Independent advocacy for children and young people: developing an outcomes framework

Advocacy services for vulnerable children and young people began to be provided in the 1980s (Willow, 2013) and have grown as legislation and guidance expanded the range and remit of services (Wood and Selwyn, 2013). Research has followed the development of policy and services, but until recently has not examined the impact and outcomes of advocacy in any depth. In this article we draw on findings from a study of the outcomes and impact of independent advocacy for children and young people to explore how the value of advocacy is understood by them and by advocates, social workers and other professionals, and to consider what differences advocacy can make to the lives of children and young people (Thomas et al., 2016). Our findings indicate that the outcomes of advocacy in children and young people’s lives can be significant and wide-ranging, including both direct effects on the child or young person and wider impact on services. This complex picture has implications for how best to capture and report the outcomes of advocacy, which we explore in the latter part of the article with the aid of a proposed new conceptual framework

Early childhood nutrition concerns, resources, and services for Aboriginal families in Victoria

Abstract Objective: To investigate the child nutrition concerns of Aboriginal families with young children attending Aboriginal health and early childhood services in Victoria; training needs of early childhood practitioners; and sources of nutrition and child health information and advice for Aboriginal families with young children. Method: Qualitative needs assessment involving consultation with Aboriginal parents of young children aged 0–8 years attending Aboriginal health and early childhood services, and early childhood practitioners from Aboriginal health and early childhood services in urban and regional Victoria. Focus groups were conducted with 35 Aboriginal parents and interviews conducted with 45 health and early childhood practitioners. Thematic analysis was used to generate and then refine distinct, internally consistent common themes from the data. Results: The most frequent issues identified were low levels of breastfeeding, inappropriate introduction of solids, reliance on bottles, sweet drinks, and energy‐dense foods, poor oral health and overweight. Concerns about staff training and capacity, and access to maternal and child health services were also common. Conclusion and implication: This study identifies major gaps in service delivery for Aboriginal families with young children and points to the need for a coordinated, culturally responsive systems approach to providing support for breastfeeding and child nutrition advice and support for Aboriginal families, including capacity building for staff, and supportive systems and policy

In the absence of cancer registry data, is it sensible to assess incidence using hospital separation records?

BACKGROUND: Within the health literature, a major goal is to understand distribution of service utilisation by social location. Given equivalent access, differential incidence leads to an expectation of differential service utilisation. Cancer incidence is differentially distributed with respect to socioeconomic status. However, not all jurisdictions have incidence registries, and not all registries allow linkage with utilisation records. The British Columbia Linked Health Data resource allows such linkage. Consequently, we examine whether, in the absence of registry data, first hospitalisation can act as a proxy measure for incidence, and therefore as a measure of need for service. METHODS: Data are drawn from the British Columbia Linked Health Data resource, and represent 100% of Vancouver Island Health Authority cancer registry and hospital records, 1990–1999. Hospital separations (discharges) with principal diagnosis ICD-9 codes 140–208 are included, as are registry records with ICDO-2 codes C00-C97. Non-melanoma skin cancer (173/C44) is excluded. Lung, colorectal, female breast, and prostate cancers are examined separately. We compare registry and hospital annual counts and age-sex distributions, and whether the same individuals are represented in both datasets. Sensitivity, specificity and predictive values are calculated, as is the kappa statistic for agreement. The registry is designated the gold standard. RESULTS: For all cancers combined, first hospitalisation counts consistently overestimate registry incidence counts. From 1995–1999, there is no significant difference between registry and hospital counts for lung and colorectal cancer (p = 0.42 and p = 0.56, respectively). Age-sex distribution does not differ for colorectal cancer. Ten-year period sensitivity ranges from 73.0% for prostate cancer to 84.2% for colorectal cancer; ten-year positive predictive values range from 89.5% for female breast cancer to 79.35% for prostate cancer. Kappa values are consistently high. CONCLUSION: Claims and registry databases overlap with an appreciable proportion of the same individuals. First hospital separation may be considered a proxy for incidence with reference to colorectal cancer since 1995. However, to examine equity across cancer health services utilisation, it is optimal to have access to both hospital and registry files

Belfast Preliminary findings of the results of the Child Development Programme; early health and development monitor

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