Nick Axford, Louise Morpeth, Michael Little and Vashti Berry
Randomised controlled trials (RCTs) are acknowledged to provide the most reliable estimate of programme effectiveness, yet relatively few are undertaken in children's services…
Abstract
Randomised controlled trials (RCTs) are acknowledged to provide the most reliable estimate of programme effectiveness, yet relatively few are undertaken in children's services. Consequently, there are few models with a demonstrated impact on child well‐being, leading to a concern not only that services may frequently be ineffective but also that some may be harmful. This article considers how this state of affairs has come into being and discusses potential remedies for improving both the knowledge base and the quality of interventions. It focuses on ‘operating systems’ that link prevention science and community engagement and so help communities, agencies and local authorities to choose effective prevention, early intervention and treatment models. Specifically, it describes an attempt in Ireland to implement a robust programme of research into children's health and development, to rigorously design new services, evaluate their impact to the highest standard (using RCTs)and integrate the results into the policy process. Based on the authors' extensive first‐hand experience of supporting the work, and the advice of international experts, the article reflects critically on the unforeseen challenges and offers lessons for others starting a similar enterprise.
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Nick Axford, Jill Madge, Louise Morpeth and Jo Pring
Children's services agencies in England are increasingly expected to work together to plan needsled interventions in their locality. Such planning requires good information on…
Abstract
Children's services agencies in England are increasingly expected to work together to plan needsled interventions in their locality. Such planning requires good information on local need and service take‐up, yet this is often lacking. Connecting data from single agency, multi‐agency and community studies in one district shows how the severity of need overlaps with different service and administrative categories. The findings point to the value of such mapping exercises, while the pattern that emerges highlights the importance of planning provision for all children and of linking intervention to thresholds of severity of need. The approach will have relevance to other care groups.
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Laura Hill, Louise Parker, Jenifer McGuire and Rayna Sage
Over the past 30 years, researchers have documented effective, theory‐based programmes and practices that improve the health and well‐being of children. In order to produce…
Abstract
Over the past 30 years, researchers have documented effective, theory‐based programmes and practices that improve the health and well‐being of children. In order to produce measurable improvements in public health, such practices must be institutionalised; however, there are a number of barriers to translating what we know from science to what we do in practice. In the present article, we discuss a number of those barriers, including: cultural differences between those who espouse a public health, prevention science approach versus those who espouse a strengths‐building, health promotion approach; practical difficulties in documenting the evidence base for existing or newly developed programmes and practices; and inflexibility of standardised programmes and resulting insensitivity to local contexts. We discuss common ground between prevention and promotion perspectives and highlight emerging methods that facilitate the adoption of science‐based practice into community‐based services.