Meta-analyses have found hepatitis C virus (HCV) infection to be associated with an increased risk of type 2 diabetes mellitus (T2DM). Here, we examine this association within a large population-based study, according to HCV RNA status. A data-linkage approach was used to examine the excess risk of diagnosed T2DM in people diagnosed with antibodies to HCV (anti-HCV) in Scotland (21 929 anti-HCV(+ves) ; involving 15 827 HCV RNA(+ves) , 3927 HCV RNA(-ves) and 2175 with unknown RNA-status) compared to that of a threefold larger general population sample matched for gender, age and postcode (65 074 anti-HCV(-ves) ). To investigate effects of ascertainment bias the following periods were studied: up to 1 year before (pre-HCV)/within 1 year of (peri-HCV)/more than 1 year post (post-HCV) the date of HCV-diagnosis. T2DM had been diagnosed in 2.9% of anti-HCV(+ves) (including 3.2% of HCV RNA(+ves) and 2.3% of HCV RNA(-ves) ) and 2.7% of anti-HCV(-ves) . A higher proportion of T2DM was diagnosed in the peri-HCV period (i.e. around the time of HCV-diagnosis) for the anti-HCV(+ves) (22%) compared to anti-HCV(-ves) (10%). In both the pre-HCV and post-HCV periods, only those anti-HCV(+ves) living in less deprived areas (13% of the cohort) were found to have a significant excess risk of T2DM compared to anti-HCV(-ves) (adjusted odds ratio in the pre-HCV period: 4.0 for females and 2.3 for males; adjusted hazard ratio in the post-HCV period: 1.5). These findings were similarly observed for both HCV RNA(+ves) (chronic) and HCV RNA(-ves) (resolved). In the largest study of T2DM among chronic HCV-infected individuals to date, there was no evidence to indicate that infection conveyed an appreciable excess risk of T2DM at the population level.

This paper reports on a feasibility study for an evaluation of a UK primary school-based prevention programme that addresses multiple forms of abuse and neglect, identifying research design and ethical issues and exploring research practice. For this feasibility study, 194 children aged 6-11 years completed a baseline survey and 113 did so following the intervention. Eight focus groups were undertaken with 52 children and nine interviews with school staff. We highlight key considerations for conducting large-scale mixed-method research on sensitive topics with younger children, a focus that is largely absent from the extant research methods literature.

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Purpose This paper examines implementation fidelity (IF) and the underpinning conceptual framework drawing on the evaluation of a UK-wide, manualized child abuse and neglect prevention program for elementary schools. We describe and assess our approach to assessing IF and consider how IF can inform program development. Method We drew on the literature on program fidelity and critical components of the program evaluated to identify three dimensions of IF: Coverage, Quality and Context. Data was collected through external observations using systemized observation schedules which were extracted to be scored using scoring protocols for each intervention type. Scores were calculated by two researchers with a random sample cross-checked by a third member of the research team. Results Observation analysis demonstrated consistency in the coverage of content when delivering assemblies for both younger and older children with at least 76% coverage of content across the assemblies. However, observation analysis revealed greater levels of variability in the delivery of workshops. Material on sexual abuse was less fully covered and children reported that some facilitators lacked confidence and clarity in delivering this material (Stanley et al., 2023). Conclusion Our results indicate the usefulness of systemized observations in capturing coverage of content, these findings underscore the importance of developing scoring protocols and training observers prior to evaluating program delivery. We highlight the significance of integrating implementation fidelity training for program facilitators and implementers to both assist with monitoring and to maintain quality, despite variations in the actual delivery and setting of the program.

This paper reports on the evaluation of an integrated violence and abuse prevention programme for children aged 5-11, focusing on children with special educational needs and disabilities (SEND). The Speak Out Stay Safe (SOSS) programme was delivered in mainstream primary schools across the UK. A small-scale study of children with SEND nested within the larger evaluation captured their understandings of abuse and harm and readiness to seek help. A specially adapted survey was completed by 76 children with SEND (aged 6-7 and 9-10) at baseline (31 intervention; 45 comparison schools), 12 in intervention schools post-programme and 37 (four intervention; 33 comparison schools) six months post-baseline. Qualitative data was captured through 16 teacher interviews. Whilst this nested study was compromised by the COVID-19 pandemic, it provides important evidence that with appropriate adaptations, a survey approach to investigating the learning of children with SEND can be effective. Findings indicate that awareness of abuse and help seeking strategies may improve over time, whilst interview data suggests that adapting the programme to be inclusive of those children may have a better effect. However, a much larger sample of children with SEND is required to confidently measure the effects of such programmes for this population. K E Y W O R D S abuse, children, prevention, special educational needs disabilities Key Practitioner Messages• This study provides important evidence that with appropriate adaptations and support, a survey approach to investigating the learning of children with SEND can be effective. • Findings indicate that awareness of abuse and help seeking strategies may improve over time for children with SEND. • Adapting the programme to be inclusive of children with SEND, providing advance preparation and follow-up material and embedding learning in school culture may have a better effect.