years (including antenatal programs). An in-depth appraisal of the psychometric properties and ease of implementation of parent outcome measures is also presented (findings in relation to child and dyadic outcome measures are presented elsewhere). Following a systematic search, 64 measures were identified as being used in three or more of 279 included evaluation studies. Data on the psychometric properties of 18 parent outcome measures were synthesised from 87 development and validation studies. Whilst it was not possible to identify a definitive battery of recommended measures, we are able to recommend specific measures that could be prioritised in further research and development and hold promise for those seeking to monitor the outcomes of parents and children in receipt of parenting programs. Electronic supplementary material The online version of this article (10.1007/s10567-019-00276-2) contains supplementary material, which is available to authorized users.
We would like to acknowledge the Bowland Trust for providing seed funding to support the employment of a student intern who supported the research team in the coding of the group videos for this paper. We thank Annie Clarke for her coding work, Professors Judy Hutchings and David Daley for their qualitative feedback on the tool, the group facilitators, and parents for their participation.
This systematic review sought to identify observational measures of parent–child interactions commonly implemented in parenting program research, and to assess the level of psychometric evidence available for their use with this age group. Two separate searches of the same databases were conducted; firstly, to identify eligible instruments, and secondly to identify studies reporting on the psychometric properties of the identified measures. Five commercial platforms hosting 19 electronic databases were searched from their inception to conducted search dates. Fourteen measures were identified from Search 1; a systematic search of randomized controlled trial evaluations of parenting programs. For Search 2, inclusion/exclusion criteria were applied to 1327 retrieved papers that described the development and/or validation of the 14 measures identified in Search 1. Seventeen articles met the inclusion criteria, resulting in five observational measures for the final review. Data were extracted and synthesized using the COSMIN rating system to describe the methodological quality of each article alongside the overall quality rating of the psychometric property reported for each measure using the Terwee checklist. Measure reliability was categorized into four domains (internal consistency, test-re-test, inter-rater, and intra-rater). Measure validity was categorized into four domains (content, structural, convergent/divergent, and discriminant). Results indicated that the majority of psychometric evidence related to children aged from birth the three with internal consistency, inter-rater reliability, and structural validity the most commonly reported properties, although this evidence was often weak. The findings suggest further validation of the included measures is required to establish acceptability for the whole target age group. Electronic supplementary material The online version of this article (10.1007/s10567-019-00275-3) contains supplementary material, which is available to authorized users.
BackgroundThe use of patient-facing health technologies to manage long-term conditions is increasing; however, children and young people may have particular concerns or needs before deciding to use different health technologies.AimsTo identify children and young people’s reported concerns or needs in relation to using health technologies to self-manage long-term conditions.MethodsA scoping review was conducted. We searched MEDLINE, PsycINFO and CINAHL in February 2019. Searches were limited to papers published between January 2008 and February 2019. We included any health technology used to manage long-term conditions. A thematic synthesis of the data from the included studies was undertaken. We engaged children with long-term conditions (and parents) to support review design, interpretation of findings and development of recommendations.ResultsThirty-eight journal articles were included, describing concerns or needs expressed by n=970 children and/or young people aged 5–18 years. Most included studies were undertaken in high-income countries with children aged 11 years and older. Studies examined concerns with mobile applications (n=14), internet (n=9), social media (n=3), interactive online treatment programmes (n=3), telehealth (n=1), devices (n=3) or a combination (n=5). Children and young people’s main concerns were labelling and identity; accessibility; privacy and reliability; and trustworthiness of information.DiscussionThis review highlights important concerns that children and young people may have before using technology to self-manage their long-term condition. In future, research should involve children and young people throughout the development of technology, from identifying their unmet needs through to design and evaluation of interventions.
Objective Maternal mental health problems in the perinatal period can cause significant distress and loss of functioning, and can have lasting impact on children. People living in disadvantage are at risk of health inequalities, including for perinatal mental health. A review of current guidance found that overall implementation of the UK detection and management strategy was satisfactory, but equity was not considered in the review. Greater understanding of implementation equity is needed. We aimed to reanalyse an existing systematic review on the implementation of current guidance for the identification and management of perinatal mental health problems for equity. Methods Studies reporting the presence or absence of variation by a social, economic or demographic group were quality appraised and the presence and direction of disparity tabled. We calculated standardised absolute prevalence estimates for overall detection and management, and absolute and relative estimates by determinants grouping. A thematic analysis of the studies that examined potential reasons for disparity was undertaken. Results Six studies, with no major quality concerns, provided consistent evidence of reduced identification and management for ethnic minority women, both those who do, and do not, speak English. There was less consistent evidence of inequality for other axes of social disparity and for characteristics such as age, parity and partnership status. Explanations centred on difficulties that translation and interpretation added to communication, and hesitancy related to uncertainty from healthcare providers over cultural understanding of mental health problems. Conclusion The identification and management of perinatal mental health problems is likely to be inequitable for ethnic minority women. Further systems-based research should focus on clarifying whether other groups of women are at risk for inequalities, understand how mismatches in perception are generated, and design effective strategies for remediation. Inequalities should be considered when reviewing evidence that underpins service planning and policy decision-making.
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