Models, theoretical design and formal evaluation of integrated specialist community health service provision for the first 2000 days: a scoping review

Ong, Sarah

doi:10.1136/bmjopen-2022-070042

Cited by 2 publications

References 34 publications

(172 reference statements)

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Housing Australian Children: A Snapshot of Health Inequities in the First 2000 Days

Li,

Singh,

Bentley

2024

J Urban Health

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Housing is a critical social determinant of children’s health. While individual pathways between housing and health are well evidenced, there has been less attention on the co-occurrence of housing disadvantages. We aim to identify typologies of children’s housing disadvantage and describe the health inequities they generate. A cross-sectional latent class analysis (LCA) was conducted on 4355 Australian children aged 4 to 5 years who participated in the Longitudinal Study of Australian Children. Nine binary indicators—dwelling tenure, external condition, affordability, stability, crowding, cleanliness, fuel poverty, and noise exposure—were used to generate latent housing typologies. Generalized linear models with robust standard errors described disparities in quality of life, injury, disability, and health service use across these housing typologies. Four distinct housing typologies were identified in this cohort: “good condition, affordable, and secure” (60%); “insecure” (11%); “crowded” (24%); and “unsuitable” (5%). Unsuitable housing, characterized by crowding, poor external conditions, and noise exposure, was more likely to be occupied by single-parent families, low-income households, and be headed by parents with low levels of education. Children in unsuitable housing lagged on quality of life indicators at preschool age (e.g., by 8.0 points on emotional functioning, 95% CI − 10.6, − 5.5), and underutilized primary healthcare services (e.g., prevalence ratio 0.76 for GP services, 95% CI 0.67, 0.87), compared to children in good quality housing. This finding supports the case for early intervention strategies that account for children’s housing circumstances.

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Housing Australian Children: A Snapshot of Health Inequities in the First 2000 Days

Li,

Singh,

Bentley

2024

J Urban Health

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Understanding the influence of leadership, organisation, and policy on delivering an integrated child health and social care service in community settings: A qualitative exploration using the SELFIE framework

Litchfield,

Harper,

Abbas

et al. 2024

Preprint

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Introduction Its understood in the UK that integrated care is well-placed to address the prevalence of chronic conditions, obesity, and mental ill-health in children and young people (CYP) living in minoritized and economically marginalised communities in high-income countries. The Sparkbrook Childrens Zone is an example of a place-based integrated health and social care service situated in a super-diverse community in a large post-industrial city, developed to support children and young people. To realise its potential, its important to understand the organisational and infrastructural requirements of a service combining clinical and non-clinical staff from a range of organisations and backgrounds. This will improve the current service offer and inform the design and delivery of similar initiatives. Materials and Methods We conducted a qualitative exploration of the experiences of staff delivering the service and used a directed content analysis to populate and present the results within the Sustainable integrated chronic care model for multi-morbidity: delivery, financing, and performance (SELFIE) framework. The analysis presented here focuses on the domains of Leadership and Governance, Workforce, Financing, and Information and Research. Results A total of 14 staff were interviewed including clinicians from primary and secondary care, social care providers, local voluntary groups, and school-based family mentors. Staff described the gap between integration at system level and the absence of process and support to deliver a unified health and social care service in real-world environments. The benefits of supportive and accessible leadership, and an open, learning environment were described, as was the trust developed through meaningful consultations with local communities. The lack of administrative support was noticeable, particularly when managing a workforce drawn from multiple organisations, as was the lack of secure funding and the need for reliable long-term evidence to inform decisions on design and funding. Conclusions Despite decades of structural reform aimed at integrating the health and social care system in the UK, there was a surprising lack of system-level practical support for delivering a place-based integrated health and care service. The balance remained to be struck between the need to demonstrate benefits for short term funding cycles and the reliability of evidence being gathered from a complex and evolving service

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Models, theoretical design and formal evaluation of integrated specialist community health service provision for the first 2000 days: a scoping review

Cited by 2 publications

References 34 publications

Housing Australian Children: A Snapshot of Health Inequities in the First 2000 Days

Housing Australian Children: A Snapshot of Health Inequities in the First 2000 Days

Understanding the influence of leadership, organisation, and policy on delivering an integrated child health and social care service in community settings: A qualitative exploration using the SELFIE framework

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