Risk and teenage parenthood: an early sexual health intervention

Purpose - This paper outlines the development of a resource designed to support practitioners, who were not sexual health specialists, but who worked with young people who may be at risk of teenage pregnancy or parenthood. Its aim was to enable practitioners to carry out an assessment using a screening tool, and to use educational interventions designed to reduce risk-taking behaviour or refer to a sexual health specialist. We report a research project to examine the perceptions of practitioners who had used the resource. Design/methodology/approach – The resource was based on a local needs assessment and developed by a multi-agency working group. The research utilised an on-line questionnaire and telephone interviews with practitioners. Findings - Practitioners reported using the screening tool with young people with an average age of 13.1 years. They thought the educational interventions provided knowledge and helped with communication, self-awareness, reflection, confidence, attitudes and values clarification. Research limitations/implications - The project was based in one county in England. A sample of seventeen per cent of the practitioners responded to the questionnaire, and they might be those who had engaged most, or most positively, with the resource. Three practitioners undertook interviews. The views and behaviours of young people are yet to be evaluated. Originality/value - Within a climate of limited resources, the findings suggest that the project was providing an acceptable proportionate universalist, early sexual health intervention for young people

Implementing the United Kingdom's ten-year teenage pregnancy strategy for England (1999-2010): how was this done and what did it achieve?

In 1999, the UK Labour Government launched a 10-year Teenage Pregnancy Strategy for England to address the country's historically high rates and reduce social exclusion. The goal was to halve the under-18 conception rate. This study explores how the strategy was designed and implemented, and the features that contributed to its success. This study was informed by examination of the detailed documentation of the strategy, published throughout its 10-year implementation. The strategy involved a comprehensive programme of action across four themes: joined up action at national and local level; better prevention through improved sex and relationships education and access to effective contraception; a communications campaign to reach young people and parents; and coordinated support for young parents (The support programme for young parents was an important contribution to the strategy. In the short term by helping young parents prevent further unplanned pregnancies and, in the long term, by breaking intergenerational cycles of disadvantage and lowering the risk of teenage pregnancy.). It was implemented through national, regional and local structures with dedicated funding for the 10-year duration. The under-18 conception rate reduced steadily over the strategy's lifespan. The 2014 under-18 conception rate was 51% lower than the 1998 baseline and there have been significant reductions in areas of high deprivation. One leading social commentator described the strategy as 'The success story of our time' (Toynbee, The drop in teenage pregnancies is the success story of our time, 2013). As rates of teenage pregnancy are influenced by a web of inter-connected factors, the strategy was necessarily multi-faceted in its approach. As such, it is not possible to identify causative pathways or estimate the relative contributions of each constituent part. However, we conclude that six key features contributed to the success: creating an opportunity for action; developing an evidence based strategy; effective implementation; regularly reviewing progress; embedding the strategy in wider government programmes; and providing leadership throughout the programme. The learning remains relevant for the UK as England's teenage birth rate remains higher than in other Western European countries. It also provides important lessons for governments and policy makers in other countries seeking to reduce teenage pregnancy rates. BACKGROUND METHODS RESULTS CONCLUSION

Protecting the rights of pupils with autism when meeting the challenge of behaviour

Accessible Summary Pupils with autism are often physically handled in schools without teachers realising that this can be distressing for them. Many teachers do not know about the United Nations Convention on the Rights of Persons with Disabilities. Teachers need support with developing their understanding of how pupils experience being handled. It is important that the rights of disabled pupils are recognised and protected. Summary ‘Positive handling’ has become a popular intervention within education and other services in England in the management of behaviours that challenge. This paper uses a vignette of an observation of the handling of children with autism as a starting point for consideration of whether this practice can ever really be experienced as positive or whether it is often little more than a mechanism of control that disregards the rights of disabled children and young people. All schools are mandated under the United Nations Convention on the Rights of Persons with Disabilities to protect the rights of disabled pupils but to date there has been very little engagement by teachers with this agenda. This paper identifies some of the rights of pupils that are negated through current practice and evaluates what support Prouty’s principles of pre-therapy from the field of counselling might offer teachers with developing a rights based agenda.</p

Supporting children’s social and emotional well-being in the early years: an exploration of practitioners’ perceptions

Children’s social and emotional well-being can be supported through their experiences of early years education to promote positive life-long outcomes. This study explored the views of 10 early years practitioners in relation to supporting children’s social and emotional well-being. Data was gathered using semi-structured interviews and analysed using thematic analysis. Themes were explored in relation to practitioners’ understanding of ‘social and emotional well-being’ as well as their views on training opportunities in this area. The findings identified how early years practitioners conceptualize social and emotional well-being and highlighted the complexities and intricacies of the parent-practitioner relationship in the early years. The emotional well-being of staff was also pertinent to early years practitioners’ views. It is proposed that future research and practice focuses on opportunities for reflective discussions for early years staff and on the development of relationships

Integrating the teaching, learning and assessment of communication with children within the qualifying social work curriculum

Qualifying social work education must provide students with a variety of experiential, personalized, participatory, didactic and critically reflective learning opportunities across both the taught curriculum and in practice placements if deep learning of the capabilities needed for effective communication with children and young people is to be ensured. At present, programmes in England are not consistent in the curriculum structures, content and pedagogical approaches they are employing to teach and assess this topic. This paper discusses first how current proposals for the reform of qualifying education in England do not address the ambiguities and discretion in regulatory guidance, which have meant that the place and relevance of this topic within the curriculum remain uncertain and contested. It then draws on a model of the sequencing of students' learning and development in qualifying training, developed through the author's recent empirical research, to present an integrated and coherent approach to the teaching, learning and assessment of this topic. It is proposed that this strategy will enable students to develop the generic, ‘child-focused’ and ‘applied child-specialist’ capabilities they need for the ‘knowing’, ‘being’ and ‘doing’ of effective communication with children

Development and evaluation of an intervention providing insight into the tobacco industry to prevent smoking uptake: a mixed-methods study

Background Smokers who start smoking at an early age are less likely to quit and more likely to die from their habit. Evidence from the US Truth® campaign suggests that interventions focusing on tobacco industry practices and ethics may be effective in preventing smoking uptake. Objectives In an exploratory study, to develop, pilot and provide preliminary evidence of the acceptability and effectiveness of Operation Smoke Storm, a school-based intervention based on the premise of the Truth® campaign, to prevent smoking uptake. Design Mixed-methods, non-randomised controlled study. Component 1 was delivered to Year 7 students, and student focus groups and teacher interviews were conducted to refine the lessons and to develop components 2 and 3. The revised Year 7 lessons and accompanying family booklet were delivered to new Year 7 students 1 year later in one school only; Year 8 students in both schools received the booster session. Setting and participants Students in Years 7–8 (aged 11–13 years) in two UK schools. Intervention A three-component intervention comprising (1) three 50-minute classroom-based sessions in Year 7 in which students acted as secret agents to uncover industry practices through videos, quizzes, discussions and presentations; (2) an accompanying family booklet containing activities designed to stimulate discussions about smoking between parents and students; and (3) a 1-hour interactive classroom-based booster session for Year 8 students, in which students learnt about tobacco marketing strategies from the perspectives of an industry executive, a marketing company and a health campaigner. Main outcome measures Odds ratios to compare the self-reported prevalence of ever smoking and susceptibility to smoking in Year 8 students after the delivery of the booster session in study schools compared with students in local control schools. Qualitative data on acceptability of the intervention. Results The combined prevalence of ever smoking and susceptibility increased from 18.2% in Year 7 to 33.8% in Year 8. After adjusting for confounders there was no significant difference in the odds of a Year 8 student in an intervention school being an ever smoker or susceptible never smoker compared with controls [adjusted odds ratio (aOR) 1.28, 95% confidence interval (CI) 0.83 to 1.97; p = 0.263] and no significant difference in the odds of ever smoking (aOR 0.82, 95% CI 0.42 to 1.58; p = 0.549). Students mostly enjoyed the intervention and acquired new knowledge that appeared to strengthen their aversion to smoking. Teachers liked the ‘off-the-shelf’ nature of the resource, although they highlighted differences by academic ability in the extent to which students understood the messages being presented. Use of the family component was low but it was received positively by those parents who did engage with it. Limitations Logistical difficulties meant that students’ responses in Year 7 and Year 8 could not be linked; however, baseline smoking behaviours differed little between intervention and control schools, and analyses were adjusted for confounders measured at follow-up. Conclusions Operation Smoke Storm is an acceptable resource for delivering smoking-prevention education but it does not appear to have reduced smoking and susceptibility. Future work The lack of a strong signal for potential effectiveness, considered alongside logistical difficulties in recruiting and working with schools, suggests that a fully powered cluster randomised trial of the intervention is not warranted

Effective dementia education and training for the health and social care workforce: A systematic review of the literature

Ensuring an informed and effective dementia workforce is of international concern, however there remains limited understanding of how this can be achieved. This systematic review aimed to identify factors associated with effective dementia educational programmes. Critical Interpretive Synthesis underpinned by Kirkpatrick’s return on investment model for evaluation of education was applied. One hundred and fifty-two papers of variable quality were included in the review. Common features of more efficacious educational programmes included the need for educational programmes to: be relevant to participants’ role and experience; involve active face-to-face participation; underpin practice-based learning with theory; be delivered by an experienced facilitator; have a total duration of at least eight hours with individual sessions of 90 minutes or more; support application of learning in practice; and provide a structured tool or practice guideline to underpin care practice. Further robust research is required to develop the evidence base; however, the findings of this review have relevance for all working in workforce education

Integrated care to address the physical health needs of people with severe mental illness : a rapid review

Background People with mental health conditions have a lower life expectancy and poorer physical health outcomes than the general population. Evidence suggests that this discrepancy is driven by a combination of clinical risk factors, socioeconomic factors and health system factors. Objective(s) To explore current service provision and map the recent evidence on models of integrated care addressing the physical health needs of people with severe mental illness (SMI) primarily within the mental health service setting. The research was designed as a rapid review of published evidence from 2013–15, including an update of a comprehensive 2013 review, together with further grey literature and insights from an expert advisory group. Synthesis We conducted a narrative synthesis, using a guiding framework based on nine previously identified factors considered to be facilitators of good integrated care for people with mental health problems, supplemented by additional issues emerging from the evidence. Descriptive data were used to identify existing models, perceived facilitators and barriers to their implementation, and any areas for further research. Findings and discussion The synthesis incorporated 45 publications describing 36 separate approaches to integrated care, along with further information from the advisory group. Most service models were multicomponent programmes incorporating two or more of the nine factors: (1) information sharing systems; (2) shared protocols; (3) joint funding/commissioning; (4) colocated services; (5) multidisciplinary teams; (6) liaison services; (7) navigators; (8) research; and (9) reduction of stigma. Few of the identified examples were described in detail and fewer still were evaluated, raising questions about the replicability and generalisability of much of the existing evidence. However, some common themes did emerge from the evidence. Efforts to improve the physical health care of people with SMI should empower people (staff and service users) and help remove everyday barriers to delivering and accessing integrated care. In particular, there is a need for improved communication between professionals and better information technology to support them, greater clarity about who is responsible and accountable for physical health care, and awareness of the effects of stigmatisation on the wider culture and environment in which services are delivered. Limitations and future work The literature identified in the rapid review was limited in volume and often lacked the depth of description necessary to acquire new insights. All members of our advisory group were based in England, so this report has limited information on the NHS contexts specific to Scotland, Wales and Northern Ireland. A conventional systematic review of this topic would not appear to be appropriate in the immediate future, although a more interpretivist approach to exploring this literature might be feasible. Wherever possible, future evaluations should involve service users and be clear about which outcomes, facilitators and barriers are likely to be context-specific and which might be generalisable