Study protocol: a mixed-methods study to evaluate which health visiting models in England are most promising for mitigating the harms of adverse childhood experiences

Introduction Exposure to adverse childhood experiences (ACEs) is associated with poorer health outcomes throughout life. In England, health visiting is a long-standing, nationally implemented service that aims to prevent and mitigate the impact of adversity in early childhood, including for children...

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Main Authors: Louise Mc Grath-Lone, Dina Jankovic, Jane Barlow, Jane V Appleton, Helen Weatherly, Sally Kendall, Amanda Clery, Jennifer Kirman, Samantha Bennett
Format: Article
Language:English
Published: BMJ Publishing Group 2022-09-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/12/9/e066880.full
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author Louise Mc Grath-Lone
Dina Jankovic
Jane Barlow
Jane V Appleton
Helen Weatherly
Sally Kendall
Amanda Clery
Jennifer Kirman
Samantha Bennett
author_facet Louise Mc Grath-Lone
Dina Jankovic
Jane Barlow
Jane V Appleton
Helen Weatherly
Sally Kendall
Amanda Clery
Jennifer Kirman
Samantha Bennett
author_sort Louise Mc Grath-Lone
collection DOAJ
description Introduction Exposure to adverse childhood experiences (ACEs) is associated with poorer health outcomes throughout life. In England, health visiting is a long-standing, nationally implemented service that aims to prevent and mitigate the impact of adversity in early childhood, including for children exposed to ACEs. A range of health visiting service delivery practices exist across England (from the minimum five recommended contacts to tailored intensive interventions), but there is a lack of evidence on who receives what services, how this varies across local authorities (LAs) and the associated outcomes.Methods and analysis This study will integrate findings from analysis of individual-level, deidentified administrative data related to hospital admissions (Hospital Episode Statistics (HES)) and health visiting contacts (Community Services Data Set (CSDS)), aggregate LA-level data, in-depth case studies in up to six LAs (including interviews with mothers), a national survey of health visiting services, and workshops with stakeholders and experts by experience. We will use an empirical-to-conceptual approach to develop a typology of health visiting service delivery in England, starting with a data-driven classification generated from latent class analysis of CSDS-HES data, which will be refined based on all other available qualitative and quantitative data. We will then evaluate which models of health visiting are most promising for mitigating the impact of ACEs on child and maternal outcomes using CSDS-HES data for a cohort of children born on 1 April 2015 to 31 March 2019.Ethics and dissemination The University College London Institute of Education Research Ethics Committee approved this study. Results will be submitted for publication in a peer-reviewed journal and summaries will be provided to key stakeholders including the funders, policy-makers, local commissioners and families.
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spelling doaj.art-2d44273511b147e79c568a684b5dd3522022-12-22T03:38:36ZengBMJ Publishing GroupBMJ Open2044-60552022-09-0112910.1136/bmjopen-2022-066880Study protocol: a mixed-methods study to evaluate which health visiting models in England are most promising for mitigating the harms of adverse childhood experiencesLouise Mc Grath-Lone0Dina Jankovic1Jane Barlow2Jane V Appleton3Helen Weatherly4Sally Kendall5Amanda Clery6Jennifer Kirman7Samantha Bennett8Social Research Institute, UCL-Faculty of Education and Society (IOE), London, UKCentre for Health Economics, University of York, York, UKDepartment of Social Policy and Intervention, University of Oxford, Oxford, UKOxINMAHR (Oxford Institute of Nursing, Midwifery and Allied Health Research), Oxford Brookes University, Oxford, UK (Please note JVA is formerly of OxINMAHR but now retired)Centre for Health Economics, University of York, York, UKCentre for Health Services Studies, University of Kent, Canterbury, UKPopulation, Policy and Practice, UCL Great Ormond Street Institute of Child, London, UKOxINMAHR (Oxford Institute of Nursing, Midwifery and Allied Health Research), Oxford Brookes University, Oxford, UK (Please note JVA is formerly of OxINMAHR but now retired)Strategic Commissioning, Kent County Council, Maidstone, UKIntroduction Exposure to adverse childhood experiences (ACEs) is associated with poorer health outcomes throughout life. In England, health visiting is a long-standing, nationally implemented service that aims to prevent and mitigate the impact of adversity in early childhood, including for children exposed to ACEs. A range of health visiting service delivery practices exist across England (from the minimum five recommended contacts to tailored intensive interventions), but there is a lack of evidence on who receives what services, how this varies across local authorities (LAs) and the associated outcomes.Methods and analysis This study will integrate findings from analysis of individual-level, deidentified administrative data related to hospital admissions (Hospital Episode Statistics (HES)) and health visiting contacts (Community Services Data Set (CSDS)), aggregate LA-level data, in-depth case studies in up to six LAs (including interviews with mothers), a national survey of health visiting services, and workshops with stakeholders and experts by experience. We will use an empirical-to-conceptual approach to develop a typology of health visiting service delivery in England, starting with a data-driven classification generated from latent class analysis of CSDS-HES data, which will be refined based on all other available qualitative and quantitative data. We will then evaluate which models of health visiting are most promising for mitigating the impact of ACEs on child and maternal outcomes using CSDS-HES data for a cohort of children born on 1 April 2015 to 31 March 2019.Ethics and dissemination The University College London Institute of Education Research Ethics Committee approved this study. Results will be submitted for publication in a peer-reviewed journal and summaries will be provided to key stakeholders including the funders, policy-makers, local commissioners and families.https://bmjopen.bmj.com/content/12/9/e066880.full
spellingShingle Louise Mc Grath-Lone
Dina Jankovic
Jane Barlow
Jane V Appleton
Helen Weatherly
Sally Kendall
Amanda Clery
Jennifer Kirman
Samantha Bennett
Study protocol: a mixed-methods study to evaluate which health visiting models in England are most promising for mitigating the harms of adverse childhood experiences
BMJ Open
title Study protocol: a mixed-methods study to evaluate which health visiting models in England are most promising for mitigating the harms of adverse childhood experiences
title_full Study protocol: a mixed-methods study to evaluate which health visiting models in England are most promising for mitigating the harms of adverse childhood experiences
title_fullStr Study protocol: a mixed-methods study to evaluate which health visiting models in England are most promising for mitigating the harms of adverse childhood experiences
title_full_unstemmed Study protocol: a mixed-methods study to evaluate which health visiting models in England are most promising for mitigating the harms of adverse childhood experiences
title_short Study protocol: a mixed-methods study to evaluate which health visiting models in England are most promising for mitigating the harms of adverse childhood experiences
title_sort study protocol a mixed methods study to evaluate which health visiting models in england are most promising for mitigating the harms of adverse childhood experiences
url https://bmjopen.bmj.com/content/12/9/e066880.full
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